Are you crazy enough to succeed?

< Prev | 1 | 2 | 3 | Next >

Most popular

• Most viewed

• Top rated

• Most e-mailed

Brazil judge: Boy must be returned to U.S. dad

The 10 most gorgeous mother-daughter pairs

Your body’s 10 weirdest health clues

3 die in dust storm crashes on Ariz. interstate

Teen faces up to 50 years in Facebook sex scam

Most viewed on msnbc.com

‘The core of all anxiety is uncertainty’
Jonathan does have OCD. He's a bright man, tall, self-possessed, funny, and utterly disabled by a disorder that has steadily taken over his life. He's living at OCDI and doing the hardest work of his life just to quiet the intrusive thoughts and maddening rituals that have been his unwelcome companions since he was 13 years old. If a negative thought — "Is my father going to die?" — intruded while he performed a task, he'd have to repeat the task over and over again until he completed it without the whisper of a bad thought.

If he thought about something bad while closing the car door, says Jonathan, "I'd have to close the car door again. If I had an intrusive thought while I was going over a review on an employee, I had to rewrite it."

We all have intrusive thoughts. They flash unbidden across our mental JumboTrons, startling us with their violence, depravity, or just outright weirdness. I'd bet every New Yorker has imagined hip-checking some stranger into the path of an oncoming subway car, and that every Californian has considered, for one brief moment, the idea of plowing his SUV into the jerk in front of him on the Santa Monica Freeway.

For a person living with OCD, thoughts like these are not wadded up and tossed in the recycling bin. Instead, they are pored over, analyzed, and scrutinized for truth.

Imagine this: You've just parked the car. You hop out, grab your bag, and head toward the gym. But wait. Did you lock the car? You head back to make sure you did. Yup, it's locked. Problem solved.

Jeff Szymanski, Ph.D., OCDI's director of psychological services, explains. "Someone with OCD says, 'I went and checked the car, but did I really check it? I'm looking at my hand turning the key in the lock, but is that perception really clear enough? Did I hear the click, or do I just remember hearing the click, or did I hear the click last time I checked this?'"

Shrinks call this pathological doubting, but the person with OCD doesn't need a memo from the Department of Justice to know it's torture.

Looking back, I realize that my OCD began to appear during my senior year of high school, if not earlier. I became convinced that every girl I dated was betraying me... nightly. And so I quizzed them on their whereabouts and demanded alibis for any unexplained absences. Oddly enough, my girlfriends found this suffocating.

My condition confined itself to that strange little corner of my world throughout my college years, and I did just fine. There are some tolerant females out there, let me tell you. But after I graduated, found a job, and moved to New York, I promptly dissolved into a puddle of anxiety.

"The core of OCD and the core of all anxiety is uncertainty. In uncertainty there is the potential for danger," Szymanski says. "OCD really has its field day in stress and in transition. Every time people with OCD go through a change, they're stuck with uncertainty. They want to make themselves certain, and they spend all their time replaying what-if scenarios."

Hell, yeah. I spent 3 years of my life wondering if I had AIDS, hepatitis, and every other infection (despite my no-risk behavior and double-digit blood tests). I called the AIDS hotline so often that a counselor finally yelled at me to get off the phone — "You're worried," he said, "but the guy on the other line is dying." I lost whole days of my young adulthood thinking about what I touched, if I had a cut on my hand when I touched it, or if I'd touched my mouth or eyes before washing. Then I'd replay the whole series of events: Did I wash well enough? Am I sure I didn't have a cut?

I lived in an Escher print.

Join the discussion

Obesessive behaviors? Do they help or hinder you?

When I tell Dr. Jenike these details, I don't get the "you freak!" reaction I still brace myself for. "Whatever's the most repugnant to you, that's often what the obsessive thoughts get stuck on," he says. "Like a mother nursing a baby — the mother will think I want to have sex with my baby and be horrified. It seems like OCD is looking for the most repulsive thing to torture people with."

For me, it stopped right there. I never developed the typical hand-washing, repeated-shaving, stove-checking, counting, or touching compulsions. I did not graduate to the level of thinking, "If I do this, then the thing I'm anxious about won't happen." But my girlfriend suspicions and infection worries were plenty bad enough.

Szymanski suggests thinking about it this way: "OCD rituals sound crazy. But find a place within yourself where you experience a negative emotion so powerful that you're willing to do anything — sell your mother — to get away from that emotion. Even if that behavior makes you look crazy to other people. That's the feeling of OCD."

That feeling finally drove me to a psychopharmacologist, who hit a homer on the first pitch. Prozac wiped out my symptoms within a couple of weeks. I could feel my brain returning to normal.

But most people dealing with OCD require a two-pronged approach of medication (in the form of selective serotonin reuptake inhibitors — SSRIs — like Prozac, Luvox, or Zoloft) and a Kafkaesque form of therapy called exposure and response prevention, or ERP. In ERP, a person learns to tolerate repeated exposure to the very cue that triggers the anxiety without acting out the attending ritual. It's administered in stages, with each stage ratcheting up the exposure.

At OCDI, residents work at dealing with their condition for hours and hours each day, all the while agreeing not to carry out the compulsive behaviors that they once used to temporarily neutralize the power of their thoughts. Each ERP is designed to address a particular obsession or compulsion. Compulsive washers will touch toilets and not be allowed to wash.

Jonathan had to listen to a loop tape, hearing, "I hope my mother will die today" while he pursued activities he enjoyed, "because the thoughts are just thoughts, there's no credence to that happening." He seems agitated and a little rote when he says this, as if the "cure" hasn't quite taken hold.

Repeated exposure to the source of the anxiety, the theory goes, will desensitize a person to it, robbing it of emotional power. In one memorable example, a person with an obsessional fear of stabbing someone was placed in ever greater proximity to knives. Eventually he graduated to standing behind an OCDI staff member for 90 minutes, holding a knife at the ready for a fatal thrust.