The Teenager With OCD: A Forgotten Victim of the Pandemic

“Don’t say it,” I whisper under my breath as Dr. Fauci imparts his sage wisdom to a captive audience. We know the drill: wear your mask, keep your distance, take your temperature, and…

“Handwashing,” he advises.

“Damn it,” I mutter, looking around the room to make sure my oldest daughter isn’t paying attention. I don’t want her to hear about the handwashing again. It isn’t just the act of handwashing that the experts stress, it’s the duration and thoroughness as well.

No, I’m not against hygiene, especially during a pandemic. My teenage daughter has Obsessive-Compulsive Disorder (OCD). Among other compulsions, she washes her hands until they crack and bleed, and the pandemic, among its myriad horrors, is hell on those suffering from OCD. OCD isn’t a cute label you slap on a friend’s urge to organize their sock drawer. It is a beast that demands reassurance, ritual, and obedience. Worse, the more reassurance you give, the more it seeks, until your heart is racing and your stomach is aching, and you are unable to cross to the other side of the room without thinking the right thought at the right time. Even if you can hold the right thought in your head, it may morph before you cross the room; then you have to go back, touch a lamp again, or read the same sentence ten times, or, as my daughter has told me, pick up an eyelash off the carpet because you were thinking about the viciousness of Nazis when you dropped it. If you don’t find it, then it means you’re a white supremacist, which is connected to Harm OCD, intrusive thoughts of hurting yourself or someone else.

My daughter’s Harm OCD can spiral until I find her dry heaving over the toilet and telling me between sobs that if the unbidden, murderous images she sees herself committing in her head are true, then she doesn’t deserve to live.  I sit on the floor with her. Sometimes presence is all we can give.

 Most of us have likely had the experience of a stray thought about harming someone, perhaps even someone we love. We shudder, shrug it off, and move on. But the person with Harm OCD cannot stop the images; the more they try to push the intrusive thoughts away, the more they persist. Their brain interprets these random flashes of nonsense as actual warnings. Dire warnings.

These are not bad people. In fact, studies have shown that those with Harm OCD may be less likely to commit violence, as the empathy and compassion within the sufferer feeds the compulsion: the very act of trying not to think of something causes the person to think about it on a punishing loop.

That’s the insidious nature of OCD. It wants to get your attention—demands it, in fact. It goes for the most vulnerable thing, the thing that would scare you the most. And it works. It works so well that it starts to take over your life. It sucks the joy from moments and crushes them. The sufferer will start to seek confirmation that they are not a horrible, unlovable, unworthy person, or that they aren’t going to accidentally kill someone by spreading COVID-19 because they didn’t wash their hands just one more time.

It can take years of therapy to learn how to stop responding and ritualizing when the thoughts and obsessions occur. I know. I have OCD as well. Now I’m on the other side of this disorder, willing to help share resources with anyone who will listen.

The pandemic has many victims, some you wouldn’t even guess. Somewhere there is an OCD sufferer who almost had their handwashing under control until the pandemic hit. Somewhere there is someone with intrusive thoughts who managed to control them until more than two million people worldwide died of COVID-19. Somewhere there is a person you would never imagine being in distress who is just barely hanging on, waking up every day to fight a beast that is threatening their sanity. Somewhere, someone needs a little more patience, a little more light and love, a little more advocacy.

We can help OCD sufferers deny the beast its power over them, to drive it back into its lair and seal the cave. The process starts by saying that their thoughts do not define them, their actions do. These actions include finding a specialist in cognitive behavior therapy—specifically exposure and response prevention (ERP). And then they must do the work. The reward is nothing less than the reclamation of their life. Just as we can beat the coronavirus with diligence, OCD sufferers can overcome their neurological disease through persistence and courage. Start today.

Vulnerability Be Thy Name

I sit at the kitchen table in another OCD discussion with my daughter. She’s in tears.

I know what to say. I’ve been through this before. I have it figured out… except, I don’t. I feel myself hesitate to share how I was feeling while I was out running today: the vulnerability that felt so icky, my urge to drown it out with some really loud, vintage Aerosmith piped in through my headphones. I realize it isn’t fair for me to expect her to be vulnerable—the only true path to healing—if I can’t do it myself. We want to ask someone else to risk exposure while we sit there in our armor, fearing that an arrow might pierce our ego.

It’s total hypocrisy. We often hide behind concepts such as “I have to be the strong one here” or “This isn’t about me.” And while those things might be true, they are often excuses for us to hide behind. We can’t ask others to do what we are too damn egocentric to do. I recall an interview with RuPaul that I listened to a couple months ago where they shred the idea that “vulnerability is strength.”

It isn’t fair for me to hold back my own fears. I’d go so far as to say that it is a betrayal to the person sitting in front of me. 

I remember the day I ran into a neighbor walking her dog and a pleasant “hello” turned into a discussion about the grief we shared as mothers dealing with children going through deep anxiety: the powerlessness, fear, and sorrow we felt as parents. I thought I was fine, coping well, chugging along, until I burst into tears on the side of the road. We both needed that talk.

Back at the kitchen table, my daughter says, “I don’t want people to pity me.”

“Me neither. It sucks, right?” I take a deep breath and begin, “Today, while I was out running, I felt…weak, powerless, and couldn’t figure out what it was. I started this blog to help others who’ve felt the horror of Harm OCD, but no sooner had I designed the site than I began to have this creeping sense of something I couldn’t identify. I wanted to ignore it. I almost did. Instead, I sat with it (well, I was running at the time, but you get it), let it wash over me without judging it.” It occurs to me that this is the essence of Exposure and Response Therapy (ERP) therapy as well. “It was a feeling of vulnerability. I asked myself what was behind that. Behind it I found fear. Fear of feeling weak again. Vulnerable. But I made myself stay with it.”

“No. I don’t like that.”

“Yeah, me neither, but I can be okay with those feelings now. I can embrace it.”

We have a long talk about how we are feeling. We don’t fix anything.

But neither are we alone.

Smiling Buddha

My teenage daughter and I come from a long line of nervous smilers, appalled smilers, and many other smile-related coping mechanisms. My Charismatic Christian grandmother even tried to pray a demon of mockery out of my sister due to her nervous giggling. Of course, that’s a whole other post, perhaps titled, “Nonsense Be Thy Name,” but I digress.

My daughter often asks me questions I can’t answer. I’m instructed not to answer by her therapist as they are reassurance-seeking questions fueled by her OCD; thus, my answers would be enabling.

They often start with, “So, I know this might be an OCD question but…”

That’s my cue. The point where I know immediately that I can listen and offer support, but I am not supposed to reassure and become part of her OCD ritual. As many who’ve suffered OCD—especially harm, morality, checking OCD and the like—know, reassurance is an abyss that can never be filled. “Are you sure I’m not a bad person? Are you sure I’m not a murderer? A weirdo? Someone who doesn’t deserve to live because I have these thoughts?” The list goes on.

“You know I can’t answer that,” I reply.

“Arr,” she moans, almost comically, as she scrunches her face and gives that little smile that helps her deal with the crushing anxiety that OCD brings. I call it the “Smiling Buddha.” It’s a wonderful counterbalance that keeps this thing from crushing her. I don’t believe Smiling Buddha is avoidance or minimizing. It is a grace. It doesn’t fix everything or banish the beast, but while the OCD beast thrashes around demanding attention, ritual, and blind obedience, Smiling Buddha tames the tyrant with a quiet, unexpected power.

We know Harm OCD is a big problem that demands big solutions, tough solutions. In fact, we feel that we are damn near broken as we implement these solutions. The ERP therapy itself is painful and demanding. There’s nothing easy about lying in the floor in absolute terror that you might be a murderer and being told to do nothing to reassure yourself. The harsh reality is pretty much what Churchill said, “If you’re going through hell keep on going.”

Here’s to the Smiling Buddha–the little graces that are so unobtrusive, modest, humble, and unassuming, that we almost overlook them. In hindsight, they are irreplaceable anchors in a stormy sea.

There is nothing weak about this bundle of fear, nerves, and sorrow I see before me seeking reassurance, this lovely soul that is my daughter. I don’t reassure. I just listen, as Smiling Buddha sits across from me, quietly accepting, unmoving in the torment that is very much still there.

Grace in the flames.

A Mother’s Perspective

It’s one thing to suffer from OCD and the even darker beast of Harm OCD, but seeing your child suffer is, as they say, a whole new ballgame. I suffered with OCD and, more specifically, Harm OCD as a child and into adulthood, but seeing my daughter so distressed by the terrifying intrusive thoughts of Harm OCD that she lay on the bathroom floor dry heaving, went far beyond any mental anguish I’d dealt with personally. I’m her mother. I’m supposed to be able to fix this. But the truth is, I can’t. When her hands were cracking from the obsessive hand washing–as horrible as that was–I could put ointment on them, but there is no ointment for this. Yes, I can find her an Exposure and Response Prevention (ERP) practicing therapist, provide her with the right books and resources, but I can’t crawl into her brain and fix it. Only she can put in the hard work that ERP demands. I can only stand by, encourage, and hope.

But as someone who’s been both the OCD experiencer and mom, I can say to other parents, I get it. I can offer the perspective of a parent who can only stand by and deal with not being able to bandage their child’s wound, perhaps for the first time feeling helpless as a mother or father. I can address the hopeless feeling that this brings– the sense, however false, that this illness might mean we are failing as parents. I can also say to the parent who hasn’t experienced Harm OCD, that this doesn’t make their children bad or dangerous.

OCD does much to isolate the sufferer; however we must not let it isolate us from each other at a time we when we need the most understanding, support, and strength. I invite you to leave comments, ask questions, and make use of the resources on my website. You may take comfort in the knowledge that, as difficult as this disorder is, you are not alone.

And while you’re at it, remember to be kind to yourself.

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