My Personal Journey with OCD

Before, During, and After Cognitive Behavior Therapy
By Nancy Mason

When I was nineteen years old I worked in a chemical plant in West Virginia. At the time I was feeling very depressed for various reasons, mainly because I could not afford to go to college like my friends. Suddenly I noticed that I had an urgent need to recheck whether or not I had flushed the toilet at work. I began to obsess about whether or not I had paid a bill, or about a white lie I had told. I barely slept and had to quit work. My mother kept taking me to our family doctor, who sent me to the local psychiatric ward to be evaluated since he could not find a cause for my illness. While there, I was so scared and I started to cry. They put me in a straight jacket. My family doctor got me released and I went home to suffer some more. Little did I know, but my journey with OCD had just begun.

In 1969 I married my wonderful husband and later had three beautiful children. I was blessed that during all of those years, while raising my kids, intrusive thoughts did not plague me. I had an occasional thought or felt like reaching out to touch someone in the grocery store. I thought it was because I was homesick. My husband was and is very supportive of me and my thoughts. Even before we knew it was OCD that I was suffering from he told me “everyone has awful thoughts sometimes.”

In 1984, after a surgery, I went into a clinical depression. I barely slept or ate. I knew I had to do something, so I went to the psych ward of a local hospital in New York and stayed there for six weeks. It was the hardest thing I ever did but the best thing, too.

After leaving the hospital I worked with a doctor to start going off of an anti-anxiety drug, but I started to notice that normal behavior like being careful around a pair of sharp scissors turned into thoughts like, “What if I picked them up and stabbed someone?” or “What if I stabbed my dog with a knife while unloading the dishwasher?” I was confused because I knew I loved my pet and that I would never want to hurt her. My life became a nightmare of harmful and sexual thoughts. These thoughts were everywhere – I might run over someone with a car, touch someone inappropriately, stab the dog, say the “F” word, and so on.

While I was experiencing these thoughts a doctor never actually diagnosed me with OCD or even mentioned it. A friend who was a psych nurse gave me info about OCD and thought that’s what it was. Later, my doctor agreed with the diagnosis.

Then I found a wonderful therapist. She confessed that she was not well educated about OCD, but she studied and we had a workbook to go by. I am also fortunate to have found the Central New York Obsessive Compulsive Foundation Affiliate support group in Utica, NY. The leaders of the group attended a national OCD conference around that time. They came home afterwards and told me about a form of therapy that involved making an exposure tape and writing a detailed story about actually acting out a harmful thought. I thought, “How could I ever do this?” It seemed the direct opposite of what I wanted to do, but my therapist Susan and I worked together to do it. I took my three most disturbing thoughts and used the hierarchy method. First I made a tape using my least disturbing thought, then the second, and finally my number one most disturbing thought.

I would sit by myself or with my dog and play the tape over and over, listening in detail about how I would stab the dog, the police would come, everyone would hate me, etc. The thoughts never became silly or funny or common, but habituation occurred. I got so used to hearing the tape that the thoughts lost their effect on me. I know now that people with OCD don’t act on their thoughts; instead, they react to the fear of the thoughts. I had learned a coping mechanism. I had my first glimmer of hope. Let the thoughts come!

Now I don’t run from the thoughts. I follow them through – for example, if I see a sharp knife in the dishwasher I say to myself, “Yes, I could stab my dog but I don’t want to. I’d rather play with her.” I breathe deeply and go on about my day. It is also worth noting that taking an OCD medication helped to calm down my thoughts enough so that I could concentrate on the cognitive behavior therapy (CBT).

I was fortunate that my therapist had educated herself about OCD. In 2007 she attended a Behavior Therapy Institute (BTI) run by the Obsessive Compulsive Foundation. The key concepts that she learned or that were reinforced were: 1) the importance of a patient’s treatment-readiness (working through resistance), 2) treatment-interfering behaviors, and 3) gaining detailed information on developing exposure hierarchies.

The therapy techniques that helped me the most were the exposure tapes, deep breathing exercises, keeping a journal, continually educating myself about OCD by reading many books, challenging the OCD by ‘bossing it back,’ and using metaphors to talk and think about my OCD.

I know how hard it is to find a qualified person to help with CBT for OCD. There is a desperate need for providers; psychiatrists are great to prescribe medication but few have the time to dedicate to CBT. My therapist significantly helped change my life for the better partly due to her experience at BTI. I would encourage any treatment provider to attend a BTI.