Tuesday, March 29, 2016
SEEING PAST A SEA OF BLOOD
I chose for my second ERP, ‘Walk down the street in trainers / shoes / boots without checking behind me for blood or contaminated needles, and don’t seek reassurance from my partner, Jan, or write down that I hadn’t been contaminated by anything on the pavement’. Before starting ERP my initial SUDS level was 90, and my goal, after ERP, is to get it down to 0.
The first time I did this ERP was a lot harder than I’d anticipated – but I did it (I walked down the street in walking boots without checking behind me for anything that could potentially contaminate me such as blood or needles, and managed not to ask Jan for / write down reassurance that nothing had contaminated me).
After I’d completed this 20 minute exposure, though, my brain fogged up and I felt very anxious and tearful. I’d just arrived at my allotment and made myself focus on the digging I’d planned to do. For about an hour, the anxiety remained, and I checked behind me once when I thought I’d seen a needle-type object in the grass.
I didn’t think I’d be able to do another ERP on the walk home, but after three hours, I’d calmed down sufficiently to be able to successfully complete another 20 minute exposure and got my SUDS level down from 90 to 87: All the way I felt so vulnerable (as if I didn’t have a skin), but kept thinking, “I am walking forwards. Keep doing it.”
On my arrival home, though, I began to feel extremely panicky and was hyperventilating: I couldn’t move or stop my mind from replaying what I’d spotted on the pavement during my walks (a red spot I’d seen became a sea of blood in my mind’s eye) and by now I was too exhausted to distract myself. Inwardly I kept shouting at the ‘OCD demons’ in my head to leave me alone, knowing that the blood symbolizes a lot of anger, which is what I need help with PTSD-wise.
It began to dawn on me, through my tears, how incarcerated I’ve been – and how incarcerated I’ve caused my partner, Jan, to be by this illness and how determined I am, after 10 years, to see the back of it.
I found it difficult to concentrate on my violin practise and to think positive thoughts, but with the invaluable support on some of the EverythingOCD community on Facebook, I was eventually able to trust that given time the anxiety and urge to seek reassurance that I hadn’t been contaminated would subside: One of the administrators of the EverythingOCD Facebook support group and fellow OCD fighter, Monique Gagne, shared with me this poem she’d written a few years ago. It helped me enormously:
Pain With A Purpose
“Don’t turn around. Keep on walking. You’re OK. Don’t turn around. Keep on walking. You’re OK.” These phrases cycled through my mind over and over again as I walked away from the subway platform. The surge of adrenaline spiking through my body caused such incredible shaking that I was sure others could see it as I passed by them. I knew I could not allow myself to look back. Every atom in my body wanted to look back. Just once. Just to check and see if I knocked someone off of the platform and onto the tracks below. I was beyond desperate to put an end to my uncertainty. Something inside whispered that I did not knock any poor unsuspecting soul over. That was my voice of reason, fleeting as it was. I would have heard screams, wouldn’t I have?
Everyone who’s been in an automobile accident has experienced an adrenaline rush. It’s a terrible feeling. Your stomach is in knots. Sometimes you break out into a cold sweat. Your body is ready to spring into action at any moment. You can get a sort of tunnel vision, where you only see what is directly in front of you. That was what this felt like. My body was screaming for me to glance back at the destruction that I must have surely left behind. However, I did not turn around. I willed my feet to move forward, though I could not really feel the motion of my legs. When I finally arrived at my waiting car, I had to sit until my breathing returned to normal and it was safe enough for me to drive away.
I don’t remember exactly when this incident occurred. It was a while after I’d been in CBT. By this point, I had learned that performing Exposure and Response Prevention can, over time, literally make visible changes to the brain. I compelled myself to keep walking because I was aware that with each painful step I made, I was re-wiring my circuitry. Experiencing that terrible anxiety was simply proof of the positive changes going on in my brain. Later, after some reflection, I was pleased that I had this strong physical reaction because of what it meant to my recovery.
At times, ERP will seem so incredibly painful. However, my psychologist reminded me more than once that I was already in terrible pain. With ERP, you twist that pain around and make it work for you, instead of against you. Eventually, the pain subsides, even during an ERP. Today, when I do exposures, the pain is never as bad, nor does it last as long as it previously did. Now, I even have times throughout my day when I am anxiety free.
You can walk away from the “subway platform” of your OCD too. One tiny step at a time. That is all it takes to get started. Don’t turn around. Keep on walking. You’re OK.
Throughout that night, the ‘sea of blood’ image continued to haunt me in my dreams, as did my parents who were unable to see the ‘needy child’ me, but by morning, the fragile ability I had to rationalize these 'walking' fears had returned.
Two days later, and armed with the realization that I was more able to do this exposure if I walked fast and with purpose than if I slowed my pace, I had got my SUDS level down another 47 points and was able to walk in lightweight trainers down a busy London street without compulsively seeking reassurance that nothing on the pavement had contaminated me. I even felt embarrassed that I’d been letting this irrational (to the point of laughable) fear rule me for the best part of a decade.
At present, my SUDS level, having continued to competently complete this exposure in both walking boots and trainers, is 15. I’m still struggling to cope with the anxiety I experience afterwards, however, when images of what I’d just spotted on the pavement, for example, a bunch of cigarette butts, replay and get exaggerated in my mind. My solution to this has been to distract myself with the TV and then have an early night.
I became aware that I was in danger of developing a new OCD: Asking Jan for reassurance that I hadn’t asked her for reassurance, and I know that I must stop myself from doing this.
One of my most severe OCDs has been to write down reassurances to myself that in checking emails, I haven’t deleted or deleted again, any important ones. Over the past few days as I’ve been checking emails, I’ve been asking myself what the worst case scenario would be if I did delete / lose an email – and the answer is, nothing catastrophic: I'm now more able to live with uncertainty for longer and longer periods of time.
The battle continues...