A Case of OCD

AnxCalm - New Solutions to the Anxiety Epidemic

J: I have a friend of mine, whose name is Ben, and he's going to talk about some of the anxiety situations he's gotten himself into, and what he did to get himself out of them. Hi Ben.

B: How are you doing, John?

J: Just fine, thanks. What I'd like to do, if you don't mind, is to go through seven of the eight kinds of anxiety and just ask you if you've experienced them, and maybe a little bit about what you've done about them. I'm going to skip the first one, which is simple anxieties, such as claustrophobia or agoraphobia, because they are very common. The first one I want to talk about is social phobia. That includes things like giving speeches or going to parties. Things like that. Do you think you have any social phobias?

B: I wouldn't say I have a social phobia. I'm a bit of a performer, and kind of an extrovert, but I also really don't like being around people all the time. I kind of describe myself as an extroverted introvert.

J; That's fine, Ben. But that's pretty clearly not anxiety. Let's move on to the third one, which is separation anxiety. Do you experience any separation from anybody as being particularly frightening.

B: Not particularly, no.

J: Ok fine. The fourth one is generalized anxiety. What about that?

B: Yeah. I'm pretty much always anxious about something, or just have a sense of anxiety, whether its towards any specific thing or not.

J: When you feel kind of anxious about something, What do you do about it? What helps you?

B: It's always something different. Thats something I’ve learned, that you can't always use one coping strategy for every situation, you have to try different things for different situations and figure it out, and even if its a similar situation to one you've had before, sometimes the same solution won't work.

J: Boy, are you absolutely right about that. You've got to have a number of arrows in your quiver in order to hit the target, that's for sure. Now I do want to mention this: some research that my colleagues and I did with large numbers of young adults, the results were that males, about seventy-five percent of males do much better with physical techniques of relaxing such as tightening all your muscles and letting them go, or deep breathing, and the women, about seventy-five percent of them, worked much better with mental things. That includes imagining yourself by a nice, quiet lake, or that you're listening to a chorus of monks singing. So are you more like the males here or the twenty five percent category?

B: I think I'm more towards the twenty five percent. Of course there's deep breathing that works occasionally, but mental stimulation tends to help me more, so I think more the twenty five percent.

J: Can you tell us what kind of imagery that you tend to seek when you're feeling anxious?

B; Yeah, I think of people who I love, or good times I've had. Sometimes I'll sing a little song in my head that I enjoy, or just try to make up a story to distract myself.

J: I seem to remember that one of your favorite songs is “oh la de da” is that correct?

B: (laughing) Absolutely!

J: That's an inside joke. Ok. Number five on our list: agoraphobia. Kind of not liking to be away from home very much.

B: Yeah, kind of. Not super, but a little bit yeah.

J: What typifies the situation where you don't like being away from home. Is it a long trip to a strange place? Or what would categorize this?

B: Something I can't get out of. So if I can't escape to calm down, or if I'm kind of stuck in a place that causes me some anxiety, if I'm not in a place I feel safe.

J: That brings up an interesting point, Ben. I have the same thing. Especially if I go to somebody's house for dinner and I find myself to be surprised to find myself quite bored by the conversation, I don't experience it as boring and that I've just got to get through it. I experience it as being trapped, being claustrophobic, and of course that makes it a lot worse for me. So very often you get to a place where you just as soon would not go out with friends or whatever. I remember back in 1984 I almost got housebound. Just didn't want to go any place. Have you had anything like that?

B: Yes, I think when I was younger, like middle school age, I was going through a lot and just couldn't make it outside or go anywhere

J: Ok. Have you ever experienced a panic attack. One of those very sharp and very strong anxieties, even to the point where you feel like maybe you are going to die or something terrible is going to happen to you.

B: Absolutely. Unfortunately I've experienced that many, many times.

J: I'm sorry to hear that. Can you tell me the circumstances that typically brings it out?

B: Usually it's a result of many things piling up over time and then I just can't handle it anymore and I snap.

J: Yeah somebody I was talking to, a woman recently who had been through a very long, difficult period of time, and she said when she thought it was going to be over, all of a sudden she experienced a panic attack. She said to me “ I always thought that people who said they were having a panic attack were just trying to get out of something, they were malingering or whatever” she said “ but I've had two of them now and they're just awful. They seem to come on you all of a sudden” and Ben you've probably heard me talk about the analogy to a stampede. If you don't pay attention to the early warning signs of a panic attack, and we do get them, we just don't pay attention to them. Sometimes we just don't want to think about it. Then the next thing you know the cows are up and they are running and it's too late, you've got a stampede on your hands, so you need to try to be more responsive and ore aware of the fact that you're on the verge of a panic attack and cut it off at the pass. Does that make sense to you?

B: Yeah absolutely, that’s something that's allowed me to have far fewer panic attacks.

J: That's terrific. I'm so glad to hear that. Number seven is Obsessive Compulsive Disorder. I happen to have known you for a long time, and I know that at least at one time, when you were only four years old, you were collecting rocks on the beach, and your mother said “that's enough rocks” and you said “ no I have to collect them all'' and she said you just can't, we don't have any room for all the rocks on the beach, and you started to cry and I remember I thought “wow it looks like he's got OCD.” At such an early age I'd never seen it before. Did that turn out to be true?

B: Absolutely. And my OCD has kind of evolved over the ages from needing to collect things to search for symmetry, and a need for tradition and keeping certain activities, and doing them the same way whenever I do them.

J: Well those are some excellent examples of what happens when somebody has OCD. As you know, it's obsessions which are thoughts, and compulsions which are behaviors, but they are both pretty much the same thing. I make the analogy to superstitions. Superstitions tend to come about because somebody says, you know the old story “Don't step on a crack, you'll break your mother's back” and so you avoid stepping on a crack and when you get home you find out that indeed, your mother's back is not broken, and we laugh about that but that's kind of the syndrome to the extreme of OCD, is that you learn that if you double check the oven to make sure you turned it off, or that the iron is turned off, or that the water is not running, then you feel better; relieved because of this. And it may be that you are trying to punish yourself for these thoughts. I don't know. But at any rate you feel a lot better when you go and check so what you learn from that is id better always go back and check. Does that sound right?

B: Yeah that's a description of OCD I hear often. But sometimes it's like that for me, but it's also less superstition in other cases, many other cases. It's just I feel a kind of existential dread or extreme discomfort until I perform an action or do a certain thing a certain way.

J: So it sounds to me like theres the threat of a panic attack, and it is relieved by doing something obsessive or compulsive. Does that make sense to you?

B: Yes it could be described that way. But there's always a wide variety of things that could determine whether or not I feel a certain way about something.

J: there's one more, which I presume you do not have, because you haven't been in the military, at least not yet. And that's Post Traumatic Stress Disorder. Do you think you have any signs of that?

B: No, I don't think so

J: Well Ben, this has been very helpful. This was exactly what I was looking for when I invited you to be on the podcast. And I think you've given us some really good examples of what these various kinds mean. I hope we'll get a chance to talk again sometime.

B: Hopefully so! I'd be happy to come back.