Guest Post by Megan Remer: Willingness To What? Changing How You See Treatment
Below is a guest post from an OCD Survivor, Megan Remer. Megan is a veteran of OCD and ERP treatment for OCD as well as being knowledgeable about typical obstacles that arise during ERP and in maintaining treatment gains after treatment.
“I’m so tired of living with OCD.”
Words I’ve said countless times and in countless ways.
Maybe you can relate.
For me personally, three different versions come to mind.
First is the hysterical version. The one where you find yourself fighting for air. The one where the desperation and despair that are constricting your lungs, become visible in the form of tears running down your face so fast that you wonder if you might drown in them.
“I’m so tired of living with OCD.”
Second is the apathetic version. The one where life moves in slow motion, and as you sit in front of a computer screen looking into the eyes of your therapist, you wonder if you will ever feel alive enough to cry again.
“I’m so tired of living with OCD.”
Third is the motivated version. The one where despair has come and gone because you are choosing to lean into the belief that maybe one day you will be free enough that you will no longer have a reason to say, “I’m so tired of living with OCD”.
Megan Remer is an OCD Survivor
How I Got Here
Hi my name is Megan, I’m a writing enthusiast, passionate advocate, and someone who happens to also live with the diagnosis of obsessive-compulsive disorder. While I typically wouldn’t say this is a great way to begin a post, I’ve decided to start this one off by admitting to all of you that when William asked me if I’d be up for writing this piece, I wasn’t sure I had anything left to say other than “I’m so tired of living with OCD”.
For context, a year ago I wrote a blog post on the topic of willingness in OCD treatment that I shared with William after just having returned from a residential treatment program. That was almost 12 months ago exactly, and it was during a time where I felt like freedom from my seven year battle with OCD was actually possible for me.
Fast forward back to this current post, and after seeing the words “Topic: willingness” written in Williams email, I was worried. Sure, maybe last year’s Megan who was filled with motivation had something to say about willingness. But now? The past 12 months of being back to my everyday life, I have found myself weary, confused, and more than ready to be done chasing exposures. Besides even if I could create something with that same passion and excitement what else is there to say? I’d already covered freedom versus functioning, how OCD keeps you stuck, and how willingness to engage in treatment can take you from a life limited by OCD to a life free from it. Not only did I not want to repeat myself, if I’m honest I wasn’t sure if what I’d said 12 months ago was still an accurate representation of my perspective on treatment.
But here’s what I know about learning:
Learning is a process.
It doesn’t just end.
As the seasons come and go, our lives change, and what we are learning changes too.
Of course, if you’re interested in what started this conversation on willingness you can absolutely check out my piece Does Treatment Work? and I’m sure you will learn something from that motivated version of myself, I know I have. That being said, if you’re interested in what a writing enthusiast, passionate advocate, and someone who also happens to have the diagnosis of OCD learned in a season of being weary, confused, and exhausted from chasing exposures, here goes nothing.
Stop chasing exposures.
The function of ERP
There I said it. It might seem controversial, but I am increasingly convinced that focusing your effort on being willing to do the right exposures, the right way, at the right time can become a hindrance.
Why? Well I want you to ask yourself two questions:
In the OCD cycle what is the function of a compulsion?
In the life of someone with OCD what is the function of engaging in ERP?
My answer to the first question is easy. The function of a compulsion is to escape the OCD trigger, fear, anxiety, thought, etc. Whatever it is that I’m so desperate to be free of the compulsion exists to neutralize it, and once it is neutralized then I can move on with my day.
Now, how would you answer question two? I’m guessing if you’ve been doing ERP long enough with a specialized clinician you might have an answer that goes something like this:
The function of ERP is to change your relationship with fear, anxiety, guilt, etc. whatever OCD presents you. This happens through a process of intentionally confronting a trigger which will likely elicit that fear and then interrupting the cycle by doing response prevention. The hope is that as you stop reinforcing the OCD cycle the relationship to your triggers and fears will change.
But here’s where things get interesting, what if we don’t stop there? What if we take it a step further? If ERP’s function is to change your relationship to your anxiety, fear, guilt, etc. then what is the function of that? Why do the work to change this relationship?
The correct answer might sound something like when you learn to sit with whatever OCD throws at you and your relationship with it changes, then you are no longer controlled by fear and can live your life on your terms free from the impact of OCD on your behaviors.
It took me a long time to come to grips with this, but the answer that I just gave is not my answer, instead my honest answer is this: I don’t see ERP as just a tool to help me live life on my terms. Instead with freedom from OCD in mind, I began to see ERP as a means to control and escape the triggers, fear, anxiety, guilt and a million other things that OCD had brought into my life. If I wasn’t free from all of that then it still needed fixing. And if it still needed fixing then I was just going to need to increase my willingness to do the work to fix it.
Sound familiar?
To me it sounds like I saw ERP as a long-term way for me to escape my OCD fears. Sure I could agree that compulsions didn’t free me long term, but if ERP was an alternative solution then I’d just keep doing it for as long as it takes to find that freedom I was looking for. To me it sounds like chasing the right exposure, the right way, at the right time became it’s own compulsion. Let me put it this way for the past two years I have treated treatment as a means to escape what I didn’t want to live with anymore.
Now I want to pause and let that sink in for you.
Is it possible that like me, somewhere along the way you have started to believe the lie that it’s only after you’ve gotten OCD under control that you could truly live? Has chasing exposures hindered you from actually living your life on your terms and kept you on a treadmill running hard but going no where.
If that’s you then I have one thing to ask you:
Why are you giving OCD so much power?
Okay, okay before you start thinking I’m oversimplifying your pain or blaming you for the presence of OCD in your life. Let me say no one wants OCD, and most often we are all just doing our best with what we know, but I do want to challenge you on this because I have been giving OCD way more power than it deserves, and I believe what I’ve been learning in this season could help you too.
If you are not convinced, let me start by giving you one reason that I know I personally have been giving too much power to OCD.
How I conceptualize and talk about both treatment and my experience with OCD is full of power language. In this post alone here are some of the words I’ve used:
Free
Fighting
Battle
Chasing
Limited
Escape
Control
Battling with OCD
Reading those words tells me that I have been operating from a specific narrative. A narrative that puts me and OCD on opposite sides of a power struggle. To even say I’m fighting for freedom from OCD paints a very specific picture. A picture of a battle. I don’t know about you but for me the idea of a battle brings up feelings of fear and a need to muster up some kind of willingness to fight in it. To succeed would mean that I took the power and control from my opponent and can now live freely because I am safe from it’s threat.
Now if my life largely consists of a battle with OCD then I think it’s safe to say that I’m going to need some weapons to fight it. At first I thought my weapons were my OCD behaviors. I thought that engaging in them would push back OCD and keep me safe. In reality compulsions are the equivalent of running away. You might be getting distance for a moment but all your really doing is allowing your opponent to gain more ground and territory in your life. In the long term it’s not hard to discover that this does not work.
Okay, so we need a different weapon?
Well, what about ERP?
ERP is clearly the better weapon. Rather than running, ERP is your sword in battle, because unlike running away a sword has power of it’s own that you can use to best your opponent.
But here’s the problem, if you’re in a battle when is it okay to drop the sword and stop fighting? When you’ve beaten your opponent. If you drop the sword at anything short of victory you die and unfortunately OCD has a way of taking what you thought was battle and turning it into a war. Sure you might have one victory but OCD sets the terms of this fight, and it will come back for more.
No wonder we’re so tired of living with OCD.
Okay, so what do we do? Is there a better weapon that can end the war?
Well instead of looking for an alternative weapon what if we look at the narrative itself. Is it possible the narrative is faulty? Is it possible we’ve been wrong about OCD? What if rather than a worthy opponent, OCD is a sheep in wolves clothing. The equivalent of the Wizard in Oz. What if OCD appears threatening and powerful but the only real power it has is the power we give it. Sure maybe theres a day it creates a really convincing illusion and it takes you a minute to get your footing and realign with reality, or to even just accept the uncertainty that exists in the midst of it. Maybe that illusion even brings up a lot of fear and you feel the need to try to escape it. I’m not saying you won’t experience that, but the true long term suffering we experience with OCD, I believe comes not so much from the thoughts, fears, emotions, triggers, etc. but from the steps we take to try and escape and control them.
After years of saying, “I’m so tired of living with OCD”, I’ve learned that what I am really saying is, “I’m so tired of trying to escape it.”
So here’s where I’m at:
I’m done chasing exposures.
I’m done trying to win my freedom.
I’m done fighting.
I’m done looking for an escape.
Whether I experience OCD triggers or not I refuse to treat them like a real threat. OCD doesn’t deserve that kind of power in my life. I believe it is in that realization, in the acceptance of OCD’s presence as an unwanted but ultimately unworthy opponent, that you will find you are living on your terms, not exhausted from an endless battle, but living your one, unique, beautiful in it’s own way, worthy of your time and energy life.
Now, before we end, I want to address what I’m sure most of you are wondering.
Am I saying people shouldn’t engage in ERP?
Not in the slightest.
ERP is a Great Tool
Exposure and response prevention therapy was a huge part of the process that allowed me to see OCD for what it is, and stop giving it so much power in my life. Unless another modality takes it’s place as the gold standard for OCD treatment I will continue to recommend it highly. At the same time I needed to change my narrative around ERP. ERP isn’t a escape route, it isn’t a effective alternative to our ineffective compulsions, it isn’t the “fix all” we are so often looking for. ERP is the tool that showed me I didn’t have to keep giving up pieces of my life to OCD. ERP is the tool that allowed me to start gaining insight that the compulsions made difficult to access.
Let me give you an example.
As I was in the process of writing this piece and intentionally reflecting on this idea of willingness and chasing exposures, I had this moment where it became practical. I was heading into a virtual session with my OCD clinician and was grabbing all the stuff I needed to go to my room and log on, but lately with living in Minnesota and having a basement bedroom, my room has been very cold. With that in mind I often grab my winter coat to wear during my session. This time as I was preparing for session and thinking about going upstairs and getting my coat I saw one of my throw blankets conveniently on the couch and I thought to myself, “Why go out of the way to go get my coat when I could just grab this blanket?”
For context one of my OCD fears is that my stuff will get mentally contaminated with an intrusive thought, and because I’ve had this happen so many times with clothes, blankets, etc. I’m pretty protective of my stuff. The last thing I want to do is be sitting in session talking about some intrusive thought and afterwards feel the need to get rid of my blanket and go buy a new one.
So here’s how I would typically handle that. I would either decide that not being able to bring my blanket to session is a big inconvenience and is worth bringing up to my therapist and planning an exposure around, or more likely in this season of ERP burnout, I would decide it’s not worth the effort and just go grab my coat. I’d probably think to myself, “Besides haven’t I already done some version of this exposure a million times and still end up back here anyway?”
Well let’s flip the script.
If I’m not in a war with OCD and everytime I experience an OCD fear I don’t have to figure out a way to fight it then maybe I could just grab the blanket and go to my session. Maybe instead of telling myself OCD is some big threat worth my time and energy I can just live my life the way I want to live it. So that’s what I did. In a matter of 30 seconds I decided to grab my blanket and go to session and in doing so not only did I save myself the energy of planning and doing an formal exposure or going upstairs to grab my coat, I also showed myself that my OCD fears aren’t something that I have to find an escape from.
Willingness to What?
Now, to conclude, the title of this piece is “Willingness To What?”, so although I know learning is a process and 12 months from now I might have something new to add, or even parts to subtract from this, here’s my thoughts on willingness:
Use ERP as a tool when you need it but remember that there will come a time when instead of chasing the next exposure you will need to take the insights you have gained from ERP and use them to be willing to drop the sword. To stop fighting. To go live your life. OCD can throw stuff around in the background if it wants, but maybe if you stop fighting you will find that OCD was never the threat it convinced you it was. You don’t have to escape or control it. In the moments when you feel like all you have left to give are the words “I’m so tired of living with OCD” and you think that the only answer is mustering up the willingness to do the next exposure, consider that maybe willingness is less about being willing to do the right exposure, the right way, at the right time, but instead about the willingness to just
LIVE.
