Brain Lock: Free Yourself From Obsessive-Compulsive Behavior (28 page)

Soon, however, Joel began to exhibit signs of extreme worry over things being “unclean.” He began washing his hands repeatedly, using huge quantities of water, and taking long showers. Carol and Steven began to suspect that it was more than an ecological awareness that was behind Joel’s ever-more-rigid eating habits. Later, they would understand that he had started to equate “nonorganic” with “unclean.” He had begun to spend hours sorting through vegetables at health-food stores. Once he brought the vegetables home, he would have to wash them for hours. Even after the greens became limp and soggy, he couldn’t always bring himself to believe that they were clean enough to eat. Steven remembers, “It was not only the
vegetarianism, which we could understand, but the minute examination of every possible contaminant, these long, agonizing sessions.” Joel was going through a growth spurt and was quite thin for his height, and his parents began to worry that he was starting to become undernourished.

About this time, the compulsive washing was getting out of control. Whereas he had always been extremely punctual, now Joel could not get to school on time. Whenever he was leaving the house, Steven recalled, “he had to go through increasingly lengthy sessions of washing. They got longer and longer and more intense. He couldn’t explain, except to say that he had to. I didn’t know what to do. Shouting wouldn’t have done any good, obviously. That would have just made him more anxious and maybe would have made it worse. Once or twice I thought, ‘Well, look, maybe I can shock him out of this by turning off the main shutoff valve and cutting off the water.’ Well, that created terrible consternation. And, in the end, it didn’t really save anything because things got so bad that he couldn’t go out if he couldn’t wash, so it was just a vicious cycle. Eventually, I realized, of course, that this wasn’t helping. Not only that, but I couldn’t do that more than once or twice without breaking the plumbing. You know, if you keep turning the main valve off and back on, you’ve got trouble. So I gave up on that.”

Now, Carol and Steven knew that whatever this power was that had taken control of their son, it was stronger than any of them.

Everyone’s life was being turned upside down. Because Joel could not dry his hands on towels others might have used, he took to just shaking his hands and letting the water splash on the floor. He would let the water rise so high in the sink when he washed that it would slosh over. Both Carol and Steven slipped on the wet floors and fell. They had to buy big commercial mops to combat the deluge. Joel’s hands were getting raw and red. Looking back, they describe life at home during that time as “an endurance contest.” Joel couldn’t pinpoint the “contamination.” It wasn’t a fear of germs, exactly, but just a feeling of “ick spreading everywhere. One thing would touch another thing that would touch another thing.”

He could not sit down to a meal without first jumping up to wash and rewash his plate and utensils. Carol and Steven emptied the
kitchen cupboards, relined them, and washed all the dishes in the dishwasher before replacing them. It proved to be wasted effort because Joel was still not convinced that things were clean.

Pretty soon, he began avoiding going to the bathroom, so he would not have to wash his hands afterward. At school, he remembers, “I didn’t go to the bathroom at all because I didn’t want people to see me wash my hands over and over. Of course, they must have known that something was wrong with me because I was arriving at school ten, twenty, or thirty minutes late with my hands white from soap.”

By now, Joel was washing his clothes compulsively, as well. Carol says, “He would take seven or eight hours to wash them and then he had to wash the dryer before he could put them in.” She could no longer be trusted to wash his clothes properly. As he took each item out of the dryer separately (with one hand), he would rush upstairs to his room with it, holding it at arm’s length as though it were about to explode, touching nothing on the way. Water rationing was in effect in parched southern California, and the family was exceeding its quota by far and being penalized. Steven installed water-saving taps and showerheads, but it was futile. Joel—who before his illness had been very drought conscious—just let the water run longer. Carol and Steven would make little jokes about Howard Hughes, but to no avail. Joel was going through piles of towels and huge amounts of non-animal-based soap. Carol says, “We were beginning to live in fear that they were going to turn off our water.” In desperation, Steven rigged up a lock for the clothes washer. Joel broke it off. Sometimes he would hang over the washing machine, compulsively turning the controls for hours. One time, out of patience, Steven hit him, hoping to bring him back to reality. But deep down, he knew that would not help. Steven tried to take away the towels that Joel had laid on the floor to absorb the overflow from the sink as he washed. Joel went into a panic and began knocking over chairs and tables.

Joel had been seeing a psychiatrist who told Carol and Steven that if the situation got totally out of control, they might have to call the police. They figured this was such a situation and dialed 911. Joel responded by striking Carol, trying to tear the phone off the wall, and running outdoors. He was gone when the police arrived.

Clearly, a crisis point had been reached. By now, Joel could touch
nothing after washing and rewashing his hands. He took to using his knee to change channels on the television and would try to “knee” his way out of the house to go to school. Whereas once he had hoarded newspapers, now he couldn’t read a newspaper because he couldn’t stand to get newsprint on his hands.

Joel had abandoned all of his hobbies, including amateur radio and gardening, to concentrate on his compulsions. Ironically, while he expended all this energy on keeping himself and his food clean, his room was becoming a disaster area because of his inability to touch anything “dirty.” Stacks and stacks of newspapers sat in the backyard, untouched, but if anyone suggested throwing them away, Joel would panic and start screaming. He rarely smiled anymore or communicated with his parents, except in a combative and adversarial way. He had begun to realize that he was losing control of his life, that he was letting his schoolwork slip—he had always been a top student—and he cried frequently, wringing his hands in frustration. He was a senior in high school, but had little interest in senior activities and left college applications unopened. An entire day could be spent doing laundry and bathing.

Joel’s food fears were increasing. He could still drink milk, but only one brand. His compulsive washing left him no time for breakfast or lunch. He insisted on cooking his own vegetarian dinner, but this was a long and messy process because he could now use only one hand, even after repeatedly washing both. Salads were out, since he could not get the greens clean enough. His skin was becoming more and more irritated, but when Carol and Steven tried to cure the washing problem by refusing to buy more of his special soap, he started using his shampoo to wash. He spent much of his time standing around with his arms bent and his hands clenched, doing nothing and avoiding touching anything. Whereas he once enjoyed riding his bike to the health-food store, he now had to be driven there. One day, Carol and Steven came home to find Joel standing in the dark, hands clenched, unable to bring himself to touch the light switch. His shoes were a disgrace, but he rejected the idea of new shoes. New shoes would be stiff—and dirty—and he would have to touch them to put them on instead of just stepping on them and forcing his feet into them.

Carol and Steven tried to get Joel to talk about his anxieties, but he would either remain silent or change the subject. Only general, light conversation was possible.

Inevitably, all this turmoil began to be reflected in plummeting grades. Whereas once Joel had been extremely organized and his work very thorough, his reports and papers were now last-minute efforts banged out on the computer with little thought or fact-finding. (His keyboard and mouse could still be touched.) Rarely was he able to concentrate well enough to study for exams. Fortunately, he had applied to several University of California campuses before he was incapacitated by his OCD, and several acceptances had arrived. Carol and Steven urged him to read the literature, thinking it would boost his ego, but he showed little interest. Ultimately, after a perfunctory visit to several campuses, he decided—without much enthusiasm—on San Diego. With his lackluster senior-year grades, his parents feared that UCSD might withdraw its offer—or that, at the last minute, Joel would decide just to stay home and do nothing.

As a family, Carol, Steven, and Joel rarely sat down together for a meal. It was too nerve-racking. If either parent prepared food in Joel’s presence, there was a long battle about whether it was clean. Carol and Steven began to describe his fixation as “molecularism”—if there could possibly be contamination, no matter how small or how imaginary, an object was unclean and unusable. Joel could not wear any clothes if they accidentally touched the floor or if Carol or Steven touched them. His washing compulsion escalated. The drains began to spring leaks, and Steven would have to place buckets beneath them and empty them regularly. The wall behind the sink was constantly drenched from Joel throwing water against it to clean it. Crumpled paper towels by the hundreds were scattered around the house. Carol and Steven were becoming hostages in their own home. “We found ourselves snacking our food when it wouldn’t agitate him. He couldn’t stand to have us near him in the house.” Joel complained incessantly that “the house is dirty.” In reality, it was he who was making it so, dropping things everywhere.

Joel’s food obsessions were getting worse. Because everything was unclean—including his parents—he could eat nothing that they had cooked. And he could eat nothing off their plates or utensils. He had
begun to subsist on commercially packaged organic vegetarian meals and organic juices drunk straight from the bottle. By now, he could not use the telephone or open a door. The movies were his only recreation. He would take the bus to the movie theater, carrying with him his own special snack food.

There were frequent family explosions. Joel was frustrated and angry. On the one hand, he had the normal teenager’s love-hate relationship with his parents, but, on the other hand, he was also abnormally dependent on them in ludicrous ways—for example, to open a door. Physically, he was exhausted from long hours of compulsive activity and a diet that was totally out of balance. He no longer slept in his bed, but just fell asleep stretched across a chair, exhausted. Later, as his obsessive rituals became too painful, he took to sleeping in a sleeping bag to avoid having to shower and change his clothes come morning.

To make matters worse, he had developed an obsession that certain areas of the house were infested with imaginary bugs. Steven had to buy him a package of throwaway plastic gloves because even his computer was now sometimes contaminated. But Joel would complain that the gloves weren’t long enough or that bug “particles” had somehow found their way inside the gloves.

His senior class at school was taking a trip to Europe, but Joel had no interest in going. He all but crawled on his knees through his last year of high school.

Just before Joel lost the ability to function at all—when he could still go outside—he happened upon Judith Rapoport’s
The Boy Who Couldn’t Stop Washing
at a campus bookstore and eagerly flipped through the pages. About the same time, Carol stumbled on the book and brought home several copies. She and Steven devoured it from cover to cover, but Joel could not; he couldn’t pick up anything that they had touched. All three of them now knew what Joel had, and after a number of inquiries, Carol and Steven were able to get him to contact me at UCLA. “That,” says Steven, “is the first time we got the full picture. That was the beginning of our understanding.”

Joel began to comprehend that he had a medical problem caused by a chemical imbalance in the brain, but his physical reserve was so
low that he could do little to combat it. By this time, he was housebound. He couldn’t go out without showering, but he hadn’t the stamina to face the ordeal of an eight-or ten-hour shower. One Saturday morning Joel awakened Steven; he was sobbing and explained that he’d had a nocturnal emission and would now have to shower. Steven agreed and suggested some shortcuts that might curtail the length of the shower, but to no avail. On that occasion, Joel showered for seven hours.

Joel still washed his hands repeatedly, but couldn’t bring himself to turn off the faucets when he finished and risk getting his hands dirty all over again. One day, Carol and Steven came home to find that the faucet had been running all day. Sometimes Joel would wake them up at night, pleading for one of them to turn off the faucet.

He could no longer drink tap water, only bottled. With greater urgency and frequency, he would ask his parents to make special trips to buy emergency food or drink or special anticontamination supplies. They rejected or deferred many of these appeals, repeatedly reminding Joel that they had a limited capacity to cater to his illogical needs.

His showering ritual had become so painful that he simply stopped showering. The very thought of starting a shower was, in Joel’s mind, a challenge of the magnitude of “crossing the desert” on foot. “Once,” Steven remembers, “he went twenty-one days before he built up the courage to take a shower. And that was only so we could take him to the hospital.” All along, Joel had firmly rejected the idea of medication because medicine might be contaminated. Everyone, including Joel, had come to realize that hospitalization was his only hope. He wasn’t functioning. He was, as he says, “frozen.”

Taking that shower was a milestone. Steven says, “It takes a heck of a lot of courage to do these things when your OCD is so bad. You know, it’s easy to say to somebody, ‘Come on, why don’t you take a shower and get out of here?’ But it’s horrible, it’s just horrible. He told us how he would get into the shower and start washing, but then some part that he’d washed would get dripped on and he’d have to rewash. He would even get to the point where he’d almost
pass out in the shower because of the hot steam. And of course, his body would be just raw afterward. When he went into the hospital, the outer layer of skin on his hands and arms was basically gone, all the way up beyond the elbow.”