Showing posts with label CBT. Show all posts
Showing posts with label CBT. Show all posts

Friday, November 15, 2019

The girl scared of 4-letter words - (OCD story part 3)


(If you are just joining, this is a continuation of a story I'm working on about a 13-year-old girl in a very tumultuous phase of her life. It will make more sense if you read the first posts here and here and then return to this post for part three.)

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Along with my newfound knowledge of the bird, it was during these early teens that I also grew enlightened with other vocabulary in the English language, namely profanity. In the same way I grew terrified of using my middle finger inappropriately, I now had a fresh fear of accidental swearing. Though no obscenity ever left my lips, I lived in a state of perpetual worry that perhaps one had slipped through without my knowing. 

I also had a rising concern about the possibility of accidentally cursing in my head. This fear wasn’t the traditional series of events that most might imagine: stub toe and then think curse word. It was more subliminal. Now that I had knowledge of these words, they would occasionally surface from my subconscious, and run their way through the forefront of my mind like subtitles across the bottom of a TV screen. Though I had as much control over them as I did preventing myself from thinking the word “tree” when I looked at a forest, I felt excruciatingly guilty and disgusted with myself for “allowing” them to be a part of my thought life. My mind continued to taunt me, like a broken record caught on a bar I’d rather skip altogether.

Curse words and using God’s name in vain, for me, were two of the world’s greatest evils. There was little in life that horrified me more, in these naive early years of privilege, where I was shielded from life’s real and true abominations. Part of it was my legalism, but I realize now that a large part of it was also my OCD at play. I was the kid who marched around on my high horse, correcting the foul-mouthed “rebellious” girls on my city-league basketball teams, requesting they please replace their expletive choices with words like “heck” and “gosh.” From my seat of judgment, I thought I was doing them a favor. 

I remember the one and only time I ever heard my Dad say the words, “Oh my God.” It is one of my most vivid childhood memories, which now said aloud, feels laughable. In the vast array of all occurrences that could be preserved and treasured into permanent memory, mine would be about the one time my dad slipped up with his words in my presence. I say this not to emphasize the gravity of the misdemeanor in the grand scheme of things, but rather to highlight the fragility of my mental state when my OCD symptoms were at their height. Everyone (myself included), was maneuvering through a world made of up of thin shapes of glass. One wrong move could result in a total shattering. The only option was to tread lightly, stay the course, do right, be right, or be crushed beyond repair. There was only black and white, not even a sliver of gray.

We had just concluded dinner and we were in the kitchen, rinsing dishes under the glowing fluorescent lights overhead. The phone rang and I answered it in the way I had been taught, greeting the caller and identifying myself by both my first and last name. It was one of my cousins, a student at our town’s university at the time. 

“Well hello Kelsie Wilson,” he chuckled, gently jabbing at my formal phone introduction, as many familiar callers often did. He asked to speak to my dad and I obliged his request, handing the receiver over. 

I went back to the pile of dirty dishes in the sink, occupying my hands while my ears stood at attention, eavesdropping on the half of the conversation I could hear. My dad hummed in acknowledgement of what was being said for a couple of minutes and then it happened. Without warning, he said it.

“Oh my God!” 

It shattered the silence and echoed repeatedly through my head. My hands froze under the flow of the faucet and my back went instantly tense. If I had been holding a plate in that moment, I’m sure I would have released it to clatter down upon the dishes below it. It was as if all time had stopped. 

Certainly I had misheard! My dad, a Scripture-reading, Bible-believing, church-going man of God would not allow such shameful words as these to leave his lips. “He must have said ‘gosh,’” I tried to reassure myself. I was unable to handle the alternative, that my dad, the one I admired and looked up to, had disobeyed one of the 10 commandments, one I viewed to be up there with the world’s greatest evil, right in front of me. 

“He would not have said that,” I thought, still trying desperately to make sense of the situation. “He knows using the Lord’s name in vain is wrong.”

No matter how much I tried to defend him, I knew in my heart that he had indeed said the forbidden phrase. I excused myself from dinner clean up and ran to my room where I threw myself on my bed and cried. The unleashing of emotion that followed was disorienting and hard to describe. To anyone else, it wouldn’t fit the crime. But for me, it was devastating. In my extreme black-and-white-rule-following reality, I couldn’t reconcile what had happened. I was terrified about what this misdeed would mean for my dad, but more so, I was devastated and unable to handle how my image of him had been crushed. Certainly he had raised his voice and said harsh words and been an imperfect parent in all sorts of ways beforehand, but this was somehow different in my mind’s eye. It seemed more explicit and I felt sick to my stomach.

I remember my mom coming to me in my room to see what was wrong. I remember crying to her, in utter devastation that my dad would ever say such a thing. I think what startled me most was her lack of surprise. She was always one to cringe and gasp during each patch of foul language in movies and on TV, but in this moment, she seemed to be shrugging it off. How could she? Did she not realize the gravity of the sin? In her attempt to comfort me, she told me about how my dad was around a lot of people at work who used that phrase with great frequency. 

“When you are around people who say these things, they can get stuck in your mind, and can slip out without your knowing,” she told me. 

Sure, this made logical sense but was she even hearing me?! Dad had used the Lord’s name in vain! I wanted her to join me in my horror, to help me normalize and make sense of these extreme thoughts that were whipping through my mind. Instead, she held her line, acknowledged the incident for what it was, and then was ready to move on. In retrospect, totally unbeknownst to both of us, her response was likely my first dose of Cognitive Behavioral Therapy (CBT), a form of psychotherapy now widely used to treat patients suffering from OCD.  

I am uncomfortably aware of the black and white, judgemental nature of my thinking here in this story. I hesitated in sharing it because now it feels so shameful. It is difficult to imagine ever viewing a situation as severely as I did. But, with my dad’s permission, I’m sharing it now because I think it so clearly illustrates the extreme rigidity I operated under. My mind could only see the world via a lens of two options: right or wrong. There was no space for gray. What I was suffering from was a specific and extremely messy form of OCD known as Scrupulosity, which I will dive into more thoroughly in future posts. Stay tuned.

Tuesday, June 19, 2018

The Slog



Hi oh faithful reader! So much for that nutrition series I promised, eh? What? You have no recollection of said series? Forget I said anything then. For the two of you that might still be waiting for the series to materialize, I must be honest and say that it ain’t happening. At least not right now. I was on a roll for a hot second (three posts – ha!) and then I fell off the wagon. In the most positive of ways one can fall off a wagon, I would argue. Technically, I guess you could say I jumped.

The old me would have powered through my verbal commitment to the internet, made the arrangements, written half-heartedly and pushed myself to the point of resentment (of whom, I’m not entirely sure) to pull off the promised series. But then I would have felt annoyed and unfulfilled because my energies were needed elsewhere, and I found myself experiencing a heavy sense of obligation, even if entirely self-induced.

I teetered on the edge of the wagon for a good long while, fighting the inner voices that screamed that not following through on a writing series that NO ONE HAD ASKED ME TO DO somehow made me a failure. Totally crazy, I realize (spoiler alert: I’m in therapy – but we’ll get there….)

Anyhow, I battled those self-inflicted negative thoughts of failure and eventually stocked up enough grace for myself to don my knee pads and jump off the wagon ON PURPOSE, intentionally trading my laptop and my promised writing series for a bedside table towering high with novels that I have been reading as if my life depended on it.

So that’s where I’ve been. Reading my novels and entertaining my 4-year-old whose preschool began their “summer” break WAY earlier than his mother feels was necessary. But I digress… It still bothers me that I didn’t finish the writing series but I’m sitting with it (which I’m told is all a part of the process). I say all this not to justify my absence but rather to give permission. For some of us, the harder choice is to say no to productivity and yes to this life-giving thing called rest. (You all know who you are).

Back in December, I began a new kind of therapy which I’ve eluded to in some of my recent posts. Graham and I did some significant work together with a couple’s therapist but then determined there were some issues that needed to be addressed individually before we could continue to move forward. There are many, many layers to the struggles I (we) have experienced, but one significant contributor that I bring to the table is my anxiety. I don’t suffer from the panic-attack-fearful-of-flying kind of anxiety, but rather, a form that presents itself as intrusive thoughts that can literally consume me if not held in check. Our couple’s therapist provided me the verbiage that these thoughts “torment” me and I can think of no better way to describe it. So, I’ve been engaging in some pretty hard work the past 7 months to kick decades of anxiety struggles to the curb. Or at least out of the driver’s seat. At this point, I would consider even that a win.

My individual therapist (who specializes in anxiety and trauma) uses a method called cognitive behavioral therapy (CBT) and, to be totally frank, it sucks. Which is one of the reasons establishing times to REST and creating MARGIN in my life has become of utmost importance. There is just no way around it: the process is dang tiring. Part of the reason for this is because it pushes you out of your comfort zone in about every way possible. It is no secret that I like a plan. Give me a verbal prescription of what you want done, exacting in detail, and I will not disappoint. When I began CBT, I came in with a list, an agenda of all that I wanted to accomplish. I was ready to get down to business and “get it done.” I would leave my appointments asking, “What is my homework for this week? What should I be working on? What do I need to be doing to achieve my goals?

My therapist saw right through this piece of me and seized the perfect opportunity to make me sit in the gray. Some weeks, she INTENTIONALLY didn’t give me homework. She let me carry the sessions all over the place ON PURPOSE. There was so much less structure in our times together than I’d envisioned. I found it super annoying and remedied these feelings of discomfort by labeling her as incompetent. Certainly, she was unskilled, and the problem was her inability to “keep us on task.”

As it turns out, she knew what she was doing. And I hate being wrong.

I don’t have a check-box therapy plan (so frustrating). There isn’t a map showing how she plans to get me from Point A to Point B (infuriating). The process has been very organic in nature (drives me literally bonkers). But now I’m started to see it. She’s pushing me. Testing me. Stretching me. Forcing me to be okay when things aren’t black and white.  

It’s awful.

And at the same time, it’s good.

Because the process has been so ALL OVER THE MAP, I often feel like I have no barometer on which to measure myself to determine if I’ve made any progress. It’s been hard to know if I’m “getting anywhere.”

This past week, we paid our couple’s therapist a visit for the first time in 8 months to “check in.” She's been in our lives for awhile now. She knows where we started, knows what I looked like before I began this most recent journey into therapy. I went into our time together wondering, Had I made any progress with my beasts? The appointment itself didn’t provide this feedback, which I found hugely disappointing. But a follow up session with my individual therapist, who collaborates with our couple’s therapist, provided the affirmation I needed. She shared the following observation that had been passed on to her: “Kelsie appears visibly stronger.”

VISIBLY STRONGER! I can think of no better praise right now.

What do these words do for me? They help me see that all this yucky-feeling unknown I’ve pushed through, all these sessions that have felt all-over-the-place have actually been doing something. I’m not following a check box, step-by-step plan (at least not that my therapist has shared with me) but it is working. My intrusive thoughts have diminished by at least a fraction of a hair. If not twice that! Or more! I now have an answer for all those times where I’ve left a session wondering “Did that really accomplish anything?” Maybe not in that immediate moment. But in the long term? Absolutely.

And my sitting on the couch reading novels instead of “doing something more productive”? This practice has held an important therapeutic role too. I’m learning to chill. I’m learning to let go. I’m learning to NOT function out of anxiety and spend my hours writing the thing for the people who didn’t even ask for it and DON’T EVEN CARE. I’m no longer operating solely under the dictatorship of those intrusive thoughts. Has it been easy? Heck no. Does it seem counterintuitive that my BEST THERAPY right now might actually be to quit doing and simply put my feet up and indulge myself in a novel. Yep. But it’s working! And that gives me such hope.

So, what does reading all this offer you, the reader, beyond just a bird’s eye view into some of the juicy details of my life? (We all love a good juicy detail - send me yours when you have a sec – j/k!) I know that some of you are in a process that isn’t fun. You might be working toward something, working on something, stuck in the middle of something, enduring something. You might be in a place where it is difficult to see the forest for the trees. The process might be feeling hard and ugly. And you might be wondering whether it’s still worth it to continue.

I have a friend who often reminds me it’s the middle that’s the hardest. The middle is the place where you could just as easily fall back from whence you came as exert the hard push needed to make it to the finish. The middle is the point where it’s most tempting to give up on progress and abort the mission.

I know the feeling. I’ve been there countless times. My word for the year is HOPE and I hadn’t had much of it until this past week. But God is meeting me here in the middle and, through the affirmations of others, reminding me He never left my side. 

I pray for the same for you. I pray that wherever it is that you are working or waiting or longing or hurting, that you would see glimmers of hope shining through the trees as you try to get a visual on your own personal forest. That you would see God showing up along the way. Stay strong and stick with your slog through the middle. Don't be afraid to do the work, no matter how much ugly it brings up or how awful it feels. You are in process and there is light at the end of this mess.

Friday, April 20, 2018

Bravery like birds


I hug her one last time, kiss her cheek, and whisper in her ear that she’s brave. In her eyes, old tears dried at the corners, I see fear, and it pains me. I bite my lip, send up yet another silent prayer, and turn my back and walk away. I feel like a mother bird, pushing her young offspring out of the nest, wishing, hoping and praying that she will open her wings and realize she can fly.

They, the ubiquitous “they,” always say that having kids is like watching your heart walk around outside of your body and I had never understood exactly what they meant until recently. In so many ways, she’s my mini-me. We think alike, we view the world the same way, we share similar struggles. I know the feelings of fear and dread that knot in her stomach this morning, all the emotions raging within, her mind that spins with tormenting thoughts, distracting, wholly consuming.

Her goal today is to get in trouble at school. There are many things we say and do in parenting that we never anticipated. Please take that rock out of your nose. Stop licking your brother’s toes. But asking my child to break a rule? This is unchartered territory, not the advice I’m accustomed to reading in the pages of parenting books. Specifically, we’ve instructed her to disregard her classroom rules and get up, walk over to the pencil sharpener and begin sharpening her pencils during a time when her classmates are seated on the floor and listening to a lesson. She is to stand there, toying with the pencil sharpener and creating a ruckus until her teacher calls her back. This is our baby step toward facing her fear of “getting in trouble.”

It’s counterintuitive and baffling, especially for me, a fellow rule-follower to the Nth degree. She and I, we care so much about what other people think. We’ve lived our lives boxed in on all sides by the opinions of others, desiring perfection, wanting to be found satisfactory. Because alas, on most days, we catch ourselves assessing our worth as based upon what we do, what we have, and what other people think of us.

It is these chains that we are trying to break today, in days past, and in the many days to come. We are undertaking what those in the psychotherapy world would term “exposures,” instances where we intentionally face situations that make us feel most anxious. And then, equipped with “coping thoughts” and strategies, we ride the waves of emotion with the goal of coming out okay on the other side, braver, stronger, relieved and very much still alive. These exercises are a part of a new approach we are taking, cognitive behavioral therapy (CBT), a practice that is believed to help individuals overcome anxiety, which is our obvious long-term goal.

All morning, I’ve watched her. I know exactly how she is feeling. It’s written all over her face. I know she will think of nothing else until the triggering deed is complete. I know how it will consume her, how she will think, rethink, overthink and then begin the cycle again. She will obsess over how and when she should approach the pencil sharpener. Should she jump up and run to it right away after her classmates are settled on the carpet? Should she wait until five minutes into the lesson? What if her teacher asks them to bring pencils to the carpet? What if it makes sense to go and sharpen her pencil during that time frame? Will the exposure be void? What if her teacher never asks them to go to the carpet? What if she can’t get the pencil sharpener to work? What if her teacher never calls her back from the sharpener and she stands there sharpening for 15 minutes? What will others think of her?

We rehearse and discuss all morning long. She is plagued. She cannot fathom how this pencil sharpening ordeal will go down without an eternal stamp of embarrassment tattooed across her forehead. She can’t get outside of the situation and see it for what it is. It feels so life-altering.

Experience tells me this is how the morning will go down: she will walk over to the pencil sharpener and her teacher will say a simple “Hey, can you please join us at the carpet?” And then it will be over. All this anxiety over a situation that lasted a grand total of three seconds. No “behavior slip” with her name on it. No trips to the principal’s office. Her permanent record with remain unmarred. Her teacher will still like her. She will not lose any friendships over this. Her friends probably won’t even notice that she was missing at the carpet and they most certainly won’t remember the situation in two minute’s time.

It’s easy being the outsider looking in, but to be the one experiencing it? I’ve been there countless times before and I know it’s the pits. I can hardly stand it, knowing I am pushing my child to do this. Yet I know it is for her best. How often have I obsessed over similar circumstances?

We have been attending an anxiety group “for our daughter” and meanwhile, I catch myself frantically taking notes for me. Everything they present applies to my struggles. They are highlighting all MY behaviors. They are giving voice to the way I view so many situations.
I’m like a schoolgirl on her first day of class, absorbing, inhaling information. I’ve been doing my own therapy too and it’s like all my worlds are colliding in perfect synchrony, pieces coming together and building upon each other. We learn about our inner critics, these voices that tell us we are failures, not good enough, voices that convince us everyone is paying attention and judging. We learn about positive self-talk, our own inner voice that is to replace all the negative ones. We need to create new pathways in our brains. We need to reroute our thoughts onto detours, with the goal of those detours one day becoming the new main thoroughfare. All this is taught at a child’s level, which is apparently just the level I need.

I feel EVERYTHING. I’m embarrassed that I didn’t see it more clearly before. I’m mortified that it took hearing the information presented at a class intended for my child to obtain a full grasp on it. I feel entirely overwhelmed. There is so much work to do. She’s been on this earth for less than a decade and I’ve been here for over three and here we find ourselves, on the same page. I mourn the fact that I didn’t have the tools I needed earlier to combat my anxiety, that for so long I have allowed what other people think of me to govern my life. I feel responsible. It stings knowing my daughter shares my DNA, that she struggles because I struggle. I know genetics are not my fault, but it doesn’t erase how this knowledge pains me.

At the same time, I celebrate our progress. I celebrate the ways God is working in our home and family. The Holy Spirit is moving and empowering and filling our minds and teaching us the way HE views us. More than ever before, we are learning to view ourselves as “fearfully and wonderfully made.” We are countering our negative thoughts about ourselves. We are replacing them with words of worth. We are learning to let go of the opinions of those around us. We are breaking the rules. We are living on the edge a little. Well. The “edge” for us anyways.

And, by the grace of God, we are being pushed from the nest and realizing, Hey. We might just have wings to fly.

This, my friends, is bravery.