Brain Lock: Free Yourself From Obsessive-Compulsive Behavior (29 page)

Joel was in the hospital for ten weeks, which wiped out the family’s medical insurance for “mental disorders.” Because he had finished high school, even though he wasn’t yet 18, he was placed in the adult ward, which was very important to him because it meant he could be part of my group. In the hospital, everything was monitored, including the length of patients’ showers. Steven says, “They had a big, beefy guy who hauled people out of showers naked. They had to do that.” The therapy included exposure-and-response-prevention exercises wherein Joel would be told to touch “contaminated” objects, such as bathroom doorknobs.

For weeks, Joel made tiny improvements, would reach a plateau, and then would make another series of small improvements. During this time, he got up the courage to try medication, which helped to relieve his anxiety. Still, there were crises in the hospital; strangers would touch his clothing, and he would demand of his parents, “Take it away. I can’t deal with it.” Repeatedly, he would ask Carol and Steven to bring him brand-new clothing and to throw out the old. They knew they could never satisfy his demands because the new clothing would have to be brought in “uncontaminated” packages. They knew, too, that they would wind up spending all their time bringing clothing to the hospital, that they could not afford to replace everything that had been laundered by the staff and thus rendered unwearable. They actually considered presenting him with an ultimatum: Either he wore what was there or he could wear hospital gowns. But they knew this would be too upsetting and humiliating to someone with his anxieties. Ultimately, they hit on a plan to bring one set of “clean” clothing on each visit. They would seal it tightly and give it to a staff person to give directly to Joel. This seemed to work.

Just before the end of the ten weeks, Joel’s condition took a significant turn for the better. Once home, he was determined not to regress. He began going faithfully to the OCD outpatient program at UCLA and to the weekly meetings of the OCD therapy group.
He still had multiple anxieties, but he was able to control his compulsive rituals. If he found himself starting to think contamination thoughts, he would force himself to Refocus on something else. The family’s awful episode was behind them. After about six months of work on his behavior therapy as an outpatient, the washing compulsions were 99 percent gone. Joel was able to enroll at UCLA, even though he was still struggling with concentration problems.

The moment of truth, Carol says, was when Joel said one day, “I’ve decided that I can’t be better than other people. I’m not going to be able to be cleaner than other people.” And she knew he was going to be okay when he did the hardest thing of all: He touched the flusher on the toilet. Steven says, “Joel was extremely fortunate to be able to get to the right help, the right people, so quickly. If he hadn’t gotten into a good treatment program early on—less than a year after he had clear-cut OCD—it could have gone on for years and years.” Of course, having parents who sought appropriate treatment and persisted in their support as he worked on his behavior therapy also played a critical role.

Carol and Steven remain alert to any signs of backsliding and will confront Joel right away if they notice, say, that he is having trouble deciding whether he is washing something the “right” way. He is usually able to reassure them that everything is under control. He has become very effective at Relabeling and Active Revaluing. As a matter of choice, he still eats a vegetarian diet, but he can eat off plates and utensils like everyone else.

Because he was having concentration problems, Joel temporarily dropped out of college and took a volunteer job at UCLA Medical Center, which led to a part-time paid job. In private psychiatric counseling, he began working on overcoming such things as performance anxiety. Steven resisted the urge to ask his son, “Why don’t you just do X-Y-Z? Why don’t you try to concentrate?” He knew, “It isn’t that easy for someone who’s been through all this. For him, it’s work, hard work. He’s a young guy, and he’s been through a lot. What difference does it make if he goes to college this quarter or next quarter?” In time, Joel was strong enough to leave home and enroll at a large out-of-state university, where he is studying computer sciences.

“This terrible episode is behind us,” Steven says. “He’ll find himself.”

ANNA AND HER BOYFRIEND

Anna’s earliest memory of having a major obsession was when she was in fifth grade and at Girl Scout camp. She had looked forward to having a wonderful time, as she had at past camps. But one day a girl who was bunking nearby happened to tell Anna about her sister, who had a severe kidney disease, and to describe the symptoms in vivid detail. Anna says, “For days, the thought of this sick sister whom I had never met stuck in my mind and refused to leave. It didn’t make a lot of sense that I would feel so bad about a total stranger, but I did.” Camp became a sad experience, and it wasn’t until Anna returned home that she was able to put these painful thoughts away.

Years later, an equally inexplicable and illogical obsessional thought—this one focused on unfounded fears and doubts about her boyfriend’s faithfulness—would drive him up the wall and almost lead to the breakup of their relationship before she learned that she was not a jealous shrew, she was a woman with severe OCD.

As a child, Anna was a worrier and, for most of her life, she had suffered from anxieties and insecurities. During her sophomore year in high school, she had her first real romance, with a good-looking boy a year ahead of her. They started going steady. “We decided we loved each other. We confided the most intimate details of our lives to each other.” One day, he confessed to her that he liked to masturbate while looking at a picture of supermodel Cheryl Tiegs in a bikini. Anna began to obsess about this, over and over picturing him doing this, until she would become sick to her stomach. “Why am I thinking this?” she asked herself, but she couldn’t find an answer. Later, she learned that it was more her boyfriend’s suppressed homosexuality than her lack of sex appeal that made him fantasize about Tiegs while being less than amorous toward her. Still, it was hard for her to shake her obsession with Tiegs. It was the late 1970s, and Tiegs’s picture was everywhere. Each time she saw it, Anna felt a wave of revulsion combined with a fear that her intense obsessions would flare up again.

Anna analyzed herself and decided that she was hypersensitive and jealous by nature and wondered how she’d ever be able to sustain relationships with men in the future if such trivial issues were so painful to her. In college, she became involved with a man who was a drug abuser. Although she tried to be open-minded about his drug habit at first, she soon began to ruminate on it. She had to know how he used drugs and with whom. Somehow, she got it in her mind that his drug problem was her fault. This thought led her to see a school psychiatrist who, on the basis of a fifteen-minute consultation, concluded that her real problem was that she was obsessed with her mother’s breasts. Anna, quite rightly, didn’t see what possible connection there was between such an obsession and her ruminations and increasingly frequent panic attacks.

Eventually, she was diagnosed with agoraphobia, an abnormal fear of leaving home. This is not an uncommon complication in people who get spontaneous panic attacks. “I was told that my panic attacks were probably due to having been raised in a perfectionist household and never having been taught to express anger effectively.” Although we now believe that panic attacks, like OCD, are due mainly to biological factors, that explanation eased her fears that she’d gone crazy. Assertiveness training and exposure therapy to situations and places that brought on the attacks—such as crowds or dark spaces—eased her awful symptoms, the feelings of terror, the fear that she was having a heart attack.

Although she and her boyfriend had long since broken up, she still obsessed off and on about his drug habit. Then, the summer after college graduation, Anna was seized by a new, more overwhelming, obsession: death. “I began to wonder how anyone could make it through the day, knowing that sooner or later death would choke off life and make existence meaningless.” She began to search for signs that she was losing her mind.

She went on to graduate school and met Guy. “Each time I had been involved romantically for any length of time, obsessions had resulted. By the time I met Guy, my less-than-healthy relationships with men in the past had made me especially sensitive to trouble, and I worried about the possible ways a man could destroy me, even if unwittingly. I knew I was prone to selecting men with serious
problems of their own, and too many times I had felt the effects of this on my delicate mental balance. Ironically, it was probably this desire to protect myself from hurt that led to my most intense bout ever with OCD.”

Guy was the innocent victim.

“For once,” Anna says, “I had selected a trustworthy and supportive companion. Then I started in on him. First, I became obsessed with the idea that he had used drugs”—he hadn’t—“and questioned him endlessly about this. Though he was faithful and loving, I began to obsess about his past romantic history”—even about whether he had ever read girlie magazines. Scores of conversations would begin with, “Have you been in love before?” “When exactly did you see this person last?” “Why don’t you see her anymore?” “Do you think about her?” Anna wanted to know when he had looked at the magazines, why, where the magazines had come from, when he last looked at one, when he first looked at one, the total number of times he had looked at them, and which magazines.

And she demanded instant answers. “Not surprisingly,” she says, “Guy hated these conversations, which would end with both of us angry. He was angry because he felt I was needlessly suspicious and distrustful. My anger stemmed from the feeling that his answers were vague and obstructionist.” She spent hours checking and rechecking his answers, mentally reciting the facts he’d told her, searching for any discrepancies. “Often, hearing an answer once wasn’t enough. If he gave an answer to a question I had already asked, and that answer didn’t fit exactly with his previous account, this caused me tremendous mental anguish. I took these inconsistencies as proof that Guy had initially been untruthful.”

Guy felt bewildered and mistreated. Anna felt vulnerable, fearful, and ashamed that she couldn’t control herself. By the time they had been dating for about a year, she had begun to develop psychosomatic ailments and was contemplating suicide, in an abstract sort of way. She had read about a man suffering from mental problems who had shot himself in the head and miraculously “cured” himself by eliminating the rotten spot in his brain, a distorted and misleading account, as it turned out. “I fantasized about a similar cure for myself.” She was now convinced that she was, at heart, a shrewish,
jealous, demanding, difficult, unhappy person—and she hated that person.

As a teenager, Guy had lived in Europe, and together they made a summer trip that included visits to his old haunts and reunions with old friends. Anna was consumed with a need to know exactly what role they’d played in his life. How long had he known the women? Had he dated them in high school? “I would always start out by answering her,” Guy says, “but by the fifth time she asked the question, it got to be completely stupid. I would ask her, ‘Why are you asking me this?’ And she’d just say, ‘I need to know. I need to be sure.’” Sometimes, he would answer her in an offhanded, abstract fashion, thinking that would satisfy her: “Oh, I saw her for the last time three years ago in August.” But later, in casual conversation, the woman would mention that it was actually four years ago or that it was July instead of August, and Anna would begin another barrage of questioning.

In her mind, one of two things had to be happening to her: Either Guy was lying to her or she was going crazy. Because she never wrote down all the details of his answers, she was never quite sure whether the discrepancies in his answers were real or imagined. So she would want him to prove that she had just imagined that he’d told her different stories.

Anna hit upon a solution. She told Guy she was going to start writing down everything he told her. At this point he put his foot down. “No, you’re not. That’s the worst thing you could do.” He was right. He says, “I knew if she asked me, ‘Did you ever go out and get drunk with this person?’ I could say yes or no, and that was that. But if I said no and then she asked me, ‘Well, when was the last time you saw this person?’ I would probably not be able to say in the kind of detail she thought was necessary,” and she would launch into another round of harassment.

During the first years of their relationship, they made several trips to Europe, where his family lived. Although he didn’t know it at the time, Guy began to use behavior therapy to help Anna. He recognized that if she got too tired, this obsession of hers “would be ready to pounce,” so he tried to plan their travel accordingly. He also planned their daily activities ahead, understanding that
when she was busy, she was not asking all those silly questions.

On their second trip abroad, they stayed with his family in their small home. That turned out to be a mistake. Guy’s mother thought her son had brought home a severely disturbed young woman and had little patience with her strange problems. She had much bigger worries—her husband had recently suffered a heart attack. She made her impatience obvious, which of course only increased Anna’s stress and exacerbated her OCD obsessions. Guy’s mother would tell her, “Well, deep down you must really want to be doing this. There must be some special urge in you.” Anna, in desperation, would tell her, “No, no! You don’t understand.” The conflict was making both Anna and Guy miserable. “I just lost it,” Anna says. “I wanted to kill myself because I was obsessing and obsessing and starting to do all these really crazy things. I just became obsessed with trying to reconstruct his life before me—although he’d actually had an extremely tame life before me.”

She grilled him about every woman he had ever dated. “What did she look like?” “What did you eat when you went out with her?” “Where exactly did you go?” What did they have for an appetizer, main course, dessert? Did they sit down to eat at noon or four minutes past? What did they talk about? Anna was distraught. “I had no idea what was going on and I felt really horrible because I was basically torturing my boyfriend with all these crazy questions. He got very upset. He thought I was just doing it for fun or something. He is a very sensitive guy and he thought I didn’t trust him, which in a way was true. But neither of us knew what this thing was. We had no clue. I had already been through therapy for my panic attacks, so I knew what panic attacks were, but this was something totally new. [About 10–15 percent of people with OCD get panic attacks as well.] I knew there was something seriously wrong and that I had to see a psychiatrist, but I was in Europe, so I had to sort of live through the rest of that summer.”