Apparently I was to meet Behavioral Therapist Jared in my room. I bet he wanted to observe how I had settled in, which could be described as “not well.” I hadn’t unpacked my large duffle bag or placed any clothes into the 1970’s style scratched, wooden three-drawer dresser. I tended not to allow my clothes and personal items to be housed in foreign containers. I may have ventured to unpack clothes into the bureaus in the Four Seasons hotel if I felt brave enough and after careful visual inspection, but placing my clean clothes into that dresser that was a dilapidated relic – no. At least my bed had been made and everything looked tidy.
I didn’t know why I even cared so much. It’s not as if Behavioral Therapist Jared would come in wearing a white glove to check for dust and then slap me if I failed the glove test. He was a therapist, not a German governess from the 1800’s. He wanted to inspect me and my acclimation to the room. My anxiousness wasn’t helped by the fact that I was standing up in the middle of the room, waiting. I didn’t want to sit down on the bed, and certainly not on the chair that accompanies the desk. I wanted to have as minimal contact with the room as possible which made waiting in it more burdensome than it needed to be.
However, because of my OCD everything in my life was far more burdensome than it needed to be. My thoughts about my awkwardness in the room were interrupted when someone in the hallway called out, “Hey Jared.” Behavioral Therapist Jared was approaching. I tried to stand casually (how does one do that?) and moments later, Jared knocked on the open door of my room.
“Hi Ben. May I come in?” asked Behavioral Therapist Jared in a tepid voice.
“Yes. Hi!” I said, over eagerly.
Jared wasn’t tall. He was just shorter than I was and thin. At least he appeared thin due to his clothes being a bit too baggy on him. He was dressed in khaki slacks and a non-descript button down shirt. He wore wire-rimmed glasses. His hair was curly and sparser around the temples. His face was smiling and kind. He held a clipboard in one hand and extended the other toward me. I took it and we shook hands. Just like his manner and voice, his skin was also soft. I was a bit nervous, but comforted by his calming presence. I wouldn’t have thought the man who was to help me slay my demons would be seemingly so gentle.
“It’s nice to meet you,” he said.
“It’s very nice to meet you as well,” I replied. It was a genuine statement. It was nice to meet the man who was to help me get well.
“So, I will be your BT,” said Jared, “and I have read your chart and everything, so I’m familiar with your OCD and why you’re here, but I still would like to hear some background on it from you if that’s ok?” he completed his sentences with a smile.
“Sure,” I said. “Well where should I start?”
“Can we sit on your bed while we talk?” he asked.
My first test.
“Yeah. Sure,” I replied trying to be as nonchalant as possible. He sat down on the bed immediately. His rear was way to close to my pillow. I didn’t know what else he had sat on while wearing those pants, but felt like all those other surfaces, whatever they may have been, were now cross-contaminating my pillow.
I looked at my bed and the spot I was about to sit on. It was a hesitation that would have been imperceptible to anyone except a specialist with a very trained eye. Jared was such a specialist and he smiled knowingly at me after I sat.
“Did you just pause before sitting?” he asked rhetorically.
I smiled and said, “Yeah.”
“Are you ok with my being on your bed right now?” he asked again with a more hesitant smile.
“Yes. Well, to be honest…”
“Yes, be honest.”
“Well I’m uncomfortable with how close you’re sitting to my pillow,” I offered sheepishly.
Jared offered a friendly laugh. “Ok. Why is that?”
I explained the whole pant-cross-contamination thing to him and my sensitivity to anything that touches my face.
“Ah,” said Jared. “That makes sense.” It was nice of him to offer that. However he didn’t move away from my pillow. He stayed put. “So,” he continued, “I want to hear about how you came to be here and then we can come up with a plan on how to get you well and get you out, ok?”
“Sounds very good to me,” I said with sincerity. “Well, ever since I was about twelve years old, I have had some OCD. Then it was rather mild. I would do the common things like washing my hands more than I should, tapping, counting out things in multiples of four, repeating things until they sounded right. Things like that. Then, when I was around fifteen my dad took me to see a psychiatrist and a doctor who said that I had OCD and suggested that I be placed on medication for it. The idea of taking medication bothered me. Taking medication for what I thought wasn’t really that much of a problem and something I could get rid of on my own if I really tried seemed unnecessary. So I made a conscious decision to stop some of the rituals. And by the time I went to college, my OCD had almost completely subsided. By the time I graduated college, I was the antithesis of someone with OCD! I didn’t ritualize anymore and I was even brazen. I mean I felt adventurous and wanted to try unknown things and go to unknown places. I liked taking risks! If some food fell on the ground, I would have no problem picking it up and eating it. I felt great.
Then about two years out of college there was an incident that changed things dramatically. Right after the incident I started getting concerned that I had exposed myself to AIDS. I started researching AIDS on the internet and throwing out clothes and any other objects that I felt had been exposed and therefore contaminated. I couldn’t stop thinking about it. I went to get tested. After the results came back a few days later that I was completely healthy, I felt extremely relieved. I thought I could now resume my life and start to live normally again. However, the trauma of the incident was too great. My OCD about AIDS just grew and became completely all-consuming. Everything I did, every decision I made, most of which were irrational, like throwing away ‘exposed’ wallets, cell phones, clothes, money, anything and everything, was motivated by my OCD.
I mean there are other things too. I mean there’s so much! I don’t want to scare you and think, ‘man this kid is one messed up dude.'”
Jared laughed at this. “I wouldn’t think that. I know you have OCD. And to be honest, you strike me as someone who is very socially well-adapted and self-aware. Some of the patients who come here are almost in a state of denial and they have kind of checked out of society. You haven’t. You’re fighting to stay in it and you know you can’t do that well with your OCD. I mean, you’re very high functioning for someone who has the extent of OCD you currently have. I want to hear some of the other things,” Jared invited.
“Well…ok…well, alright well something that really made me feel like I was living a double life was my living situation. When I was living on my own. I mean, if anyone came inside my apartment in the latter stages of my living there, which I wouldn’t and didn’t allow, they would have genuinely been frightened by what they would see. It was frightening. It wasn’t just ‘quirky’ or a weird sort of messy. It was more like complete chaos. It looked liked an insane person lived there and…” I pause. I start to get a bit choked up when talking about this bit.
“Continue,” Jared encourages.
“Well, essentially my entire apartment, other than a few small areas, was ‘contaminated’….I mean to me. I could only sleep on the end of one side of my bed and could only walk on a narrow path from my bedroom to the bathroom and to the door. The rest of the apartment I didn’t use because it became contaminated. I mean it was a large apartment and fully furnished with really nice furniture that I paid a lot of money for. However, one night, the night I had a house-warming party at my place something happened that made everything and everywhere I touched in the apartment that night ‘contaminated’ and off limits from that night on. For almost two years after that night, I used only a very small area of my apartment. I didn’t use my dresser with the special deep drawers that I had to assemble myself, my rustic looking laundry baskets from Pottery Barn, my closets, anything in my living room like my custom-ordered couch, my oversized coffee table that I loved, or anything. I didn’t ever again use my kitchen and all the new dishes and cookware were off limits after that night. The brand new gourmet knife set my dad gave me as a housewarming gift, the glasses and cutlery I picked out with my sister and brother-in-law, which they generously paid for and I carefully lugged back from Portland, Oregon. I mean things with sentimental value…all just became hazardous in my mind. It was a prison really. A prison with a high monthly rent.
For two years after the night of my house-warming party, everything I touched that night remained untouched. I left everything as I had at the end of that night. The same dishes from that night were in the sink for two years. The appetizer platter with the triangular cut pita bread for hummus sat on the kitchen counter for two years, with the bread still on it. Everything was left as it had been from that night, which was pretty much close to when I first moved in. Yeah, so shortly after I moved into my new apartment and carefully furnished and decorated with expensive items, it all became a bio-hazard. Everything went to waste! And I lived in that for two years! I wasted away in that overpriced apartment with all my expensive things for all that time. I think if any of my friends or family who were at my house warming party had ever come back inside and witnessed that everything had been left as it was from that night, they really would have been weirded out. They would think I was a very sick person. Which uh, you know, I guess I was.”
“Well from what I have read on your application and from what you’re telling me, I’m amazed you were able to keep a job and function socially as much as you did,” said Jared. “I mean to keep a high pressure job and still continue to cavort with your friends is fairly high functioning for a person with your level of OCD. That’s impressive in a way,” said Jared.
I liked that he looked at things with a happy spin to them. It made me feel less awkward about describing such an abnormal living environment. He actually made it sound like what I did was an accomplishment. He contextualized my ability to function in society while having severe OCD as some sort of feat. That definitely catered to my ego, but was his commentary sincere? I didn’t want to be placated.
“I mean, don’t get me wrong,” said Jared, “You were living in extreme conditions that yes, if anyone had witnessed, they probably would have been shocked to see. It isn’t normal behavior by any stretch of the imagination.”
Well, so much for feeding my ego.
“However,” he continued, “you fought on and tried to push through rather than completely retreat. I think that effort to push through the OCD will bode very well for you when we get into therapy and treatment.”
“I hope so,” I said. Then it occurred to me that I didn’t want Jared to assume the wrong image of me. I had practiced diminishing the severity of my condition and behavior for so long for the sake of appearances, that I didn’t want Jared to be duped by me as well. I was there to get better. I needed to be honest to do that. So before I basked too much longer in Jared’s happy spin of my behavior, I decided to let him know my continued participation in society wasn’t as rosy as it seemed.
I let Jared know the extent of my avoidance. I shared some stories with details so that he knew how involved a simple, seemingly reflexive task would be. I let him know that exiting my apartment, even when I was in a hurry, wasn’t just about opening and closing a door. It involved my finding a barrier – a paper towel, a sheet of paper, something that would provide a safe barrier after it was folded over one or two times, for me to use to turn the doorknob, which was “contaminated.” I had to be careful in handling this barrier after I used it to open the door and not allow my fingers to touch the underside, since it had now come into contact with the doorknob, and as I needed to use the barrier again to pull my door closed upon walking out of my apartment careful to not brush any part of my person against the door or door frame. Then I would walk outside, still holding the barrier, usually pinching it with my thumb and pointer finger until I came upon a public trash can to drop it into. I didn’t bother locking the door to my apartment because handling the “contaminated keys” with a barrier would require more complex maneuvering and where would I place my keys afterward? I couldn’t just throw them out. So instead to save some time, I just left the door unlocked. I let him know I did all this using just one hand as I had to keep my “clean hand” free from contact just in case.
Using one hand was more shameless when I wasn’t being watched, but when I had to do it in public such as when I paid for coffee or bought anything really, I felt very watched and I felt shame. It was weird behavior. I knew that, but it was the compromise I made.
I let Jared know about how many things, very valuable things, I had to throw away. These included relationships, my reputation, confidence and sense of self-worth.
I let him know that I spent at least a third of my waking day ritualizing behaviorally – repeated hand washings, discarding items, taking the long route to avoid neighborhoods, etc. and the rest of the time I was ritualizing mentally. I was always mentally consumed to some extent by OCD thoughts. Always. I let him know that my “waking day” was actually a misnomer, because as I didn’t get much sleep anymore, my every waking day included much of the night.
I let him know all these things and much more and when I was done, I let him know that I desperately wanted to get better. See, I had to get better because continuing such a life wasn’t a prospect I could reconcile myself to accepting and continuing any longer.
After my confessional I looked at Jared. He smiled and nodded, doing both softly and with care. “Ok,” he said, “we will get you better.” I looked at Jared a while longer studying his face and demeanor. Then I breathed out and and let my shoulders fall because I believed him. I knew he would save me.