A responsibility OC combats her obsessive concerns for harming others while managing medical school.
I was born with OCD. My mother tells me that as a toddler I would pull out my hair. This was probably baby trichotilomania, which is associated with OCD. For almost 30 years OCD caused me mental anguish that I'm sure only few people can appreciate. My story is probably not an unusual one for sufferers of OCD. It's replete with pain and confusion, difficulties with family and friends, and extreme fears that strike others as ridiculous and bizarre. Professionals misdiagnosed me more than once.
To put it mildly, things are much better now. For the last few years, and for the first time in my life, I have lived virtually OCD free. I have never been happier. I am currently a third-year medical student and look forward to a very rich and fulfilling life with my husband. So what happened? Dr. Steve Phillipson happened (and I thank his parents).
My earliest memories of OCD were of germs. I gradually became deathly afraid of touching anything that may have had germs. I was careful where I walked to avoid any dirty areas. The search and avoidance of germs consumed my day. My parents eventually took me to see a psychiatrist for help, although I received little. One session was spent playing the board game "Sorry". The psychiatrist concluded there was nothing wrong with me. Shortly thereafter, my preoccupation with germs faded away. However, I quickly found myself obsessing about something else. This time it was my hair. I thought it was too thin and that I looked ugly because of it. I would ruminate for hours each day about this. This was to be a become a pattern that would often repeat itself: a disabling obsession lasting about two years that would gradually diminish, only to be replaced by another. In hindsight I believe that this is because I would do what I could to fight the obsession when it had finally reached a debilitating extreme. However, given my lack of OCD counseling, I could do nothing to prevent the immediate appearance of a new obsession.
Religious obsessions that caused me extreme grief began in junior high. I obsessed on a fear of sinning. This eventually became so severe and disabling that I was put in a psychiatric hospital for treatment. The treatment, however, was minimal. Over the two-week period I met with a psychiatrist twice for ten minutes each time. Following discharge I met weekly with a psychiatrist for one year. At the end of the year I asked if he had figured out my problem. Indeed he had. His conclusion was that I had a desire to have sex with my father and that I found the idea so distressing that I repressed it. Repressing is bad he said and I was displacing my feelings onto religion. This of course sounded very strange to me, but at first I tried to talk myself into believing it, hoping he had indeed found the solution to my misery. However, this was only the wishful thinking of a young teenager. The man was an idiot.
Soon thereafter I began seeing a psychologist. We talked for a year. He was the first to correctly diagnose my OCD. He suggested I try to "flow" with my obsessions, neither holding on to them nor pushing them away. I found this helpful, but shortly after introducing this technique my family and I moved away. I then saw a social worker that was not qualified to be of any help.
During college my OCD abated. I became only slightly bothered by it during vacations when I wasn't so occupied with academics. I thought that perhaps I had finally outgrown OCD - no such luck. Shortly after I graduated and got married it came back with a vengeance. This time it was fear of contracting AIDS by casual contact with inanimate objects. Eventually I could not touch anything outside my home without first pouring rubbing alcohol on the surface and on my hands. I even began wearing latex gloves in public. This all came as a surprise to my husband who was unaware of my OCD history. However, he was, and has always been, incredibly patient and supportive. The AIDS obsession lasted about two years before the next one reared its ugly head.
I learned later from Dr. Phillipson that my next obsession fell under the title of responsibility OCD. I became extremely fearful of inadvertently passing on an illness to other people, and the measures I took were extreme. I also felt I had to warn others about every danger that existed, or appeared to me to exist in the environment. At this point I was applying to medical school and was becoming desperate to find some kind of relief. I knew I could never survive in the medical field with these obsessions.
It was then that I learned of the existence of the OCD Foundation. I joined and promptly ordered every existing video, audiotape, book, and pamphlet they had. I also started taking Prozac. I watched, listened to, and read all of the materials. Dr. Phillipson's articles entitled "Guilt Beyond a Reasonable Doubt" and "Thinking the Unthinkable," and his video tape were the first rays of light into the dark hell I had been living. All of his information hit a strong chord and I felt strongly that the techniques he described could help me. Other books and articles I received from the foundation were not helpful in describing ways to handle pure obsessions, nor did any publications mention responsibility OCD.
Unfortunately, I lived in California and Dr. Phillipson practices in New York. Nevertheless, I called him and he agreed to counsel me over the phone. We spoke one hour each week for two years. Not seeing him face to face was never a problem. It was his words that I needed. After our first session I decided on my own initiative to stop taking Prozac. I had been taking it for a little over a month and the side effects were disturbing.
The techniques I learned and perfected are outlined in the two articles mentioned above. I could not reword them any better than they are already written. These articles are available on Dr. Phillipson's web site. Initially, I tried to implement the suggestions from the articles on my own. However, I was not successful. People suffering from OCD have difficulty seeing the traps that OCD sets for them. It took Dr. Phillipson to clarify and expand upon the issues in his articles, and to discuss other topics with me not mentioned in these articles. He worked with me to make many minor adjustment and refinements of the techniques as OCD threw twists and turns into my road to recovery.
To combat responsibility OCD Dr. Phillipson had me engage in exposure exercises where I purposely exposed people to my germs. This was extremely difficult at first, however I eventually learned to tolerate the discomfort associated with the anxiety and guilt. I accepted the possibility of people being harmed by my actions and was willing to take the risk. I learned never to give in when OCD was trying to force me to perform a ritual. My motto is "I don't give in to force." Contrary to my initial feelings, the exposure exercises worked great. I have also learned to live with ambiguity and uncertainty. I perfected the technique of "Let it be there" to handle the many obsessions that plagued me. It took a long time to get good at this, but it was well worth the effort.
I can't say for certain that I'll never again have a major OCD episode in my life. I can say for certain, however, that now I have the tools and training to go head-to-head with the OCD monster should it resurface. And if the past is any indication of the future, odds are I'll kick its butt.
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