Brain Lock: Free Yourself From Obsessive-Compulsive Behavior (17 page)

Like many others who suffer from OCD, Brian sought help when he’d “had a bellyful” of that nonsense. “I got so damned tired of that stuff, so tired of the depression it caused. I couldn’t do normal things. Every minute of the day, my mind was concentrating on battery acid.”

Brian is quick to say that the Four-Step Method “is the only good tool out there right now for people like me…. You’ve got to get to the point where it’s mind over matter. You’ve got to say to yourself, ‘Man, there’s just no way.’ And you know what the hard part is for me? Well, with somebody who’s afraid of cotton or dustballs or whatever, theoretically there’s no real danger, but theoretically sulfuric acid is dangerous. So it was real hard for me to make that split. You’ve got to have a healthy respect for it, but at the same time you can’t let it go over that edge. I was living over that edge all the time, I mean, acid was everywhere. It was in my bedroom, on the walls of the house.” For the record, OCD can make a person just as frightened of a dustball as Brian was of acid. It’s hard to overstate how bizarre and ridiculous OCD symptoms can be.

With the help of the Four Steps and some medication to help get him through his therapy, Brian has been able to work around most of his obsessions. His garden is where he tends to do his best Refocusing. “I have a lot more success on weekends when I’m working in the yard, and working hard. I’m an avid gardener and I can get out there and mow and plow and pull and sweat. That’s a great escape for me.” The general principle is simple: If you have a hobby you love, use it as much as you can to Refocus. Then you’ll be getting two benefits for the price of one.

THE POWER OF SELF-DISTRACTION

Anna, the philosophy student who interrogated her boyfriend relentlessly because of her unfounded fear that he was being unfaithful, recalls, “The third step—Refocus—was essential to my recovery, but it was a very difficult step to learn. Waiting is about the last thing you want to do when life itself seems to be hinging on whether a compulsion is performed. Distracting myself by doing something else helped. However, even if I couldn’t really concentrate on another activity, letting time pass still had a salutary effect. Usually, when I managed to make it through fifteen minutes and would try another fifteen minutes, I was in much better control of myself when the time had passed.”

Anna then made an important observation: “Those who have compulsions can sometimes remove themselves from the place where they perform their rituals—the sink or the door. But removing oneself physically from one’s own thoughts is impossible.” Still, she has found that the fifteen-minute rule, though difficult to implement, gives her space “to stand back and assess an obsession as OCD, not as a matter of significant content.”

Using shorter periods, even one minute or thirty seconds, is perfectly acceptable, especially in the beginning. The key is to keep making mental notes and Relabeling: “This is just OCD—nothing is really wrong.” By conscientiously turning her thoughts to other matters, Anna learned over time that she was able to resist her urges to ask her poor, beleaguered boyfriend all those crazy questions and to Refocus away from her OCD thoughts and urges, rather than to pour more energy into them, as she had done before treatment. Consequently, the intensity of her OCD attacks diminished. “Over a period of months, these small gains added up to a significant improvement in my mental health.”

Although she still has the obsessions and compulsive urges to a greater or lesser extent, depending on the stresses in her life at a given time, Anna is now “more likely to let OCD thoughts wash over my brain, rather than allow them to seep in and infect my whole thought process. For example, almost every time I see a sharp knife, a strong, intrusive thought or picture comes into my mind.” (Her
obsession with knives was totally unrelated to her jealousy obsession.) “Completely involuntarily, I envision the knife slicing through my own flesh, and this vision is vivid enough to cause me to wince. Or, if someone is in the room with me, I have the thought that I am stabbing that person. But because I now know that these are simply unwanted, and basically senseless, thoughts, I just let them go by without trying to figure them out, as I once would have done. I don’t let them ruin my peace of mind. My success in implementing the Four Steps increased quite a bit as I gained confidence that I could prevail, rather than give in, when OCD attacks strike. I am not free from OCD, but most of the time I manage it, rather than allow it to manage me.” This is a great description of applying the principle, “It’s not me—it’s the OCD.”

Karen, the compulsive hoarder, also found that Refocus is one of the most helpful of the Four Steps. She advised, “Do something you like to do and get involved in it. Plant an herb garden. Read a short story. Arrange some flowers. Go Rollerblading. The compulsive urge will pass if you can redirect your attention and behavior. If it does return, it may not be as strongly compelling. Again, do another behavior. It works! I use this technique when I encounter a garage sale or an attractive trash can. If I can stall the compulsion long enough, the sale will be over, and someone else will have taken the trash-can item. More likely, however, I’ll be tired, and the urge will have passed.”

As your behavior changes, Karen promises, so will your attitude. “The taste of each success has a unique sweetness, and it urges you onward to further success. You know you can do it this time because you have done it before. Your whole outlook changes from negative to positive, from darkness to light.”

After two years of cleaning out and tossing out, Karen and her husband are about three-fourths of the way to a junk-free home. And she now knows the huge satisfaction that comes from having a tidy house and a pretty yard—and feeling free to invite friends over to share them. But, she says, “I got an even greater reward. Somehow I went over an invisible line in my mind and told myself, ‘I am going to beat this thing.’ And that’s the real jackpot. The promise of behavior therapy has come true. The old, disturbing thoughts and
feelings that make me want to hoard may reappear—I’m sure they will—but they will never again have the same power over me. The fruits of success and self-confidence are much sweeter than the false promise of future security that the stockpiling of material things gave me. I have the tools of behavior therapy, and I have the power of the belief in a God who cares what happens to me. That thought comforts me and gives me strength.” Karen—the new Karen—has started a small business. She is successful and forward looking. This is the power of faith based on personal knowledge and experience!

DON’T WORRY, YOU WON’T DO IT

One thing our patients at UCLA learn early is that no matter how real their obsessive thoughts with dangerous content may seem, they will never act on them.
No one ever does anything morally objectionable because of OCD
. Lara, whose obsession about doing some violent act was so strong that she was terrified to pick up even a butter knife, now understands, “I have never acted out an obsessional thought that would harm anyone. I will not, nor do I want to. It is repulsive to me. I know I have control over the thoughts and urges, no matter how strong or disruptive they become.” It’s important to remember: OCD cannot take over your will, certainly not in a way that would make you do something you believe is wrong.

Lara has also learned the cardinal principle of behavior therapy: “The harder I fight to make the obsessions go away, the stronger they get. So I shift and reframe my thoughts. I try to focus on something else—a project, a book, a television show. I shift my thoughts, alleviating the symptoms. If I can redirect my behavior and energy onto another path, I can usually get on with another task.” When her obsessions worsen, Lara tends to feel sorry for herself, thinking she no longer has any control over them. “But then I shift. I call someone, I start cooking, I go to the gym. I am not always successful in being able to shift my obsessional thoughts. Sometimes I just have to ride out the storm. The obsessions are difficult to walk away from. They stay with me wherever I go as ‘added baggage.’ So I must work harder not to pay attention to the obsessions.” Again, Refocusing your attention on something else, even for brief periods, can be very
helpful with bad obsessions, if only to prove to yourself that the bad thought doesn’t have to totally leave your mind before you can Refocus. This is what I mean by “working around” it.

In Lara’s case, there is an interesting dichotomy: Although compulsive shopping is one of the compulsions with which she struggles, she will sometimes use shopping as a way to divert herself from her disturbing thoughts or urges. “I will go out to get out of the house, to be busy. I’ll go shopping basically because I don’t want to come home and be alone with my obsessions, because I know they’ll get worse at home. If I’m out, looking around, I can quell them a bit.” In essence, she is Refocusing away from her obsessions.

For Carla, whose awful obsession was that she was going to murder her infant daughter, the Four Steps are now so automatic that “it’s like writing my name or drinking water. When you keep doing them on a constant basis, all day, it automatically clicks, like a light-bulb going off. It’s the greatest defense.” This is when the transmission in the brain starts to become automatic again.

Keeping busy is part of that defense. Carla is on the advisory board of her daughter’s school and collects clothing for distribution to the needy. “When you do these positive things for people,” she has learned, “it gets you off yourself. It doesn’t make the OCD go away. I will not tell anyone that I do not have OCD. I still have OCD. I take medication every day. But there are so many things other than OCD, and I want people to understand you have a life beyond OCD, and you deserve that life. Don’t think you’ve done something bad or horrible or maybe God wasn’t with you when this thing, OCD, happened to you.” This is a beautiful example of the kind of spiritual acceptance that makes all aspects of the Four Steps work better.

Jill, who had terrible fears about contamination and would “alcohol” her entire house, also learned this vital lesson: “When I’m not working, my OCD gets worse because I have more time to let it get worse. The busier I am, the healthier I get.” Now that her OCD is under control, she is “ready to get back into the mainstream.” Before she took time off from working to get treatment for OCD, Jill had been a real estate agent. At that time, it suited her needs; the flexible hours gave her time to take care of her disease and to cope
with rearing her two daughters, who are now young adults. Today, she thinks she is ready to “do something more creative.” It’s a big leap forward for someone who was once so overwhelmed by her OCD that she couldn’t leave her house and literally had to clean the air that she breathed with alcohol swabs.

Gary had been plagued since his teens by intrusive thoughts that told him to “strike out” at people with whom he might be talking or to make rude and inappropriate remarks to them. Of course, he never acted on these weird thoughts. As we’ve learned, people with OCD never do. Nevertheless, the thoughts were ruining his life. As he worked diligently at doing the Four Steps, with low dosages of medication as his waterwings, Gary was able to Refocus on other behaviors for gradually increasing periods. Assiduously working around his OCD thoughts, he found that he was spending less and less time repeating senseless phrases in his head and doing other compulsive rituals that he had once thought were the answer to making his violent thoughts go away. Gary’s social life began to improve as he became more confident that he could cope with the bothersome thoughts when they intruded while he was talking to others. In fact, he used social interaction itself as a Refocusing tool. He made new acquaintances and became friendlier with casual acquaintances at work. After fifteen months of behavior therapy and medication, Gary was able to get off medication. No longer fearful of letting anyone get close to him, he is dating for the first time in years. And as part of his Refocusing, he is doing volunteer work for AIDS Project L.A.

Joanne, who at one stage was “coming unglued” as a result of the dark, brooding thoughts that smothered her, remembers clearly the day when she experienced for the first time the sensation of having her mind “move on,” get unstuck. This is the awareness of the brain unlocking. Until then, she says, “I had no concept of how that felt; my brain had no idea how that felt. Everyone is always saying, ‘Live in the moment,’ but that’s hard to do when you get stuck in that moment. I’ve learned that, for me, time cannot stand still, even for a moment. Now, I always try to keep moving forward.” Today, she says, “My life is so different. From the outside, I probably haven’t changed much. No one knew the torment going on in my brain. But
now I have joy, I can focus on the things I want to do, I can be who I was meant to be. I can live a life! When the dark voice inside starts to bother me, I know what it is. I Refocus on something else and tell myself to move on. I have been given the tools to help myself, to have control over a voice in my head that was destructive and affected everything in my life.”

What Joanne has learned is that she has mastery and control over her OCD. If, early in treatment, people can be taught to Refocus, to ignore their intrusive thoughts by working around them—for even a couple of minutes to start—it gives them some sense of control. This sense of mastery and control is very helpful and important, and it is to be reinforced and encouraged. In the beginning, even extremely small steps are meaningful. This is how people learn that it is not necessary that they fully control the intrusive thoughts or totally remove them from their awareness to make significant functional progress by doing behavioral therapy. The big effort it takes to make a very small Refocusing step in the beginning will be enough effort to make a large step later on. The same effort yields greater results as time goes by, because your brain is changing as you work at the Four Steps.

Jenny, who for years has battled numerous obsessions, including one that nuclear radiation was going to jump off her and onto others, is now able to put all this in proper perspective and even make light of the avoidance techniques she once used to deal with her OCD. At one time, she developed a not uncommon obsession that she had struck and killed someone while driving. Her attempt at a solution? She simply decided not to own a car. “I would make up stories—‘I can’t drive at night because my eyes are bad’ or ‘I’m too broke to own a car.’” And her checking compulsion? Well, because she couldn’t bear to look at other people’s stoves—the knobs might be a tiny bit askew—she found a way to avoid that neatly, as well. “When I went to parties at other people’s houses, I would avoid the kitchen by bringing a dish that you didn’t have to heat up.” Of course, none of her symptoms abated until she faced up to her problem; called it OCD; and then Refocused on other, positive behaviors. She learned behavior therapy as an outpatient at UCLA and later, in my weekly therapy group, was introduced to the Four Steps.
Although Jenny still has “a little mixture of all the classic OCD fears,” she is now able to “just kind of move on” when the feelings strike. She has a good job and a lot of friends. She drives a car. And she can bring a dish that needs to be heated. And, she says, “I feel I can move anywhere in the world and go on to different careers.”