For this week’s edition of “Everyday Thursday,” I want to report back on my most recent visit to my psychologist. I didn’t go into my appointment in a very good state, but I guess that’s fine. Maybe seeing your psychologist on a rough day is like going to get your haircut when you’re having a really bad hair day—perfect timing?
My Morning
Anyway, I was having a bad OCD day slash week. I woke up stressed and anxious, had to clean the bathrooms, and was bleaching some towels from the kids (they have been in the habit of getting one bathroom towel super filthy with large brown/black stains, which I hope were/are chocolate…).
I was trying to clean the bathrooms and get that laundry started before leaving for my appointment, got some bleach water on my pants, had to change… and ended up arriving late for my appointment, super frazzled and not in a good state.
My husband came along, not wanting me to fudge on any of my “reporting back” to the doc. It was long and more honest accountability report on the last month, and my doctor encouraged me (as he often does) to go on the offensive against the OCD.
I don’t like being aggressive when it comes to my OCD. I am more of a reactor—something happens and I try not to obsess (usually I do) but the point is, I’ve never liked purposefully doing exposures. It has seemed like cruel punishment when my OCD will give me obsessions anyway.
Medication vs. CBT?
My husband asked about medication (and whether or not I should go back on meds), but my doctor told us that if I do daily exposures, that can be as helpful as medication. I asked how I can deal with difficult OCD days and try to avoid the OCD breakdowns that seemed to be coming more and more often. He said that my breakdowns are likely being caused by my lack of consistency with fighting back and aggressively combating the OCD. He urged me to do deliberate, purposeful exposures: to attack versus react.
Basically, we determined that I need to pick my battles and systematically attack, assigning myself specific exposures and a time to do them each day. If I want to avoid breakdowns and severe OCD attacks, I need to be on the offensive. I need to seek out the discomfort.
Putting it into Practice
I went home and made a daily worksheet for myself to fill out each day. I have a hand washing chart that includes an area for me to write down my reason for washing and to record the timing (too long?), amount of soap, temp of water, and whether or not I washed all the way down to my wrist (bad habit I have). I have a checklist for various exposures for each day—things like touching door handles or light switches, using all the bathrooms in the house (inc. the ones the kids use), sitting on all the couches and chairs, not using disinfectant spray, and other specifically chosen exposures that I can quantify and check off (or not). I’m not perfect, but for me, having these physical reminders and accountability helps so much. Next up: consistently setting aside specific time each day to do more exposures!
Doing ERP and CBT are a lot of work, but mental health and trying to keep control of our mental illness are important. If we are not in control of ourselves and let the OCD or anxiety take over, the rest of our life is affected negatively. Setting aside a half hour or hour (or less) a day isn’t much in order to maintain a good mental health state. It’s worth it. It takes work to fight OCD. We each have to decide if we are willing to put in the time and effort to do it.
There are many reasons to do exposures. The exposure tackles the obsession. What if my kids have dirty hands and dirty clothes? Well let’s find out. You deliberately get them dirty and then do not wash which is the response prevention and therefore tackles the compulsion. You have to do both parts in order to get well. I do not see it as torture. What I see as the true torture is a life debilitated by OCD. With exposures you are in charge and can determine when it happens and you can do it repeatedly for the practice in order to habituate. With response prevention only, you area at the mercy of a random act happening and you are not prepared for it. Exposure goes beyond what a typical person without OCD might do because that is what has to be done in order to retrain your brain. If you can get through deliberately getting dirty you can certainly tolerate a small amount of accidentally getting dirty. You have to do exposures as well as the response prevention. And I know you can do it!