As someone living with Obsessive Compulsive Disorder (OCD), I often struggle with intrusive thoughts of being unworthy of happiness in an intimate and loving relationship. Or I dissuade myself from ‘splurging’ on a new outfit. I say to myself, why do I deserve to feel attractive? How could anyone love a person like me?
Going out on dates and engaging in intimate relationships, acknowledging that I’m a sexual being, buying a new outfit and treating myself to something nice (just because), and taking care of my preventative health-care needs in particular, has been the focus in 2021 with the help of Cognitive Behavioral and Exposure and Response Prevention therapies, (CBT and ERP). If I close out the year successfully meeting these treatment goals, it will mean that I now accept I deserve to be healthy, and am worthy of happiness. With the first round down, and many more to go, I’ll be able to tally the score as multiple points for me, OCD zero!
I've managed to attain some of my physical wellness goals. For example, in January even COVID regulations and fear that the pen I pulled from the holder to fill out paperwork at the check-in desk at the doctor's office was one of the used pens mistakenly mixed in with the sanitized ones, somehow isn’t terrifying enough to stop me from tolerating the radiologist during a routine mammogram; The radiologist tugged at my breast and flattened my nipples with the same level of boredom and disinterest as a worker picking up and assembling widgets on a factory conveyor belt. I’m willing to submit to having my breasts palpated and kneaded like a raw roll of sourdough bread, just to receive confirmation and peace of mind that my body is free from malignancies and stage four breast cancer.
In April, I went to great lengths preparing for an endometrial biopsy which Dr. F, the surgeon who had performed the Dilation and curettage, D&C and implanted the Intrauterine Device, IUD in me the summer prior, recommended I endure every six months as a preventative measure to avoid the extremely unlikely scenario of needing a hysterectomy sometime down the line. For two weeks leading up to the procedure, I practiced with a dilator twice a day in fifteen- minute increments.
I have been working with my OCD therapist, Alison, for nearly seven months. I’m sure she’s caught on that I have an unwavering, studious nature and only on the rarest occasions have I veered away from following through. I’m also sure she had enough insight to recognize that assigning purchasing a dilator and lubricant as homework was the best and probably only way to ensure that I followed through.
A few defiant sneers and deep sighs later, I found myself reviewing the items in my shopping cart and clicking the link to complete my purchase on the women’s health website Alison had forwarded to me. I’m resistant towards digging into my wallet to support these goals. But I also possess a competitive spirit and always strive to be a conscientious student.
The box containing the dilator instructions for insertion and a bottle of lubricant sat on my desk untouched until Alison assigned opening the box and use of its contents as homework. Another part of the assignment was that I was only permitted to look over the instructions for the dilator and lubricant once. After that, I had to stow the instructions away in the box.
In addition, I was not permitted to perform any additional compulsions and ritualistic behaviors like washing and then re-washing the applicator. I also couldn’t cheat and sneak a peek at the instructions to verify. Maybe that burning sensation in my vagina was a severe allergic reaction to the lubricant, or I had been wrong to second-guess myself about the directions saying the dilator needed to sit and air dry for five minutes before insertion. Or maybe it was a perfectly natural reaction and my lady-parts just needed time to grow comfortable feeling like someone poured lemon juice and vinegar on them. I had to fight the urge to dial 911. Rolling the dice on the odds of death was a risk I had to be willing to take.
For the next two weeks, leading up to the day of my biopsy appointment, I set a timer, lay on the floor on a yoga mat with the lights dimmed and listened to Pandora’s ‘spa channel’ twice a day for fifteen minutes, embracing the burning sensations of having a small lavender silicone apparatus slathered in lubricant shoved up my vagina. I took deep breaths, inhaling, exhaling, letting my muscles slowly contract in and out. When the timer went off, I rushed to the bathroom, turned the knob on the shower until steam filled the room, and scrubbed myself until I was raw.
Despite taking two Ativan an hour before, hoping the medication would numb the pain and help me feel less agitated, the biopsy was excruciating. When Dr. F clamped down on my uterus, I let out a blood-curdling scream more chilling than Janet Leigh’s legendary shriek from the shower scene in Psycho. After the procedure was over, Dr. F appeared as haggard as I was. Flustered, she looked me square in the eye, waved her finger and said, “ I’m not in the habit of torturing my patients, next time we do this you're sleeping!”
You could liken the completion of this homework exercise to saying I wanted a pony but got a goldfish. It wasn’t an absolute success, not by a long shot. But, still, I was able to check off one more box, inch one step closer to completing my journey towards wellness.
I’ve come to believe over the years that in order to truly be healthy, you must first understand the systemic root of the illness. General practitioners schooled in Western medicine recommend a pill or a procedure, a quick one and done solution, that only masks a growingly pervasive problem. Most doctors don’t take you seriously if you say I think there’s a connection between my kidney stones, Polycystic ovary syndrome, (PCOS) and OCD, especially if one of the themes of your OCD focuses on health and physical illness. With health OCD, figuring out what’s wrong and why becomes the obsession. Researching the problem and seeking reassurance from everyone around you, including your doctor, becomes the compulsion. But even patients with OCD have the ability to recognize when something is just not quite right with their bodies.
I had grown weary watching Dr. B. look away from me and shrug her shoulders if I suggested there was a link between my gastrointestinal issues and kidney stones. Instead, she would prescribe over the counter antacids to treat my reflux. A quick one and done solution. Leave the excavating and exploration to a doctor of archeology, not one of medicine. I was angry at being dismissed. This anger was like a stale pungent stench permeating a room. I decided the only way to get rid of that odor would be to follow the advice of my friend Helen and see her doctor who was trained in both Western and Functional medicine.
In spite of his spotty communication skills over email, which included mistyping my name with an O rather than an E and calling me John instead of Jen, Dr. Graham was the first doctor to say, “Yes I believe you Yes I think that there is a connection. I think you have an absorption problem.” I soon realized that earlier rage was conjured out of fear, first fear that I would never be heard and now an even stronger fear that I would be heard. I didn’t know it at the time but the heaviest lifting on my journey towards wellness was about to begin.
At our first appointment, Dr. Graham asked if I was committed to make a change in my life, prepared to lose weight, and to be healthy, to live outside my comfort zone? To feel vulnerable, take risks, rather than avoiding them.
In the sticky hot July that followed, revamping my diet and tinkering with food habits stretched far beyond risk taking and feeling vulnerable. Every nightmarish fear of contamination and disgust over bodily fluid and function, their accompanying smells and sights, pushed me to the edge of a precipitous cliff. I was clinging to this cliff to avoid tumbling down.
At our next therapy session, I’m sure Alison was elated when I described Tuesday morning’s bathroom routine. There was no imaginal exposure she could have assigned for homework, or even a catastrophizing script I could have crafted, that would have come close to raising the level of anxiety and horror I was now experiencing everyday in real-time.
Relationships are for partners and friends, not intestines. No one should be as intimate with their stool as I was starting to become with mine. I turned into a chemist in a lab, mixing and stirring specimen contents, storing completed test vials in the refrigerator only inches away from my oat milk and eggs until I was ready to ship them off for analysis.
Staring down at undigested pumpkin seeds, bumpy, pimply corn kernels, and garbanzo beans, magnified to the size of gourds was revolting. I watched as extended members of the legume family greeted me, plopping and sinking to the bottom of the container the lab had provided for collection. The red and white paper receptacle looked like one of those cartons your fries came in at a fast food joint. All I could think was do you want fries with that?
I was both amused and horrified but also felt a little bit nostalgic as I reminisced about my childhood at the Jersey shore, eating funnel cake on the boardwalk, picking out crumbs from clam strips, and using my fingers to scrape French fry oil caked at the bottom of the carton. Despite this throwback to nostalgic times, this scenario also thrust me beyond my OCD comfort zone with wind whipping fervor. Collecting stool samples challenged my fears of contamination, allowing me to accept that the outcomes of my long term goals were still to become increasingly unphased by the ickiness of life now served up on a daily basis.
So it behooved me to be mindful that not all outside observers might be primed with the same level of determination. When I detailed my undertaking to a friend, who certainly had her fair share of physical unpleasantries, our text thread stalled mid sentence, then she abruptly tapped out in caps: TMI! Shit belongs in the toilet not near food.
In spite of contaminating one of the samples with an unseemly bowel movement, whose bulk, size, heft, and density could have easily qualified for the Guinness book of world records, despite snapping and breaking multiple plastic scoops and having to wait for the lab to ship new restaurant supply containers and spoons to me, I powered through. FedEx delivered my bio-hazard without a hiccup, the results came in, and Dr. Graham and I embarked on a new pilgrimage of re-populating my gut microbiome with daffodils and roses instead of stinkweed and thorns. If this metaphor is lost on you. Don’t worry I groaned when I heard it too. Make no mistake though, replanting the metaphoric garden with good bacteria, (roses and daffodils) and cleaning out the bad bacteria, ( stinkweed and thorns), is more difficult than it sounds. especially when belching and flatulence, which are part of the healing process, became too disgusting and my grit and determination waned.
If this year has taught me anything, it is that the stinkiest and most unflattering moments make us the strongest.
In 2021, my journey towards wellness included turning the stove on for the first time in years, learning to cook, and sometimes enjoying scrambling eggs and boiling pasta. I probably added too much salt in the pot and not enough butter in the frying pan. I no longer store unopened mail in the oven. I’m eating healthier and preventing my apartment from burning to the ground. I date regularly and live with the uncertainty that kisses could give me herpes or impetigo. If a man says they're attracted to me then I wonder less if they’re suffering from double vision. I often treat myself to something nice just because. In the year ahead, I have a lot more work to do. But so far I do feel that I’ve earned enough bragging rights to tally the current score as multiple points for me, OCD zero!