#38: Inverted advice

This week, I share about a conversation that took an unexpected turn, and the reminders of my mental health journey up until now.

These weekly updates are an ongoing series in which I share what it is like to live with OCD in an effort to reduce the stigma around mental health, particularly in the workplace.

Story

Last weekend I had an interesting experience. I had a conversation with someone in which I expected to get advice. There were questions that I wanted to explore, and I was looking forward to discussing.

When we started talking, I first asked how her recent trip had gone. As we started discussing that, the conversation quickly turned from sharing vacation stories. She told me about a situation she had, and that as she was thinking things over on her way home, I came to mind as someone who could give her advice. Because of my life experience, particularly my struggle with scrupulosity OCD, she thought I was uniquely qualified to provide some insights, at least among people that she knew.

Over the new three hours or so, we talked deeply about my treatment and recovery, and lessons I had taken from it. Much of what I had to share came from my time at the OCD & Anxiety Treatment Center. I talked about what led me up to being willing to go to an intensive outpatient program, and what made it effective.

Part of the key for me in being willing to engage in intense treatment was seeing the effect that my mental illness was having in my life, particularly on my family. Even though I felt guilt at the idea of leaving home for a time, I finally realized that my being home was harder for the family. And this was at a time when my wife was pregnant with our seventh child. I felt such shame at leaving her to cope with all of the demands of a busy household alone, but I had seen how my presence, in my deteriorated state, was making life even harder.

A large part of what made treatment effective for me was engaging in exposure therapy. Essentially, I had to identify rules that my brain insisted were vitally important. I had to find the core fear driving the rule, and come up with ways to approach those fears that would challenge my mind’s insistence to perform compulsions.

As an example, my first exposure was to confront the rule to take good care of my things, with the fear being that I could be shut out by God if I didn’t. We identified my phone as an opportunity to challenge that fear. I had to start by intentionally putting fingerprints on my phone without cleaning it off. I initially resisted the idea, claiming that it wouldn’t be effective. During the therapy session where I was discussing the exposure, my therapist asked if I knew that I had cleaned my phone half a dozen times while we were sitting there. I protested, but looked down and saw that the screen was completely clean, and knew that I had been handling it.

As the exposure progressed, I had to touch my phone, and its leather case, with an increasingly distressing variety of substances on my hands, from water to lotion to chalk to Doritos cheese to popcorn grease. It was brutal, but ultimately effective.

One of the almost magical effects of exposure therapy was finding that these somewhat contrived activities were extremely effective in challenging the rules in my brain. Not only did I become able to sit with the distress that came from violating those rules, but the mental freedom that came applied to other areas in my life. I remember discussing with my therapist as I was going through this what a waste of time some of these exposures were. She taught me that when I challenged my mind to confront these rules, countless other rules in my life benefitted from the experience. I was gaining skills in identifying compulsions that my brain insisted that I perform, and becoming empowered to choose whether I engaged with them or not.

There are still many times that I relapse and find myself succumbing to the rules in my brain. I still get obsessed, and find myself compulsively doing behaviors that I don’t want to do. I have to identify the rule driving the compulsions and find ways to challenge it.

Lesson

The conversation took such a different turn that I was expecting before we started. The interesting thing to me was that by the end, I no longer felt that I needed the advice I was planning to seek. In many ways, I had already given myself the answers that I needed.

There were a couple major takeaways for me. One of the first was my own flexibility. As I discussed last week, plans changes are often extremely difficult for me. To engage in a conversation that was the opposite of what I was expecting is a situation that would have been distressing to the point of being almost impossible just a couple years ago.

The second takeaway builds on the first, and that was a perspective of how far I have come. Two years ago, I had just graduated from the intensive outpatient program. A year before that, I was oblivious to the fact that my mental health was about to explode, and I would become nearly crippled for a time. For me to be able to look back on my situation with some detachment and identify the pieces of my recovery that were crucial is a major win.

Challenge

The challenge I issue to myself, and to you if you will accept, is to identify a conversation in the coming week with some expectations, and consciously set them aside. Instead, focus on being present, and allow the conversation to go wherever it goes.

In my experience last week, I was able to do that in large part because the person with whom I was speaking explicitly said at the beginning that she needed advice for me. I can often adjust my expectations if the situation is defined for me.

However, for this challenge, it is important to allow the conversation to flow freely without definition. Mindfully focus on what the other person is saying, and respond genuinely. Avoid the temptation to think about what to say, to plan excessively how things will go.

As always, a healthy dose of compassion goes a long way. We need to extend that to ourselves, even in the moment of adjusting. We need to extend that to others, including the person with whom we are speaking. They may be adjusting their own expectations as well. This compassion can transform us and those around us.


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