Reflections on Therapy Part One

I first entered therapy when I was eleven. I started seeing a child psychiatrist for OCD (obsessive compulsive disorder) and GAD (generalized anxiety disorder), both of which made day to day functioning impossible. My psychiatrist was a young woman (I said I would only see a woman as some of my obsessions were sex related and I was very ashamed). She had a nice office with toys in the corner for her younger patients. We worked together on my anxiety and I wish I had written more down because I don’t remember all the techniques we worked on together. I know we did CBT (cognitive behavioral therapy) which functions on the premise that by changing your thoughts you can change your emotions and behavior (the three work together in a triangle). Of course OCD doesn't really work with reason so this didn't always help. 

Exposure prevention therapy is like the holy grail for OCD. Basically you are exposed to what bothers you until it upsets you less and less.  We did this with several things. I had several food phobias because I felt they were “contaminated”. These included mustard, mayonnaise and (this one might surprise you) cheese. I made a special exception for pizza and for a little while I tolerated grilled cheese. Melted cheese was somewhat safer. But consuming most cheese was unheard of. Even touching it really upset me.  I remember the session my psychiatrist handed me a piece of American cheese. My mom was there for support. I briefly touched the cheese and then had to wait five minutes to wash my hands.  I felt so unclean.  It was very uncomfortable.

I also worried I stared too much at women's breasts. I was developing my own and I did not want to make any woman feel as self conscious as I did.  My psychiatrist told me to stare at women's breasts (clothed) in magazine and on TV to expose myself to it. Here is where it might have backfired. Now I am always comparing my breasts to other womens breasts. It doesn’t matter if its a close friend or someone I just met; they get subjected to the same scrutiny and I always want mine to be bigger. But I’m not blaming my psychiatrist for that.

My main OCD symptom was checking. I checked verbally with my mom alot: “Everything is going to be okay, right?” or “You’re not mad at me, right?” or “I’m a good person, right?” Sometimes I had to check to make sure things were where I thought they were, like if my bathing suit was in my suitcase for the millionth time. We arranged a reward system so that if I went a week without checking I’d get a prize. Usually we went to Barnes and Noble and I picked out a book. The reward system was good incentive and good practice for resisting impulses.

When I turned thirteen, my psychiatrist recommended I start seeing a social worker/ therapist because she was suspicious I had a mood disorder like depression. I did have a mood disorder…only not depression. My new therapist thought I had borderline personality disorder due to my impulsive nature and fear of abandonment but she clinically could not diagnose me until I turned eighteen (personality disorders can only be diagnosed in adults in case they are just symptoms of adolescence). After my first year at college, my therapist was concerned about me so my parents enrolled me in a partial hospital program and I started to see an outside therapist named Geoff. At our first meeting, Geoff asked if I had ever been diagnosed as bipolar. My therapist, my psychiatrist and my parents all balked. No, I was definitely not bipolar.

Geoff really helped with my OCD. He told me to envision it as a person that was a fourth of my age. I was twenty at the time so this would make  her (I decided it was a her) five years old. “I can’t be mean to a five year old” I said. “Why do you have to be mean to her?” Geoff asked. This blew my mind. All my life I had been in head to head combat with my OCD. The idea of treating her like an unreasonable child was insane. And yet it worked better than fighting against the OCD. At the time I was worried I was pregnant (common OCD worry, even when there was no evidence) but I managed to talk down my OCD. After all, what did a five year old know about pregnancy? 

I completed the hospital program and returned to college for a very very rocky semester that culminated in hospitalization. I thought it would be one and done. If only I knew.