by: Jennifer Brighton, MSW, RSW, Ph.D (c), Clinical Director, Exhale Academy
Today I was working with an individual who struggles with OCD, Obsessive Compulsive Disorder. Every moment of their day is wrought with challenges because of this illness. This isn't just a "wiggy" feeling they get but rather every day feels like death is lurking if they do not do a series of ritualistic behaviours. Many people will joke without much thought saying, “I’m a little OCD.” But there is no such thing as “a little OCD.” This is a debilitating neurophysiological disorder that can devastate an individual’s life. We can have quirks and desires that are rigid, and feel like we cope better when things are just so; this may be that you experience personality traits that are reminiscent of OCD. The average individual with OCD is often deeply ashamed of their illness and will likely never make light of it because of the internal torture it causes.
I’ve worked with many people with this mental illness over my years in practise. My first step is to ensure that my client understands this is by no means their choice. It is the result of faulty brain functioning. There are many reliable research studies that demonstrate particular areas of the brain light up and almost lock up when an individual with OCD is triggered. The average person might have these brain centres light up but they very quickly can adjust, whereas, functional brain scans and show that a brain with OCD lights up faster and remains firing in these centres for much longer periods of time.
My recent client has spent the better part of his adult life, wanting to change, be free of these symptoms and be cured. Desperately wanting something that can radically change him so he can slip out of the OCD and into the confident, 'I’m living my life” self. The only trouble is, the OCD is not going anywhere. OCD is on the severe end of anxiety disorders, and as far as the research shows to date, there is no cure, it is an illness that you must learn to manage. And, it can be managed, well!
When I say this to my client, he tells me that “just managing” would be a massive failure in his eyes. I urge him to see that he has spent his entire life trying to “fight” this illness and it has only made it worse. I explain that “fighting” was always the wrong set up for treatment. I urge him to see that his system turns to a pattern of behaviours to protect him. To “fight” against a blueprint of protection, even if the pattern is not logical, would only put his body in a tail-spin, creating dissonance, loss of trust in himself and further anxiety and compensatory behaviours.
So, he asks, "how will I be cured?" I suggest that looking to be “cured” is again the wrong approach and that perhaps healing starts from a place of deep self-acceptance. To this, he says, “Acceptance equals complacency!” To that, I say, “To accept is to be empowered!” Who is right?
I tell my client about a friend of mine from my early 20s. I reflect on me going white water rafting with a bunch of friends and this individual. "We were all having a blast, as we bounced out of our raft so many times, dove from cliff edges and bungee jumped. We were young and energetic and living the life of emerging adult freedom." Only a few days after this trip my friend was out on his motorcycle and ended up in a terrible accident. He just survived but ended up paralyzed from the waist down. For so many years he just was not a part of our group anymore. He isolated himself and would not come out anymore. He went into his own place of self-hate and anger, asking “why me?” He could not accept how radically his life had changed in a matter of moments. He felt we wouldn't "see" him anymore and would only see the chair and his obstacles. Years passed and then one day I walked into a party, and I saw him from behind, in his wheelchair. For a few moments, I was rattled, thinking “what do I say to him?” We have never addressed the accident, I have never caught up with him, do I say something about the accident, do I ignore it, do I pretend like its not a thing. While I was saying my hellos to other people, I was feverishly thinking how do I manage this? And, then, with such grace and ease he rolled up beside me and said “Hi, Jen!” and as he looked into my eyes he said, “It's okay, it really is okay!” With a tear to my eye and a sigh of relief, he and I both knew we didn’t need to say anything else. We moved on quickly to catch up, he told me about his journey, and we laughed together as if no time had ever been between us. He told me about the cool devices he had to assist him and then went on to tell me he was married and had two children. For all intents and purposes, he seemed happy. I couldn’t help but ask him how he went from anger to who he was at that moment. He ever so eloquently taught me one of the most helpful lessons I have ever learned. He said “I learned to accept that no matter the why, this was his now. This was his life. He could be in a state of anger all the time and not really live his life, or, he could accept his new life and really live it.” He chose the latter.
When my client heard this story, he was reflective. His response was a question of doubt whether the other people in his life could accept his illness. He retorted that his family believes he chooses his illness given he knows his obsessions and compulsions are not logical. They figure that because he knows it is not rational, he should be able to just stop himself. I explain to him that this is the hardest part of the illness, knowing what you are obsessing about and what you feel compelled to do is not logically, but literally being unable to stop yourself. I further explain that this is 100% a brain dysfunction and not something he can simply will himself to stop.
I further encouraged my client to reflect that if he accepted the OCD as a brain dysfunction that he had to learn to manage, his loved ones might be able to do the same. Until now, he has been incredibly self-loathing and feeling like he is a weak man who has failed. I also urged him to recognize that if his loved ones could not accept his illness, he had more information about what his family was capable of providing him in the way of support. Most mental illnesses are hard for loved ones to understand and it often requires that the family take the initiative to learn about the illness so they can be of genuine support.
I encouraged my client to understand that his process of learning to manage the OCD might be bumpy as he was up against a lifetime of negative thinking and self-talk, along with poor self-worth and tremendous self-loathing. It was going to be a slow process of developing mindful awareness and discretely shifting his philosophy on his illness. I reflected back to him that just like my friend normalized everything for me, my client was holding that power with their own family and friends. If my client could normalize the OCD as brain dysfunction, then what felt so abnormal, could be understood within this framework and then perhaps his family could understand it this way too. I pondered reflectively that if my client’s family observed that his acceptance enabled him to start living his life more effectively, they might just be supportive. I further brought my client's attention to the fact that this "disability" of his was really an "ability." Perhaps over-expressed and thus problematic, but still skills that others might not have. You see, my client is a fierce advocate for what he feels is right. His rigidity ensures that he will fight the fight if need be. He is also incredibly detail oriented, picking up on things the average person would miss. Furthermore, he is tremendous at researching topics and issues, and because of this, he is a fountain of knowledge that so many people benefit from. I could go on, but do get my drift here? This person is amazing! Even with OCD. If my client could be self-compassionate, see his strengths, and genuinely accept himself, flaws and all, life wouldn't be such a struggle, even with OCD! If for even a moment, my client could liken his OCD to the paralysis my friend has experienced, he might have a chance of choosing a new way of living rather then feeling flawed and damaged.
There is no “right” way to live our lives, but there are some “right” values that we can have that will enable all of us to settle into contentedness. Like for instance, acceptance. With a history of self-loathing and criticism learning to accept ourselves can be a process of "acting as if" for quite some time. There is an internalized blueprint you may be working against. It might feel like the salmon swimming upstream, but, it is so worth it. Acceptance creates the platform for growth, it is the soil to the seed that needs those nutrients to grow into the plant.
So, then, does acceptance lead to complacency. 100% NO. It leads to living an authentic life, a life on purpose, a life that is in alignment with what is real, right now. Acceptance leads to being empowered to live your life with authenticity. Acceptance of what is, lead to clarity. With clarity, we can make decisions that are healthy. So if my client could 100% accept his OCD when symptoms started to present themselves, he would not turn to self-hating thoughts, or, fear that others will hate him if he indulges the illness. Instead, he would say something like this, "Hey there OCD! I know you are here to help me. Thanks! I know you worked for a long time. I know you showed up when I had no other resources to cope with really overwhelming life circumstances. And, by god, you worked for a long time. I'm learning however that this kind of help has consequences for me in the long-term. I am still scared of change, so, I promise I will not do anything too fast or too radical. I'm wondering if you could let me experiment just a little with some new ways of dealing with stuff? If it doesn't work, hey, I know you well, and I can come right back to this pattern. You game?" Then slowly, like a snail, he would be able to nudge himself to a degree of freedom that perhaps would allow him to tap into happiness for what is.
We all have our struggles and challenges and we all need to lead from a place of self-acceptance. Form this place, tremendous growth is possible!
Namaste, my dear friends, I see the light in you.