PLEASE NOTE: The following blog post contains discussion of topics that may be upsetting, including suicide. Please take care of yourself as you read this article. If you are in crisis, know that help is only a call or click away at 1-800-273-8255 or suicidepreventionlifeline.org.
Chapter 3: High school and the never ending search for perfection
My mom has always been a huge fan of Disney. We have a Mickey Mouse-themed bathroom at my parents’ house. My parents even had their honeymoon there back when they first got married. Growing up, my family would go to Disney World often for family vacations.
While Disney World claims to be “The Happiest Place on Earth,” for a kid with OCD, it can be a very challenging place to be. My family would stay in Disney for over a week every time we would go. My parents and my sister always seemed to be having the time of their lives, but it was a peculiar type of torture for me. I knew that an amusement park like that would be crawling with germs. We were eating out in restaurants for every meal, which made my anxieties around food hard to manage.
The thing that stressed me out the most was the rides. I loved roller coasters and wanted so badly to enjoy them. Even though I liked them so much, they caused me a great deal of anxiety. Rides can make people sick and I was terrified of that prospect. I knew that I didn’t have to go on anything I didn’t want to, but I still felt pressure to do everything I possibly could to have a good time. My perfectionism tended to slip into my enjoyment of experiences in this way. I constantly felt like I had to make the most of every moment, especially on vacation. I worried about ruining each experience the same way I worried about ruining a blank sheet of paper. I was terrified of regrets. I worried that if I didn’t enjoy something enough that I would regret it. That was the case with the rides in Disney World. I feared that if I didn’t go on them, I would be missing out on something and I would regret it later. Deciding to go on each roller coaster was a major battle within my mind. I wanted to go on them not only because I enjoyed them but because if I didn’t, I might regret it. On the other hand, I was terrified that it would make me throw up.
In order to make these vacations bearable, I decided to be more mindful of when I was eating. I would simply eat less during the week that we were there so that I could go on the rides without worry about getting sick. This plan would have worked if we had been visiting for a day. Eating almost nothing for a week was not sustainable. Getting me to eat on vacation was a struggle and my parents and I had a lot of fights about it. When we were there I wanted my constant feeling to be hunger so that I wouldn’t have to worry about getting sick on the rides and I wouldn’t have to worry about missing out on anything either.
The summer before my junior year of high school, my family took one of our infamous Disney trips, this time including my grandparents on my mom’s side. Though most family vacations were a struggle for me, this one was particularly difficult, all thanks to my worsening OCD. This particular trip was also difficult for my dad and his OCD. When asked to recall that trip, he says that during that time he was “spiraling.” He remembers obsessively making my whole family frequently use hand sanitizer. He says he feels guilt about that trip because he can see now how his behavior was also feeding into my OCD at the time.
During that trip, I had a little bit of a breakthrough. My family was in line for a new ride that had just opened up and everyone was excited except me. We had eaten not very long ago and I didn’t think that it was safe for me to go on a ride yet. As we got closer and closer to the front of the line, I went into panic mode. I was scared I would get sick on the ride, but I was also upset that I wasn’t enjoying myself as much as I thought I should be. I looked around at the 23 people in line around me and they seemed happy. I looked at my sister laughing with my grandparents and the way they all seemed to be enjoying each other’s company. I was too anxious to enjoy anything. I was supposed to be in the Happiest Place on Earth and I was miserable.
It was right there that I told my mom I wanted to start seeing a therapist. I decided I wanted to enjoy my life and I wasn’t going to at the rate that I was going. I finally was ready to admit that I needed help. When we got back from Florida, the hunt for a therapist began.
We were able to find a therapist near my house who was taking new patients and within a few weeks, I had my first appointment. She was an okay therapist, though she wasn’t able to recognize my OCD. Going to see her every week became something I looked forward to. It was nice to be able to talk to someone about my anxiety.
However, even with a therapist, school was always a challenge. Middle school and high school can be a trying time for any kid, let alone one with OCD. For most of my schooling, I put an immense amount of pressure on myself to be a perfect student. I would hear my classmates talking about how their parents would be mad if they got a B instead of an A. My parents didn’t mind if I got a B as long as I was trying my best. However, my best wasn’t good enough for me. I wanted to get straight As. Even further, I wanted every teacher to like me. I was constantly terrified of disappointing everyone around me even though no one was putting that pressure on me except myself and my OCD.
I spent a lot of time striving for unattainable perfection. I would spend hours in my room every night doing homework, staying up until 3am some nights. My junior year of high school I took AP U.S. History. We were each given a workbook filled with terms to define and questions to answer. I would spend hours on end doing my workbook. I would write and rewrite each word until it looked perfect.
My parents had no idea that I was struggling so much. They just thought that I got a lot of homework as an AP student. They weren’t aware that not all AP students spent this much time on their work.
Handwriting perfectionism became a major issue for me in high school. Among the many other ways I am similar to my dad, I also inherited his messy handwriting. If I write quickly you can barely tell our writing apart.
Messy handwriting was not something my OCD would allow, so by high school I had perfected my handwriting. I knew what I wanted it to look like, but sometimes I just could not seem to do it right. There was always something off. I would often slip into this cycle of erasing and rewriting until I thought it looked just right.
My perfectionism when it came to handwriting was just the beginning when it came to stressing about my schoolwork. I was in the top classes for every subject except for math. Sometimes I would worry so much about my schoolwork that I wouldn’t be able to get myself to do it. This avoidance led to more and more stress because I started to fall behind with my assignments.
Because of all of this, I had to pay a visit to my school guidance counselor, Ms. K. With her help, I was able to get accomodations for schoolwork because of my anxiety. This meant that I had extra time to complete assignments and sometimes extended deadlines. This was incredibly helpful for me, as it allowed for my anxiety to not completely take over my life.
My OCD was not recognized by my guidance counselor. Despite this, she was able to help me significantly. The accommodations I was able to get made my life much easier, though my OCD was still hindering my ability to function. Going to school became harder and harder for me. Some days I would go in late and some days I wouldn’t even make it into school at all. I had to get additional accommodations for missing so much school. My peers would ask me where I had been and I never knew what to tell them. I had so much shame surrounding my mental health challenges that I couldn’t tell them the truth.
Also during my junior year of high school, eating became increasingly difficult. I started restricting how much food I ate on a daily basis to avoid even the slightest chance of getting sick. I started by cutting foods out one by one. The first to go was meat. Meat has always made me nervous because of how easy it can be to cook it wrong and to cause food poisoning. In order to avoid food poisoning, I avoided meat altogether.
My parents noticed that I had started to lose an unhealthy amount of weight and became concerned. They decided to take me to the pediatrician to figure out what was happening. My doctor explained to us that I had an undefined eating disorder and that the goal was to get me to gain weight because I was dangerously underweight. In the following weeks, I would go to her office once a week to get weighed. Much to my doctor’s dismay, I continued to lose weight each week. In addition, my doctor prescribed me anxiety medication for the first time. I started out on Prozac.
When she prescribed it to me, she said something that has stuck with me for the rest of my life. She told me that I should be careful about who I tell that I’m on anxiety medication. She said that if people knew that I was on medication for my mental health they would see me differently and she didn’t want that to happen. I listened to her warning. The first time I had to take my Prozac at a sleepover I hid in the bathroom to take it. My doctor had instilled a sense of shame in me that made me believe that no one would understand what I was going through. I decided that I didn’t want any of my friends to know what was going on and I kept everything that was happening a secret.
I began to dread going to see my doctor every week as I lost more and more weight. She would get frustrated with me every week when I was weighed. She told me that if I didn’t start gaining weight I would have to quit my extracurricular activities. Looking back, my dad says he is glad that he and my mom didn’t enforce my doctor’s threats about taking away my extracurricular activities. My doctor saw them as a reward that I should only get if I was properly taking care of myself. My parents saw them as something that made me genuinely happy. Going to rehearsal for shows I was in or dance class were the only times that my anxiety wasn’t taking over and I actually enjoyed myself. I was frustrated because I wasn’t getting any better because I didn’t know how. She didn’t tell me anything other than, “just eat,” which was not something I could do without facing extreme anxiety that I had no real explanation for.
My parents were extremely worried about me and my new eating habits. To keep them from worrying too much about me, I hid my eating anxiety from them as much as possible. My dad would buy an abundance of protein bars for me, most of which would go half eaten into my trash can. They had no idea how little I was truly eating.
My family’s life became about getting me to eat more so I could gain back the weight I had lost. My doctor told us to focus on protein, which was difficult for me because of my newfound fear of anything resembling meat. I ate a lot of peanuts and protein shakes during that time. My mom always had a jar of nuts with her at all times, on the off chance that I would be hungry and ask for a snack. As the weeks went by and I wasn’t gaining any weight and my levels of anxiety remained the same, my doctor decided to take me off Prozac and to try Zoloft. The Zoloft didn’t help either, even after increasing the dosage.
After Zoloft failed to help with my anxiety and much frustration on the part of my doctor, she told us that she was out of her depth with my case. She said I needed to see a psychiatrist and that that might be much more helpful for me. She admitted that she wasn’t very knowledgeable about mental health and that she was sorry that she couldn’t be more help to me.
Looking back, I am also sorry that she couldn’t be more helpful to me as well. As my primary care physician, I should have been able to rely on her for information relating to mental health. It is because of this that I believe that medical doctors should be better educated on mental health. This way, problems can be identified much sooner and people who are suffering can get the help they need faster. Even within the medical community, OCD is a misunderstood illness and was not recognizable to my doctor.
My OCD also impacted my friendships in high school. After hearing what my doctor had to say about hiding the fact that I was on medication, I was terrified to reveal to my friends that I was struggling with my mental health. Occasionally I would have to leave school early to go to my weekly doctor’s appointments. People at school would sometimes ask me where I was going and I would just tell them that I had somewhere to be. I was determined to keep that part of my life a secret.
Chapter 4: Turning point
I didn’t eat much my senior year of high school. My OCD took a look at eating and decided it wasn’t something we needed anymore. In October that year, I was finally given a diagnosis of OCD. Suddenly everything made a little more sense. Why I thought the way I did. Why I did the strange things I did.
An explanation was nice to have, but that didn’t stop it from continuing to take over my life. I asked my dad what it was like for him for me to get a diagnosis of OCD. He agrees that not much changed with my diagnosis. While it provided an explanation for my behaviors, it didn’t offer any sort of plan. He says he was lured into a false sense of security that everything would somehow work itself out now that we knew what was going on.
In reality, things took a turn for the worst after receiving the OCD diagnosis. I started to notice that I was finding eating to be more and more of a challenge. I expressed this to my therapist. She said I should focus on my college applications and we could worry about that when that was all settled. I thought she knew better than I did, so I agreed. When I got home that day I tried to eat dinner and the overwhelming fear of getting sick set in again. It was then that I decided I wasn’t going to eat anymore. I would get by on eating as little as I possibly could. Enough to barely survive.
By November, I was down to a few crackers a day. I was too terrified to eat, too caught up in the “what if” of eating too much. I don’t remember much of the beginning of my senior year. I remember going through the days in a fog, not really feeling anything. I would drag myself to school when I could and come back and spend hours on homework, all on the fuel of a few crackers and occasionally a piece of bread. A lot of the time, I didn’t even make it to school. I’d stay in bed far too late, too scared to leave the house and to face the germs of high school. Even the thought of the bacteria crawling on every inch of my high school was enough to make me wash my hands over and over. My mind was on a never ending loop of intrusive thoughts, telling me to follow rules that made no sense.
As the days went by, I became more and more depressed and more and more malnourished. I was shaky all the time. I walked around the world ghost-like, all skin and bones. My face grew thinner. I looked like I was constantly sucking in my cheeks. My hands looked like those of a skeleton.
Even theater, the thing that had brought me the most joy throughout my whole life, was not enough to make me feel happy anymore. I was in a production of The Addams Family Musical at my community theater which was a group that I had been a part of since I entered high school. I used to look forward to rehearsals. Now rehearsals were just another place I had to force myself to go to, another place where I had to force myself to smile at people who asked me if I was okay or if I had lost weight. I went through rehearsals in a daze, doing what I was told to do.
About a week before we were set to perform the show, I decided I couldn’t do it anymore. I couldn’t keep living the way I was living, but I didn’t know how to get out of the spiral. I didn’t know how to ask for help. As I tried to come up with a way to ask for help, I decided that I wasn’t worth the help. I didn’t deserve to get better. I was damaged and broken. I saw what I was doing to my family and friends. They were worried about me all the time. I was a burden. I came to the conclusion that their lives would be improved without me in it. I wished I had never been born. I wished there was a way I could disappear and for everyone to forget I had ever existed. The only way I could take the pain away from the people who loved me was to leave them. I knew my death would hurt but I also knew that it was something they would eventually get over. I thought they would be able to move on with their lives without ever having to worry about me again.
I don’t remember an exact moment, but sometime during that week, in the midst of costumes and makeup and last minute dance rehearsals, I made the decision to commit suicide. Not wanting to ruin the show for everyone else, I figured I would wait until after the show had finished. Every night after rehearsal, I prepared. I thought of ways I could do it. I would scratch at my wrists with safety pins until they bled, just to see if I could still feel something. I wanted to hurt. I wanted to punish myself for the hurt I had caused everyone in my life. I had a notebook that I filled with letters to the people I loved. I wrote to my parents, telling them to forget about me and to put all their energy into my little sister. I wrote to my best friend and told him not to blame himself. I spent hours writing. That notebook became both a suicide note and a love letter to everyone I had ever loved.
Finally, it was the weekend of the show. I pushed myself through the weekend with the thought that it would all be over soon. After the second night of the show, I felt the best I had in a long time. The show had gone well and I felt the familiar high that I always felt after being onstage. I looked around at all my friends and I decided that maybe there was something to live for. I told myself that as soon as I got home I was going to throw that notebook in the fireplace and burn it.
I drove myself and my sister to the cast party at the restaurant we always went to after our last show of the weekend. Riding on the high of a good show, I told my friend she could follow me in her car. I had been to this restaurant a million times. I knew the way, so the three of us set off. As we drove on, I began to realize that the directions had gotten mixed up in my head. We were lost and late for the cast party. My sister innocently asked why I told our friend she could follow us if I didn’t know where I was going. I blew up at her and called her some nasty names. As soon as they had left my lips I regretted them. I saw her face, full of shock and sadness, the tears welling up in her eyes.
In that moment I was reminded of all the pain I caused. How much my mere existence was hurting everyone I loved so much. My decision to stay alive was short lived and ended there. I was without a doubt that that dinner with my friends would be my last. During dinner I couldn’t focus on what anyone was saying and I didn’t eat a bite. I have very few memories from that night and they are scattered. I remember my friend Alisha telling me to drink water. I remember my best friend Ed hugging me and telling me that my favorite song was playing. I remember my friend Manny driving me and my sister home and my own car behind. I watched it get smaller and smaller in the rear view mirror of Manny’s car as we drove away.
That night after I got home I couldn’t sleep. I called my friend Julisia and told her everything. The next night my dad drove me back to the restaurant to pick up my car. When I got back home, I realized my dad had beaten me home. My parents were whispering to each other and I could see that my dad was crying. I asked them what was happening. My mom held up my notebook. “What is this?” I pushed past my parents and rushed upstairs to my room. A moment later my parents came into my room and told me that Julisia had called them and told them everything. They told me not to be mad at her. I wasn’t mad. They told me to get my stuff together. We were going to the hospital.
The next 24 hours are clear in my mind. My parents and I sat in a room in the emergency room for hours. Several doctors came in and evaluated me one after another. Every few minutes, I had to run over to the hand sanitizer to sanitize my hands. With all the germs in a hospital, sitting there was my nightmare. I could feel the bacteria crawling all over me. I tried to hold my breath. At first the consensus was that I would be in a psych ward somewhere for a couple days. The more doctors that came in to talk to me, the longer they would say they thought I should stay.
After a full 24 hours of sitting in that hospital room, sleeping on a cot with my mom, and many hand washes, the doctors all decided to send me to Bradley Hospital in Rhode Island for at least a week. Thanksgiving was four days away and I would not be with my family for the first time in my life.
They took me in an ambulance to Bradley. When we got there, it was late and all the other patients were asleep. They measured and weighed me and took my vital signs and then took me to my room. My parents were crying as they left. My dad has said that leaving me that night was the hardest thing he’s ever done. He gets choked up talking about it even now. I laid in my hospital bed covered with a thin blanket and wearing the same clothes I had been wearing for over a day. I let the tears stream down my face. I felt like I should be panicking but I actually felt strangely calm. I somehow knew I was where I was supposed to be. I knew things were going to change for me after this.
Chapter 5: Navigating Exposure and Response Prevention
As my time in the inpatient program came to a close, I met with my psychologists to decide what the next steps would be. Their conclusions were that my OCD was much worse than they had originally thought. Before I came to Bradley, I had been diagnosed with moderate OCD. Now, they believed it to be somewhere between severe and extremely severe. It was recommended to me and my parents that I do the OCD intensive program there at Bradley instead of going back to school. The program was described to us as a two-week program. That sounded promising to me. I figured I’d be back to school before Christmas.
Later that day, we met with the director of the OCD program. She explained what it would be like. I would arrive at 8:30 am and do a check in with the therapists and the other kids in the program. We would do an hour or two of exposure therapy, then lunch and an activity. After that, we would complete another hour or two of exposure therapy. At 1:30 pm, the program would end and I would go home. “So I will do that for two weeks?” I asked. The director looked down at her paper and sucked in a breath. “Well,” she said, “That is the typical amount of time people spend in the program. However, in your case, I believe it will be much longer.” My heart sank. “How much longer?”
“At least a few months.”
My hopes of being back at school by Christmas disappeared. Now I was unsure if I would even be at school enough to graduate. My college applications sat unfinished on my computer at home, waiting to be completed and sent to schools all over the country. I thought of them and how I might not be sending them anywhere if I wasn’t on track to graduate. Everything I had been planning for my life was slipping through my fingers. I tried to listen to my parents and psychologists talk about the plans for the next few months but I could only focus on the fact that my entire life plans had been derailed. Everything was happening so fast.
After spending almost two weeks in an inpatient program because I was suicidal, I had found my reason to live again. I began to understand that I had a future and people who loved me and wanted to see me succeed in life. During those two weeks I made plans for my life. I dreamed of getting out of my hometown and going to college in a city. I imagined what my dorm would look like and who my roommate would be.
Suddenly all of that could be ripped from me once again. In agreeing to go to the program, I made a choice for myself. I chose to work on myself and get myself better. I also chose to not give up on the future I had begun to plan for myself. I was going to make up the work I missed at school and graduate on time. I was going to do the program during the week and go to college auditions on the weekends. I would be back to school as soon as I could and I was going to make it to my senior prom. Now that I had a future again, it wasn’t going to be taken away from me if I could help it.
The next day I started the OCD program. At 17 years old, I was by far the oldest in the room. The next oldest kid was 12 and the youngest was about six. I didn’t mind being with younger kids. It took away the pressure to be a certain way that I always felt in school. Even though we were all different ages, we could still all relate to each other in a way that I had never related to anyone before.
As time went on, I grew to really care for every kid that was in the program with me. Even though each of them was struggling with their OCD, they were all kind hearted and incredibly intelligent. Looking back even now, I am in awe of how determined and strong they were. The most effective way to treat OCD is a form of cognitive behavioral therapy known as exposure and response prevention therapy, or ERP. During ERP, the patient is slowly exposed to things that make them anxious and tries to resist doing their compulsions.
This may seem cruel to the average person. It may leave people wondering why anyone would ever purposely make themselves anxious. Truthfully, it can be a difficult process and can be traumatic at times. However, nothing is ever done without the patient’s consent. The person going through treatment has to decide to take these exposures on or else it will not work. Sometimes, a patient may resist doing their compulsions. Some therapists call this “white knuckling.”
The entire process is very gradual. The patient starts with something very small and works their way up to harder exposures. As they resist doing their compulsions to manage the anxiety, the anxiety will eventually go away on its own. This is called habituation. Therapists will sometimes call this “riding the wave of anxiety.” The most important thing for someone who is going through exposure therapy to know is that anxiety is always a temporary feeling, though when you’re experiencing it, it feels like it will last forever. The more exposures someone does, the easier it becomes to manage the anxiety without doing their compulsions.
The program I was in was specifically for kids with OCD and centered around ERP. I would go there every day from 8am to 1pm, when I would normally be in school. Every day we would start with a check in of how we were. After check in, we would start our first exposure period. That could last anywhere between 45 minutes to an hour and a half. The time differed every day to discourage white knuckling. If we didn’t know how much longer we’d have to do the exposure, we wouldn’t be able to just watch the clock and tolerate the exposure without actually letting it affect us. After the first exposure period, we would have an activity, usually either an art project or a trip to the gym. By then it would be lunch time. The hospital would provide us with lunch every day.
All the other kids would eat whatever the cafeteria made that day, but I had a special meal plan. Because my OCD was centered around food, there was a lot that I wouldn’t eat. While I worked on being able to eat a wider variety of things, the hospital provided me with food that I would eat. Usually my meal would be plain pasta or grilled cheese. Outside of the program I would have been embarrassed to have a special meal plan that was different from everyone else’s, but at the program I never felt judged for the things I was working on. When lunch was over, we would have another exposure period, followed by another check in; then, it was time to go home. Almost every day after the program, we would also have what we would call “home visits.” This was when one of the therapists would come to my house and do exposure with me.
Aside from the regular exposure schedule, I would also meet with a psychiatrist and a psychologist by myself and for family meetings. My psychiatrist explained to me in our first meeting that the anti-anxiety medication I was on probably wasn’t working because I wasn’t on a high enough dosage. In fact, OCD usually requires a higher dosage of medication than other anxiety disorders. He put me on a higher dose and medication finally started to help me.
Family therapy sessions were difficult and often left at least one of my parents or me crying. My doctors had us talk about the ways that OCD had taken over our lives and how we could change things so that we were in control instead of OCD. On my first day of the program, I sat down with a therapist named Joan and we made a list of things that would scare me to do, in terms of my OCD. We ranked them from easiest to hardest, giving each a rating of how hard they would be. She told me this was my hierarchy and we would work our way up to it together and it would get easier and easier. My therapists told me to draw my OCD as some sort of being and to give it a name. A personification of the thing that had been torturing me my entire life. They said it would help me to separate the OCD from myself and figure out which thoughts were mine and which ones were not.
This process of externalization of OCD is a highly effective way for people, particularly children, to take the blame off themselves and to put it onto their illness. Often kids will wrongly place the blame on themselves for the intrusive thoughts that OCD causes them to have. Externalizing the illness allows them to feel like they are fighting the illness instead of fighting something within themselves. I noticed how well the other kids took to this concept very well. Since they were so much younger, it seemed easier for them to use their imaginations that way.
They didn’t have that element of logic that you unfortunately develop as you reach adulthood. I had to twist my brain a little bit to do this exercise. When it came to drawing my OCD, I decided that my OCD was actually divided into two parts and so it required two beings. The first was Marsha. She was beautiful and looked like all the girls that I thought were better than me at my high school. She was my perfectionism. She was the one who noticed if my handwriting was slightly off or if I didn’t get an A on an assignment. She was judgmental and mean. She kept me up for hours on end every night trying to perfect each assignment, telling me the endless list of things that were wrong with it. She scrutinized what I chose to wear every day, telling me it didn’t feel right. She put an immense amount of pressure on me.
As awful as Marsha was, the other side of my OCD scared me a lot more. His name was Kevin. He had been around much longer. He was the one who made me scared to throw up and made me afraid of dying. He had been there through every car ride that I held my breath, terrified that the speed of the car would make me sick. He had been there my whole life, telling me that getting sick would be the worst possible outcome of every situation. He represented my deepest fears. He was terrifying looking. After I drew him I couldn’t even get myself to look at what I had drawn.
For my first exposure, my therapists and I decided that I would try to eat some chocolate pudding. For the average kid, this might seem like a fun thing to do, but for me, it was going to be incredibly difficult. Kevin was very averse to the idea. The texture of pudding made my skin crawl and I didn’t want it anywhere near my mouth. However, I had made a pact with myself to do whatever it took to get back on track with my life, so I did it.
The therapist who was working with me that day, Tim, said for the first day I could just look at it. I didn’t have to even touch it if I didn’t want to. I thought about it, but I decided that I was going to try and take a bite. If I wanted to get back to school as fast as possible, I had to do things here as quickly as possible. I took a little bite of the pudding. Tim told me that I could stop after that and we could just sit with that anxiety for a while, but I knew that I could do more than that. I took another bite. And then another bite. Each one I made a bigger bite than the one before. I was going to conquer the whole thing. Tim kept telling me that I didn’t have to push myself so far, but I knew I could do it.
Suddenly, the anxiety completely took over and I went into a full panic. I closed my eyes because I couldn’t even bear to look at the pudding anymore. I could feel it in my mouth and the fear ran through my bones. I had the urge to lie down on my back, the way I always did when I was afraid to get sick. Tim put away the pudding and I could finally open my eyes. He asked me why I felt like I had to do so much already. I couldn’t help but burst into tears as I explained that I wanted to get all of this over with as quickly as possible. I wanted to be the best patient I possibly could. Even in therapy, my OCD told me I had to go above and beyond. I had to be perfect.
After that exposure, Tim and I decided that we would tackle Marsha a little bit first before turning to Kevin. He explained that I couldn’t just get through this treatment as quickly as possible or it wouldn’t work. He said ERP takes time and a lot of energy and that I was a good enough patient by even deciding to take on this challenge. The idea of being a perfect patient was a challenge I ran into a lot during the course of my treatment.
One night, I decided to put in some extra work and write out my hierarchy of exposures that I could do. I spent hours making the list of exposures look perfect. The next day when I had my home visit, I proudly showed my therapist what I had done. Instead of getting the praise I expected, she looked disappointed in me. I was taken aback by this. I thought I had done a good thing by putting in extra work on my OCD outside of therapy. She asked how long I spent on it. I realized what she was getting at. I hadn’t done the extra work because I wanted to. I had done it because I wanted to be the best patient I possibly could. We talked about how my need for perfection was actually going to hinder my progress if I let it take over. I ripped up my perfectly written list of exposures and threw it in the trash.
During the next few months, I spent hours doing exposures. The first exposure after my first failed attempt was simple. All I had to do was write my name without erasing and rewriting anything. A menial task that seemed impossible to me. After I wrote my name, I sat and looked at it for about 45 minutes. I had a small notebook to keep track of my thoughts. Each time I had the urge to erase and rewrite what I had written but did not give into the urge, I got to put a tick mark in the “Resist” section of the notebook. We repeated this exposure a few times and it got easier and easier every time.
The more I was able to resist that compulsion, the weaker my OCD became. For my next few exposures, I wrote full sentences and then paragraphs. Sometimes we would have the other kids in the program look at what I wrote. Other people seeing my imperfect handwriting was a challenge, but each time it got easier. Once I had my perfectionism somewhat under control, we decided to try and tackle my fear of vomit. For my first vomit exposure, my therapist wrote the word “vomit” on a piece of paper and I had to look at it. Even seeing the word was enough to spike my anxiety, but just like with every exposure, once I did it enough times, it wasn’t so hard at all. Soon enough I could even say the word out loud. As saying the word got easier, we decided to take my exposures up a notch. The next step was looking at pictures. First, I could only look at cartoon pictures of people looking sick. Eventually, I was able to watch videos and listen to sounds of real people throwing up. Tim even printed up a picture of a man throwing up to hang on my bedroom door so I would have a mini exposure every time I went into my room. We named him Chuck, and he stayed on my door as a reminder of what I never thought was possible before. Although I did have to explain why I had that picture hanging up whenever I had friends over.
We also worked on my fear of germs and foods that I had deemed unsafe to eat. I worked on not washing my hands excessively or using hand sanitizer when I felt like something was contaminated. I slowly reintroduced foods back into my diet. I began to gain back the weight I had lost and I started to look healthy again. Doing an intensive program like the one I was doing is a lot of hard work that extends far beyond the work you do while you’re physically there. When fighting OCD in that way, your life becomes centered around readjusting your life so that you are in control instead of OCD. My therapists would say that “exposure is a lifestyle,” and I wholeheartedly agree. Treatment for OCD is so much more than just the official exposures. It is taking the skills you learn while doing official exposures and applying them to your everyday life.
In addition to going to the program every day, I was also in the process of applying for colleges. As a prospective theater major, I had to audition for all of the schools I had applied for. I spent a lot of my weekends going back and forth to New York City for college auditions.
The auditions added a lot of stress to my already stressful routine of going to the program. However, I was determined to do everything I could to keep my life on track, and that meant continuing with my college auditions so I could go to college in the fall. Going to New York City was difficult for me. I wasn’t used to being in the city, especially one as big (and dirty) as New York. I had to use the skills I was learning in the program to be able to function and do my auditions at the same time. Looking back, I may have pushed myself too far at some points by doing things that I wasn’t quite ready to do yet.
After a few months of the day program, my therapists and I decided that it was time for me to start transitioning back to school. For my home visits I would go to my high school after hours and practice being there. At first it caused me a lot of anxiety, but just like with everything else, it got easier with time.
In late February I was able to start going to school regularly again. I switched to the after school program and would go to school during the day. Going to school all day and then going to the program for several hours was exhausting. After only a few weeks into doing both school and the program, my doctors decided that I was ready to stop doing the program. We talked about how it was becoming more stressful than it was helpful for me to continue doing both. On my last day of the program, the other kids all wrote me a card wishing me luck. I was disappointed that Tim wasn’t working my last day because I hadn’t been able to see him much since I had switched to the afternoon program. Even though he wasn’t working, he still came in that day just to say goodbye to me. I left the program as a patient for the last time that day. I felt ready for the rest of my life, unencumbered by the restraints of OCD.
While the program was over for me, my treatment was far from over. I still saw a therapist for exposure therapy at least twice a week. Even though I was still doing treatment, it was a big adjustment to go from going every day to only twice a week. It was nerve wracking to lose that feeling of constant support that I got going to the program every day. I had to get used to another therapist in a completely different place. Eventually I was able to get used to him and I continued to see him through the summer, up until it was time for me to go off to college. While seeing my new psychologist, we did more exposures and took back more and more from my OCD.
I worked hard to catch up on all my missed school work from the past few months and was able to finish in time to graduate. I dropped one of my classes and spent that time in the library catching up on my makeup work. I got a tutor who helped me plan out how to get all of my work done. When I was finally finished with all my makeup work, my parents bought me an ice cream cake and we all celebrated together that I was still on track to graduate on time. I was able to enjoy the end of my senior year. I went to prom and senior night. I was able to walk at graduation with my classmates.
It meant so much to be able to finish high school on time. I was so proud of how far I had come. At the beginning of my senior year, I was not functioning due to my OCD. I was sickly thin and malnourished. I was incredibly unhappy and came close to committing suicide. By the end of my senior year, I had become a completely different person. I had gotten into both of my top colleges and was set to go to one of them in the fall. I felt strong and capable of living the rest of my life.