OCD update

Well, it's been eight weeks on very low doses of Fluoxetine, and I'm happy to report that the symptoms are 90% under control! The other 10% is long-entrenched behavioral stuff that takes a while to overcome. It's hard to get rid of 25 years of stuff.

Here's a fascinating look into a subtype of OCD - called "Relationship OCD". This is a great example of what living with OCD is like. It is marked by the same mind-freezing anxiety and uncertainty of all types of OCD, and the sufferer's attempt to use of logic, (whether or not it's truly logical!) to justify or understand the uncertainties and discomfort they are feeling - in this case, within a relationship, which as anyone in one knows, is filled with uncertainties and discomfort no matter how 'perfect' it is. How hard it is to discern the truth thoughts from the OCD thoughts when you're in a situation that, even for those who don't have OCD, is naturally uncertain and uncomfortable much of the time.

OCD is twofold: a dysfunction of the anxiety and fear inducing center of the brain (amygdala) which makes feeling "good" and "certain" impossible, and the behavioral habits that become entrenched as a result of desperately trying to feel "good" and "certain". Also, when the article talks about a "spike", this is referring to a particularly severe episode brought on suddenly by one of the toxic thoughts that send OCD sufferers spiraling. At my worst, I was spiking several times a day, releasing a flood of adrenaline into my system (imagine the shock and fear and adrenaline release you get when you have a life-0r-death near miss, such as a close call with a severe traffic accident). Imagine that occurring to you, sometimes several times a day for weeks on end, year after year, whenever your trigger thought pops into your head. It is exhausting. I am so glad that has mostly stopped, thanks to the medication, which seems to miraculously block the adrenaline release.

One thing that I really think is interesting about the following article is how being plaqued by self doubt really is a hallmark of OCD, but could also just be a normal person trying to grasp how they feel. So how do you tell if it's OCD or if it's just standard self-doubt? Look for other symptoms of OCD in your life. For example, if you find yourself obsessing about any type of thought for an hour or more a day, or if the same bothersome types of thoughts is recur over and over, day and night, weeks and years on end, and you just can't find relief from it, you probably are dealing with OCD, or as I would prefer to call it, "thought disorder due to serotonin imbalance".

Finding My One and Only

All OCD sufferers possess a driving force to prove that their own particular risk is not justified. Most persons with OCD will readily admit that they are painfully aware that the nature of what they spike about is irrational. Amongst persons with relationship justification spikes, there tends to be much less clarity about the irrational nature of their particular concern. This is in large part due to western society's romantic notions about what being in a relationship entails. Our fairy tales and popular media present all-loving relationships as being endlessly earth moving, firework events. There is very little mention that being with the same person over a long period of time tends to create a habituated effect, such that we actually get our appetite back and do find that there may be at least one other person on this planet whom we also find attractive.

Persons with relationship spikes in general, seem substantially more perfectionistic in their actual life philosophy then the general OCD population at large. This perfectionistic tendency leads to the belief that the answers to some basic questions will ultimately prove whether one is with the correct person. Examples of questions include: "Do I love him?," "Is she right for me," "Isn't it reasonable to assume that I could find someone just as good, but who doesn’t leave the toilet seat up?" If perfectionism seems to be a life theme, then one might consider reading the article "The Right Stuff" from the web site, (WWW.OCDOnline.com).

The mind of the OCD sufferer is so desperate for a conclusion that one cannot casually gaze at one's partner for affirmation of one's feelings. In the overall attempt to find the rational for remaining in the relationship, the mind acts like a high powered microscope and general experiences of satisfaction are replaced by a focus on minute details. Persons with this spike theme will often intently focus on minutia defects within their partner, such as the thickness of one’s partners eyebrows or the excessive dryness of their partners skin. Questions might even arise regarding one’s own laugh intensity in attempting to ascertain whether a response to the joke was a sufficient reply to their partner's humor. "Oh, my god! If I don't think he's funny enough what am I doing with him?!" Feelings of satisfaction and happiness occur naturally in the course of the relationship as long as one does not actively seek them out in an effort to get a definite answer. As a result, a relationship spiker's emotional connectedness can only be experienced in his or her psychological periphery.

Absence makes the heart grow fonder

The aftermath of this desperate need to measure the emotional intensity of a person’s commitment can greatly disturb a person’s choice to remain in the relationship. Relationships can be like a revolving door when persons end their commitments in an effort to turn off the endless cycle of mental anguish. A constant temptation for the relationship spiker is to see what peace they would experience if they would just break up with their partner. Generally, persons with this spike theme believe that their ruminations indicate that a fundamental defect exists within the relationship. On the contrary, the vast majority of these relationships function in an exceptionally healthy way. This tendency explains why many significant others remain devoted despite their partner's constant doubts. The choice to get married despite ones mental anguish is occasionally made to put an end to the uncertainty. The rational being that since I have taken the plunge, the nagging question is brought to a close. Unfortunately, neither marriage or separation really brings an end to the toil. This explains why a number of patients have initiated therapy up to five years after they have ended the relationship and are still trying to bring a close to justifying that the final choice was the correct one.

The saying "absence makes the heart grow fonder" is apropos. Usually, when one follows through with the urge to break away, the realization of what has been lost comes back with a vengeance. Persons with this form of OCD who have ended relationships often incessantly ruminate about whether the choice was justified. After the relationship has ended, the mind becomes very selectively focused on only the positive memories and tends to disqualify the negative times. The natural discord associated with getting "the answer" in regard to whether to be in the relationship is tremendous. When OCD is involved, the magnitude of this discord is amplified to the point of torment. Persons who, in their reasonable mind, are aware that the relationship is truly over, can still spend hours pondering whether or not it might still be worthwhile making one more attempt to salvage it. When this element of obsession is present the natural healing effects of time tend to be eliminated.

There Must Be Fifty Reasons to Leave Your Lover

The most common justification for persons considering the termination of basically good relationships is the absence of the anticipated emotional longing and desire when they are both with and without their partner. In the absence of these feelings, individuals interpret their experience (i.e. anxiety, depersonalization, derealization, etc.) as uncomfortable emptiness. The disorder offers a compelling promise of relief, if one were to merely end the relationship. A common position taken amongst persons with this spike theme is that "It seems only reasonable that since everyone else gets to 'feel' love for a partner, I should be able to do the same." Persons often contemplate and occasionally dabble in the effort to establish whether they would feel different if they were with someone else.

There are a number of other common rationales that persons focus on which keep the endless desperate cycle spinning. The belief in a "singular soul mate" can promote an intense scrutiny of having to feel that the person they are with is compatible with them in every way. Minor differences, which in any other relationship would easily be absorbed into the natural diversity of relationships in general, become extreme points of contention. For example, "If I don't fully appreciate my partners sense of humor, then wouldn't I be better off finding someone who was just like my partner, but whose sense of humor I could appreciate more?" Another common misconception is that, "If I can find someone else attractive, that might mean that my partner and I were not 'meant to be' or I'm not sufficiently attracted to her." Being aware that one can still find others attractive at any point in a healthy relationship is an important basis to operate from. Believing that one's soul mate should be perfectly compatible in every way, and/or uniquely and completely attractive, results in endless doubts and insecurities about the person being your "true" soul mate.

One possible reason for the prevalence of this spike theme is the common notion in society that one should "feel" in love with their partner. Being guided by one's "true feelings" is a popular romantic notion which plays itself out in a variety of media venues. The author M. Scott Peck wrote in the book The Road Less Traveled that a committed love is one based on the conscious effort to prioritize one’s partner and make CHOICES which demonstrate one’s level of commitment. He emphasized that romantic love, in contrast, is an attachment based on an intensity of an overwhelming experience. Many persons in long-term relationships will end the relationship due to no longer feeling prior levels of emotional intensity. Often the statement "I love you, but I'm not IN LOVE with you," becomes a justification for the end of the relationship.