At the ADAA Conference

Image courtesy
Image courtesy

For the last 4 days I’ve been at the annual conference of the Anxiety and Depression Association of America (ADAA). I’ve attended sessions on the latest in research and treatment for Obsessive-Compulsive Disorder, anxiety disorders, depression and related issues. I’ve listened to leading experts from the United States, Canada and from many countries around the world, and I’ve sat and talked with some of them during breaks and in the evening at dinner. I’ve taken copious notes, filled my head with as much as I can, and I am bringing home a list of books to read and trainings to take. The entire experience has been inspiring, exhilarating and exhausting. What I didn’t expect is that is has also been incredibly emotional.

Being both a therapist who treats these disorders, and the mom of a teen with OCD, I feel like I have a somewhat unusual perspective. If other conference goers or presenters also have these dual roles, they aren’t sharing it publicly, as I did in my own presentation yesterday. Either way, I find that I take in the entire experience in a deeply personal way. Every case triumph presented stirs up feelings deep inside of me.

Yesterday, I listened to Dr. Reid Wilson present on his latest innovations in anxiety treatment – often with very rapid improvements for patients. I sat in row 2 with tears streaming down my face. How amazing to see the joy and triumph on the faces of the case examples he shared. I listened to the International OCD Foundation folks share how they are trying to spread the message about effective treatment for OCD, and their quest to get more clinicians trained. And I cried again at the recognition of how their work has touched my family, my patients, and so many other people. And, today, I watched Dr. Steven Kurtz of the Child Mind Institute tear up as he shared the success stories of graduates of that organization’s intensive program for Selective Mutism – and I cried along with him.

I cried for the triumphs and the struggles. I cried for the hope that people can overcome OCD and anxiety disorders. I cried at the generosity of a representative from the International OCD Foundation, who offered to personally be there for Blake – to discuss his ambivalence about choosing to turn his back on his OCD, and to connect him with other teens with OCD. I cried because I am touched by these people who truly care about the work they do and the people they serve. I sense here a true compassion for the suffering of those with OCD, with anxiety, with PTSD, with depression, etc. This isn’t just a job for the people who do this work; it is a mission and a passion. It is an ongoing labor to halt the suffering, to find better ways to do more quickly, and to continually improve our understanding and keep moving forward.

It is inspiring and an honor to be here. I am deeply humbled.

The Odyssey of Scrupulosity

Image courtesy Stuart Miles @
Image courtesy Stuart Miles @

When your child has Obsessive-Compulsive Disorder, many people fail to see what the problem is.  OCD’s symptoms are often hidden from public view, or are so subtle to the outside eye that no one who is not very close to your situation would ever notice.  Many children with OCD are also notoriously good at hiding their symptoms.  When your child’s OCD takes the form of scrupulosity and religious observance, the whole thing can become (at least in our family’s experience) even more insidious.

Blake’s OCD took the form of increased religious observance and polite and moral behavior about two years ago.  At that time, our family began a journey that has caused us to question right/wrong, respect/disrespect, and the very basis of religious observance.  On the surface, Blake appears to be a very polite and religious young man.  We receive compliments all the time on his behavior.  The truth is that Blake is a very nice young man. He has solid values and believes in treating others with respect.  To the uneducated eye, there is nothing wrong here.  How refreshing to come across a 14-year-old who is so kind to others and who places such a strong emphasis on his religion.  Why would we be concerned or want that to change?

I have to say that we question that all the time ourselves.  Why, indeed, would we not want our child to embrace the religion of his family, or why would we not rejoice that he is as polite and conscientious a young man as he is?  Even my husband has found himself laughing with Blake about, “How bad can it really be?  I mean, we could be arguing over drugs or illegal activity.  Instead, we argue over being religious.”

We are in a quandary, for certain.  We are incredibly grateful to have a son who has internalized what we, and others who meet him, believe are good values.  On the other hand, when, in our private moments, I watch my son rise to pray over and over again because he repeatedly believes he has committed a sin, I hurt inside.  When my son panics and insists I must take him home NOW because he might not accomplish reciting ALL the prayers he needs to today, I feel cheated of his time and presence.  When the rules he has around food are based in religious observance, but go far beyond what any religious authority has counseled him – and when he rejects that counsel – I can’t help but feel frustration.  How do I explain this to an outside party?

Friends and family often ask me what they can feed Blake.  I get angry inside when I start to think about it, because the answer is, “I don’t know.  It really depends if he thinks what you have to offer will pass his test of ‘fitness.’  What was fit yesterday may not be tomorrow, and tomorrow’s may not be the following day.”  Sometimes I actually try to explain that to people.  I think they must believe I’m nuts – which I just may be.

Where I am going with this post, I am actually not quite sure.  What I am trying to communicate is that OCD, when played out in the form of scrupulosity, becomes a confusing situation for all involved.  To the sufferer, it is a never-ending process of trying to be the “best” person or to get religious observance “right.”  To the immediate family, it is a maddening experience of watching the core values and ideals you were taught being twisted in unimaginable ways, and to the outside observer it appears that this is just a very good and religious human being – nothing wrong here.  How we get out, how we separate what’s real from what’s OCD is such a strange odyssey. I’ll keep you posted on the journey.  – Angie

Inspiration and Hope

Image courtest graur codrin at
Image courtest graur codrin at

Blake stands in a corner, shuffling and swaying, praying his fervent best before he begins what looks like a dance – part Bunny Hop, part Cha Cha.  He gives one last look up toward the heavens (actually the ceiling of our kitchen), looks satisfied and walks away.  My hubby and I have been sitting close by, working on a project, but taking in the scene all the same.  When Blake is safely out of earshot, my husband looks at me with wide eyes.  He’s trying to find the humor in this.

“I don’t know what religion that is, but it isn’t mine,” he says with a half-smile.

We must do this – try to find the humor, the funny side of our 14-year-old son’s compulsions – in order to keep going.  It’s a way of maintaining the peace, of staying sane, and of not crumbling into a mess of argument and discord.  The truth is, we are sad that our son chooses OCD’s ways over defeating the disorder.  Yet we have to let him come to his decision to accept treatment when he is ready.

Along those lines, I found myself inspired this week by a young man who did just that.  He sought treatment for himself.  He’d contacted me because he’d done his research.  He recognized that he had OCD and it was affecting his life to such a degree that he was willing to do whatever it took to get better, including driving well over an hour to meet with me.  I was inspired because this young man, barely an adult, empowered himself and chose to get better.  I am committed to helping him get there.

What made me sad, though, is that he is all alone in his recognition that he has OCD.  No family member or friend is aware.  He is that good at hiding it – at least that’s what he tells me.  Either way, he and I are the only ones who have ever discussed that he is suffering.  While it is an honor to share knowledge of his story, it is my honest hope that, as he progresses through treatment, he will find the courage to share this with another supportive soul in his life.

When I meet a young person like this, it gives me hope, once again, that one day Blake will decide that living according to OCD’s rules is not worth it.  I hope that he, too, will find the courage, either with our knowledge or without, to brush up on his OCD fighting skills and put the disorder in its place once again.

“But I Have Prayers To Do!”

Image courtesy wiangya at
Image courtesy wiangya at

My husband came rushing home one night this past week.  He had gotten off work early to pick up Blake and take him to a school presentation.  It was yet another of our sometimes chaotic family nights.  I was driving Michael and several other kids to an event in another town.  Blake was supposed to have been going to, but the night before he’d announced, “I can’t go.  I have a presentation at school.”

It was one of those maddening moments for me as a parent.  I’m driving carpool.  You can’t go?  And how long have you known about this presentation?  Both of my boys do this kind of thing – spring on me last minute that there’s something going on that we should have been preparing for days or weeks ago.  That’s a teenage thing, right?

Anyhow, with some scrambling, my hubby was able to rearrange his schedule to be able to get Blake to school and attend the presentation so that I could drive the carpool to their destination.  On the day of the event, as we drove home from school, I let Blake know what time to be ready for Dad.  When my hubby called, letting me know he was going to be home with just enough time to pick up Blake and get to school, I conveyed the message to Blake that he was to get ready to leave as soon as Dad pulled up.  This is when he became indignant.

“I can’t go now.  I have stuff to do.”

“What?  Blake, Dad got off work early so he could get you to your presentation on time.  You need to be ready so that you can leave right away.”

“I’m sorry.  I can’t do that.  I can’t be ready for a while,” he answered.

You see, he had prayers to be done.  It didn’t matter that he had an entire group of kids waiting at school for him on this important night.  It didn’t matter that he was a key part of their presentation and that this event was a big part of their grade in several classes. It didn’t matter that Dad had rearranged his afternoon and evening to be there and support him.  When scrupulosity is a part of your life, praying comes first, or you will feel guilty, uncomfortable and anxious.

I tried to coax Blake into getting ready – to no avail.  My hubby walked in the door, ready to collect Blake and get on the road.

“I’m sorry, Dad, I can’t go yet.  I have stuff to do.”

“Blake, you’ve been home for an hour.  You knew when this event was.  We need to leave.  Your classmates are depending on you.  And I changed my schedule for you because this was so important…”

“I’m sorry.  I can’t go”

I wasn’t sure if my husband was going to blow his top or not.  OCD was affecting him, Blake, Blake’s classmates….

“Blake.  If you do not come with me now, you will miss the presentation.  I am not waiting for you to do your prayers.”

Somehow, Blake managed to pick up his things and head out.  They made it to the presentation on time.  My husband said it was splendid, and I was sad to have missed it.  In the end, though, Blake couldn’t shake the nagging need to pray. He found a few moments to slip away from everyone to complete his task.  Relief achieved – for the moment.