The first OCD meeting of 2011, held Friday January 21, offered warm support for the fifteen souls who came out on a cold, snowy, winter evening. Many expressed worry that the meeting would be cancelled because of inclement weather, but as it turned out, the snow from the night before had been cleared from roads and parking lots early in the day, and the afternoon was sunny, so the meeting was held as planned. And what a worthwhile one it was!
The discussion ranged around many topics related to OCD, including its causes, symptoms, and treatment. What made it particularly meaningful, were the stories individuals told about their symptoms and the personal journeys they described about learning to manage their OCD, sometimes successfully and sometimes not. Members talked about a variety of types of OCD – symptoms involving contamination, harming, safety, ordering, counting, checking, hoarding, intrusive thoughts, and perfectionism. Many members were able to share personal experiences about using behavior therapy. One member talked about gaining control over compulsive cleaning of his car by practicing Exposure and Response Prevention, including allowing dirt to be thrown into his car as an exposure exercise! Nowadays, he says that he doesn’t care very much whether there is dirt in or out side the car, but he emphasized that it took enormous work and repeated practice of Exposure and Response Prevention to get to that point.
All who spoke expressed how difficult it is to confront OCD urges without giving in to them. It is difficult precisely because doing a compulsion provides quick, albeit temporary, relief. It takes great courage to stay the course by pushing through anxiety without engaging in compulsive behavior. Most members agreed that the short term distress associated with exposure exercises is preferable to the misery of being locked in to the vicious cycle of carrying out compulsions day in and day out, week after week, month after month, and year after year.
Giving in to obsessions can indeed be a miserable affair. A woman with obsessions about running people over with her car told a story about the extreme lengths she would go to in order to find out whether she hurt anyone while driving. After parking her car one day, she pushed her child in a stroller down to the bottom of a long hill in order to look for any injured pedestrians. Finding none, she had to push the child in the stroller back up the long, steep hill – her exertions further compounded by the fact that she was in an advanced stage of pregnancy! Looking back on this experience, she laughed about it, but at the time it was not really a laughing matter! It is certainly preferable to learn to cope with the short term distress from not giving in to such an obsession, for it leads to healing the brain and ultimately to better control over the OCD – and, of course, no strenuous walks up the hill! Taking small steps to manage OCD is counsel heard repeatedly in the group. Everyone can benefit from this sage advice. Clearing out a small area of clutter, reducing checking behavior from 10 to 9 to 8 to 7 times (etc.), counting a few times less, making small errors in writing, spending a few minutes less in the shower, are small, but meaningful steps to get control over OCD.
The evening ended with discussion about work and work related difficulties. Some individuals talked about the problems they have motivating themselves to go to work, others talked about problems getting jobs because of poor performance in interviews, and others spoke about the frustration involved in finding fulfilling work. Work is a complex topic and we barely scratched its surface. But there were many worthwhile issues raised in this lively discussion. As one person noted, having to keep a work schedule definitely contributes to better functioning. Without it, he said that he has an abnormal sleep wake schedule and he doesn’t feel good physically or psychologically. When OCD is severe enough it can clearly interfere with an individual’s ability to work. The depression that frequently accompanies OCD can add further to problems with working. Some people are thus truly incapacitated and unable to work. For anyone who can work, as the members pointed out, work has many benefits that go well beyond the financial rewards. As one member pointed out, work helps to make your life normal, and as a result, one may be better off in efforts to tackle the OCD. And as another explained, when he served on jury duty for two weeks, he actually felt better following a jury service schedule. Signing in each day, he got to know the people at the courthouse and they in turn got to know him. He had pleasant and friendly interactions with the courthouse personnel on a daily basis. Daily coffee was an enjoyable part of the routine. He interacted extensively with the other jurors and was elected foreman of the jury. He agreed to lead the jury and carried out the special responsibilities assigned to the foreman.
Service on the jury exemplifies many of the benefits humans receive from
work. They include opportunities for social interaction, gaining social support, having a sense of purpose, achieving recognition, having control, increasing self-worth, and developing self-efficacy. For individuals with OCD who are able to work, these benefits can fortify them and assist them in their efforts to control OCD. For those who have been sidelined from work because of their illness, taking small steps to regain their footing may be a good course of action. For example, one member said that his goal over the next month would be to go on some job interviews in order to work on problems he has had interviewing in the past. Group members applauded one another in announcing similar small (and medium) steps to be taken in the coming month. We look forward to hearing about these efforts at the next meeting. In the meantime, keep in mind the words of Eleanor Roosevelt (not those of my cat who is named after the First Lady), “Do one thing every day that scares you.” See you February 18! Stay warm!