It’s No Picnic

Image courtesy jackthumm @ freedigitalphotos.net

Image courtesy jackthumm @ freedigitalphotos.net

“It’s beautiful outside,” my hubby remarks.  “Let’s eat dinner on the patio.”

“That’s a great idea,” I say.

“I don’t like that idea at all,” Blake pipes up.

It’s an unseasonably nice weekend night (I started to say “warm,” but it’s not warm, really.  We will need jackets outside) and I’m grilling ribs.  They were a request from Michael.  Something to make the evening a little more festive, a break from his piles of schoolwork.  We all welcome the opportunity to eat outdoors. Well, all of us except for Blake.  He’s looking uncomfortable and I can tell he’s trying to figure out how to dodge this event.

“I’ll eat inside,” he says.

“Um…that would be a ‘no.’ ” I say.  “You’re part of a family.  You’ll join us.”

“Then, I’ll sit outside with you, but I’m not eating out there.”

“You can choose not to eat; however, that means you choose not to eat for the night.  You don’t get to start grazing after we all finish.”

Blake already refuses to eat the food I cook.  He prepares his own meals.  I stand firm, though, that we eat together as a family.

“I’m not comfortable with this.  There’s…flies…and other insects out there.”

“Yep, probably.”

He paces around for a while.  He stares out at the patio. Then he disappears.  He comes back a few minutes later.  He’s lugging a card table with him.

“Can someone open the back door for me?” he asks.

“Blake, what’s this about?” my husband asks.

“There’s not enough room for everybody at the table,” he says.

He manages to get the table outside onto the patio.  I watch him set it up.  It’s about ten feet away from the table where the rest of us will eat.

Our Food Is Contaminated

Image courtesy chawalitpix @ freedigitalphotos.net

Image courtesy chawalitpix @ freedigitalphotos.net

“Blake,” move the table closer to the other one.  “You’re not eating in isolation.  And, by the way, I know that this is about you thinking our food will contaminate yours.  You’re not fooling anyone.”

“I’m trying to figure out a way to be out there with you guys, Mom!  Really!  I’m trying!”

“Come on, Blake.  Let’s get this set up.  I think you can be closer than that,” my hubby says.  He steps outside onto the patio with Blake.

Blake’s best friend is sitting on the sofa just inside the door from where Blake is.  He stays focused on his video game.  He knows the drill with Blake.  He’s watched it for the past seven years, since they were in third grade together.  And he accepts Blake unconditionally.  I thank heaven for him regularly.

When dinner is ready, we all manage to eat together.  Blake and his friend eat at a table tandem to ours.  Blake makes it through his meal without flinching when everyone else’s food is passed.  We have a nice conversation.  Blake even leaves his food uncovered for a time, and we laugh at the fact that he seems suddenly unworried about flies.

He leaves the table, briefly, while we are all eating.  When he returns, he has a can of soda in his hand.  “May I?” he asks.  “This is hard work being out here.  I think I deserve this.” And he opens the can, takes a big swig, sighs a big sigh, and joins his friend back at their table.

When Being Polite is Really OCD

Image courtesy Stuart Miles @ freedigitalphotos.net

Image courtesy Stuart Miles @ freedigitalphotos.net

What?! Being polite is OCD?  Now that just can’t be right.  That has nothing to do with being a neat freak.  Yes, yes.  I’m invoking the OCD stereotype.  I’m doing it for a reason and that is that sometimes OCD can present itself in ways that people would not recognize as OCD.  Even people who have OCD sometimes don’t initially recognize some of their symptoms as being OCD.  That’s because many OCD symptoms can present in ways that are far, far away from the stereotypes people often have of OCD sufferers being neat, organized, germaphobes who go around checking that the stove is turned off.  It can sometimes present in the form of one very polite and seemingly grateful individual.

I started thinking about OCD and politeness after I read Janet’s post on “OCD and Apologizing.” She wrote about how apologizing could be an OCD compulsion, a true expression of remorse, or any number of other things. Usually we think of an apology as a positive thing, but, at times, it can be something else entirely.

As I read her post, I recalled a time when Blake did something that would normally be seen as a welcome expression:  he thanked people.  That should be good, right?  Well, imagine this.  We’d go to a restaurant.  The server would give him water.  Blake would say, “thank you very much.”  The server would give water to Michael.  Blake would say, “thank you very much.”  The server would give my hubby and I water.  Blake would say, “thank you very much” twice more.  The host would seat another family.  Blake would say, “thank you very much.”  Are you getting the picture?  Blake incessantly thanked others, even for things that had nothing to do with him.  It became maddening to me and I dreaded hearing his next “thank you very much.”

So How is Saying “Thank You” a Symptom of OCD?

I am often complimented on what a polite young man I have.  I am proud of him for being appropriately polite.  It is a wonderful thing to have a flight attendant, a teacher, or another parent notice that your child has good manners. Saying “thank you” for the purpose of being polite and respectful is one thing.  Saying “thank you” incessantly because you fear that maybe you weren’t respectful enough, thankful enough, or kind enough is something else entirely.

And that was exactly the case for Blake.  He felt like a terrible person if he missed the opportunity to say “thank you.”  He became incredibly anxious if he thought he hadn’t been thankful enough.  It started with just saying thank you for things for himself.  That wasn’t enough for his OCD, though.  It moved on to saying “thank you” for things that others did for the rest of our family, and it continued right on growing as he had to say “thank you” for any kindness that he saw being done for anyone within eyesight.  He had to be constantly vigilant.  He had to be ready with his “thank you’s.”  That’s not politeness; that’s private torture.  That is OCD.

What to Do When the Problem is “Thank You?”

My hubby and I grew weary of constantly being thanked.  We felt like the most ungrateful parents in the world.  Imagine explaining to other parents – or to teachers – “Our son says ‘Thank you’ too much.”

Luckily, or perhaps understandably, Blake’s therapists understood what all this thanking was about.  It was scrupulosity, which, before then, I had thought was just about OCD playing itself out in religion.  They explained to me that it also is about worrying that one may have committed a moral sin or violation.  Blake was worried about not being perfectly moral. Therefore, he had to be perfectly thankful.  What could be done about this?

Well, in keeping with the principles of Exposure and Response Prevention (ERP), a very effective treatment for OCD, Blake needed to be in situations where he’d be tempted to say “thank you” and not be able to perform his ritual.  That is, he had to let people do nice and considerate things for him without saying thank you.  I remember during that time that we had assignments to go out to eat and Blake was not allowed to thank servers for anything they did for him (or for anyone else).  When it was our family, in private, his exposures pushed back at OCD a little harder.  Not only would he not thank us, he was directed to be un-thankful.

“I do not appreciate this,” he would say to us.  Perhaps it would be, “I am not grateful that you’ve done this.”

It was actually kind of funny, and we had some fun as a family being ungrateful together.  The thing is, when you can poke at OCD and find some humor in it, you can conquer it.  Very soon, this OCD symptom was a thing of the past.  Blake’s therapists were not completely done with him on this one, though.  A person cannot go on forever not expressing thanks or gratefulness.  I guess they could, but there is something to be said for being polite, and it’s not good to be a young teen who never says a thankful word.  The problem was in giving him back his ritual words too soon.  What if he started saying, “thank you” again and went right back into OCD mode with them?

When it came time for expressing gratitude again, the words “thank you” were banned from Blake’s vocabulary.  He had to find more creative, thoughtful ways of expressing his appreciation.

“I really appreciate this.”

“That was so nice of you.”

It took a new kind of creativity to find words and ways to say, “Thank you” without actually uttering the words.  Ultimately, Blake was able to go back to expressing thanks in whatever way he wanted to.  The anxiety around not being perfectly thankful was gone.

In answer to the question I posed at the beginning of this post, yes, being polite can be a form of OCD.  First, there must be some sort of intrusive or upsetting thought that a person cannot seem to be rid of that focuses on a fear of not being polite enough or good enough (or something similar).  In answer to that, the person feels pressure to behave in polite ways.  This is how they relieve their anxious feelings.  In many cases, the initial ways of being polite won’t be enough and the person will have to keep adding more to their routine.  Sadly, there isn’t true gratefulness behind this kind of politeness.  It is an expression motivated by fear and discomfort, and it robs both parties of the opportunity for a real and connected exchange.

Good Morning!

I found this piece of writing the other day.  It is something I wrote for myself about two years ago – before I started writing this blog.  It reflects the feelings I felt at seeing my son stuck in an OCD ritual, and my struggles with a public who often does not understand that OCD can wreak havoc on lives. 

Image courtesy scottchan@freedigitalphotos.net

Image courtesy scottchan@freedigitalphotos.net

“Good morning!” I say in my most cheery voice as I open the car door and a load of kids tumbles out. I’m working at morning valet at my son’s school, a volunteer position I’ve helped with for the past four years. “Have a great day!” I wish them as they enter school for the day. Across the parking lot, I catch sight of my own son, standing by my car.   I can make out the brown curls on the top of his head, which is bowed in prayer. I check my watch – 20 minutes have passed since he began this process. Twenty minutes on a prayer that reasonably ought to take less than five. I can see him repeating the same motions he’s done over and over already. I even think I can see him mouthing the same words.

Enough already,” I think to myself and begin to walk in his direction.

“Be right back,” I tell my fellow volunteers as I leave my post. When I get to him, he doesn’t acknowledge me. He’s deeply, fervently in prayer.

Image courtesy David Castillo Dominici @freedigitalphotos.net

Image courtesy David Castillo Dominici @freedigitalphotos.net

“Hon,” I ask, “can I help in some way?”

Absolutely no reply. His lips move at rapid-fire pace and he’s planted in place. I put my hand on his shoulder.

“It’s time to go in to school now,” I tell him.

“Mom! I was almost finished! Now I have to start it all over!”

“Honey, you’ve been saying the same prayer over and over for the last 20 minutes. It’s enough. Go join your friends before school starts.”

“I have NOT been saying it over and over. I keep messing up or skipping parts so I have to start again and get it right. I almost had it this time and you interrupted.”

“I don’t think the point is to get it perfectly right. I think it’s about what’s in your heart. You-know-who is just trying to trick you.”

I say this last part in reference to his OCD, which we’ve known he’s had since he was 7. He is nearly 14 now.

“Really? Do you think so?” he says sounding just a little bit hopeful.

“You know that’s the truth. Come on, you can fight this.”

“No, no, no. I have to get it right,” he says. “Just let me do what I have to do.”

“Come on, honey. Stop and go to class.”

“Mom!!!”

“Fine! It’s your OCD. You handle it the way you see fit.”

I throw my arms up in exasperation as I walk back to the waiting line of cars. He goes back to his prayers, trying to finish before he is tardy to class. My heart is heavy as I watch him being caught up in this cycle…trying to get it just perfect and falling short over and over again. I want to make this better for him, want him to be able to go hang with his buddies who are all together before school begins, but I am just an interruption to a process he feels he must go through.

Not long ago I saw a segment of an interview of Howie Mandel by Larry King. Larry was asking Howie about his OCD. At one point Larry looked at Howie and asked, “It’s not a severe mental illness, is it? I mean, it’s not depression.” Larry went on to talk about how we all have a little OCD and how he has all his vitamins and medicine lined up in a certain order and takes them in that order. Howie did his best to explain how OCD can severely impact someone’s life, but I never really felt that the point hit home.

I think Larry’s question reflects what we see in the media about OCD. People with OCD are portrayed as quirky, silly, and super organized. Maybe they are controlling and bothersome. What we miss seeing is the anguish and the suffering. We do not understand how OCD can hold an individual – and entire families – hostage to it. If we can ask the question, “It’s not a severe mental illness, is it?” then we have never witnessed a child with hands so bloody and oozing from over-washing that they wince with pain if anything brushes against them. We have not had a family hike interrupted by the un-ending screams of a child who is certain he is about to die because there may have been a Lyme disease carrying tick on the shrub that brushed up against him. We have never had a sheriff’s deputy come over to us in alarm because our child is screaming so horrifically that they sound like they are being torn limb from limb. We have never had a family meal interrupted over and over because our teenage son has to stop eating to repeat a ritual before he can go on eating. And we have never seen a 13-year-old boy reduced to an exhausted crumpled mass in his mother’s arms after fighting off the demon in his own mind.

“It’s not a severe mental illness, is it?”

Yes, sadly, OCD is a severe mental illness, and it attacks the things that are most precious to a person.   People think our family must be very religious because they see our son in prayer all the time. What they do not realize is that the religion our son practices bears little resemblance to any religion we practice in the home – or that anyone practices anywhere for that matter. His practices are born out of a fear that OCD gives him – a fear that something awful will happen if he doesn’t get things just right. What used to be a source of enjoyment, connection and deep meaning for him – and for us all – has become a source of endless doubt and a cycle of torturous repetition that has long lost its original intent.

Yes, there is treatment. There are terrific, highly effective treatments – and my son is in treatment now. He has beaten OCD to a pulp in the past. With this relapse, he is a teenager, in the throes of puberty and determined to be independent of what Mom and Dad want for him. So we wait, with hope that the day will come that he will decide that he loves himself more than he loves fighting us. We wait for the day that he turns his strong-willed nature against the OCD that currently holds him in its grasp and moves toward a freer life. But it’s going to be one heck of a war when it comes because, yes, OCD can be severe – and it grows in strength over time. In the meantime, our family will be here, honing our skills so that we can back this boy up when he is ready to fight.

Milestone or Stumbling Block?

Image courtesy dititalart@freedigitalphotos.net

Image courtesy dititalart@freedigitalphotos.net

Blake had a milestone event of sorts just a little over a week ago. He left the school that has been his home for the last five and a half years.  It is a local charter school that we chose to enroll him in when he began the fifth grade. Back then we could see the writing on the wall – the local junior high school and Blake would not be a good match.  A project-based learning charter school seemed a much better way to go for our bright, anxious boy.  He could have remained there through high school graduation, and we all imagined that he would.  Yet Blake’s growing religious observance clashed with the secular atmosphere.  He asked us for over a year to allow him to move into a home study program, until we finally agreed, but was it the right move?

Blake began the journey toward becoming more religious about three and a half years ago.  He started small, a little change here and there.  At the time, he had been managing his OCD incredibly well.  We barely saw any sign of it, and we would rejoice when he made choices to do the opposite of what OCD told him to do.

Then, things changed.  Blake’s OCD made a strong comeback.  He knew what to do and he reached out to his therapist to coach him.  Yet, despite making regular plans of action, Blake didn’t follow through.  He gave in to his anxiety. His compulsions around his contamination fears grew, but OCD wasn’t done there.  It found Blake’s newly growing interest in religious observance the perfect area to attack.  Blake was already uncertain about whether he was practicing his religion correctly, and his OCD dug right in.

Maybe you didn’t say that prayer right.  You should say it again,” OCD would taunt him.

“You may have just done something to offend something sacred.  You’d better undo it.”

Religion and OCD became entangled and it became difficult to tell one from the other, at least for those of us at home.  To people on the outside, Blake just looks like young man of “a deep and reverent faith” to quote one of his teachers.  When people learn that Blake is more observant than the rest of the family, my husband and I often receive praise for being so supportive of our son.  I received much positive feedback as Blake wound down his final week of school, but I felt like a sham.  I am not who these people think I am.

Image courtesy Stuart Miles @freedigitalphotos.net

Image courtesy Stuart Miles @freedigitalphotos.net

For the last five and a half years, Blake has been nurtured by educators who have strived to understand his OCD.  He has been welcomed by resource specialists who’ve listened patiently to his anxious moments.  He has kept warm company with the health office attendant – sometimes for hours on end and for days in a row.  Never once has anyone suggested that this young man, initially unable to even sit in a classroom, didn’t belong at that school.  No one ever tried to send him home like they did at his former school, because he was wearing the nurse down.  No one called home or sent him to the principal because his repetition of prayer sent him late to his first period yet again.  They accepted him as he is.  And they told me that I am a good mother for supporting his growing religious needs.

So, why do I feel like a sham?  Because deep inside, I’m not sure if this is really religious observance.  Sure, it looks like it on the surface, but it’s still too tangled up with OCD’s need for a black and white design for living for me to know if it’s genuine, or if it’s OCD.  Did I just pull my son out of one of the most wonderful and nurturing experiences in his life in the service of his OCD?  Or did he really grow into a religious young man with different needs?  I don’t know if we made the right decision.  I don’t know if I gave in because I was tired of fighting, or because it really was time for Blake to go in a new direction.  All I know is that I am uncertain right now, and I miss the home that was my home, too.