7:00am – Alarm goes off.
7:01am – Inner Dialogue begins: “You are a horrible person. Seriously? Who let you be a father? You know you’re a monster, right? No one else would ever think those things. Only sick, demented people would think the thoughts you’ve thought. YOU. ARE. A. MONSTER. I can’t believe you can live with yourself. Everyone knows what kind of a person you are – they all know the real you. You are sick and probably the only person in the world who’s had those kinds of thoughts.”
This was the inner dialogue I experienced every moment I was awake from the end of September 2014 through March 2015.
This was my hell.
In March, through a combination of the MMPI psychological exam, a psychologist who was at the right place at the right time and my decision that I needed to talk, I learned I have Primarily Obsessional Obsessive Compulsive Disorder.
A Primer on Intrusive Thoughts
Let’s get one thing out of the way at the beginning. OCD manifests itself in many ways – but for me, it’s not like I had to wash my hands for 30 minutes or check things repeatedly or avoid opening doors in public. Those are some of the common compulsions people’s obsessions drive them to do.
The form of obsessive compulsive disorder I have is called Primarily Obsessional OCD (or Pure Obsessional, or Pure-O OCD). It means I don’t have compulsions I need to perform, but I place an unrealistic amount of significance and power in random intrusive thoughts.
I have found the Wikipedia description of Pure-O to be a helpful summary of this type of OCD:
The nature and type of primarily obsessional OCD varies greatly, but the central theme for all sufferers is the emergence of a disturbing intrusive thought or question, an unwanted/inappropriate mental image, or a frightening impulse that causes the person extreme anxiety because it is antithetical to closely held religious beliefs, morals, or societal mores. The fears associated with primarily obsessional OCD tend to be far more personal and terrifying for the sufferer than what the fears of someone with traditional OCD may be. Pure-O fears usually focus on self-devastating scenarios that the sufferer feels would ruin their life or the lives of those around them. An example of this difference could be that someone with traditional OCD is overly concerned or worried about security or cleanliness. While this is still distressing, it is not to the same level as someone with Pure-O, who may be terrified that they have undergone a radical change in their sexuality (i.e.: might be or might have changed into a pedophile), that they might be a murderer or that they might cause any form of harm to a loved one or an innocent person, or to themselves, or that they will go insane.
They will understand that these fears are unlikely or even impossible but the anxiety felt will make the obsession seem real and meaningful. While those without primarily obsessional OCD might instinctively respond to bizarre intrusive thoughts or impulses as insignificant and part of a normal variance in the human mind, someone with Pure-O will respond with profound alarm followed by an intense attempt to neutralize the thought or avoid having the thought again. The person begins to ask themselves constantly “Am I really capable of something like that?” or “Could that really happen?” or “Is that really me?” (even though they usually realize that their fear is irrational, which causes them further distress) and puts tremendous effort into escaping or resolving the unwanted thought. They then end up in a vicious cycle of mentally searching for reassurance and trying to get a definitive answer.
Invisibilia, a new NPR podcast, began their season with an episode called The Secret History of Thoughts. In the segment below, called Dark Thoughts, they detail what life can be like with those who have this form of OCD. You can listen to it below.
Have you ever been driving down the expressway, and wondered, “What would happen if I yanked up the emergency brake right now or swerved into a semi?” Or maybe you’ve thought, “I wonder what it’d be like to drive off this cliff right now?”
Perhaps you were watching a violent movie, and after one especially gruesome scene, the thought crossed your mind, “Could I do that? I guess if I had to, I could…” Maybe a random thought popped into your mind about hurting yourself or someone close to you.
Or maybe you caught yourself having a sexual thought that struck you as especially perverse. You didn’t know why you had the thought, but somehow it got in your mind.
These are called intrusive thoughts.
Everyone has them.
For folks who do not have OCD, those thoughts pop into their minds and pop right out. A disturbing thought might materialize, but then they think, “Huh! That was weird…oh well,” and it’s gone.
For those with OCD, the intrusive thoughts and the rumination that accompanies them, can cause anxiety, depression and can be paralyzing for sufferers when they try to stop thinking about the thoughts. Thought-suppression never works and makes the OCD worse.
Last September, I was home with Caleb while Sarah was out at a meeting, and all of a sudden, I had a couple thoughts pop into my mind that involved hurting Caleb.
Intrusive thoughts. Random thoughts that just popped into my mind…but as the evening went on, I couldn’t stop thinking about those thoughts, and began to try and figure out what they meant about who I was.
Believing the Lie
The next few days, I was running errands, having lunch out, getting groceries, and everywhere I went, I looked at people and thought, “They must know. They must know that I’m a horrible father. They would never have these kinds of sick thoughts. I’m sure they’re good people – and I’m the one who is a monster and a horrible person.”
That narrative began to run on repeat in my mind throughout the day. The anxiety I felt manifested itself physically, and I experienced shallow breathing – feeling like I could never quite catch my breath.
The more I experienced the shallow breathing, the more I believed it was caused by the fact that I was ruminating on those horrible thoughts. And the more I believed that…the more I noticed the shallow breathing.
I longed to go to bed at night. Because at least then…the thoughts would go away for a little while. And the anxiety would lessen.
But the moment I woke up in the morning…that narrative began to play on repeat again, and the anxiety came back in full force.
I’m not exaggerating when I say this running commentary (“Adam, you’re a horrible person – a sick person – a monster!”) was on repeat in the back of my mind (and sometimes at the very front of my mind) from the moment I woke up until the moment I fell asleep. Every now and then, I’d be busy for an hour or so and realize I hadn’t been thinking about the commentary…and then it would be back.
When you hear yourself say those things all day, for months on end, it’s hard not to believe the lie.
It can be debilitating.
The more I listened to, and believed in, the narrative in my mind, the more I believed I truly was a horrible person.
I’d be driving home from work, listening to NPR, and I’d hear a story about a serial killer. As I’m listening to the story, my mind would start asking questions like, “Could I be capable of becoming a serial killer? That could be me, couldn’t it? If I had the thoughts I did, becoming a serial killer couldn’t be that far off.”
Or I’d check Twitter and see a Breaking News alert about someone who was a child abuser. My mind would think, “That could be you, Adam. That could be you.”
I avoided listening to NPR, tried to not read Breaking News tweets…all to stop providing my mind with any additional fuel for the fire in my head, that is obsessive compulsive disorder.
But it was the running commentary that was the hardest.
Trying to Find Help
I initially only told my spiritual director. It was difficult to speak the thoughts I had and share how I was feeling about myself. He listened, was full of grace and helped me become aware of just how hard I was being with myself. He encouraged me to go for a walk on the beach and write out a dialogue between myself and God…as I’ve gone back to read those dialogues, it’s pretty sad. I was at the end of my rope.
Telling someone felt good, and I knew I should find a therapist. But I was terrified to meet with a therapist, because I had this fear that when I told the therapist what had been going on with me, that they would call Child Protective Services and they would take Caleb away.
I understand now this was the OCD at work. I couldn’t distinguish between the random intrusive thoughts and actual, concrete actions. I knew there was no way I was going to hurt Caleb, but for some reason I equated thinking a thought with carrying out an action.
I did find a therapist…and met with him 6 times…with little to no improvement. He thought I had some type of general anxiety disorder – and never once did the possibility of OCD come up.
The Initial Diagnosis and Therapy
This past March, as part of a vocational consultation program, I took the Minnesota Multiphasic Personality Inventory (the MMPI). The MMPI is a test that consists of 567 True/False questions like these:
- I am easily awakened by noise
- There seems to be a lump in my throat much of the time
- I am sure I get a raw deal from life
- I have often wished I were a girl
- My soul sometimes leaves my body
- I think playing with fire is interesting
- I like to hurt animals
When I met with the psychologist to go over the results of the MMPI, it showed that I was off the charts in three areas:
- Depression: That much was obvious to me. It had been a rough fall. The same week I first had the intrusive thoughts that started everything, I received a less-than-glowing annual review after being at my church for about a year.
- Repression: The MMPI could tell I was trying to repress something. The psychologist asked, “Do you have any idea what that might be?” I was silent for a minute and said, “Yes…I know what it is.”
- Negative Thoughts About Myself: Again, no surprise given that things were not going well at work, and I was convinced I was a horrible person.
Receiving a diagnosis helped me understand what I was dealing with, and it helped me separate myself from my thoughts.
Getting Help and Educating Myself
A month or two before the diagnosis, I had decided it was time for some pharmaceutical help. After trying a few different SSRIs, I ended up on Zoloft. That helped, but it was just one part of what I was going to need to do to make strides in coming to terms with having obsessive compulsive disorder.
I started telling people. Sarah, my sister and parents, my doctor and a few good friends. It was hard to figure out who to tell and who not to. And I know there will be some who I wanted to tell in person who will find out by reading this blog post. It felt good to share with friends and family, and to receive their grace and understanding.
I lucked out and found a great therapist. He has helped me learn more about my OCD and how it has affected my life. I’ve been in weekly therapy since March, and it’s been one of the best things I could have done.
I’ve attended a few OCD support groups, which have been interesting and helpful. At first, I looked around the small room while listening to people share some intense obsessions and compulsions, and I caught myself thinking, “Gosh…these people are really fucked up.” But then I would share, and they’d all nod their heads, knowing exactly how my mind was trying to mess with me. I remember thinking to myself, “These people get it. They know what it’s been like for me these past six months.”
I’ve been reading a lot too. One of the best books I’ve read is called The Imp of the Mind, by Lee Baer. The author refers to OCD as an “imp,” and that image has been helpful for me. I picture this imp, this little devil, trying to convince me that things that are false are true, and trying to mess with my mind. Baer also describes OCD as a cognitive error:
“This cognitive error occurs when we conclude that simply because we have a particular thought, it must be meaningful. Similarly, we may conclude that simply because we are thinking about something, this means that it will actually happen. If we have this mistaken belief about the importance of thoughts, we may start to believe that we have to exercise complete control over all our thoughts (which unfortunately, as we have seen, is doomed to fail).”
Accepting that I have OCD, that I have a “cognitive error” or brain disorder, is hard. But acceptance is necessary because OCD wants you to try and fight with it, the imp. The OCD wants you to try and outsmart it, or prove that it’s wrong…and you’re never going to win against an imp.
In addition to cognitive behavioral therapy (more on that in another post), research has shown that mindfulness meditation can, in fact, retrain your brain. Over the last four months, I’ve entered the world of self-help books and podcasts, mindfulness meditation, yoga and more. Combined with weekly therapy, and drugs, I’m in a much better place today.
A few weeks after the diagnosis I told Sarah I felt better, that I felt like a somewhat normal person again. I asked her if she could tell any difference. Her response was something like: “Yeah. You were a shell of a person there for awhile.”
And that’s what it felt like. I went through the motions, doing what needed to be done, taking care of Caleb and handling my responsibilities at work, but I wasn’t really there at all.
And specifically with Caleb, during the six months of my hellish reality, I could tell I was drawing away from him. We did things together and we had fun, but I didn’t feel present with him. And how could I? I had this idea in my mind that I was a horrible father, and maybe it was unsafe for him to be around me.
I still don’t feel like I’m “back to normal,” but I’m in a much better place.
So, Why Tell Us?
I wasn’t sure I wanted to write this post.
And even as I hit publish in a few minutes, I’m not entirely sure I want to.
But in the end, I think it’s important to write and share this post.
It’s hard for me to find words to describe what those six months were like (although I’ve tried in this post). I didn’t understand what was happening to me, and there were a few occasions when I thought to myself: “If I died…the thoughts would stop.”
I never made a plan, I never got any further than just that brief thought. But still, I’ve never before had suicidal thoughts.
And yet the OCD, and the anxiety and depression that came with it, led me to a dark place.
I wrote this post for two reasons: I wanted to share my experience and do what I can to help raise awareness.
The first reason is primarily self-serving: telling people about my OCD and writing about it (first through journaling and now publicly through this blog) helps me to feel more in control. Sharing about this with others helps me to accept the OCD; but it also helps to separate myself from the intrusive thoughts and the OCD. I am not my thoughts has become a mantra of mine, and talking and writing about the OCD allows me to take a more objective look at it.
But I also want to help raise awareness. There is a gentleman in the support group I attend who is in his 60’s and has had OCD for the past 40 years. It’s only been in the past couple years that he felt he could seek out help, and the only person in his life that knows what he’s been going through is his wife. It’s been very difficult for him.
Studies find it can take an average of 14–17 years from the time someone first experiences symptoms of OCD to seek out appropriate treatment.
I know now that while my 6 months felt unbearable, many people suffer for years and years without seeking help. My hope is that if anyone were to come across this post, and recognize some similarities between their story and my story, perhaps it would help them feel more confident in seeking out the help they need.