How can i step on a

How Can I Step on a Crack Without Cracking Up?
Surviving Obsessive-Compulsive Disorder Oh no, did I turn off the stove? I hope the house isn’t burned down when I get home! Where did that thought come from? Or crossing the street, I might count and hit the curb with my “good” right foot—on purpose. This happens because a few past actions can still encroach, but fortunately lack stay-ing power. Unlike years ago when the days—thick with anxiety—filled my mind with something I did-n’t understand and couldn’t talk about. Instead, I withdrew and isolated myself to face my worry, shame and guilt alone. I didn’t understand why I needed to pat my clothes while mindlessly chanting before dressing. Or why I disbelieved my own eyes, and checked the iron countless times for fear of causing a catastro-phe. It didn’t stop—I was also preoccupied with germs and washed my hands dozens of times a day, yet never felt clean enough to stop. But as bad as it all was, my worst torment came from the terrible thoughts that shocked me against my will—thoughts I feared might harm innocent people. It didn’t oc-cur to me that anyone else’s imagination could possibly be so horrible. But I really wasn’t alone, for now I know my experiences were just the classic symptoms of an anxiety disorder known as Obsessive-Compulsive Disorder, also called OCD. Described as a “hiccup of the mind,” the OCD brain is stuck in a time-consuming cycle of obsessions and compulsions. First, ob-sessions arise and cause anxiety. Next, overt compulsive behavior follows in an attempt to relieve this mental distress. But the relief is short lived, because the obsession inevitably recurs, perpetuating the cycle. Obsessions and compulsions may vary, but examples include: • Ritualistic counting and chanting • Preoccupation with symmetry and order • Hoarding (e.g., newspapers, junk mail) • Intrusive thoughts (violent, blasphemous or perverted) OCD sufferers, often ashamed, don’t want others to know about their bizarre behavior. We realize that our actions are ridiculous and irrational. I knew this, and would have been mortified to share my need to chant words while passing under a doorway. And if someone caught me flinching and con-torting, I couldn’t admit I was driving bad thoughts out of my head. In shame, I hid my behavior. Though many OCD sufferers likewise choose to lock themselves in the figurative closet, oth- ers might elect to seek professional help. Effective treatments for OCD have emerged, and one or both of two major strategies are usually adopted: drug therapy and behavior therapy. Research has revealed low serotonin levels in the brain; therefore medications to restore normal levels of this neurotransmitter are often administered. These “selective serotonin reuptake inhibitors” include Paxil, Zoloft, Luvox and Prozac. The other major treatment, behavior therapy, employs a lifestyle change known as exposure and ritual prevention (ERP). ERP aims to desensitize the OCD sufferer by controlled, gradual exposure to obsessions with deliberate bypass of the compulsive behavior. For instance, a germ-obsessive may touch a few “unclean” objects a day without the compulsive washing responses. As the initial anxiety subsides, gradually exposure is increased so that in time handling more unclean objects can be tolerated without anxiety. Seeking outside help wasn’t an option for me. I was ashamed, and furthermore, my shame was commingled with guilt because I was supposed to be a Christian. As a child I went to church, but didn’t know much about God. But I was sure something must be wrong with me to experience such inner tur-moil. Although striving to be good and trying to drive away the violent and perverted thoughts, I failed. I was desperate for sound spiritual counseling, but asking for it was too risky. It would force me to re-veal my inner self to a spiritual authority who would probably confirm my already full-blown self-condemnation. I couldn’t take that chance, so I remained closed off. But the desire for spiritual strength led me to a pathway where I discovered how to defeat ob- sessions. I wanted to know God, and He revealed Himself through His Word. To my surprise, He wasn’t wrathful and waiting to punish me, but gracious and loving! No strings were attached to Je-sus Christ’s forgiveness of all my flaws, including my countless obsessions. To learn to walk by faith, I No strings were attached to Jesus Christ’s forgiveness of all my flaws, including my countless obses-sions. To learn to walk by faith, I needed a safety net--the security that I could never be snatched from His hand. And though I stumbled and fell into the net many times, the assurance it provided was key to my securing freedom from OCD. However, my obsessive impulses didn’t just instantly vanish. They came, and I wanted to compulsively drive away the anxiety. But instead I learned to trust God, casting these anxieties on Him rather than relying on useless compulsive actions for relief. It meant letting Him take control, some-thing new and vital to my mental health. Like many OCD sufferers, I had been overcome with doubt. With rituals and compulsions I was trying to control the wrong things--both in this world and the world beyond (things over which God never intended me to worry). But when I chose to stop fighting my ob-sessions and instead entrusted them to God, the result was life-changing. Looking back, I see parallels between how God helped me overcome obsessions and the tradi- tional ERP behavior therapy approach: common elements to both are the exposure to obsessions, the bypass of compulsive rituals, and subsequent relief. But God also gave me hope, peace and forgiveness, not just relief from obsessions. The value of professional therapy notwithstanding, once we taste relief we must also decide how fill the void left by the vanquished obsessions and compulsions. For example, just because I’ve conquered an anxiety disorder doesn’t mean anxiety won’t at- tack on another level such as concerns about family, work, finances, health or safety. God filled the vacuum in my soul and became my compass to stay focused upon while dealing with all of life, not just obsessions and compulsions. Yet I’ve seen how my struggle with obsessions serves a purpose as my thorn in the flesh; the once-painful memories remind me today how much I need God to stay free. Oth-erwise, I risk falling into OCD and anxiety again, or taking some other unproductive and unhealthy detour off the road leading to God’s purpose for my life. Though God’s help was indispensable, I desperately wanted human support and understanding about my anxiety. I wasted countless hours absorbed in worry and guilt, afraid to tell anyone, unaware that I had a clinical disorder. How can others help? A degree in psychology isn’t necessary, but some basic knowledge about OCD is invaluable. Well-informed families, friends, coworkers, teachers and clergy can recognize OCD in people, understanding and encouraging them rather than reacting in anger or confusion. Consequently, those afflicted are less likely to feel ashamed and hide their disorder; in-stead they’re more likely to discuss it. The more OCD is exposed, the more manageable it becomes. It’s been useful learning about my disorder so that when obsessions arise, I can spot them and affirm, “That’s just OCD, not reality.” Although not as plentiful as resources for some of the other mental dis-orders, there are a number of outstanding books, websites and organizations dedicated to assisting OCD sufferers and their families. Moreover, most people can identify with many types of OCD behavior. Don’t many “normal” folks occasionally perform silly rituals, harbor superstitions, or think bad thoughts? OCD sufferers aren’t deviants, just very sensitive people who over-react with odd behavior carried to extremes. And who hasn’t been anxious? Someone’s weakness may not be rituals and germs, but maybe it’s fear of flying or overeating. Compassion and understanding offer a cup of cold water for anyone beset with frailties, including the parched OCD soul. My husband knows about my history with anxiety. While interacting with me, he might some- times notice something strange and ask, “Is this OCD?” There’s no shock, disapproval, or scorn, just recognition of a weakness. Moreover, the fact that he yet loves me means everything. But his under-standing and support don’t encourage my weakness; we both realize obsessions are useless and irra-tional. Helping me to see this and speaking the truth in love serve to quell the fires of anxiety. OCD brought me much anguish, but surpassing it were the wonderful things God brought out By Mary Nixon


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Abstracts 11. Forum Aktuel e Neurologie und Neurogeriatrie für Ärzte in Klinik und Praxis Samstag, 26. Februar 2011 9.00 – 16.00 Uhr Die Veranstaltung findet stat mit freundlicher Unterstützungder DESITIN ARZNEIMITTEL GMBH, Hamburg. Videogestütztes Epilepsie-Seminar: Wie sehen Anfäl e aus? Prof. Dr. med. Andreas Schulze-Bonhage (Freiburg) Das paroxysmale, unvorhersehbare

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