“I don’t understand,” he tells me. “Are we fighting OCD or are we gracefully accepting it as a part of our life?”
His face is thoughtful and perplexed. He is holding his sobbing pre-teen in his arms on my office couch and is trying to make sense of something I’ve just said to this child. The young “man-ling” in his embrace is trying to pull himself together. He is gearing up to do what he has done many times before: stand up to his OCD.
What’s led to this scenario is that my young patient has brought his father to session with him. He is on a maintenance schedule with me now, having successfully learned what OCD is all about, how to identify its tricks, and how to put it back in its place. We meet every few months to fine tune things. Until now, it has been mom who has come to treatment with him. Today, he insisted on dad. When he arrived, after some initial resistance, he poured out the thoughts OCD has been torturing him with over the past week. They’d made it difficult to sit in nearly any place someone has sat before him. In what was a mixture of embarrassment, anger and relief, he burst into sobs.
Dad has never seen this before, having been at work as we’ve challenged his son’s OCD. He is a loving father; an involved father. What we do in session is foreign to him. He seems to want to jump in and fix it. He is confused by his son’s emotions and by the interaction between us. I suggest that his son can use a hug from his father, and the boy melts into his father’s big chest.
I have full confidence in this young man. He could teach a kids’ class on how to beat OCD. He could devise interventions for other kids. I calmly wait for the tears to slow down. Then I remind him that it is OCD that is the strange one here, not him. I ask him, now that we’ve gotten this out into the open, what he thinks is the next step. Without hesitating, he shares his plan.
“I’m going to sit in every chair I can. I’m going to watch for places where people have been sitting and sit there.” He pauses. “May I curse?”
This is significant. Six months ago, even the thought of cursing would have been unacceptable in his OCD world.
“Certainly,” I say. “If that’s important in getting your point across.”
“F&$@ you, OCD! F&$@ you!” He starts sobbing again. This time, there is empowerment behind his tears. He is garnering his anger to use in his fight against OCD’s current challenge.
“That’s right. Stand up to it. Fight it. You can beat it.”
And here is where dad is confused. Hence the question, “Are we fighting OCD or are we gracefully accepting it as a part of our life?”
What Are We Doing?
“Isn’t it important that we accept that OCD is a part of our life? Why would we be fighting with it?”
“Those are very good questions,” I note. “There is definitely something to be gained from acceptance. And there’s a time for fighting, too. Let’s look at it this way. If your son had diabetes, it would be important that all concerned accept that he had diabetes. If all you did was get angry and not accept it, he might not get the treatment that he needed. There is something very healing in acknowledging that the diabetes is a part of life. You can learn about it, understand it, and take steps so that he lives a very productive life. However, if he has a flare up or crisis, accepting isn’t enough. You need to take aggressive steps to keep him healthy.”
I can tell that he’s following me so far. The diabetes comparison is one I seem to come back to over and over again. People can wrap their minds around it.
“It’s really the same with OCD,” I continue. “It is valuable to accept it as a part of his life. It doesn’t help for him to walk around in life always angry that he has OCD. But when it flares up, like it is right now, it’s time to be aggressive with it. We want to put it in its place now so that he can get back to it having as little impact on his life as possible.”
I can see the confusion leave his face. Now he understands and he can stand side-by-side with his son when it is time to battle.
OCD is a Family Affair
This whole interaction reminds me of the period of time where we struggled as a family to understand Blake’s OCD. Since I was the one going to treatment with him, there was information my husband was missing out on. He couldn’t make sense of what we were doing in treatment. He asked questions that made me realize the gap in what we both understood about OCD.
Yet, we were struggling with OCD’s ramifications on a daily basis. We were (and still are) all affected by the rituals. We needed a common understanding about how to respond.
I know that not all family members can attend therapy all the time. For our family, the answer finally came in the form of the annual conference of the International OCD Foundation. There, my husband, Michael, Blake and I were all immersed in information that helped us come to a better understanding. For others, it may be books, or websites, or workshops. As a therapist, I recognize more than ever that I need to make a better effort to be sure that all family members are informed. It can make a world of difference for everyone.
When my patient entered his session, I asked him why he had insisted on his father coming today. He said he didn’t know. My guess, looking back on it, is that he realized, on some level, that he needed his dad in on the fight. As I write this, I have a sense that my young patient is stronger now in his journey – with his dad having joined his side.