OCD is Hell
“In the quiet heart is hidden
Sorrow that the eye can’t see.”
– Susan Evans McCloud
(1945-Present)
MY EXPERIENCES WITH OCD
Coarsely Crossed
Coarsely crossed, the angst-filled smart
Of agony did fill my heart.
An outgrowth of my humbling path,
Bedecked with the refiners wrath,
That ripped my soul and taxed my mind,
Beat me through life’s unending grind,
That was ordained to make a king,
Who after night is o’er will sing
A thousand praises to the cause,
That aided an end to my flaws.
As to the realms of royal right,
I will transcend the cold dark night,
And gratefully begin to see
The road into eternity's
A path that starts and ends with He.
And all between calls upon me!
UNWANTED SEXUAL THOUGHTS
Unwanted sexual thoughts are among the most common symptoms of OCD. As a teenager, I liked girls and was therefore naturally curious about female anatomy and sex. Most of my sexual thoughts, however, were not triggered by my “nature,” but by my OCD. My sexual obsessions were also strongly influenced by my ROCD. The connection between unwanted sexual thoughts and scrupulosity was triggered by my church’s counsel to avoid preoccupation with sexual thoughts. The operative word in the injunction was, of course, “preoccupation,” which is good advice for any teenager. However, due to OCD, my brain tended to see things in “all-or nothing” dichotomies. [11] At the time, I did not clearly understand the difference between “preoccupation with” and natural, passing thoughts on the matter.
Worried that I was sinning by merely having a sexual thought, my mind began to involuntarily ruminate about thoughts of having sex with girls and women. Any female I saw would trigger the unwanted obsession, and I would become very anxious about the possibility of her knowing I was thinking about it. It was a wretched experience.
After a few weeks of horrific mental and spiritual anguish, I again went to my parents. Once more they assured me I was okay. My father, who clearly—albeit erroneously—viewed my problem as the natural inclinations of a typical teenage boy, was especially reassuring and said, “Jordan, there isn’t a thought you’ve thought that I haven’t thought a lot more and a lot longer than you have.” Such an outpouring of love, concern, and attention from Mom and Dad made all the difference—for about a day. I went to bed feeling free and comforted, only to wake up the next day and find that my mind—ever determined to magnify misery—shifted my obsession from heterosexual to homosexual thoughts.
Agonizing over this new variation on a theme, my suffering continued for months. When I could take it no more, I went again—in tears—to my parents for comfort and relief. It was evident this time around that they were growing increasingly perplexed at the pattern that was developing with their sixth child. Unaware of the root cause of my affliction, they simply didn’t know how to best help me.
Following this third, dramatic, tear-filled episode, I stopped opening up to my parents on a regular basis about my obsessions. First of all, it was difficult—and embarrassing—to disclose intimate details of my horrid thoughts to my parents, despite us being quite close. Second, over time, reality set in and I realized that I likely had “miles to go before I sleep” with regards to this malicious mental malaise. [12] Third, unaware I had a mental disorder and could seek out professional help, I increasingly began to think—and to some degree accept—that I was really weird and had something terribly wrong with me.
GERMS, BLOOD, AND STEROIDS
Over time, an evolution in my unwanted sexual thoughts localized around contact with germs. I became an obsessive hand washer, although not to the degree that marks some sufferers of OCD. I also became fearful of blood—my own, and that of others. My fear was born out of a dubious association between blood (generally speaking), and the concomitant fear of contracting Acquired Immune Deficiency Syndrome (AIDS), a condition caused by HIV (human immunodeficiency virus). My irrational fear was that I could somehow pick up HIV from someone else, even though I was not engaging in any behavior that put me at risk. Even more nonsensical was my fear that I might somehow infect someone else with my own blood, even though my blood was contaminant free. This fear led to the development of compulsive Band-Aid wearing, which was ironically exacerbated by a mild form of trichotillomania (skin picking) that caused my skin to occasionally bleed. It also led to a general avoidance of touching objects I believed could have been exposed to blood in any way.
As I became more involved with athletics in high school, my germ, blood, and AIDS obsession evolved into a new fear that I might accidentally ingest anabolic steroids into my body. The use of banned substances is always against the rules in ethically run sporting programs. The word “rules” became the trigger, because another obsession compelled me to adhere to rules and regulations, often to a ridiculous and illogical degree. Because I was obsessed with keeping certain rules, my mind would obsessively conjure up ways in which I might break the rules inadvertently many of which, like my fear of capriciously ingesting steroids, were completely irrational.
To be clear, I never used steroids. I did not even know of anyone in my community who used—or had access to—steroids. I never had an opportunity to even see, much less use, steroids. Moreover, I never had the slightest desire, temptation, or intention to do so. I nonetheless remained fearful I might somehow ingest them in my body and would therefore be “breaking the rules,” thereby becoming a “dishonest person” whose achievements were illegitimate and deceitful. In response to these obsessions, I developed various compulsive behaviors involving when, where, and how I would wash and clothe myself. These even dictated where I placed personal belongings to avoid the calamitous event of accidentally ingesting steroids. I remember one day watching my older brother get dressed and feeling jealous of his ability to put his clothes with such ease – without having to tip-toe around, or complete any of the other time- and energy-consuming compulsions I felt I “had” to do just to don my own clothes.
During my junior year, I became increasingly successful as a runner. My victories caused my steroid obsessions and compulsions to grow even more severe and debilitating. It seemed as though the more races I won, the worse the symptoms became. It was as if my brain was intent on sabotaging the success (or at least the satisfaction of the success) I was starting to enjoy. I experienced the worst of it in the two weeks leading up to the state championship race. As I packed for the trip, I obsessively stressed about it; as my team and I rode up to Salt Lake City for the meet, I obsessed even more. In the hours leading up to the race itself, the obsessions and related compulsions maintained a firm grip on my mind and behavior, despite my continual efforts to hide my symptoms from others.
THE UNPARDONABLE SIN
I grew up in a religious family that valued faith, fellowship, and freedom. Moreover, I was, by nature, a religious and spiritual person. Adding OCD to this mix concocted a toxic cognitive cocktail in my life, causing me to developing strain of OCD known as scrupulosity, [8] or “religious OCD” (ROCD). [9]
This section details an experience that occurred in 1992 when I was just starting junior high (seventh grade). At that point in time, I was still four-plus years away from any awareness that I was suffering from a clinically diagnosable mental disorder.
According to my church’s theology, the most severe of all sins is becoming a “son of perdition,” which involves denying the Holy Ghost. LDS doctrine is very clear on this point: “For behold, if ye deny the Holy Ghost when it once has had place in you, and ye know ye deny it, behold, this is a sin which is unpardonable.” [10] In seventh grade, I began to obsess that I would be found guilty of this most heinous of sins against God by involuntarily ruminating on the words, “I deny God, Jesus Christ, or the Holy Ghost.”
Such thoughts were anathema to me, and that is precisely what triggered the obsession. OCD takes great glee in diabolically dangling everything a patient holds most dear over the cliff of cognitive distortions. Ironically, OCD often causes massive cognitive distortions about their most precious beliefs and ideals. The more awful and repulsive the thought or action, the more the OCD mind seeks to replay it.
In grave desperation, and naively fearing for the welfare of my soul, I finally confessed my problem to my parents. Lacking the insight to discern the symptoms of a mental disorder, they mistakenly perceived my plight to be a childlike misunderstanding—which it also was. As concerned and loving parents, they assured me I was in no danger of becoming a son of perdition because I had not seen God or Jesus face-to-face and thereby gained a full knowledge of them through physical experience—apparently a doctrinal prerequisite to perdition. Nor had I turned fully against the Godhead after having had such complete knowledge of them.
Mom and Dad were not the slightest bit worried about my spiritual state, but these clarifications helped a great deal in easing my mind in the matter. Clearly, I was not a candidate for perdition. In helping me to this conclusion, my parents had unwittingly extended a healthy dose of cognitive therapy. Fortunately, it worked. Unfortunately, this was just the beginning of a whole slew of OCD symptoms that were about to latch on to my troubled brain. As my obsessions surrounding religious blaspheme began to subside, other, just as insidious symptoms began to plague my mind. Thus began an on-going saga of over a decade whereby I found myself continually shackled in one mental prison or another.
HONESTY...THE BEST POLICY?
Paralleling my unwanted thoughts surrounding sexuality, germs, blood, and steroids was another growing obsession involving honesty that would torment me for many years. It included following “the rules” to the letter, always doing “the right thing,” and telling “the truth, the whole truth, and nothing but the truth.” Such efforts—inherently good in and of themselves—became pathological as the vice grip of OCD squeezed tighter and tighter in my mind. Because this obsession was triggered and influenced by ROCD, I became something of a well-intentioned Pharisee, unable in many instances to see the forest for the trees.
A particular event during ninth grade triggered this new and metastasizing obsession. In my seminary class, I was reintroduced to a verse of scripture I had read over several times previously in my life. This time, however, it struck my mind with obsessive force and would not let go. The verse read, “Woe unto the liar, for he shall be thrust down to hell.”
I had always been an inherently honest person. It was not in my nature to lie, cheat, or steal. Nevertheless, after reading about liars being thrust down to Hell, my already honest nature was seized upon by an honesty compulsion that was, to say the least, absurd.
That same semester, I had procured a license to go mule deer hunting. One day, I was up on my dad’s land hunting with a cousin. As we took turns shooting at deer within the sights of our rifles, a pickup truck came rolling along the dusty dirt road where we had been firing. When it arrived where we stood, a man got out of the truck and confronted us about where we had been shooting. As it happened, his home (and family) was about a half-mile or so from where we had been firing, and he was therefore understandably concerned about where we had been aiming our high-powered rifles. He asked me if we had been shooting in the direction of his house, east of us. Nervously, my mind replayed the shots we had taken toward the west, and I quickly blurted out that we had not taken shots toward the east.
Almost as soon as I said it, I realized that we actually had taken a few shots to the east. When I realized the half-truth I had inadvertently told, I began to feel sick to my stomach. Too afraid to admit my partial deception after my inner realization, the man parted ways with us after adding a word or two in promotion of safe hunting practices. As we climbed on the all-terrain vehicle that carried us home that night, I was beside myself knowing I had not been completely honest with the man—even though my fib had been unintentional.
For the better part of the next year, I might as well have gone to hell because of the mental anguish over that small accidental mistruth. I replayed the incident and reflected on it over and over again. As I did, the guilt, fear, and agony I suffered reached proportions of the most poignant extremity. Many times I contemplated going back to the man’s house to confess my lie, but as bad as my obsessive guilt was, my fear of confession was even worse. Every time I would drive by his home, and on countless other occasions, the obsessions and vacillations would return. My mind could find no peace.
In fact, it was common for the obsessive thoughts to swoop down and do their worst at precisely those moments when I was feeling happiness or peace—thus sucking the joy out of many otherwise positive experiences. For example, one night, as I lay in bed thinking about my future as a competitive runner, I was filled with a spontaneous, joyful anticipation of the future. It was a wonderful feeling! In the midst of this joy, however, my obsessive mind interjected into my thoughts to remind me of the accidental mistruth I had told the man. Suffice it to say, all of my evening’s erstwhile joy had been squelched.
Finally, after about nine months had gone by, I could take it no more. Mustering up all my courage and praying for strength, I returned to the man’s house one Sunday afternoon after church. I knocked on his door, confessed my error, apologized, and then drove home having finally relinquished one of the most excruciating burdens I had ever borne. I had repented of my sin, and could finally find peace. The man was not angry and I felt better after confessing; I was finally able to put the matter to rest.
This act, while morally noble in my own mind, reeked of obsessive-compulsivity on another (had I intentionally lied to the man, it would have been a different story). My inability to recognize I had committed a momentary mistake—not a malicious deception—allowed OCD to begin its vicious cycle. As a result, the confession actually made things worse in the sense that it reinforced the cycle of compulsive behavior to alleviate anxiety. Giving in to compulsions ensures not only that the obsessions will return, but that they will return with greater force than before. While confessing my accidental “white lie” brought my conscience temporary peace, it also further fueled my honesty obsession. It was only a matter of time before the next trigger would start a whole new cycle of unnecessary anxiety and guilt.
The deeper I plunged into this new strain of obsessive thinking, the more closely my obsessive mind policed my every word and deed. In my mind, the slightest deviation from the absolute truth, regardless of the situation, was not to be tolerated. The problem with this, of course, is that 100 percent completely honest communication in every situation is not only unrealistic, but can also be both unwise and unkind. No matter how well intentioned a person might be in regards to truth-telling, there are many flaws in human communication that make it virtually impossible to live up to the standard my OCD demanded I uphold. This strain of OCD created many awkward social situations, and my compulsive confessions and apologies sometimes did more harm than good. They certainly surprised—and probably confused—a lot of people too.
I have thankfully come to recognize the difference between intentionally misleading someone and accidentally neglecting to mention every single minor detail. I can now see the difference between strait-up lying and omitting certain details or compassionate embellishment out of concern for someone’s welfare or feelings.
For example, if you visit someone’s home, and they ask you what you think of it, is it kind to say that you honestly think their new décor is rather tacky? Or, if a five year old overhears the word “rape” and asks about it, would it be in the child’s best interest to provide a wholly accurate definition of such an adult term?
Another related strain of obsessive thoughts evolved out of this penchant for absolute honestly: the fear of offending others. I would go to great lengths not only to avoid offense, but also to confess and apologize to the person I had offended (or believed I had offended).
As a means of mollifying the intense guilt, fear, and anxiety produced by my OCD, I became addicted to the “reassurances” that real (or perceived) authority figures could grant my afflicted mind. Again and again I continually sought for the same kind of loving reassurances my parents had granted me when I first approached them with my obsessive sexual thoughts. I would confess to a variety of individuals, including those I believed I had, or may have, offended, as well as parents, teachers, church leaders, and other “authority figures” that my OCD deemed capable and worthy to grant me clemency and absolution for real (or perceived) mistruths or misdeeds. Such reassurances gave me temporary peace of mind, but in the long-run, they simply recycled OCD’s insidious cycle.
SALES TAX REFUNDS
In between my junior and senior years of high school, I joined my brother’s sales team and began peddling Cutco Cutlery in my hometown of Monticello, Utah, and its surrounding environs. I once heard my Uncle Hyrum say that people do not try sales, sales tries people, and it chews up and spits out 95 percent them. It only took me a week or so to figure out I was one of the 95 percent, although it took a while for me to fully admit and accept what was, at the time, a very disappointing reality for me.
Before I threw in the towel, I did manage to make about 20 sales. At the end of the summer, while reviewing some of my orders, I discovered I had accidentally charged my customers the wrong sales tax percentage. My slight error (or perceived error, since I never did gain verification from Cutco that I had made an error in the first place) caused me much obsessive worry and concern.
After no shortage of stewing over the situation, I finally gave in to a compulsive action in an effort to find relief. I went back through all the duplicate copies of orders I had processed and mathematically calculated how much excess sales tax I believed I had inadvertently charged each of my customers. By the numbers, my error amounted to a matter of literally pocket change. According to my calculations, the largest order of the summer (over $1,000) merited less than a $3 refund. Nevertheless, I totaled it all up and mailed refunds to around 20 customers with a letter explaining my mistake in detail, the numbers involved, and the alleged misappropriated funds.
I can only imagine how surprised some of those people must have been to open up my letter and find a nickel and a few pennies, or a dime, or a quarter, or at most a dollar or two. They must have scratched their head a bit at the oddity of my action, and wondered how I justified sending refunds, which, in several cases, amounted to less money than the stamp it cost to mail it. To this day, I never heard anything from the company about my need to take such an action. Chances are good that the home office fixed those kinds of errors in-house if necessary anyway, but unsure of the “truth” of the matter, I opted to err on the side of covering every possible base. My OCD would have let me sleep slept well at night, nor find any peace during the day, with the knowledge that I might not have been 100% honest with my customers.
SCHOOL IS HELL WHEN YOU HAVE OCD
I exhibited a propensity for academic achievement early on in my educational journey. In elementary school, I got almost exclusively A’s and B’s, and mostly A’s. I also scored well above average on standardized tests.
In seventh grade, as OCD began to really take hold of my life, things began to change. I suppose there are not many people anywhere who would speak fondly about middle school; nevertheless, mine was particularly hellish because of my recent immersion in a sea of neurosis. It was one of the worst years of my life, both socially and emotionally.
In light of my growing obsessions involving honesty, morality, and all-around circumspect human behavior, junior high seemed to me an outright den of debauchery. I was horrified by foul language I heard in hallways and classrooms, and I was mortified at the way some of my peers referenced sexuality, had already become sexually involved (or at least talked as if they had). One day in English class, a friend of mine repeated to me something a girl sitting next to him, who was acting very tired, if not stoned, had casually offered up: “I f----- four different guys last night.” Was this real life? Such things were horrifying to me.
While nothing particularly bad happened to me in seventh grade, the intensity of the external stimuli (and worse, what I worried might be going on around me) set up a relentless barrage of triggers to my growing list of OCD symptoms. As a result, I began to despise the time I spent in school. I loved to be home; peace would fill my heart when I’d settle into my bike seat each day after school. Such peace was increased if I was heading home on Friday afternoons or preceding holidays, spring break, or Christmas vacation because I knew I wouldn’t have to return to campus for a while.
Returning each day, and especially on Mondays, became a dreaded chore. I often tried to persuade my mom to sign me out of school for a few class periods on Fridays so we could go to lunch or the mall together. The more I suffered from obsessive thinking and compulsive behavior, the less I cared about my grades. While I still got good grades (A’s and B’s) my seventh grade year, my erstwhile ambitions for academic excellence began to evaporate.
At the conclusion of seventh grade, my family moved from Mesa, Arizona to Monticello, Utah. In terms of dealing with my OCD, it turned out to be an enormous blessing. Mesa was a major suburb of one of the fastest growing metropolitan areas in the United States (Phoenix, AZ). Monticello was a town of about 2,000 residents in the middle of nowhere, Utah, whose population has remained relatively static for decades. My entire eighth grade class in Monticello had only about 50-60 students; my graduating class in Mesa would have been around a thousand.
The move to Monticello provided a welcomed return to a relatively innocent atmosphere I had enjoyed throughout elementary school. This did much to provide relief from the agonies of seventh grade; however, it did not eradicate my OCD symptoms. Aside from dealing with bullies, my OCD continued to evolve and pose a major personal problem for me as I strove to meet my adolescent academic and other obligations.
OCD affected my scholastic performance in part through my honesty obsession. When it came to my schoolwork, I began to take honesty to unrealistic extremes. For example, when I would receive an assignment, I would assess what my standards would be to complete the assignment honestly. These standards were largely self-imposed and usually ridiculous. Because of the extra mental stress and physical effort required to adhere to my own self-imposed “rules,” I would sometimes neglect to finish—or even start—an assignment because doing it completely “honestly” was not worth the effort it required. I started determining it would be easier mentally and emotionally to just not do the assignment and take a zero.
A concrete example of this bizarre phenomenon occurred my sophomore year in high school in Advanced Placement (A.P.) American History. One day, we were instructed to write an essay. I hadn’t done the reading for the assignment and decided to just do my best using whatever background knowledge and common sense I possessed. I did not consult anyone else and did all the work myself. When I got the paper back, I was pleased to see that I had scored a 92, and got an A on the paper. This self-satisfaction was soon replaced by a different emotion: guilt.
I quickly convinced myself that I had not earned the points in an honest manner because I had not done an adequate amount of reading, studying, and pondering on the topic before I wrote my essay. Even though I had done all the work myself, I was guilty of “B.S’ing” the paper, which was not perfectly honest. To my obsessive mind, merely guessing was tantamount to cheating.
To make matters worse, this paper was one of the last assignments and grades of the semester. Considering I received a D-plus for the fourth and final quarter, [13] it was possible that my A on that essay was the only thing keeping me from failing the class. I then reasoned that had I gotten the grade I really deserved on that paper, I might have gotten an F instead. An F would have made me ineligible to run cross-country during the beginning of my junior year (which, as it turned out, was the semester I would win the State Championship victory). That summer, I replayed this theoretical scenario ad nauseam in my mind. I worried, stewed, and felt guilty about it. Maybe I really shouldn’t be eligible to run cross-country after all. What to do?
Having already established a pattern of confessing and apologizing for whatever was neurotically chafing at my conscience, I finally gave in a few days after school started my junior year. I went to talk to my A.P. American history teacher. Even at the time, a part of me questioned the perceived necessity in doing so. I recognized she might think I was a little bit crazy. After all, who worries about things like this?
I understood rationally that my behavior did not constitute actual cheating, and was well within the realms of what other upstanding and honest students would do without hesitation. I do not even remember exactly what I said, but whatever she said, I was able to walk out with sufficient reassurance to not let the issue cause me to doubt the legitimacy of my athletic eligibility any longer.
A related experience involved classroom attendance. Punctuality was not my greatest strength in high school. This was especially true for the first period of the day as well as the first period after lunchtime. Not given much to socialization before school or during lunch, I would habitually stay at home as long as I possibly could. As a result of this habit, I was often tardy. This was okay with me as long as the teacher made sure to mark me tardy on the attendance sheet. If the teacher would forget (and I’d obsessively notice) I would feel compelled to go and remind them I had been tardy to class that day. Occasionally, the attendance sheet would make it to the office before I could request the change. On more than one such occasion, I guiltily went down to the office myself to ask that I be marked tardy.
PROMPTINGS FROM "GOD"
Growing up, I was taught that God’s Holy Spirit could communicate with me, thereby directing my life through personal revelation. For the most part, this belief has been an enormous blessing to me. As a teenager, however, OCD hijacked the belief and made my life miserable over the issue. As a result, I began to receive an unusual quantity of faux “spiritual promptings” in all sorts of everyday situations. These “promptings” ranged from the supposedly spiritual to the ridiculously random, and everything in between. As a result, my mind began conjuring up all sorts of odd ideas cloaked in the pseudo-robes of religious enjoinment.
Aside from producing poignant, wild-eyed anxiety, I grew increasingly confused whether my “promptings” were legitimate communication from God, or recurring unwanted thoughts dressed up as directions from Deity. This ambiguity led to unnecessary actions and socially inappropriate behavior. Such actions were well intentioned – I thought I was doing God’s will—but in reality, I was engaging in compulsive behavior aimed at reducing the anxiety triggered by my obsessions. Such relief was predictably temporary, surviving only until the next “prompting” triggered a new obsessive thought.
To illustrate, my senior year of high school, I enrolled in an Advanced Placement (A.P.) European History course. Academically and intellectually, this was a wise decision on my part. History was my best subject, and I was a good writer. After being in the class for a few days, however, I began to feel strong “promptings” in my mind and heart that I should not be in the class. These “promptings” led me to drop A.P. European history—a decision I regret to this day.
Once out of the class, I had to fill the hole in my schedule with a new course. I chose regular 11th grade American history, which was a completely illogical move! I had already passed the A.P. American history exam as a sophomore. Now I was a senior enrolled in a regular 11th grade U.S. history class because I thought God didn’t want me in A.P. European history.
Instead of stretching my intellectual capacities, I suffered day after day through tedious lectures from the most boring and monotonic teacher I have ever had – in basic U.S. history. I love American history, yet bearing through that class was almost as painful as dealing with my OCD. As a result, I ended up sleeping much of the time. When I wasn’t asleep, I had to be wary of several immature students who sat behind me. Their crass conversations were carried on clandestinely to avoid getting in trouble, but I could always hear them. This daily dosage of foul language induced enormous anxiety and deep resentment within me. One day, I made a comment or two in their general direction about how I felt about their foul language. My preaching only made things worse, causing me to be singled out for persecution.
After many weeks of being driven to a breaking point, I finally felt compelled to act in a more dramatic fashion. Summiting my soapbox with the courage of a crazed zealot, I proceeded to upbraid my offenders so that everyone in the room could hear—including the teacher. Fixated on, and astonished by, this unexpected tirade, I’m not sure I’ve ever seen a class rendered so speechless, or beheld a more baffled teacher at the front of the room.
Before I concluded, I also made an appeal to the rest of the class wherein I questioned their own collective acceptance of such behavior. I was hoping other students might rally behind my verbal assault of the enemies territory, or at least show some evidence of agreeing with me. Alas, only shock and utter silence prevailed.
Humiliated, I picked up my backpack and strode to the far side of the classroom with an audacity that was as pronounced as it was pathetic. I found a new seat on the opposite side of the room where I would sit for the remainder of the semester. While no one bothered me after that, nobody made any effort to be my friend either. There was one girl who, in another class, confessed to me that she agreed with me and appreciated that I stood up to the offenders. Later, I ended up asking her out on a date; she stood me up.
My compulsive “solutions” to these situations were usually gravely naïve and terribly misguided. Instead of approaching situations with care, compassion, and logic, I preferred to soldier through situations like George Pickett – I’d put my head down and charge headlong into the high ground with a foolish obstinacy, borne of an utter disregard for consequences, social or otherwise. Such an approach predictably ends in colossal failure, and I “died” on more than one occasion trying to unwisely “take the high ground” when I lacked the firepower (moral authority) or could have addressed issues in much more productive, compassionate, and intelligent ways.
This particular strain of OCD produced some of my most severe symptoms. It was also one of the more difficult things to learn how to manage effectively.
Consternated Underneath [14]
Consternated underneath
A soul that’s ever burdened,
With all I am,
And all I’m not,
And all I want to be!
O please dear God do not forsake
My ever-anxious mind.
Be always near me
Is my prayer,
And peace help me to find….
MISSIONARY ANGST
My compulsive honesty and obsession for sacrificing the spirit for the letter of the law made my missionary service especially difficult. My working relationships with other missionaries were negatively impacted by my obsessive concerns over what, in many cases, amounted to relatively meaningless minutia, especially as it involved the already strict mission rules. My quibbling over such relatively unimportant regulatory specifics almost always did more harm than good. In hindsight, I feel sorry for those who had to serve close to me because quite frankly, I could be, with the best of intentions, a real jerk sometimes. While I take consolation in the knowledge that I was well intentioned, and struggling with neurosis, the fact is that I was still a jerk. In my present estimation, those who served closest to me were far more saintly for putting up with me than they were sinners for whatever minor deviations they incurred from exact obedience to every mission rule.
A professional counselor on my mission tried to help me avoid valuing rules above people by teaching me to, “Always err on the side of love for my companion.” Unfortunately, the full impact of his advice did not sink in until well after returning home from my mission, as evidenced by an incident that occurred at the very end of my two-year service.
To preface this sad story, I should note that LDS missionaries are not allowed to listen to secular music while on their missions. But on one final mission occasion, while we were on our way to the airport, our driver (also a missionary) popped in a cassette with music designed to rouse our enthusiasm and patriotism as we returned to the U.S. (e.g. Neil Diamond’s Coming to America). Any sane person would have recognized the appropriateness of this special moment at the end of our missionary service. Completely blinded to the humanness of this unique circumstance, I could see nothing beyond the fact that these missionaries were staining my last day in the mission field by choosing to play unauthorized mission music. [15]
Burning with frustration inside, I opted to “courageously” speak out and express how unfortunate I thought it was that we would “blow it” our last day in the field. In my shameful failure to “see the forest for the trees,” I utterly ruined a moment that should have been special for all of us. Oblivious to the spirit-of-the-law in the matter, I rigidly rained on everyone else’s parade, and after two years of diligent, unpaid, voluntary service, everyone in that van rightly deserved a little patriotic parading.
Other missionaries in the van responded with awkward silence, not sure how to react to such unexpected and vociferous self-righteousness over such a ridiculous matter. One missionary, however, had had enough, and he let me have it! Vehemently confronting me, he angrily bellowed, “Shut up Elder Jensen! Just shut up! You aren’t going to ruin this moment for all of us.” But sadly, the moment had already been ruined, and there was nothing any of us could do to restore what might have been. The music continued to play, but the joy and camaraderie was gone; it had been stolen, and I was the thief. Perhaps this poor missionary (or maybe someone from that van that day) will have an opportunity someday to read this narrative. If they do, I would like to apologize for my myopic dampening of your spirits that day. I was a real jerk, and I am sorry. Just know that such an unkind reaction and unnecessary response was rooted in Jordan Jensen’s OCD, not in Jordan Jensen himself.
I will share the rest of my book's OCD chapter tomorrow, whereby I will provide additional stories from my experiences with OCD & depression, and MOST IMPORTANTLY, how I have been able to effectively manage these disorders so they don't take over my life anymore. In the meantime, for those interested in learning more about what OCD is, and how it can be effectively treated, read on...
ALL ABOUT OCD
Obsessive-compulsive disorder (OCD) affects approximately 2 percent of the population. This harrowing affliction touches lives in every corner of society. Many high profile persons from a variety of societal sectors have suffered, or were believed to have suffered, from OCD. These individuals come from a wide range of fields, including art (Michelangelo), the armed forces (Thomas J. “Stonewall” Jackson), science (Charles Darwin and Albert Einstein), music (Ludwig Van Beethoven), business (Donald Trump), athletics (David Beckham), and entertainment (Justin Timberlake, Katy Perry, Harrison Ford, Penélope Cruz, and others).
OCD symptoms include obsessive thoughts and compulsive behaviors. For persons suffering with OCD, obsessive thoughts are unwanted and often turn into agonizing ruminations that cause great mental anguish. Compulsive behaviors are then undertaken to reduce the anxiety produced by the obsessive thoughts – often evolving into irrational rituals. While everyone may experience some obsessive thoughts and compulsive behavior, a person with clinical OCD often experiences symptoms that consume significant amounts of time and interfere with normal, daily functioning.
CAUSES OF OCD
It is hard to say what causes OCD, but a combination of genetic, social, chemical, and environmental variables are typically involved in its onset and exacerbation. It’s sometimes referred to as “the doubting disease,” and common obsessions include intrusive doubting, sexual thoughts, religious blasphemy, incurring harm to self and others, order, symmetry, cleanliness, and fear of germs. Typical compulsions include washing, checking, ordering, and repeating words and prayers. Compulsions can be accompanied by involuntary body, facial, and verbal tics. Trichotillomania (hair pulling and skin pulling) sometimes accompanies an OCD diagnosis; I myself have dealt with the latter symptom of trichotillomania for much of my life.
OCD'S INSIDIOUS CYCLE
OCD manifests itself in a three-step, cyclical process. The first step involves intrusive, unwanted, obsessive thoughts that trigger anxiety. The second step involves ritualistic, compulsive behaviors performed in hopes of alleviating the anxiety. The third step involves experiencing relief. The pattern then painfully repeats itself until a combination of time and/or therapy, medication, and personal growth can break the cycle.
One of my mental health counselors explained that even non-OCD people have all kinds of would-be thoughts waiting to enter their minds at any given moment. For most people, however, their brains possesses a “screen” that filters many of these would-be thoughts from ever reaching their conscious minds. For people with OCD, the holes in the screen are enlarged, allowing a slew of thoughts to pass through the mind that would typically not rise to the level of conscious thought. It is believed that OCD medication may decrease the size of these holes and thereby prevent obsessive thoughts from slipping past the mind’s filter. Symptom alleviation for many patients, including my own, serve to corroborate this hypothesis.
THE IMPACT OF OCD ON LOVED ONES
Having OCD can produce negative effects on family members and friends. Substantial percentages of those with OCD do not marry. Those who do tend to marry later in life and have trouble sustaining healthy marital relationships. [1] Negative effects can impact other family members as well. In more serious cases, these effects can include “serious disruption of family functioning and overt conflict.” [2]
While serving my LDS mission, my mission president suggested that my OCD would influence my role as a husband and father. I chose to interpret his observation as an important warning for my future. Desperately desiring to avoid the dangers and damages to family life I knew OCD could create, this forewarning was a trigger that motivated me to “attack” my OCD with exceptional vigor. This, in concert with a pathological romantic letdown, led me to seek out regular therapy after returning home from my mission. I yearned for emancipation from my OCD.
METHODS OF TREATMENT
There are many methods of treating OCD. The two most common involve Cognitive-Behavioral Therapy (CBT) – including Exposure Response Prevention (ERP) – and medication. Other, lesser known, treatment options also exist. [3] My experience with treatment includes CBT, medication, as well as self-help and spiritual approaches that involve prayer and fasting.
COGNITIVE-BEHAVIORAL THERAPY
Cognitive Therapy (CT) focuses on what a patient is thinking. Behavioral therapy (BT) focuses on what a patient is doing. The goal of Cognitive-Behavior Therapy (CBT) is to rationalize, minimize, diminish, or eliminate obsessive thought processes and their accompanying behaviors. CBT is usually undertaken with a licensed professional, such as a counselor, psychologist, or clinical psychiatrist. Generally speaking, CBT—including ERP (see next section)—is considered the best method for treating OCD.
CBT was vital to my successful, long-term management of OCD. In therapy, I was introduced to Dr. David Burns’ list of cognitive distortions:
- All-or-nothing thinking
- Overgeneralization
- Mental filter
- Disqualifying the positive
- Jumping to conclusions
- Magnification (catastrophizing) or minimization
- Emotional reasoning
- Should statements
- Labeling and mislabeling
- Personalization [4]
My personal and therapeutic goals were to escape the shackles of these cognitive distortions, many of which had a near-stranglehold on me. I wanted to see things as they really were, not as my troubled mind filtered them to appear. By applying insights from my counseling sessions, I was able to apprehend, confront, and replace cognitive distortions with more accurate conceptions of reality.
EXPOSURE RESPONSE PREVENTION
Exposure Response Prevention – known as ERP – is one of the most prominent and successful methods of Cognitive-Behavioral Therapy used to treat OCD. ERP is a counterintuitive healing method in that it requires a patient to consciously think more about the very thoughts he has been trying to avoid, and to refuse to act on any concomitant compulsions. Initially, ERP is likely to increase a patient’s anxiety (sometimes severely). However, if she persists, her heightened anxiety will eventually diminish. Repeated mental and physical exposure tends to lead to a welcomed diminishment of obsessions and compulsions.
ERP takes courage and commitment. But the long-term benefits outweigh the short-term unpleasantness. Research continually validates ERP as one of the best methods of treating OCD. Research further corroborates that miracle that ERP and other forms of cognitive-behavioral therapy have the capacity to positively affect—and even alter—brain chemistry in the long run. This is significant because it means that ERP may be able to permanently accomplish what medication can only temporarily manipulate.
From my own experiences, I can vouch for CBT’s (including ERP’s) capacity to alter brain functioning. In conjunction with medication, CBT, ERP, and other approaches, I have been able to drastically reduce, or entirely eliminate, many strains of my own obsessions and compulsions.
MEDICINAL TREATMENTS
Medicinal approaches (i.e., drug treatments) are also commonly used to treat OCD. Selective Serotonin Reuptake Inhibitors (SSRIs) are typically the drugs of choice for pharmacotherapy. Examples of SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). Other drugs used to treat OCD include the tricyclic antidepressant (TCA) clomipramine (Anafranil), the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine (Effexor), and the benzodiazepine (BZD) alprazolam (Xanax).
Common side effects of these drugs include lethargy, restlessness, dizziness, and sexual side effects. An OCD patient should work closely with one’s doctor to achieve the right dosage to maximize benefits and minimize side effects. The effectiveness of one drug over another depends on the patient and their genetic makeup and physiology. Family members tend to respond similarly to various medicinal treatments. [5]
Since 1997, when I was first diagnosed with OCD, I have personally been treated by six of these different drugs. To my benefit, I currently take 20 milligrams of escitalopram (Lexapro) once each day. While the medication does not eradicate all my symptoms, and while it cannot achieve the same long-term results of—or replace—CBT and ERP, it does serve to take the edge off, which helps me keep my OCD shrunk down to a faint hum in the background of my life, rather than a blaring bugle in the forefront thereof.
HOMEOPATHY & SELF-AWARENESS
Homeopathy is a lesser-known treatment method. Australian Mark Simblist promotes homeopathic treatments that could potentially align effectively with SAL practices. Homeopathic methods include “a humane and caring approach” [6] that focuses on comprehensive treatment plans including:
- Different forms of vibrational medicine e.g. flower or shell essences.
- Counseling, therapy, or group therapy.
- Regression techniques to confirm facts e.g. kinesiology, hypnotherapy.
- Various forms of energy clearing techniques, breath and bodywork.
- Techniques to change a person’s “core beliefs” e.g. affirmations.
- Meditation and raised spiritual consciousness.
- The homeopathic similimum. [7]
While I have never pursued any extensive homeopathic treatments for my own OCD, I am a proponent of Simblist’s philosophy that therapy should be comprehensive, holistic, and ultimately self-reliant. I also believe individual patients should consider, and perhaps even try, a variety of treatment options in a diligent quest to find what treatment approach works best for them.
End of Part 1...
Part 2 of this Story Can be Found Below Notes
Notes:
[1] De Silva, P. (2003). The Phenomenology of Obsessive-Compulsive Disorder. In R. G. Menzies & P. de Silva (Eds.), Obsessive-Compulsive Disorder: Theory, Research and Treatment (pp. 21-36). West Sussex, UK: John Wiley & Sons.
[2] Ibid. Page 36.
[3] Examples of lesser-known treatments for OCD include: Homeopathy, neurosurgery, repetitive transcranial magnetic stimulation (rTMS), acceptance and commitment therapy (ACT), and progressive relaxation training (PRT).
[4] Burns, D. (2009). Feeling Good: The New Mood Therapy (Revised and Updated Edition). New York, NY: Harper Health. Pages 42-43.
[5] Several members of my family have taken Celexa for depression, and all of us have found similarly positive results.
[6] Simblist, M. (1998). Homeopathy and Obsessive-Compulsive Disorder. The Journal of Australian Homeopathic Association Inc. Volume 11, Issue 2, p 18-21. Page 20.
[7] Ibid. Page 20.
[8] See Rosmarin, D. H., Pirutinsky, S., Pargament, K. I., & Krumrei, E. J. (2009). Are Religious Beliefs Relevant to Mental Health Among Jews? Psychology of Religion and Spirituality. Volume 1, Issue 3, p. 180-190.
[9] See Himle, J. A., Chatters, L. M., Taylor, R. J., & Nguyen, A. (2011). The Relationship Between Obsessive-Compulsive Disorder and Religious Faith: Clinical Characteristics and Implications for Treatment. Psychology of Religion and Spirituality. Volume 3, Issue 4, p. 241-258. DOI:10.1037/a0023478.
[10] Alma 39:6 (The Book of Mormon).
[11] Burns, D. (2009). Feeling Good: The New Mood Therapy (Revised and Updated Edition). New York, NY: Harper Health. Page 32.
[12] A paraphrased line from Robert Frost’s poem, Stopping By Woods on a Snowy Evening (1923).
[13] This grade was indicative of my OCD-related poor habits for turning in assignments more than it was a measurement of my ability to perform well in the class. Despite my D- grade the final quarter, I ended up passing the A.P. Test with a score of four (out of a possible high score of five). In so doing, I outscored one of my classmates who had earned an A in the class the same grading period I got a D- (she received a three on the A.P. test). This is a prominent example of how my grades were rarely commensurate with my academic potential in high school.
[14] Reprinted from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: AuthorHouse. Pages 43-44.
As I struggled with OCD, I eventually fell prey to all ten of Dr. David Burns’ cognitive distortions. The amalgam of these distortions gave me unrealistic expectations for perfection, and resulted in the enormous pressure of maintaining a spot-free conscience at all times. Generally speaking, we can all benefit from striving to live with a clear conscience. The problem with my OCD was that my cognitive distortions created sins that were not really sins at all. These distortions not only created unrealistic expectations regarding my own behavior, but they also induced a sense of unnecessary responsibility for others that was often presumptuous. This resulted in getting me entangled inappropriately in other people’s business.
The sum result of this madness was a self-imposed punishment that saw me morph into a mentally ill Atlas archetype, burdened by the self-imposed responsibility for perfection not only in my own conduct, but also for the moral actions of other people—and not just one or two persons, but essentially the entire Planet, or at least anyone with which I came into contact. It was an utterly infeasible task, and placed an indescribably heavy burden upon my shoulders. This obsessive sense of faux responsibility traveled with me everywhere I went, and obnoxiously stuck its head into virtually every situation in which I found myself.
It also conjured up many situations and circumstances that did not exist except for in my own troubled mind. As a result, I often had a sense of panicked-urgency to take action when none was required – action that often led to more harm than good. In the process, I annoyed—and probably bewildered—many a family member, friend, acquaintance, and even stranger. To this day, I still shudder when I recall some of the ridiculous things I did because of my neurotic moral responsibility. Moreover, such an anxious and discontented spirit made it difficult to develop normal, functioning, and mutually satisfying friendships or relationships with my peers.
Amazingly, I held myself hostage to these self-imposed and unrealistically high standards for an ungodly number of years. How I avoided a nervous breakdown is a wonder to me. The sense that I was teetering on the edge of insanity at times prevailed for many years, and created a tremendous sense of existential insecurity and vulnerability. Fortunately, I was always able to somehow hold my ground, but there were times when insanity might have proved a welcome reprieve from the ever-conscious conundrum of my agitated neurosis.
It was not until I began seriously attending therapy after my mission that I finally started to relinquish this unrelenting burden. Even then, my achievement of mental hygiene was accomplished incrementally over a long period. In the ensuing years, and through much cognitive-behavioral treatment (professional, homespun, and self-help) I have become better at recognizing the difference between real and imagined responsibilities.
As I continue my journey through life, my mantra has become to simplify anywhere and everywhere I can. The process of simplification and the accompanying re-organization takes time. It took me seven years to achieve a satisfactory level of simplification, and the journey has by no means ended. As time passes, I get a little bit better. It’s taken a long time and a lot of effort to shrink my perceived responsibilities down to their actual size, but it has been well worth the effort. With help from God and my support network, this effort has initiated enormous healing, and allowed me to be happy and at peace.
In elementary school, I was charismatic, cheerful, and extroverted. I had many friends, was popular with my peers, and was well liked by my teachers. In first grade, I was voted class president. In third, fourth, and fifth grade, I was voted by my classmates to represent them in the student council. In fifth grade, I was cast as the lead male role in the school play. A talented and respected athlete among my peers, I was routinely one of the first players picked when selecting teams to play basketball or football on the playground. I was well liked by both my male peers and my female counterparts. In fifth grade, I even had three different girls vying for my affection. One girl in particular I especially liked, and turned down her invitation to “go out” only because my church taught me not to date until age 16. Inspired by my older brothers’ obedient examples, it was important to me to follow in their footsteps by living true to this tenet of my faith.
This youthful popularity and social success came to a dramatic halt in seventh grade following my graduation from elementary school. The onset of my mental disorder was exacerbated by the external challenges and realities of being thrust out of a relatively innocent elementary school world and into a junior high environment that, by comparison, seemed like a cesspool of puerile prurience. It took me nearly two decades to recover completely from the social repercussions of OCD that began taking root in seventh grade. My high school and college years were particularly negatively affected, especially as it related to romance.
Over the years, I developed comorbid depression. For every ten days I’ve spent under the yoke of OCD, five or six of them have been further tainted by depression. Depression has also morphed into its own unique manifestation of obsessive thinking. This has been one of the most nefarious influences in my life, as it seeks to stamp out joy wherever it attempts to blossom.
My obsessive depression has made it difficult to experience and enjoy those blessed moments of spontaneous joy that crop up in life from time-to-time. This joy-killing process plays out like this: I feel joy for a few short seconds and then, almost as soon as the joyful feelings or thought has passed, it is immediately sabotaged by awful feelings of despair, self-loathing, and a barrage of other painful obsessions. It is as if my condition condescendingly screams at me to say:
“Listen here dumb ass! Don’t you know joy is unacceptable around here? Here’s something really unpleasant to think about; now ruminate on it till all your damn joy is smothered. Oh, and by the way, I hate you and wish nothing more than for you to experience continuous misery every day of your life. Blank you, you blanking piece of blank!”
This permutation of obsessive depression has been omnipresent throughout all other obsessions I’ve experienced. Indeed, it seems to be the very essence of my OCD itself. It is a fiendish monster eternally committed to the corruption and annihilation of as much peace, happiness, and joy as possible.
As an adult, most strains of OCD I suffered with in high school and college have either diminished significantly or virtually vanished. Nonetheless, for the past decade or so, perhaps the most perplexing strain of all has replaced other strains to produce tremendous anxiety and obsessions surrounding unanswerable existential questions about life and eternity. While I am a person of faith, religion and faith do not answer all questions, and my OCD-inflicted brain is quite adept at finding unanswerable queries to dwell on. Fred Penzel, Ph.D., an OCD expert, recently wrote about this “flavor” [1] of OCD in a recent issue of the International OCD Foundation’s “OCD Newsletter.” [2]
Many people in the general public and the media have a very stereotypical image of what OCD is all about. Individuals with OCD are seen as people who either wash their hands too frequently, or who are super organized and perfectionists. Thus, it can be difficult to recognize the types of OCD that don’t resemble these common stereotypes. The reality is, there are many forms that OCD can take. The types and topics of your obsessions and compulsions are limited only by your brain’s ability to imagine. OCD is insidious, as it seems to have a way of finding out what will bother someone the most.
In concert with the mental malaise and general depression produced by this existential strain of OCD, I also experience panic attacks where I feel existentially trapped, imprisoned, and psychologically strained to a near breaking point. These panic attacks are accompanied by a frenzied sense of nihilistic dread that sweeps over me like a cold, wet blanket. These attacks make me wish I could escape from my body and mind, both of which seem like shackles and instruments of torture. The only certain escape from such moments is to completely immerse myself in an activity that places a substantial cognitive load on my brain, thus successfully distracting me from the obsessions. There are several activities that provide this complete mental immersion (e.g., writing, speaking, engaging conversation, eating a delicious meal, watching an interesting movie or documentary, downhill mountain biking, detailed yard work, playing video games, and sex with my wife). I am deeply grateful for God that such activities exist as a healthy reprieve from such ponderous burdens.
As described in the sonnet below, these panic attacks give me great grief. They cause a deep dislike and fear of life, and instill a desire for death, non-existence, or at least a divine reprieve from the suffering. Such moments also provide a vivid appreciation of, and empathy for, the madness that drives some to suicide.
Sonnet 21 [3]: The Passage of Time
Thanks be to God for the passage of time,
That life marches on to a welcomed grave,
Where at last we may hasten the sublime
Status of being, in a new enclave
Outside of time—that fleeting enemy—
Which serveth death to each blessed moment
We would fain prolong through eternity.
When after all each precious second sent
Away, lost, returns with divine interest
Into the holy coffers of the soul,
Wherein we may perpetually invest
In glory that ne’er dies, which doth cajole
A sharpened focus of my use of time;
That I, by spades, might yet summit the climb.
In one of his poetic masterpieces, the late British poet (Wordsworth) once lamented the woeful state of the world when he exclaimed in his immortal sonnet:
The world is too much with us; late and soon,
Getting and spending, we lay waste our powers.
Little we see in Nature that is ours;
We have given our hearts away, a sordid boon!
The sea that bares her bosom to the moon,
The winds that will be howling at all hours,
And are upgathered now like sleeping flowers—
For this, for everything, we are out of tune;
It moves us not. Great God! I’d rather be
A Pagan suckled in a creed outworn,
So might I, standing on this pleasant lea,
Have glimpses that would make me less forlorn,
Have sight of Proteus rising from the sea,
Or hear old Triton blow his wreathed horn. [4]
My obsessive ruminations about the otherworldly and the endlessness of existence cause me to wish I could be more present in the ‘here and now,’ as others seem to do so effectively. Such drowning in existential anxiety profoundly inhibits my ability to be an emotional participant in my own life, causing me to miss out on many smaller moments of happiness others might routinely experience. Such experiences influenced my penning of the following sonnet:
Sonnet 17 [5]
The world is not enough with me, NOW,
Too much time spent thinking and forecasting,
Trying too hard to see it all—blasting
The feelings and peace—I fail to allow
Real emotions, the wonder, the WOW,
The satisfied sense of sweat on my brow,
And pure joy—spontaneous in my youth—
The unsullied acquisition of truth,
It moves me not! Great God, I’d rather be
A zealot, willing to fight and to die
For any just cause that might make me free,
Possessing the will to work and to try,
What e’er it may take through eternity
To gain the God-granted privilege to fly.
M. Scott Peck, M.D. suggests that rather than classifying the human race into a simplistic dichotomy of the mentally healthy and the mentally ill, it is more accurate to view mankind as existing along a spectrum of mental health.
According to Peck, “All psychological disorders are basically disorders of consciousness.” This paradigm breaks with Freudian concepts that mental illness is rooted in the unconscious. Peck’s paradigm that neurosis is rooted in consciousness grants more choice and control to the patient, but it likewise creates personal accountability since neurosis is ultimately a result of “a conscious mind that refuses to think and is unwilling to deal with certain issues, bear certain feelings, or tolerate certain pain.” [7] According to Peck, “therapy’s purpose is to help people become more aware so that they can think more clearly and live their lives more effectively and efficiently.” [8]
To accomplish these goals of increased consciousness, effectiveness, and efficiency in a patient’s life, self-action leadership is required of the patient. This is because no therapist (no matter how effective), and no pill (no matter how efficacious) can fix the problems (internal or external) of an individual who lacks the will to change.
Peck further emphasizes that if psychotherapeutic processes are to be successful, the onus for progress falls primarily on the patient, not on the shoulders of the health care professional. It requires a heightened “awareness of [one’s] own feelings and imperfections,” [9] a “willingness to think in broader ways or to handle different situations creatively,” [10] a willingness to “tolerate pain,” [11]“great internal strength,” [12] and “self-control.” [13] Peck equates “a high degree of consciousness” and “self-control” with “psychological competence,” [14] which is the goal of therapy. Hence, victims of mental illness, especially neurotic (as opposed to psychotic) [15] illnesses are, in the final analysis, only victims if they choose to be.
All my mental health related study, self-action research, and experiences corroborate Peck’s paradigm of personal responsibility in effectively treating non-psychotic mental illness. There are many things that can palliate symptoms of neurosis; but the choice to improve and heal must ultimately be made by an individual.
My motivation to get help came in part from observing my dad’s experiences with bipolar disorder. It also came from a deep desire to transcend my neurosis in order to accomplish important life goals (especially as they related to marriage, family, schooling, and my career). Over time, I gradually came to know that if I did not take full responsibility for my OCD, I would relinquish control of my life and fail to obtain the future I wanted.
In high school, while I was still just learning about OCD, I completed a research paper on the subject. One particularly powerful article by Mark Simblist, an Australian homeopathic doctor, resonated deeply with me. In his article, Simblist writes:
It was in the spirit of Simblist’s words that I proactively pursued professional help in connection with self-help strategies to confront my illness. I felt empowered and emboldened by the concept that choice plays a key role in defeating mental illness, including OCD. Every time I visited a professional, even as a minor, I did so willingly. I do not say this to impress you, but to impress upon you that the operative word in holistic healing is always will. While medication may mitigate symptoms along the way, a patient’s will to be honest with oneself and work very hard are the only lasting keys to success.
From ages 13-17, I did not know I had OCD. I just thought I was “different” and “weird.” As an adolescent, I hid my obsessions and compulsions as best I could. Even when I was not hiding from those seeking to help me, such as my parents, I did not have sufficient knowledge of abnormal psychology to understand what was really going on. While my parents were supportive and loving through this difficult period, they were also quite ignorant of what was wrong and specifically how they could help me.
My dad’s struggle with bipolar disorder was instrumental in helping me discover my OCD. As I observed the deep distress he faced, which nearly led to his suicide, the thought occurred to me that maybe I also had something wrong with my mind, albeit with a different name. I started doing research in the small library of my rural high school. I first found a book with information on agoraphobia. Some of the symptoms looked familiar, but it did not describe my issues precisely. My next step involved browsing the Internet, which had just recently come to our community. Before long, I came across some information about OCD, and the more I read, the more certain I became that I had found a correct diagnosis. This was a glorious occasion because it helped dispel the idea that I was “just weird.” It also produced hope for help and healing.
Several months later, in January 1997, I visited the same psychiatrist who had diagnosed my dad with bipolar the previous summer. He officially diagnosed me with OCD and wrote me a prescription for Luvox (fluvoxamine). Thus began an extended period of medication for OCD that would continue intermittently up until the present day (2015). I recall feeling much better after going on medication, but was frustrated by my inability to precisely identify how much of my improvement was caused by improving external circumstances versus the direct impact of the medication. In hindsight, I think it was a combination of both.
I do not remember exactly when I stopped taking Luvox, but I moved to Spokane, Washington in August 1997 (six months or so after I began taking medication) and I do not recall taking the medication in Spokane. It is possible this played a minor role in the overall difficulty of my senior year in Washington.
While in Spokane, I met with a counselor at LDS Social Services [17] a couple of times in 1998. That fall, I had a couple more sessions with a different counselor in Denver, Colorado.
On my mission, I met with my mission president every four to six weeks for a personal interview. Over time, it became increasingly evident to him that I needed counseling beyond what he was able to provide. He referred me to LDS Social Services where I attended four or five professional counseling sessions, which were both illuminating and encouraging.
After returning from my mission, I had a profoundly difficult and disappointing romantic letdown. The emotional fallout and exacerbation of my OCD symptoms were so severe that I again sought out professional counseling about seven months after returning home. This was the first time I had done so without suggestions from my parents or ecclesiastical leaders.
As a poor college student, I was concerned about how I would pay for professional counseling. Fortunately, I discovered the Comprehensive Clinic at Brigham Young University (BYU) – a counseling center where graduate students in training provided counseling services at a reduced rate. I could get the therapy I needed for only $15 per session, or for free if I could not afford the $15.
Taking advantage of this affordable opportunity, I pursued regular, ongoing therapy for the first time in my life. I started out meeting with my counselor at least once a week, tapering off to once every other week, etc. I continued to meet with her until she moved on from the Comprehensive Clinic. I spent a total of 10 months in therapy on this first go-round. The following journal entries shed some light on my experiences with, and attitudes toward therapy and my counselor.
Thursday, October 11, 2001
Thursday, October 18, 2001
Thursday, October 25, 2001
Tues. Oct. 30, 2001
Sun. November 11, 2001
Tuesday, November 27, 2001
Thursday, December 6, 2001
Extreme insecurity Demanding of self Heightened anger
Demanding of others Extreme anxiety Skepticism and cynicism
Health problems Overemphasize rationality Apprehensiveness
Self-critical Plagued by self-doubt Distortion of problems
Lack poise in social situations Over-react to stress Depression
Blunt with others Blunt with good motives Order centered
Need to achieve Unwanted disturbing thoughts Tendency to brood/ruminate
Strange thoughts Feeling unreal Difficulty processing feelings
Hard on self Lack of energy to cope See myself as weak
Ambivalence/vacillation Untrusting of others Hyper alert about environment
Trouble warming up to others… Yet actively seek social life Internally focused
Persistent fear response Arrogant
Feel some isolation w/ male counterparts because of certain inherent feminine interests
Might possibly like to participate in child rearing and housekeeping
Appreciate feeling wrought out in artful endeavors and [have] aesthetic inclinations
Difficulty incorporating values in my own schema.
Perceive others’ actions as disingenuous
Trouble tolerating discomfort—inability to delay gratification for extended period of time
Lack of family understanding of what I am going through
Problems with losing control of thought (losing mind)
Daily activities are boring, unrewarding
Marked discomfort during interpersonal interactions.
Thursday May 23, 2002
Wednesday August 14, 2002
During my counseling at the Comprehensive Clinic, I was also seeing a psychiatrist, albeit far less frequently as he was much more expensive. The main purpose of visiting a psychiatrist was to procure prescriptions. Viewing my medicinal treatments, and therapy in general, as an ongoing Self-Action Research (SAR) project, I expressed an interest in trying something other than Luvox. He suggested I try the selective serotonin reuptake inhibitor (SSRI) Celexa (Citalopram). My journal records are spotty regarding my medicinal treatments, but I do know that I went on the medication in late February 2002, and was still on it eight months later, as the following entry recounts:
Tuesday October 1, 2002
The most important counsel he offered was that I seek for spiritual help in filling the existential vacuum that I have found myself in so much. He was very impressed at the depth of my understanding of the cognitive end of things, but noticed that I am not as effective at my emotional, feeling side of things.
Fortunately, I was able to remain on my parents’ insurance during this time, which kept my medication costs to a small co-pay fee.
I don’t remember when I went off medication, but I was no longer taking it when I moved to Georgia in August 2003. Some time after I returned to Utah in February 2004, I experienced another melodramatic romantic rejection and crisis. I again found myself in the grasp of severe OCD symptoms, prompting me to return to therapy and medication. This time, the psychiatrist prescribed me Lexapro (Escitalopram). Lexapro is chemically analogous to Celexa, but purports to having lesser side effects.
The following journal entries describe some of my experiences with this next round of therapy with a new counselor who, like my former counselor, was also female. I experienced more ups-and-downs with this counselor, who, despite her sincerity, was not as well suited for me as my previous counselor had been.
May 10-16, 2004
Mon-Thurs. May 17-20, 2004
Sun May 23, 2004
October 3, 2004
October 4, 2004
Fri. Oct. 15, 2004
The last journal entry I can find that mentions this round of therapy was April 12, 2005. During this same time, my psychiatrist decided to change my medication from Lexapro to Effexor (Venlaxafine). Despite terminating this round of therapy, I would continue with my medication until 2006, when I weaned myself off it gradually and then went off it completely in April.
In conjunction with formal counseling, I also engaged my brother Joe as a lay therapist for the first four years following my mission. I had great respect for Joe, and just as importantly, viewed him as a sterling example of mental hygiene. When comparing Joe’s counseling “services” to the professional (and semi-professional) therapy I have received to date, I can honestly say that Joe held his own, and his billing system was far kinder to my wallet. Particularly in 2001 and 2002, I regularly went to Joe either by phone or in person to talk through a given situation or scenario with which I was struggling. A skilled and patient listener, he was generous with his time and helpful with his counsel. I will always be grateful for the guidance and support he so liberally offered during those difficult years. His presence in my life was a gift from God. My sister Jody also served as a lay therapist for me between 2001 and 2003, especially in relation to my troubles with dating and women. She and her husband and young daughter were a great strength to me socially and emotionally.
After terminating therapy and medication in 2005-06, I was able to remain off medication for five years. It would be nice to report that I did so because my OCD had been cured, but that was not the case. Beginning in 2007, I began experiencing symptoms that once again needed professional help, and in 2008-09, these symptoms worsened.
The most prominent strain of OCD at this period involved existential frustration. I would arise in the morning quite depressed—almost to the point of wishing for non-existence—and it would often take many hours before I was able to snap out of my funk. I delayed seeking out help, mostly out of a fear that my new wife would worry unnecessarily.
There were, however, moments where it was hard to hide my symptoms from her. Whenever I felt caught up in the “existential vacuum,” [18] I would become subdued, un-talkative, and stare off blindly into space. Such moments concerned her, and her concerns filled my heart with fear and dread that my OCD might destroy the most amazing human relationship I’d ever enjoyed.
Fortunately, things worked out with us, but getting married did not signal an end to my struggles. Even though I had been upfront with her about having OCD before we had even started to officially date, the idea of her husband going to professional counseling for mental problems was difficult for her to bear at first. Her concerned tears over the issue pained me, and influenced me to avoid seeking further help.
Things improved in 2009-2010. This was due in large part to my full-time employment as a high school teacher. While my year of in-classroom teaching was one of the most challenging of my life, I did enjoy many aspects of it. Just as importantly, my schedule was sufficiently busy that I did not have much mental time or energy to spare on brooding and obsessing.
In 2011, in the midst of my doctoral sabbatical, I lacked the kind of externally enforced, rigid schedule I had experienced as a full-time teacher. Moreover, I was bearing through a Canadian winter in Newfoundland, which was cold, dark, wet, and snowy. Existential frustrations and other challenges returned. This disquieting combination caused me to finally return to therapy and medication for the first time in years.
Due to an industry shortage in the St. John’s area, it was about four months before I could get an appointment. I entered counseling with a professional psychologist (Ph.D.), and attended approximately eight to ten sessions with her, which I found beneficial. When I finally met with my psychiatrist, he started me off on Anafranil (Clomipramine) and then later switched me to Celexa (Citalopram). The switch to Celexa was made after experiencing meager results – with noticeable side effects – with Anafranil. The doctor was also optimistic of the switch when he learned several of my siblings had experienced positive results with Celexa, and family members typically respond similarly to the same drug.
When my wife and I returned to Houston, I was taking 30 milligrams of Celexa in the morning and 20 milligrams in the evening. I considered the possibility of going off the medication in 2012, but ultimately decided to remain on it until reaching a place of greater homeostasis in my life and career. Furthermore, my symptoms are not as severe when I am on mediation, so why go off it?
As the severity of my symptoms has cycled over the years, the question naturally arises: how do I know when I need to re-enter therapy and/or return to medication? M. Scott Peck has a good answer that I have used as a litmus test for my own needs.
Another piece of advice my mission president gave me at the end of my mission was to be good to myself. People with OCD are typically not those in danger of committing high crimes and misdemeanors, although personal gaffes and other minor mistakes may sometimes feel that serious to someone with OCD. Coming from a spiritual leader I greatly respected, this advice has benefitted me enormously in my battle with OCD and depression.
OCD influenced me to be an uptight, intense, and austere person. These characteristics were not lost on others. For example, one of my missionary companions nicknamed me, “Stress-Bomb.” My mission president himself once remarked that I would never be an easy-going person. Instead of viewing my mission president’s prediction as a foregone conclusion, I took it as a challenge to change.
I take great pride in the fact that I have become more relaxed and easy-going over the years. I still take important things seriously; doing so is one of my greatest strengths. But I don’t sweat the small stuff like I used to, and I am much more relaxed socially than I was before my diagnosis. In fact, I take great pride whenever I catch myself being easy-going.
My second counselor at the Comprehensive Clinic once said to me, “Jordan, you are really good at OCD!” I was unsure what she meant at first, but she went on to explain that I am really good at becoming self-aware of my own mental status, identifying where I need to improve, and then doing something about it. This has turned out to be one of the more memorable and meaningful compliments of my life. I like the idea that I can be “good at OCD.” It means I have chosen to not be a victim, and that I can break free of my psychological shackles; it demonstrates that I possess power over challenges I face in my life. Finally, it promotes the potential I have to accentuate the positive side of the two-edged monster-genius of OCD and depression.
I wish I could say today that I am fully “cured” of my OCD. Unfortunately, despite the significant progress I have made, I am not cured. In fact, the battle goes on most days of my life, and it is doubtful I will ever transcend it entirely in this life, and that is okay. The trick I’ve discovered is not to live on false hope for complete healing, but to reasonably, practically, and faithfully work for adequate management and ongoing improvement. [23] Consider the following journal entry from a decade ago.
Sat. Jun. 8, 2002
I have been in and out of therapy many times since 1997, the most recent being just last year. I also take medication daily right now, and am grateful for the way in which it takes the “edge” off of my symptoms. Chances are good I will need to continue medication and therapy to varying degrees throughout my life. I am okay with this fact, and stand ready to do whatever is necessary to ensure I control my OCD and depression, rather than letting them control me.
Many battles have been won, but the war goes on, and will probably do so until the day I die. My hope lies in recognizing the enormous progress I have made, seizing opportunities for further progress, and exercising my potential to provide help and hope to others who struggle similarly in their own lives.
[1] For a great article that outlines a dozen different “flavors” of OCD, see Weg, A.H. (2011). Living with OCD: Strategies and Treatments for Anxiety Disorders and Compulsive Behaviors. Psychology Today (Online). Published July 16, 2011. URL: http://www.psychologytoday.com/blog/living-ocd/201107/the-many-flavors-ocd
[2] Penzel, F. (2013). To Be or Not to Be, That is the Obsession: Existential and Philosophical OCD. Newsletter of the International OCD Foundation (IOCDF). Volume 27, Number 4 (Fall/Winter 2013). Boston, MA. Page 15.
[3] Previously unpublished.
[4] Reprinted from Rolfe, W. J. (1889). Select Poems of William Wordsworth (Google Books version). Pages 120-121.
[5] Reprinted from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: author House. Page 48.
[6] Peck, M. S. (1978). The Road Less Traveled. New York, NY: Touchstone. Page 16-17.
[7] Peck, M. S. (1997). The Road Less Traveled and Beyond: Spiritual Growth in an Age of Anxiety. New York, NY: Touchstone. Page 75.
[8] Ibid. Page 78.
[9] Ibid. Page 79.
[10] Ibid. Page 77.
[11] Ibid. Page 75.
[12] Ibid. Page 85.
[13] Ibid. Page 81.
[14] Ibid. Page 81.
[15] When mental illness advances beyond the stages of neurosis to more advanced stages of psychosis, there is a point when an otherwise autonomous individual capable of growing through their mental illness may no longer be reasonably accountable for their mental state and/or physical actions. The diagnosis and assessment of neurosis and/or psychosis is the business of licensed mental health care professionals, and should not involve casual guesswork.
[16] Simblist, M. (1998). Homeopathy and Obsessive-Compulsive Disorder. The Journal of Australian Homeopathic Association Inc. Volume 11, Issue 2, p. 18-21. Page 19.
[17] Presently known as LDS Family Services, the professional counseling arm of the LDS Church.
[18] Frankl, V. E. (2006). Man's Search for Meaning. Boston, MA: Beacon Press. Page 106.
[19] Peck, M. S. (1997). The Road Less Traveled and Beyond: Spiritual Growth in an Age of Anxiety. New York, NY: Touchstone. Page 76.
[20] Reprinted with slight revisions from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: authorHouse. Pages 56-58.
[21] A reference to M. Scott Peck, M.D.
[22] Reprinted from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: authorHouse. Page 149.
[23] In this sentence, “faithfully” refers to faith in God, faith in others who can help me, faith in helpful available information, and most importantly, faith in my own capacity, power, and will to act.
***** Part 2 *****
WEIGHT OF THE WORLD ON MY SHOULDERS
As I struggled with OCD, I eventually fell prey to all ten of Dr. David Burns’ cognitive distortions. The amalgam of these distortions gave me unrealistic expectations for perfection, and resulted in the enormous pressure of maintaining a spot-free conscience at all times. Generally speaking, we can all benefit from striving to live with a clear conscience. The problem with my OCD was that my cognitive distortions created sins that were not really sins at all. These distortions not only created unrealistic expectations regarding my own behavior, but they also induced a sense of unnecessary responsibility for others that was often presumptuous. This resulted in getting me entangled inappropriately in other people’s business.
The sum result of this madness was a self-imposed punishment that saw me morph into a mentally ill Atlas archetype, burdened by the self-imposed responsibility for perfection not only in my own conduct, but also for the moral actions of other people—and not just one or two persons, but essentially the entire Planet, or at least anyone with which I came into contact. It was an utterly infeasible task, and placed an indescribably heavy burden upon my shoulders. This obsessive sense of faux responsibility traveled with me everywhere I went, and obnoxiously stuck its head into virtually every situation in which I found myself.
It also conjured up many situations and circumstances that did not exist except for in my own troubled mind. As a result, I often had a sense of panicked-urgency to take action when none was required – action that often led to more harm than good. In the process, I annoyed—and probably bewildered—many a family member, friend, acquaintance, and even stranger. To this day, I still shudder when I recall some of the ridiculous things I did because of my neurotic moral responsibility. Moreover, such an anxious and discontented spirit made it difficult to develop normal, functioning, and mutually satisfying friendships or relationships with my peers.
Amazingly, I held myself hostage to these self-imposed and unrealistically high standards for an ungodly number of years. How I avoided a nervous breakdown is a wonder to me. The sense that I was teetering on the edge of insanity at times prevailed for many years, and created a tremendous sense of existential insecurity and vulnerability. Fortunately, I was always able to somehow hold my ground, but there were times when insanity might have proved a welcome reprieve from the ever-conscious conundrum of my agitated neurosis.
It was not until I began seriously attending therapy after my mission that I finally started to relinquish this unrelenting burden. Even then, my achievement of mental hygiene was accomplished incrementally over a long period. In the ensuing years, and through much cognitive-behavioral treatment (professional, homespun, and self-help) I have become better at recognizing the difference between real and imagined responsibilities.
As I continue my journey through life, my mantra has become to simplify anywhere and everywhere I can. The process of simplification and the accompanying re-organization takes time. It took me seven years to achieve a satisfactory level of simplification, and the journey has by no means ended. As time passes, I get a little bit better. It’s taken a long time and a lot of effort to shrink my perceived responsibilities down to their actual size, but it has been well worth the effort. With help from God and my support network, this effort has initiated enormous healing, and allowed me to be happy and at peace.
SOCIAL DIFFIDENCE AND UNEASE
In elementary school, I was charismatic, cheerful, and extroverted. I had many friends, was popular with my peers, and was well liked by my teachers. In first grade, I was voted class president. In third, fourth, and fifth grade, I was voted by my classmates to represent them in the student council. In fifth grade, I was cast as the lead male role in the school play. A talented and respected athlete among my peers, I was routinely one of the first players picked when selecting teams to play basketball or football on the playground. I was well liked by both my male peers and my female counterparts. In fifth grade, I even had three different girls vying for my affection. One girl in particular I especially liked, and turned down her invitation to “go out” only because my church taught me not to date until age 16. Inspired by my older brothers’ obedient examples, it was important to me to follow in their footsteps by living true to this tenet of my faith.
This youthful popularity and social success came to a dramatic halt in seventh grade following my graduation from elementary school. The onset of my mental disorder was exacerbated by the external challenges and realities of being thrust out of a relatively innocent elementary school world and into a junior high environment that, by comparison, seemed like a cesspool of puerile prurience. It took me nearly two decades to recover completely from the social repercussions of OCD that began taking root in seventh grade. My high school and college years were particularly negatively affected, especially as it related to romance.
DEPRESSION JOINS THE MIX
Over the years, I developed comorbid depression. For every ten days I’ve spent under the yoke of OCD, five or six of them have been further tainted by depression. Depression has also morphed into its own unique manifestation of obsessive thinking. This has been one of the most nefarious influences in my life, as it seeks to stamp out joy wherever it attempts to blossom.
My obsessive depression has made it difficult to experience and enjoy those blessed moments of spontaneous joy that crop up in life from time-to-time. This joy-killing process plays out like this: I feel joy for a few short seconds and then, almost as soon as the joyful feelings or thought has passed, it is immediately sabotaged by awful feelings of despair, self-loathing, and a barrage of other painful obsessions. It is as if my condition condescendingly screams at me to say:
“Listen here dumb ass! Don’t you know joy is unacceptable around here? Here’s something really unpleasant to think about; now ruminate on it till all your damn joy is smothered. Oh, and by the way, I hate you and wish nothing more than for you to experience continuous misery every day of your life. Blank you, you blanking piece of blank!”
This permutation of obsessive depression has been omnipresent throughout all other obsessions I’ve experienced. Indeed, it seems to be the very essence of my OCD itself. It is a fiendish monster eternally committed to the corruption and annihilation of as much peace, happiness, and joy as possible.
PHILOSOPHICAL & EXISTENTIAL OCD
As an adult, most strains of OCD I suffered with in high school and college have either diminished significantly or virtually vanished. Nonetheless, for the past decade or so, perhaps the most perplexing strain of all has replaced other strains to produce tremendous anxiety and obsessions surrounding unanswerable existential questions about life and eternity. While I am a person of faith, religion and faith do not answer all questions, and my OCD-inflicted brain is quite adept at finding unanswerable queries to dwell on. Fred Penzel, Ph.D., an OCD expert, recently wrote about this “flavor” [1] of OCD in a recent issue of the International OCD Foundation’s “OCD Newsletter.” [2]
Many people in the general public and the media have a very stereotypical image of what OCD is all about. Individuals with OCD are seen as people who either wash their hands too frequently, or who are super organized and perfectionists. Thus, it can be difficult to recognize the types of OCD that don’t resemble these common stereotypes. The reality is, there are many forms that OCD can take. The types and topics of your obsessions and compulsions are limited only by your brain’s ability to imagine. OCD is insidious, as it seems to have a way of finding out what will bother someone the most.
In concert with the mental malaise and general depression produced by this existential strain of OCD, I also experience panic attacks where I feel existentially trapped, imprisoned, and psychologically strained to a near breaking point. These panic attacks are accompanied by a frenzied sense of nihilistic dread that sweeps over me like a cold, wet blanket. These attacks make me wish I could escape from my body and mind, both of which seem like shackles and instruments of torture. The only certain escape from such moments is to completely immerse myself in an activity that places a substantial cognitive load on my brain, thus successfully distracting me from the obsessions. There are several activities that provide this complete mental immersion (e.g., writing, speaking, engaging conversation, eating a delicious meal, watching an interesting movie or documentary, downhill mountain biking, detailed yard work, playing video games, and sex with my wife). I am deeply grateful for God that such activities exist as a healthy reprieve from such ponderous burdens.
As described in the sonnet below, these panic attacks give me great grief. They cause a deep dislike and fear of life, and instill a desire for death, non-existence, or at least a divine reprieve from the suffering. Such moments also provide a vivid appreciation of, and empathy for, the madness that drives some to suicide.
Sonnet 21 [3]: The Passage of Time
Thanks be to God for the passage of time,
That life marches on to a welcomed grave,
Where at last we may hasten the sublime
Status of being, in a new enclave
Outside of time—that fleeting enemy—
Which serveth death to each blessed moment
We would fain prolong through eternity.
When after all each precious second sent
Away, lost, returns with divine interest
Into the holy coffers of the soul,
Wherein we may perpetually invest
In glory that ne’er dies, which doth cajole
A sharpened focus of my use of time;
That I, by spades, might yet summit the climb.
In one of his poetic masterpieces, the late British poet (Wordsworth) once lamented the woeful state of the world when he exclaimed in his immortal sonnet:
 |
| William Wordsworth |
Getting and spending, we lay waste our powers.
Little we see in Nature that is ours;
We have given our hearts away, a sordid boon!
The sea that bares her bosom to the moon,
The winds that will be howling at all hours,
And are upgathered now like sleeping flowers—
For this, for everything, we are out of tune;
It moves us not. Great God! I’d rather be
A Pagan suckled in a creed outworn,
So might I, standing on this pleasant lea,
Have glimpses that would make me less forlorn,
Have sight of Proteus rising from the sea,
Or hear old Triton blow his wreathed horn. [4]
My obsessive ruminations about the otherworldly and the endlessness of existence cause me to wish I could be more present in the ‘here and now,’ as others seem to do so effectively. Such drowning in existential anxiety profoundly inhibits my ability to be an emotional participant in my own life, causing me to miss out on many smaller moments of happiness others might routinely experience. Such experiences influenced my penning of the following sonnet:
Sonnet 17 [5]
The world is not enough with me, NOW,
Too much time spent thinking and forecasting,
Trying too hard to see it all—blasting
The feelings and peace—I fail to allow
Real emotions, the wonder, the WOW,
The satisfied sense of sweat on my brow,
And pure joy—spontaneous in my youth—
The unsullied acquisition of truth,
It moves me not! Great God, I’d rather be
A zealot, willing to fight and to die
For any just cause that might make me free,
Possessing the will to work and to try,
What e’er it may take through eternity
To gain the God-granted privilege to fly.
SEEKING HELP
M. Scott Peck, M.D. suggests that rather than classifying the human race into a simplistic dichotomy of the mentally healthy and the mentally ill, it is more accurate to view mankind as existing along a spectrum of mental health.
[The] tendency to avoid problems and the emotional suffering inherent in them is the primary basis of all human mental illness. Since most of us have this tendency to a greater or lesser degree, most of us are … lacking complete mental health. Some of us will go to quite extraordinary lengths to avoid our problems and the suffering they cause, proceeding far afield from all that is clearly good and sensible in order to try to find an easy way out, building the most elaborate fantasies in which to live, sometimes to the total exclusion of reality. In the succinctly elegant words of Carl Jung, “Neurosis is always a substitute for legitimate suffering.” [6]
According to Peck, “All psychological disorders are basically disorders of consciousness.” This paradigm breaks with Freudian concepts that mental illness is rooted in the unconscious. Peck’s paradigm that neurosis is rooted in consciousness grants more choice and control to the patient, but it likewise creates personal accountability since neurosis is ultimately a result of “a conscious mind that refuses to think and is unwilling to deal with certain issues, bear certain feelings, or tolerate certain pain.” [7] According to Peck, “therapy’s purpose is to help people become more aware so that they can think more clearly and live their lives more effectively and efficiently.” [8]
To accomplish these goals of increased consciousness, effectiveness, and efficiency in a patient’s life, self-action leadership is required of the patient. This is because no therapist (no matter how effective), and no pill (no matter how efficacious) can fix the problems (internal or external) of an individual who lacks the will to change.
Peck further emphasizes that if psychotherapeutic processes are to be successful, the onus for progress falls primarily on the patient, not on the shoulders of the health care professional. It requires a heightened “awareness of [one’s] own feelings and imperfections,” [9] a “willingness to think in broader ways or to handle different situations creatively,” [10] a willingness to “tolerate pain,” [11]“great internal strength,” [12] and “self-control.” [13] Peck equates “a high degree of consciousness” and “self-control” with “psychological competence,” [14] which is the goal of therapy. Hence, victims of mental illness, especially neurotic (as opposed to psychotic) [15] illnesses are, in the final analysis, only victims if they choose to be.
All my mental health related study, self-action research, and experiences corroborate Peck’s paradigm of personal responsibility in effectively treating non-psychotic mental illness. There are many things that can palliate symptoms of neurosis; but the choice to improve and heal must ultimately be made by an individual.
My motivation to get help came in part from observing my dad’s experiences with bipolar disorder. It also came from a deep desire to transcend my neurosis in order to accomplish important life goals (especially as they related to marriage, family, schooling, and my career). Over time, I gradually came to know that if I did not take full responsibility for my OCD, I would relinquish control of my life and fail to obtain the future I wanted.
In high school, while I was still just learning about OCD, I completed a research paper on the subject. One particularly powerful article by Mark Simblist, an Australian homeopathic doctor, resonated deeply with me. In his article, Simblist writes:
Our aim should be to raise a victim’s awareness to the level where they know they have a choice – a choice to think what they want to think and a choice not to be victims of intrusive thoughts or compulsions any more. This naturally involves healing very negative thought patterns built up over years and releasing bottled up emotions…. In general I think patients will need to take responsibility for their condition and work quite intensely with a number of different healing methods, particularly some form of therapy, and be prepared to make changes to their lifestyle…. Most of all, patients must realise that compulsive behaviour [sic] began with a choice at some level, and conscious choice is the key to breaking it. [16]
It was in the spirit of Simblist’s words that I proactively pursued professional help in connection with self-help strategies to confront my illness. I felt empowered and emboldened by the concept that choice plays a key role in defeating mental illness, including OCD. Every time I visited a professional, even as a minor, I did so willingly. I do not say this to impress you, but to impress upon you that the operative word in holistic healing is always will. While medication may mitigate symptoms along the way, a patient’s will to be honest with oneself and work very hard are the only lasting keys to success.
From ages 13-17, I did not know I had OCD. I just thought I was “different” and “weird.” As an adolescent, I hid my obsessions and compulsions as best I could. Even when I was not hiding from those seeking to help me, such as my parents, I did not have sufficient knowledge of abnormal psychology to understand what was really going on. While my parents were supportive and loving through this difficult period, they were also quite ignorant of what was wrong and specifically how they could help me.
My dad’s struggle with bipolar disorder was instrumental in helping me discover my OCD. As I observed the deep distress he faced, which nearly led to his suicide, the thought occurred to me that maybe I also had something wrong with my mind, albeit with a different name. I started doing research in the small library of my rural high school. I first found a book with information on agoraphobia. Some of the symptoms looked familiar, but it did not describe my issues precisely. My next step involved browsing the Internet, which had just recently come to our community. Before long, I came across some information about OCD, and the more I read, the more certain I became that I had found a correct diagnosis. This was a glorious occasion because it helped dispel the idea that I was “just weird.” It also produced hope for help and healing.
Several months later, in January 1997, I visited the same psychiatrist who had diagnosed my dad with bipolar the previous summer. He officially diagnosed me with OCD and wrote me a prescription for Luvox (fluvoxamine). Thus began an extended period of medication for OCD that would continue intermittently up until the present day (2015). I recall feeling much better after going on medication, but was frustrated by my inability to precisely identify how much of my improvement was caused by improving external circumstances versus the direct impact of the medication. In hindsight, I think it was a combination of both.
I do not remember exactly when I stopped taking Luvox, but I moved to Spokane, Washington in August 1997 (six months or so after I began taking medication) and I do not recall taking the medication in Spokane. It is possible this played a minor role in the overall difficulty of my senior year in Washington.
While in Spokane, I met with a counselor at LDS Social Services [17] a couple of times in 1998. That fall, I had a couple more sessions with a different counselor in Denver, Colorado.
On my mission, I met with my mission president every four to six weeks for a personal interview. Over time, it became increasingly evident to him that I needed counseling beyond what he was able to provide. He referred me to LDS Social Services where I attended four or five professional counseling sessions, which were both illuminating and encouraging.
After returning from my mission, I had a profoundly difficult and disappointing romantic letdown. The emotional fallout and exacerbation of my OCD symptoms were so severe that I again sought out professional counseling about seven months after returning home. This was the first time I had done so without suggestions from my parents or ecclesiastical leaders.
As a poor college student, I was concerned about how I would pay for professional counseling. Fortunately, I discovered the Comprehensive Clinic at Brigham Young University (BYU) – a counseling center where graduate students in training provided counseling services at a reduced rate. I could get the therapy I needed for only $15 per session, or for free if I could not afford the $15.
Taking advantage of this affordable opportunity, I pursued regular, ongoing therapy for the first time in my life. I started out meeting with my counselor at least once a week, tapering off to once every other week, etc. I continued to meet with her until she moved on from the Comprehensive Clinic. I spent a total of 10 months in therapy on this first go-round. The following journal entries shed some light on my experiences with, and attitudes toward therapy and my counselor.
Thursday, October 11, 2001
I ha[d] a psychological evaluation done today. Met w/ a fellow named ———who got a background idea of my struggle with obsessive-compulsive disorder and depression. I took a personality test as part of it, which was 240 questions long.
I then met w/ my therapist ——— for the second time. Was productive insofar as she helped me identify one of the symptoms of which I had not thought of much before. That is a mind that has thoughts which race and race. She pointed out that even my way of presenting info to her comes out quickly, and jumps from here to there. It was very eye-opening.
Thursday, October 18, 2001
Today I spent four hours at the Comprehensive Clinic. Took a 500+ question evaluation/test, by far the longest I have taken. It included a true/false and personality test. It was easy to take and went quickly, but the sheer quantity of questions was a bit intimidating. Then I took another 90- question test, then waited for my session of therapy w/ ——— which went very well. I learned a lot.
Thursday, October 25, 2001
Had a therapy session w/ ———. It went well. She taught me a relaxing exercise that should be beneficial. I also did some more testing, including an ink-blot test where he would show me some abstract ink blotches, symmetrical in form, and would ask me what I saw in them. My mind obsessively saw sexual images before it saw anything else because that is the most embarrassing thing to see—and then have to say. He recorded everything I said. Afterward I took another true-false personality test of 170 questions or so.
Tues. Oct. 30, 2001
Had an excellent therapy session with ———. I am feeling more comfortable w/ her as our sessions go on. Today’s session was very productive, and I came away with some concrete items to work on.
Sun. November 11, 2001
I think I was very mature tonight. Spent some time w/ a girl named ——— tonight. She is a cute girl. I was proud of myself to be able to talk w/ her and strive to get closer to someone as my psycho-therapist ——— has asked me to strive to do—to just try and get closer to people. In fact she even assigned me a few weeks ago to try to have an emotionally based conversation w/ a female.
Tuesday, November 27, 2001
I went to a therapy session today w/ my therapist ———. She is great. Had a great session and made some progress. Her emphasis of solution is based on really pounding the exposure-response treatment, in ways I haven’t so much done.
Thursday, December 6, 2001
Today I had a review w/ ——— at the clinic of how my psychological assessment went—that was all those tests I took about six weeks ago. Today I had the chance to hear at point blank range, and in plain words of biting sharpness 45 pointed weaknesses or areas of neurosis and cognitive distortions that became evident by the results of the tests.
At the time, I had a hard time holding in the laughter, because it just seemed funny to me. Tonight it doesn’t seem so funny to me anymore. What I see is a re-affirmation of the reality and severity of my neurosis, and an uphill battle yet to fight.
The results of my combined psychometric testing, as described in the entries above, revealed the following data about my psychological state of being.
Extreme insecurity Demanding of self Heightened anger
Demanding of others Extreme anxiety Skepticism and cynicism
Health problems Overemphasize rationality Apprehensiveness
Self-critical Plagued by self-doubt Distortion of problems
Lack poise in social situations Over-react to stress Depression
Blunt with others Blunt with good motives Order centered
Need to achieve Unwanted disturbing thoughts Tendency to brood/ruminate
Strange thoughts Feeling unreal Difficulty processing feelings
Hard on self Lack of energy to cope See myself as weak
Ambivalence/vacillation Untrusting of others Hyper alert about environment
Trouble warming up to others… Yet actively seek social life Internally focused
Persistent fear response Arrogant
Feel some isolation w/ male counterparts because of certain inherent feminine interests
Might possibly like to participate in child rearing and housekeeping
Appreciate feeling wrought out in artful endeavors and [have] aesthetic inclinations
Difficulty incorporating values in my own schema.
Perceive others’ actions as disingenuous
Trouble tolerating discomfort—inability to delay gratification for extended period of time
Lack of family understanding of what I am going through
Problems with losing control of thought (losing mind)
Daily activities are boring, unrewarding
Marked discomfort during interpersonal interactions.
Thursday May 23, 2002
I had an appointment with ——— today. The coolest thing was that I was able to tell her that there really wasn’t a lot to talk about, because I am doing so well as far as working situations through on my own. It was a lovely visit. She asked about how I was doing with the ——— situation and I said okay—and explained that having met ——— was a big help. I took the opportunity to express a heartfelt thanks to her for all she has done. I expressed that she has changed my life, and she in truth has had a critical influence on my life. I am so grateful that I took the initiative to begin this intensive period of therapy, and the results have been astoundingly successful.
Wednesday August 14, 2002
I had my last visit with ——— this morning. She is not going to be doing therapy at the comprehensive clinic anymore. It was a good visit, and I focused mostly on giving her a travel log of my romantic woes I have experienced since I last met with her. It wasn’t the wisest way to go about it, and it led me to feel a bit poorly most of the day, as it induced me to obsess about it all.
During my counseling at the Comprehensive Clinic, I was also seeing a psychiatrist, albeit far less frequently as he was much more expensive. The main purpose of visiting a psychiatrist was to procure prescriptions. Viewing my medicinal treatments, and therapy in general, as an ongoing Self-Action Research (SAR) project, I expressed an interest in trying something other than Luvox. He suggested I try the selective serotonin reuptake inhibitor (SSRI) Celexa (Citalopram). My journal records are spotty regarding my medicinal treatments, but I do know that I went on the medication in late February 2002, and was still on it eight months later, as the following entry recounts:
Tuesday October 1, 2002
Had an appointment this morning with my psychiatrist, Dr. ———. We decided to try a larger dose of medicine. Things are really looking better, but I am eager to try anything that will help even more. He suggested I definitely stay on the medicine, at least at 20 mgs/day. For now, we are going to bump it up to 40 mgs and see what happens. I really like my doctor. He is a good man.
The most important counsel he offered was that I seek for spiritual help in filling the existential vacuum that I have found myself in so much. He was very impressed at the depth of my understanding of the cognitive end of things, but noticed that I am not as effective at my emotional, feeling side of things.
Fortunately, I was able to remain on my parents’ insurance during this time, which kept my medication costs to a small co-pay fee.
I don’t remember when I went off medication, but I was no longer taking it when I moved to Georgia in August 2003. Some time after I returned to Utah in February 2004, I experienced another melodramatic romantic rejection and crisis. I again found myself in the grasp of severe OCD symptoms, prompting me to return to therapy and medication. This time, the psychiatrist prescribed me Lexapro (Escitalopram). Lexapro is chemically analogous to Celexa, but purports to having lesser side effects.
The following journal entries describe some of my experiences with this next round of therapy with a new counselor who, like my former counselor, was also female. I experienced more ups-and-downs with this counselor, who, despite her sincerity, was not as well suited for me as my previous counselor had been.
May 10-16, 2004
This week was hard. I have been quite depressed. Getting out of bed has been difficult. I have mostly wanted to lay flat on my back. I did run several times and am in the process of getting in shape for the Utah Games.
[My waiter job] is wearing on me. As soon as I can quit that job I will. Joe suggested perhaps a job at a Motel in the evening where I could have time to just read. That appeals.
Had my second counseling appointment this Wednesday. It was good. I really like ———, my counselor. I am extremely disillusioned right now. Don’t know when I will really come out of it.
Mon-Thurs. May 17-20, 2004
Hellish first couple of days. Hard to get out of bed. Very frustrated. Very miserable. Felt like dying—or had desires along the lines of wanting to cease to exist.
Had a good therapy session on Thursday night. I like ———. She is a good therapist, but I think that my situation is stumping her to some degree. It is frustrating and I don’t know how much good is coming of it.
Sun May 23, 2004
Nice day. Had a few minutes to spend with ———, which was nice. The last several days—ever since I had the counseling session with ———, things have really looked up. As frustrating as the counseling session itself was (in the sense that I didn’t feel like we were getting anywhere) it has coincided with a timing that has me going in the right direction mentally and psychologically in a big way.
I feel healthier and less uptight and filled with a heart that is open and forgiving and mature and seeing things again as they really are to an extent that I think the Sun is truly coming out again in my life. It is so fascinating to me how nothing really changes, but when I change internally, my world changes with it, and motivation and love and compassion, and all kinds of wonderful things begin to return.
October 3, 2004
Experienced a lot of anxiety today over ———. This is one of the worst days for that. It will only get better from here—I hope.
October 4, 2004
Was hard to do, but I knew it was the only road I could take—that I wanted to take—to pick myself up once again and keep moving forward. To keep trying—that is the highest of actions.
I resolve to humble myself regarding where I am at with relationships and the obsessive element in that part of my life. I am resolved and committed to going forward and resting not until God enables me through His grace and the fruit of my own efforts to conquer this maddening weakness and struggle just like I have conquered so many challenges in the past.
As I said to ——— my therapist tonight … “this weakness will bow to me.”
Fri. Oct. 15, 2004
Another tough day physically and emotionally. Better emotionally though.
I had a therapy session with ——— this morning. I didn’t feel like I got much out of it. I am thinking about either terminating therapy soon, or else getting a different counselor. Bless ———‘s heart, but I don’t think that I am getting much from her anymore. I am dubious whether she is a good fit for my needs. She does love and care about me though as a client and I appreciate that. It is nice to think that someone out there really does love and care about me and even thinks about me and how I am doing once in a while—not that my family isn’t a great support—because they are, but, at this point in my life, that is still different for me.
The last journal entry I can find that mentions this round of therapy was April 12, 2005. During this same time, my psychiatrist decided to change my medication from Lexapro to Effexor (Venlaxafine). Despite terminating this round of therapy, I would continue with my medication until 2006, when I weaned myself off it gradually and then went off it completely in April.
In conjunction with formal counseling, I also engaged my brother Joe as a lay therapist for the first four years following my mission. I had great respect for Joe, and just as importantly, viewed him as a sterling example of mental hygiene. When comparing Joe’s counseling “services” to the professional (and semi-professional) therapy I have received to date, I can honestly say that Joe held his own, and his billing system was far kinder to my wallet. Particularly in 2001 and 2002, I regularly went to Joe either by phone or in person to talk through a given situation or scenario with which I was struggling. A skilled and patient listener, he was generous with his time and helpful with his counsel. I will always be grateful for the guidance and support he so liberally offered during those difficult years. His presence in my life was a gift from God. My sister Jody also served as a lay therapist for me between 2001 and 2003, especially in relation to my troubles with dating and women. She and her husband and young daughter were a great strength to me socially and emotionally.
After terminating therapy and medication in 2005-06, I was able to remain off medication for five years. It would be nice to report that I did so because my OCD had been cured, but that was not the case. Beginning in 2007, I began experiencing symptoms that once again needed professional help, and in 2008-09, these symptoms worsened.
The most prominent strain of OCD at this period involved existential frustration. I would arise in the morning quite depressed—almost to the point of wishing for non-existence—and it would often take many hours before I was able to snap out of my funk. I delayed seeking out help, mostly out of a fear that my new wife would worry unnecessarily.
There were, however, moments where it was hard to hide my symptoms from her. Whenever I felt caught up in the “existential vacuum,” [18] I would become subdued, un-talkative, and stare off blindly into space. Such moments concerned her, and her concerns filled my heart with fear and dread that my OCD might destroy the most amazing human relationship I’d ever enjoyed.
Fortunately, things worked out with us, but getting married did not signal an end to my struggles. Even though I had been upfront with her about having OCD before we had even started to officially date, the idea of her husband going to professional counseling for mental problems was difficult for her to bear at first. Her concerned tears over the issue pained me, and influenced me to avoid seeking further help.
Things improved in 2009-2010. This was due in large part to my full-time employment as a high school teacher. While my year of in-classroom teaching was one of the most challenging of my life, I did enjoy many aspects of it. Just as importantly, my schedule was sufficiently busy that I did not have much mental time or energy to spare on brooding and obsessing.
In 2011, in the midst of my doctoral sabbatical, I lacked the kind of externally enforced, rigid schedule I had experienced as a full-time teacher. Moreover, I was bearing through a Canadian winter in Newfoundland, which was cold, dark, wet, and snowy. Existential frustrations and other challenges returned. This disquieting combination caused me to finally return to therapy and medication for the first time in years.
Due to an industry shortage in the St. John’s area, it was about four months before I could get an appointment. I entered counseling with a professional psychologist (Ph.D.), and attended approximately eight to ten sessions with her, which I found beneficial. When I finally met with my psychiatrist, he started me off on Anafranil (Clomipramine) and then later switched me to Celexa (Citalopram). The switch to Celexa was made after experiencing meager results – with noticeable side effects – with Anafranil. The doctor was also optimistic of the switch when he learned several of my siblings had experienced positive results with Celexa, and family members typically respond similarly to the same drug.
When my wife and I returned to Houston, I was taking 30 milligrams of Celexa in the morning and 20 milligrams in the evening. I considered the possibility of going off the medication in 2012, but ultimately decided to remain on it until reaching a place of greater homeostasis in my life and career. Furthermore, my symptoms are not as severe when I am on mediation, so why go off it?
As the severity of my symptoms has cycled over the years, the question naturally arises: how do I know when I need to re-enter therapy and/or return to medication? M. Scott Peck has a good answer that I have used as a litmus test for my own needs.
There’s no need for therapy when you’re clearly growing well without it. But when [you]’re not growing, when [you]’re stuck and spinning [y]our wheels, [you]’re obviously in a condition of inefficiency. And whenever there’s a lack of efficiency there is a potentially unnecessary lack of competence. [19]
THE TWO-EDGED SWORD OF OCD
At the conclusion of my missionary service in 2001, my mission president interviewed me for the final time. In the course of my final interview, he made a comment I’ll never forget. As a reference to my capacity for hard work and obedience, he said, “OCD has not been all bad for you Elder Jensen.” Far from lionizing the disorder, President Andrus taught me an important life lesson about the freedom I possessed to choose my own destiny regardless of my challenges.
The more I have reflected on his words, the more I have realized that my greatest strengths are – like a two-sided coin, or a two-edged sword – often the other side of my greatness weaknesses. The same mental capacities that spiral into agonizing obsession and melancholy also produce tremendous agility and focus. They empower me to assimilate, organize, synthesize, and communicate information in an organized and articulate manner. Thus, whether the disorder overtakes me or whether I utilize the same capacities as positive strengths, is a choice over which I have power.
The ever-looming question then becomes, which will I choose to embrace? Which side of the two-edged sword will I choose to keep sharp, and which side will I work to dull over time? Thank God for the freedom and sovereignty to make my own decisions each day in the matter. As I have exercised SAL, and otherwise sought to overcome my disorder, I have been blessed with the positive feelings of satisfaction and fulfillment associated with overcoming difficulties, setting and achieving goals, and experiencing enormous Existential Growth. This has done wonders for my self-esteem and confidence.
A Two-Edged Sword [20]
OCD:
What has it done for me?
Is it my friend?
Or my enemy?
The answer,
You see,
Though I’ve
Oft been its slave—
Pathological knave!—
Made me crave for the grave,
Yet somehow . . .
It managed to
Set me free!
Yes it does rather seem
That my nightmare extreme,
Sometimes guised as a dream—
And a good one forsooth!
For in truth,
I behold
That for brain hygiene’s gold,
I must work hard to mine,
Spending mountains of time,
Sweating tears as I pine,
Many years ere I find,
That the cure for my mind—
So oft plagued by the grind—
Is just like that gold,
Mixed betwixt all the old,
Common, cheap, rocky ore,
Whose plentiful store
Hides all worth
Worth pursuing,
Investing,
Accruing,
There’s no need for
Stewing,
For Freedom’s
Now
Mine,
And ever can be
Into eternity
If I’ll never
Forget
That the price
Involves sweat and
Avoiding regret,
And that I’m only set
When I see I’m not yet,
And then rightly perceive
That in time I’ll receive
A most pleasant reprieve
That’s as grand, I believe
As it badly began,
As if Alchemy’s claim
Held water—not sand.
So I’ll keep on the fight,
Through each day,
And each night,
With a calm, tranquil might,
That affirms I’m all right.
And ne’er e’er forgetting,
The puzzling piece
Of the pie
Peck [21] calls
Grace—
So truly Amazing—
To see its pow’r
Razing
My mind’s ills
Erasing.
Yes, there’s help from my pills,
My shrink and SAL to boot,
But shoot!
What a pathetic hoot!
I would be
On my own,
All though I’m now full grown,
And have carefully sown
Seeds of thoughtful decision,
Crafting nobly a vision:
Important!
Yes all,
But lest I should fall,
I will never
Forget
The Source
That doth heal.
With salve that is real—
As real as You—
And me,
And OCD,
And the help,
And the cure—or
The management—
Here, and
Now,
As I await its ultimate
Eradication
THEN . . .
By Him
As long as
I
Do
My
Part
Now.
In striving to effectively manage OCD in my life, a key to my success has been recognizing that the goal is not necessarily perfection, but PROGRESS
Progress [22]
Alas, my inmost heart breaks free,
From all that has been stopping me,
And I exult in all that will,
Break forth into my life yet still.
There is still so much more to learn,
Things to achieve and things to earn,
Folks to meet—my heart doth burn—
As for it all I greatly yearn!
This anxious state amidst it all,
Oft seems to be my life’s true call,
Yet spite the pain and petty pelf,
I’ll still claim victory over self.
And meantime I’ll enjoy the ride,
And bask in the abundance here,
My life will be serene inside,
And outside I’ll be filled with cheer.
Knowing I have a choice in matters of mental health empowered me to seek out help and achieve the mental hygiene I so desperately needed. Along the way, I learned there is more to mental hygiene than therapy and medication. The most important variable of all is to have a purpose for living beyond myself. Therapy and medication can be important, even essential, steps along the way. However, relying on medication and therapy beyond the scope of their capacity to alleviate symptoms and rebuild healthy cognitive function will only result in long-term failure.
To contrast these three variables in healing, consider an analogue to a physical ailment – a broken bone. If I break my leg, having the bone reset and placed in a cast is like getting therapy. Receiving pain medication is like getting medication to ease my symptoms. But can anything be more powerful and motivating than having a driving desire to use my fully functioning leg for some grand purpose (e.g., working to provide for my family, running a marathon, or exercising my mobility to serve and bless the lives of others)? I believe most, if not all, physical healings judged to be miraculous result from patients whose will to heal and live is influenced by some purpose beyond themselves. Whether it is a parent striving to live for his children, an employee needing to get back to work to contribute meaningfully to her company, or an elite athlete dedicated to one’s sport, having a purpose is powerful.
The healthiest periods of my life were not always the times I was in therapy or on medication, but when I was most engaged in work I enjoyed, found meaningful, and provided service to others. For example, despite the enormous challenges involved in teaching high school, I was considerably healthy mentally during this time period because of the structure it provided to my schedule, and the responsibility I had to serve others in meaningful ways.
When my wife and I had our first child, some asked me about the difficulty of our new responsibility. Despite any difficulties, irritations, and inconveniences involved in being a parent, I thank God for the enormous purpose I have found in raising my son, and in nurturing my relationship with his mother. This vital work transcends virtually all other purposes in my life. As a result, having a child has actually improved my mental hygiene.
This isn’t to encourage someone to go out and have a child in an effort to battle mental illness. Such a decision could be disastrous if you’re already dealing with psychosis or severe neurosis. Remember that I had been working on my illness for over a decade in preparation for fatherhood. But when you are healthy enough, and if you are in a positive and healthy relationship with your co-care giver, child rearing can actually bolster your mental hygiene because of the profound purpose it provides.
If you do not have a driving purpose in your life, I encourage you to find one. If you had a purpose, but lost it, I encourage you to strive to regain it. If you don’t feel like working to find a purpose, I suggest willing yourself to the task until you do feel like it. If you persist, I promise you will eventually find or regain it. If you fail, you are apt to give up on life. But remember, the only true failure is quitting. If you are interested in long-term mental hygiene, I believe there is no better remedy than having a compelling purpose that transcends self. Such a purpose will be the catalyst for getting help, for trying every day, and for moving forward.
The more I have reflected on his words, the more I have realized that my greatest strengths are – like a two-sided coin, or a two-edged sword – often the other side of my greatness weaknesses. The same mental capacities that spiral into agonizing obsession and melancholy also produce tremendous agility and focus. They empower me to assimilate, organize, synthesize, and communicate information in an organized and articulate manner. Thus, whether the disorder overtakes me or whether I utilize the same capacities as positive strengths, is a choice over which I have power.
The ever-looming question then becomes, which will I choose to embrace? Which side of the two-edged sword will I choose to keep sharp, and which side will I work to dull over time? Thank God for the freedom and sovereignty to make my own decisions each day in the matter. As I have exercised SAL, and otherwise sought to overcome my disorder, I have been blessed with the positive feelings of satisfaction and fulfillment associated with overcoming difficulties, setting and achieving goals, and experiencing enormous Existential Growth. This has done wonders for my self-esteem and confidence.
A Two-Edged Sword [20]
OCD:
What has it done for me?
Is it my friend?
Or my enemy?
The answer,
You see,
Though I’ve
Oft been its slave—
Pathological knave!—
Made me crave for the grave,
Yet somehow . . .
It managed to
Set me free!
Yes it does rather seem
That my nightmare extreme,
Sometimes guised as a dream—
And a good one forsooth!
For in truth,
I behold
That for brain hygiene’s gold,
I must work hard to mine,
Spending mountains of time,
Sweating tears as I pine,
Many years ere I find,
That the cure for my mind—
So oft plagued by the grind—
Is just like that gold,
Mixed betwixt all the old,
Common, cheap, rocky ore,
Whose plentiful store
Hides all worth
Worth pursuing,
Investing,
Accruing,
There’s no need for
Stewing,
For Freedom’s
Now
Mine,
And ever can be
Into eternity
If I’ll never
Forget
That the price
Involves sweat and
Avoiding regret,
And that I’m only set
When I see I’m not yet,
And then rightly perceive
That in time I’ll receive
A most pleasant reprieve
That’s as grand, I believe
As it badly began,
As if Alchemy’s claim
Held water—not sand.
So I’ll keep on the fight,
Through each day,
And each night,
With a calm, tranquil might,
That affirms I’m all right.
And ne’er e’er forgetting,
The puzzling piece
Of the pie
Peck [21] calls
Grace—
So truly Amazing—
To see its pow’r
Razing
My mind’s ills
Erasing.
Yes, there’s help from my pills,
My shrink and SAL to boot,
But shoot!
What a pathetic hoot!
I would be
On my own,
All though I’m now full grown,
And have carefully sown
Seeds of thoughtful decision,
Crafting nobly a vision:
Important!
Yes all,
But lest I should fall,
I will never
Forget
The Source
That doth heal.
With salve that is real—
As real as You—
And me,
And OCD,
And the help,
And the cure—or
The management—
Here, and
Now,
As I await its ultimate
Eradication
THEN . . .
By Him
As long as
I
Do
My
Part
Now.
In striving to effectively manage OCD in my life, a key to my success has been recognizing that the goal is not necessarily perfection, but PROGRESS
Progress [22]
Alas, my inmost heart breaks free,
From all that has been stopping me,
And I exult in all that will,
Break forth into my life yet still.
There is still so much more to learn,
Things to achieve and things to earn,
Folks to meet—my heart doth burn—
As for it all I greatly yearn!
This anxious state amidst it all,
Oft seems to be my life’s true call,
Yet spite the pain and petty pelf,
I’ll still claim victory over self.
And meantime I’ll enjoy the ride,
And bask in the abundance here,
My life will be serene inside,
And outside I’ll be filled with cheer.
THE POWER OF A PURPOSE
Knowing I have a choice in matters of mental health empowered me to seek out help and achieve the mental hygiene I so desperately needed. Along the way, I learned there is more to mental hygiene than therapy and medication. The most important variable of all is to have a purpose for living beyond myself. Therapy and medication can be important, even essential, steps along the way. However, relying on medication and therapy beyond the scope of their capacity to alleviate symptoms and rebuild healthy cognitive function will only result in long-term failure.
To contrast these three variables in healing, consider an analogue to a physical ailment – a broken bone. If I break my leg, having the bone reset and placed in a cast is like getting therapy. Receiving pain medication is like getting medication to ease my symptoms. But can anything be more powerful and motivating than having a driving desire to use my fully functioning leg for some grand purpose (e.g., working to provide for my family, running a marathon, or exercising my mobility to serve and bless the lives of others)? I believe most, if not all, physical healings judged to be miraculous result from patients whose will to heal and live is influenced by some purpose beyond themselves. Whether it is a parent striving to live for his children, an employee needing to get back to work to contribute meaningfully to her company, or an elite athlete dedicated to one’s sport, having a purpose is powerful.
The healthiest periods of my life were not always the times I was in therapy or on medication, but when I was most engaged in work I enjoyed, found meaningful, and provided service to others. For example, despite the enormous challenges involved in teaching high school, I was considerably healthy mentally during this time period because of the structure it provided to my schedule, and the responsibility I had to serve others in meaningful ways.
When my wife and I had our first child, some asked me about the difficulty of our new responsibility. Despite any difficulties, irritations, and inconveniences involved in being a parent, I thank God for the enormous purpose I have found in raising my son, and in nurturing my relationship with his mother. This vital work transcends virtually all other purposes in my life. As a result, having a child has actually improved my mental hygiene.
This isn’t to encourage someone to go out and have a child in an effort to battle mental illness. Such a decision could be disastrous if you’re already dealing with psychosis or severe neurosis. Remember that I had been working on my illness for over a decade in preparation for fatherhood. But when you are healthy enough, and if you are in a positive and healthy relationship with your co-care giver, child rearing can actually bolster your mental hygiene because of the profound purpose it provides.
If you do not have a driving purpose in your life, I encourage you to find one. If you had a purpose, but lost it, I encourage you to strive to regain it. If you don’t feel like working to find a purpose, I suggest willing yourself to the task until you do feel like it. If you persist, I promise you will eventually find or regain it. If you fail, you are apt to give up on life. But remember, the only true failure is quitting. If you are interested in long-term mental hygiene, I believe there is no better remedy than having a compelling purpose that transcends self. Such a purpose will be the catalyst for getting help, for trying every day, and for moving forward.
MY QUEST TO BECOME EASY-GOING
Another piece of advice my mission president gave me at the end of my mission was to be good to myself. People with OCD are typically not those in danger of committing high crimes and misdemeanors, although personal gaffes and other minor mistakes may sometimes feel that serious to someone with OCD. Coming from a spiritual leader I greatly respected, this advice has benefitted me enormously in my battle with OCD and depression.
OCD influenced me to be an uptight, intense, and austere person. These characteristics were not lost on others. For example, one of my missionary companions nicknamed me, “Stress-Bomb.” My mission president himself once remarked that I would never be an easy-going person. Instead of viewing my mission president’s prediction as a foregone conclusion, I took it as a challenge to change.
I take great pride in the fact that I have become more relaxed and easy-going over the years. I still take important things seriously; doing so is one of my greatest strengths. But I don’t sweat the small stuff like I used to, and I am much more relaxed socially than I was before my diagnosis. In fact, I take great pride whenever I catch myself being easy-going.
GOOD AT OCD
My second counselor at the Comprehensive Clinic once said to me, “Jordan, you are really good at OCD!” I was unsure what she meant at first, but she went on to explain that I am really good at becoming self-aware of my own mental status, identifying where I need to improve, and then doing something about it. This has turned out to be one of the more memorable and meaningful compliments of my life. I like the idea that I can be “good at OCD.” It means I have chosen to not be a victim, and that I can break free of my psychological shackles; it demonstrates that I possess power over challenges I face in my life. Finally, it promotes the potential I have to accentuate the positive side of the two-edged monster-genius of OCD and depression.
THE WAR GOES ON
I wish I could say today that I am fully “cured” of my OCD. Unfortunately, despite the significant progress I have made, I am not cured. In fact, the battle goes on most days of my life, and it is doubtful I will ever transcend it entirely in this life, and that is okay. The trick I’ve discovered is not to live on false hope for complete healing, but to reasonably, practically, and faithfully work for adequate management and ongoing improvement. [23] Consider the following journal entry from a decade ago.
Sat. Jun. 8, 2002
Neurosis is not something that is usually overcome completely. In the words of Dr. ———, and I paraphrase—“the [goal] with OCD is to work with is so that it becomes a faint hum in the background of your mind and life, instead of a blaring horn in the forefront of your conscious experience.”
I have been in and out of therapy many times since 1997, the most recent being just last year. I also take medication daily right now, and am grateful for the way in which it takes the “edge” off of my symptoms. Chances are good I will need to continue medication and therapy to varying degrees throughout my life. I am okay with this fact, and stand ready to do whatever is necessary to ensure I control my OCD and depression, rather than letting them control me.
Many battles have been won, but the war goes on, and will probably do so until the day I die. My hope lies in recognizing the enormous progress I have made, seizing opportunities for further progress, and exercising my potential to provide help and hope to others who struggle similarly in their own lives.
[1] For a great article that outlines a dozen different “flavors” of OCD, see Weg, A.H. (2011). Living with OCD: Strategies and Treatments for Anxiety Disorders and Compulsive Behaviors. Psychology Today (Online). Published July 16, 2011. URL: http://www.psychologytoday.com/blog/living-ocd/201107/the-many-flavors-ocd
[2] Penzel, F. (2013). To Be or Not to Be, That is the Obsession: Existential and Philosophical OCD. Newsletter of the International OCD Foundation (IOCDF). Volume 27, Number 4 (Fall/Winter 2013). Boston, MA. Page 15.
[3] Previously unpublished.
[4] Reprinted from Rolfe, W. J. (1889). Select Poems of William Wordsworth (Google Books version). Pages 120-121.
[5] Reprinted from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: author House. Page 48.
[6] Peck, M. S. (1978). The Road Less Traveled. New York, NY: Touchstone. Page 16-17.
[7] Peck, M. S. (1997). The Road Less Traveled and Beyond: Spiritual Growth in an Age of Anxiety. New York, NY: Touchstone. Page 75.
[8] Ibid. Page 78.
[9] Ibid. Page 79.
[10] Ibid. Page 77.
[11] Ibid. Page 75.
[12] Ibid. Page 85.
[13] Ibid. Page 81.
[14] Ibid. Page 81.
[15] When mental illness advances beyond the stages of neurosis to more advanced stages of psychosis, there is a point when an otherwise autonomous individual capable of growing through their mental illness may no longer be reasonably accountable for their mental state and/or physical actions. The diagnosis and assessment of neurosis and/or psychosis is the business of licensed mental health care professionals, and should not involve casual guesswork.
[16] Simblist, M. (1998). Homeopathy and Obsessive-Compulsive Disorder. The Journal of Australian Homeopathic Association Inc. Volume 11, Issue 2, p. 18-21. Page 19.
[17] Presently known as LDS Family Services, the professional counseling arm of the LDS Church.
[18] Frankl, V. E. (2006). Man's Search for Meaning. Boston, MA: Beacon Press. Page 106.
[19] Peck, M. S. (1997). The Road Less Traveled and Beyond: Spiritual Growth in an Age of Anxiety. New York, NY: Touchstone. Page 76.
[20] Reprinted with slight revisions from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: authorHouse. Pages 56-58.
[21] A reference to M. Scott Peck, M.D.
[22] Reprinted from Jensen, J. R. (2012). Psalms of Life: A Poetry Collection. Bloomington, IN: authorHouse. Page 149.
[23] In this sentence, “faithfully” refers to faith in God, faith in others who can help me, faith in helpful available information, and most importantly, faith in my own capacity, power, and will to act.
