Mom’s novel:
AA:
My Road to Sobriety:
OCD:
~
My OCD has been terrible the past few days. I mean really just brutal. It’s my own fault. This isn’t always the case but this time it is. For some reason beyond my understanding, I go through these unadvised phases wherein I either a) stop taking my meds (Prozac) completely and suddenly (exactly what you’re not supposed to do), or b) Begin taking the Prozac “every other day.”
I know. I’m two steps ahead of you: Stupid. Foolish. Not wise. The exact opposite of efficient. There seems to be some weird delusional part of myself that tells me the story that I don’t need the meds. But there’s a reason I started taking them to begin with, in 2019.
For a long time, like many Americans I was “anti-medication.” There were three main reasons for this. Two were very personal reasons and one was more abstract. The first personal reason was that my mother, who’d ended up in the public psych ward for two years as a teen—read her book here—had taken medication and it’d saved her life, literally. She’d made two serious attempts on her life leading up to her stay in the ward. Ditto my father, who’d attempted suicide at age 27, leading to his meeting of my mother. (Long story.) And my mom—who I’ve always had a complex relationship with—had put pressure on me for years to take meds. This only pushed me further away from the idea of meds. Her controlling side came out and she felt I needed to take meds because it had saved her. But this wasn’t her life. It was mine.
My rebellious, prideful side responded.
So I had two parents who had basically been saved by medication.
The second personal reason was my sobriety and involvement in Alcoholics Anonymous. Sober for 13.7 years now, I quit the bottle at age 27, in 2010. I’d known too many people in 12-step circles who’d taken medication say for pain after an accident, only to find themselves badly addicted. Often this ruined their lives—or nearly did—and ultimately led them to sobriety and recovery. (Which is a good thing, but often the road there was harsh. My road was, for sure.)
The third more abstract reason was a mixture of most of the people I knew in my life—minus my folks—including family, friends, AA buddies and even therapists, who complained often and self-righteously about the “over-prescribing culture” we live in. They bemoaned the doctors and psychiatrists who were like legal drug-pushers. I tended to agree with them. Having been “forced” to take Ritalin as a child for supposed ADHD (I stopped taking it early in high school), I felt certain these popular 90s meds had pushed me into my demonic cocaine use.
Perhaps there’s some truth in all of this. Ritalin is similar to coke, is an upper and is very much like street-speed in many ways. People do get addicted. And I was and am an alcoholic and addict (albeit a sober one now). We do very much live in an over-prescribing culture. Look no further than my wife, who got a prescription of Adderall almost immediately without having to say almost anything.
And yet.
From when I got sober in 2010 until 2019—almost a decade—I probably saw a dozen different therapists in several different cities. These therapists spanned across ages, genders and therapeutic modalities, from CBT-obsessed early thirties to an 80-year-old Jungian therapist and everything in-between. I’ve gotten something—and often a lot—from basically every therapist I’ve ever had. But none ever truly solved my problem, which was, among other things, my nasty, ruthless OCD (obsessive compulsive disorder). Specifically—and I learned this designation on my own—Harm OCD. (It means what it sounds like: Obsessive, intrusive violent, sexual, immoral thoughts.)
I’ve always had a sort of love/hate relationship with talk-therapy. On one hand I find it helpful to have someone to talk to, to explain my problems to, to dialogue with about my deepest, most inner struggles. Someone who will listen and nod and give me honest, helpful feedback on what I’m going through. Someone I don’t have to worry about thinking badly of me due to some of my wild, taboo repetitive thoughts. Who I can bear my heart to, express my demons to.
But.
On the flip side, I also often feel like: Ok, I’m on the payroll now; they’re getting that regular weekly payment. What is their incentive to “fix” me? (I know the goal of therapy isn’t to fix you, but I guess what I mean is: What is the incentive to help you solve your problems if solving your problems means leaving therapy, and thus removing their financial anchor?) This seems to be one of the fundamental problems with any "capitalistic” endeavor, especially ones that involve your mental health.
The constant articles criticizing the prescribing culture as well as diagnosing the insane Opioid Epidemic didn’t help my and many other Americans’ feeling about medication. Pills were overprescribed and evil, many seemed to think.
*
It was in New York City in 2019—summer—that I started seeing a very experienced therapist. I’d fled the Bay Area for Manhattan in March of that year, to follow my Writer Dream of doing the deal in The Big Apple. The OCD had started in 2015 while I was looking for a house to buy in the Bay Area. I’d been with my ex back then. My 80-year-old Jungian therapist told me the OCD started right then because I was looking for a home with my then-girlfriend, and home had never felt safe to me. Growing up, my mom had gone through waves of emotional instability. I’d been molested. I’d been dropped off at Mom’s psychiatrist’s house at 3am one night when she was emotionally rocky. The neighbor kid up the street had put his father’s loaded 9mm handgun into my mouth and counted down from ten.
Life, as a child, had not felt safe. Home had not felt safe. And now I was re-entering this idea of home. After years and years of drifting and moving alone from apartment to apartment and city to city.
Perhaps.
*
Either way—whatever the reason—this therapist in NYC changed my life. We met four times a month on the 31st floor of a high-rise off 7th Avenue and 57th near Columbus Circle. I’d take the 1-2-3 train from Harlem/125th Street.
Anyway, she said something very simple one day. And I should add that she did not take insurance but only charged me $50/session. After several months seeing me she said: You know, you might consider medication.
Honestly: This hit me like a fist to the face. Not in a bad way. In a revelatory way. Regarding the OCD, I’d truthfully never actually even considered it. How many thousands of dollars had I spent on therapists? And yet not one single therapist had ever mention this idea. Until now. We discussed it further. She recommended a psych center way up in Washington Heights around 168th along the Hudson River. They saw people for free. Interns.
Long story short: I went. I saw. I received. Prozac. It changed my world.
It wasn’t that the OCD suddenly went away and all was perfect. That’s generally not how it works. But, what did happen was that the volume in my tumultuous, hyperactive brain was turned way, way down, and I for the first time since 2015 possessed the ability to choose. What I mean is: When the obsessive, cyclical, intrusive thoughts came, I actually for the first time had the ability to choose whether I’d stay with those thoughts or instead release them and think about other things, or just be in the present.
As you can probably imagine: This was a revolutionary shift in consciousness. My whole body and soul relaxed. Suddenly I wasn’t wrapped up in hours and hours of tedious, spirit-draining obsessions. I felt free, like a bird let out of its cage after many years. Four seasons I’d gone through the brutality of OCD, chained to my cognitive distortions. And it wasn’t just the thoughts; it was the fear, shame and guilt which accompanied them. How many times had I thought:
1. Am I a bad person?
2. Am I going to prison?
3. Will I be shamed by society?
4. Is my life worth living?
5. How do I turn this manic brain noise OFF?
And all of these thoughts were based on nothing but paranoid, irrational delusion brought on by obsessive thoughts which had literally zero basis in objective reality. I hadn’t done anything weird, bad or wrong. I’d only suffered from the incessant, looping, intrusive thoughts. Thoughts can feel incredibly real.
I started taking meds right in time for Covid lockdowns. (Who knows what would have happened without meds during that time.)
*
Yet, here I am, five years later, and I still make this dumb mistake of not taking the meds, or only going every other day. It’s as inexplicable as why I drank again the next day after a terrible blackout the night before (wherein I swore I’d never drink again) before I got sober.
Some of the thoughts have to do with a fear of skin-cancer. The idea goes: If I don’t wear sunscreen everyday, I’m going to die of cancer. This isn’t shocking given that my father died 10 months ago of skin cancer largely for that very reason. But he almost never wore sunscreen (different generation), and he waited far, far too long to get looked at, and by the time he did it was stage four. (Still shocking when I contemplate that he’s really gone.)
The most troubling thing about OCD is not the thoughts themselves. (Almost every therapist and psychiatrist I’ve ever had, and every book about OCD I’ve read, has assured me that these taboo thoughts are actually quite normal, though usually not spoken about for obvious reasons.) It’s the inability to stop thinking about them, and the rancid, unceasing desire to “resolve” the thoughts. That’s the most dangerous aspect of OCD: The cognitive delusion that if you could just get the thought “exactly right,” then it would lessen, weaken and dissolve. But of course that never happens. It’s just the opposite: The more you try to resolve the thought, the bigger and stronger it gets. You circle round and round the drain in a never-ending circle of madness.
One of the OCD books I’ve read that helps is called Freedom from Obsessive Compulsive Disorder: A Personalized Recovery Program For Living with Uncertainty. (By Jonathan Grayson.) It’s very helpful. Grayson is one of the pioneers of Harm OCD. He explains that the basic idea behind OCD is that the sufferer is desperately—and in theory, rationally—trying to attain 100% certainty about the fearful thought they’re having. You keep telling yourself, Yes, you’re a good person, and No, it doesn’t mean you’re fill-in-the-blank, or, No, you won’t get or don’t have skin cancer, or, No, you didn’t harm that person and you never would.
Again, the repetitive reassurances make rational sense…if you don’t have OCD. But for those of us who do have OCD…it’s terrible. Because, like Grayson says, what we’re ultimately seeking is absolute, total, unimpeachable certainty, and there is no such thing as 100% certainty in life. I could get skin cancer. I could go crazy and hurt myself and/or someone else. I could die tomorrow. I could say something in public I deeply regret. Now, clearly all of these things I mentioned are highly unlikely. But still: I can’t ever be 100% certain, because that’s just not how real life works. Life = uncertainty. I learned about this in AA, and in Buddhist meditation groups. You have to accept life “on life’s terms,” life as it is, not as you think it “should” be. My OCD tells me things “should” be certain.
But they aren’t.
Therein lies the rub.
That mad drive for inner certainty is a soul-crushing phenomenon.
*
I don’t know why I keep feeling the need to open the door and look into the face of my disease (OCD), via the method of going off or partially off my meds. But I do. There’s some ego-driven willful side of myself (shocker) that somehow still thinks I can “do it alone.” In some ways I’m like that with AA, too. When I first got sober in 2010 I sat in the back of the meetings for the first entire year, not speaking, not sharing, not participating. But I met people before and after the meetings and I stayed sober.
After a year something clicked and I “did” AA: I got a sponsor, did all 12 steps, made amends and changed my life. I got “commitments” in meetings and I was plugged in. Yet around year five—this is common—I disconnected again. I felt trapped. It seemed like AA was supposed to be done a “certain way,” and I didn’t want to do it that way. So I distanced myself. Two years passed. I didn’t go to meetings. I didn’t drink. But I was miserable. My relationship fell apart. I got back into the program. (AA.) I saved up, moved to New York.
Since then I’ve been in and out of attendance in AA. I don’t sponsor. I don’t have a sponsor. I don’t currently go to in-person meetings. I hit perhaps a meeting a week or so online, usually with my camera off. I don’t feel like drinking. I don’t think I’m totally “dry.” But I also can’t call myself spiritually “fit.” This is a longer and separate conversation, anyway, because there have always been aspects of AA I disagree with, and many I cherish.
My point is: I have a tendency to do things a) my own way, and b) the hard way. (a and b = the same thing.)
So here I am with the fruit of my own ego: Going partially off my meds again. I know this lesson yet I keep doing it.
Maybe this essay will serve as a reminder that I am, in fact, not God. I am just a man, like all other men, weak and flawed and afraid. Meds help me cool the flames of fear and delusion. Sobriety helps with that, too. Ditto human connection. Ditto gratitude.
Ditto writing it all down.
And of course taking my meds everyday again.