Interview with OCD: Forty-Five Days to End of a New Beginning

review.

INTRODUCTION

The dialogue you are about to read contains the unaltered self-dialogue (self-interview) script of Dr. Engin Ozertugrul’s doctoral dissertation. Unlike any previous research on the subject, the author/researcher self-dialogued his thoughts and feelings in real-time self-to-self conversation in which he was both I-Researcher (IR) and I-Participant (IP). In this format, the conversation between IR and IP is impromptu and immediately available to readers. In the dialogue, the author explored two research questions: How did I experience obsessions and compulsions? And how do I experience healing from obsessions and compulsions? The results are presented within creative synthesis, the artistic creation that demonstrates the essence of the experience as a true reflection of 45 interview sessions that were conducted over the course of 85 days. There were two creative syntheses—one was formulated at the end of the Part I interview sessions (1-22) and the other at the end of the Part II interview sessions (23-45). The first creative synthesis answered the first question; the second creative synthesis was the composite depiction of both research questions.

We, people with OCD, face a common enemy and this entitles us to that extra something (or that inner something) that makes our experiences less than amenable to scientific methods. When this mysterious inner experience is absent, our healing may not be complete, however valid and justified our treatment (or therapy) may be. This book can best help you by sharing not only our sorrows, disappointments, and failures but also by framing them in new ways to achieve a real sense of healing. Although, this book is self-contained, it demonstrates the application of the self-healing method described in the author’s doctoral dissertation entitled, Heuristic Self-Search Inquiry into One Experience of Obsessive-Compulsive Disorder. Readers are strongly encouraged to read the dissertation, which is provided as a free supplement, to gain a fuller understanding of the method. The dissertation can be accessed through the following link (web page opens June 2015): www.OCDinstituteforchange.com (No registration or membership is required. Use Promotion code: ‘OCDinstituteforchange’ to download the free copy).

Special note from the author to people with OCD: Interview with OCD will not provide you with a magic wand. You will still need to do your part: Read. Read closely and repeatedly. The dialogue is designed to use our obsessions to our benefit; it does not intend to treat or cure our OCD. The dialogue is easy to follow. But you may stumble on words that you may not be familiar with. Don’t panic. These words will not hamper your understanding.   They will become clear to you at the end. Be prepared to experience self-doubt. People with OCD are masters of self-doubt; it comes with the territory. I designed the dialogue so that self-doubt becomes part of the process—something that you can learn to tolerate, and finally leave behind. Stop reading if you feel very anxious or panicky. Remember, feeling anxious or panicky does not make you stupid. But it can make the material seem more difficult to understand. Be patient with yourself. Do not try to understand everything at once. As a person with OCD, you may encounter similar shifts as you move from one dialogue session to another. If you find yourself conversing with yourself, do not stop. You can always return to reading. It is far more important for you to find your own dialogue rather than reading to mine. Interview with OCD is not about my dialogue, it is about yours. It is about you going somewhere. It is about you removing that barrier, layer upon layer upon layer. Do not stop reading to the dialogue until you start your own. No matter how powerless you feel right now, you can still be an active participant in your healing process. In the dialogue, you will find a problem, a method, and directions for a solution. But the dialogue does not suggest that you must follow my path; it will give you the tools to compose your own story, to pick your own battles, and find your own resolutions. It took me 85 days to write the dialogue. But it took me three decades to get into writing. The first two decades were about pain and suffering. The last decade was about a transformation that rewarded me beyond my wildest expectation. This book constructs the dialogues of these three decades to the best of my recollection. Our goal is to make self-dialogue (as much as possible) inclusive to integral, honest, and transparent presentation. This may be limited by our ability and willingness to disclose. The good news is our ability and willingness to do things is not carved in stone. As you will witness in the dialogue, we occasionally underestimate our capabilities because we generally focus on what we are and rarely stop and think what we can be. Through the experience of one individual, this book informs us about who we are and what we might become.

Interview Sessions/days: 45

Interview Period: 85 days

IR: I-Researcher

IP: I-Participant

Part I

How did I experience obsessions and compulsions?

(The minutes of the interview sessions indicate the actual duration of the interviews as they occurred and recorded).

Session 1: Duration 101 minutes

IR: What was your first conscious experience of OCD?

IP: My first conscious experience of OCD concerns agoraphobia. I was eight years old. It was a hot summer day. I was walking up hill toward a beach to catch up with my mother. She must be 30-40 yards in front of me when she reached the peak of the hill and then disappeared while she was calling my name. I ran and caught her on the other side of the hill. Now she was standing next to me, yet she seemed so far away as if I was looking through the other end of the binoculars. I felt a sudden wave of intense fear. It felt like my mother was slipping away from me.

IR: Now try to remember more; what else can you tell about the experience?

IP: What I remember was that distinctive horrifying sensation which passed through my body like an electric current. I was convinced that if I kept my eyes open she would be sucked into the vast skyline in the background and disappear forever. I frantically closed my eyes and opened them at least couple of times, hoping that my vision would return to normal. Momentarily, it did return to normal; but then it switched back to that scary and unreal vision. My fear uncontrollably intensified. I felt no option but to stand there with my eyes closed until my mother held my arms and asked me if I was okay. I was too ashamed of my fear, so I told her that I was fine. On the drive back home, sitting next to my mother, my vision returned to normal. I felt better, but I was still shaken by the experience.

IR: Didn’t you have another experience like this when you were sick? I think you had a cold and slight fever. You must have been about the same age. Remember?

IP: Oh yeah, I completely forgot about that (pause)… my mother was standing at the door a few feet away from me, but all of a sudden she seemed far, far way; I blinked my eyes frantically to restore my vision. This did not last more than couple of minutes, but it left me very frightened.

IR: Now I am trying to remember; did you ever tell mom anything about these experiences?

IP: Only in one occasion (I must have been around nine) I found the courage to tell her of my experience. After hearing what I had to say, she tried to comfort me with her reassuring soft voice. But I also noticed a hesitant and a concerned look on her face. I took this as a sign of something abnormal about me. After this incident, I decided not to talk about these occurrences.

IR: How do you know that these earlier experiences have something to do with what we are exploring now?

IP: I don’t. I mentioned these here because in both incidents, the fear felt like panic attacks that I experienced during OCD episodes. And since then I never had this particular experience again.

IR: You mean seeing things as if you were looking through the other end of the binoculars?

IP: Yes.

IR: Moving forward, do you have any other earlier memories that you think relevant to your OCD experience?

IP: Uhmm … I am not sure how relevant this is, but in my early teens, I spent most of my time worrying about having a serious illness. When I was 15 years old, I was hospitalized for stomach bleeding (accompanied by nausea, shortness of breath, and dizziness). The loss of blood was so intense I slipped into a coma and required a blood transfusion. Five years later, I experienced the exact same sensations. I had no doubt that I was having stomach bleeding, but this time the medical results were definitive: there was nothing physically wrong with me. I couldn’t believe that the persistent nausea, shortness of breath, and dizziness, which I exactly experienced the same way five years ago, had no medical basis. Embarrassed and shaken, I left the hospital, trying my best to act normal.

IR: To act normal! Was this the first time you started to think that something might be wrong with you; I mean mentally?

IP: It might very well be. Not sure.

IR: For now, let’s assume that this and your earlier experiences have something to do with what you experience (as OCD) much later in life. How did you manage these agoraphobic and hypochondriac occurrences? And what thoughts and feelings were present when you were dealing with them?

IP: I think I managed them considerably well. I was able to fully attend my daily activities. I neither run from doctor to doctor (as hypochondriacs would do) nor gave up to fear of leaving home or being alone outside (as agoraphobics would do). As being a competent person, I avoided these activities at all costs. I did not want people to think that there is something wrong with me. But competence also worked against me.

IR: How so?

IP: Instead of considering a serious plan of action or seeking help, I devised a series of rituals in order to avoid overwhelming anxiety.

IR: What kind of rituals?

IP: Mostly, these were mental rituals. I managed to minimize behavioral rituals and was careful about doing repetitious activities such as checking of doors, stoves, and locks when people were not around. I did not want to alert others that something is wrong.

IR: But you also had other types of obsessions and rituals.

IP: Right. Over the years, my OCD focus evolved and spread to other areas, forcing me to come up with new rituals. I developed low levels of ordering, counting and contamination obsessions. Then there were these intense religious and violent obsessions.

Session 2: Duration 61 minutes

IR: In the previous session, you mentioned intense religious and violent obsessions. Let’s talk more about that.

IP: I was horrified with the idea of being an immoral or violent person. As these were more abstract issues, it required more energy and time to devise rituals counteracting the intense fear and anxiety I was experiencing.

IR: But it wasn’t just the idea, was it?

IP: No it wasn’t. You know… I was aware that these are my moral obsessions. But knowing this cognitively did not help. Just the presence of these thoughts made me feel like I am an immoral or violent person.

IR: Did rituals work?

IP: Not really; (pause)… may be a little. But I did not know what to do. I was running out of rituals; for every ritual I created to reassure myself that I am a good and moral person, there existed the possibility that I am neither.

IR: Now, let’s talk about your life situation at the time. Try to remember what was happening in your life when you were having these obsessions.

IP: Well (pause), in 1982, when I was a freshman at college, I remember that the intensity and frequency of my mental rituals gained strength. I suffered insomnia. I was having occasional anxiety attacks, forcing me to come up with new rituals. These were extremely exhausting experiences, leaving little energy and time for daily activities. My social relations were interrupted and I fell behind my school work. I lost a term, but somehow managed to graduate in 1987.

IR: Wait! Let’s go back a little. You said your mental rituals were intensified and became frequent during your first year of college. I remember you were overwhelmed at the time; was it all these new people and a new environment?

IP: Perhaps, not sure.

IR: Now I want you to set aside the descriptive details of your obsessions or rituals. Try to explain the overall felt sense of the experience. What I am asking is the quality or dimension that stood out above all for you.

IP: There was this continuous presence of fear or anxiety.

IR: What were you fearful of?

IP: I don’t know; all I know is that I was afraid that something horrible was going to happen any moment… (Interrupted).

IR: Now you were thinking about your earlier agoraphobia experience with your mother

IP: Yes.

IP: Do you know why?

IR: Not sure. But something about this experience reminded me of that experience.

IR: Let’s find out what that is. Was it the way you felt the fear?

IP: I guess so; it was that hollow sensation of fear all over again.

IR: Describe this hollow sensation of fear

IP: It is like I am horrified with something, but I don’t know what exactly that is.

IR: Because you didn’t know what you were afraid of this made you more self-aware. It was almost like you were afraid of being afraid!

IP: Exactly! I was always self-conscious. Even when I was with friends or other people, my internal dialogue was always present and strong.

IR: What were you telling to yourself?

IP: It was something like: What is happening to me? Why can’t I shake this thing off? Or Oh God! They are going to notice something is wrong with me. Am I sweating? Is my voice cracking? And so on.

IR: So you worried about your fear, but at the same time you worried about how you were perceived by other people.

IP: Yes, I did everything in my power to appear normal and this was very exhausting. Sometimes I had a hard time understanding how I could appear normal to other people when my world was falling apart inside.

IR: And this made you feel like… unreal?

IP: There you have it.

IR: Tell me more about this unreal experience.

IP: It felt like there were two worlds: the one I was in and the one all the other people and other things were in. I did not want this experience; I wanted to feel normal again.

Session 3: Duration 98 minutes

IR: In the previous session, you talked about your rituals in reaction to stressful times at college. Then you talked about the feeling of unreal. I know you have more memories with similar experiences.

IP: Yes (pause). In 1990, in the midst of financial problems and a strenuous love affair, I was stressed and those unreal feelings returned with full-blown anxiety attacks. I was extremely frustrated; I was saying no, not again.

IR: And you responded with rituals?

IP: Right.

IR: Tell me more about your rituals.

IP: Over the years, I developed extensive rituals. I used them against OCD not because they were effective, but because I felt no way out. The more rituals I created, the more the focus of the OCD was varied. Eventually, I found myself obsessing with almost anything.

IR: Do you have one vivid example of that?

IP: Once, I remember developing an intense aversion from the sight of blood for about 9 months. Then just the thought of blood was enough to trigger an extreme avoidance behavior of places such as hospitals or violent movies. I was telling myself that as long as I stayed away from hospitals or watching violent movies, I should be okay.

IR: You stayed away from these activities… but this did not help.

IP: No, it didn’t.

IR: Your mind was occupied with relentless what-if thoughts.

IP: Yes, I could avoid violent movies or hospitals, but I could not escape from my thoughts; they would come to me so suddenly and so relentlessly.

IR: In one of the previous sessions, you said rituals did not really work. Do you think this is because your obsessive thoughts were faster?

IP: (Pause)… I think so. They were always faster than my mental rituals and would follow me anywhere I went. By the time I came up with a counteracting ritual, I would already be in the midst of anxiety attack.

IR: Now let’s think vivid examples of that.

IP: (Pause)… once I was at the sea shore, suddenly a thought popped into my mind: What if I see blood every time I look at the water? Or I would be just lying in bed looking at a white ceiling before a thought comes to my mind What if I see blood every time I see anything in white?

IR: You never actually saw these things happening.

IP: No.

IR: And you were well aware of how irrational these thoughts were.

IP: Yes.

IR: And yet knowing this did not reduce your fear.

IP: Yes, exactly.

IR: Although these things never happened, you felt as if they were going to happen at any moment.

IP: Yes it was that fear of being in a fear experience all over again.

IR: Now try to remember your body’s reaction to fear.

IP: (Pause)…I remember having a strangled feeling, accelerated heartbeat, cold sweats, chest pain, and feeling unreal.

IR: Were they present all at once?

IP: Yes

IR: How long?

IP: When all of these were present, I don’t think that they lasted more than 5-10 minutes.

IR: Then what?

IP: Then these feelings gradually subsided; I was still uncomfortable but not panicky.

IR: For this particular obsession, you said you developed an intense aversion to the sight of blood for about 9 months. But this is not entirely accurate because, if I remember correctly, this quickly shifted to other types of obsessions; just like the one that you described: What if I see blood every time I see anything in white.

IP: That’s correct. And this is a much harder obsession to deal with because (interrupted)

IR: Because white is everywhere; it was hard to avoid.

IP: Yes.

IR: Do you think you picked white because it contrasts with blood?

IP: Possibly, but it is funny that you use the word pick. You know; I did not have any choice in the matter.

IR: You are right, this was the wrong word. Now what I am trying to understand is the sensation of your fear. How did it feel like? Was it the image of blood spilling on a white color that scared you most?

IP: That and other things.

IR: What other things?

IP: You know it was not really the white color or the blood what I am scared of. It was what they represented.

IR: You mean violent things; like murder?

IP: Yes.

IR: And you did not want to think about these things.

IP: Yes again.

IR: And white automatically meant murder or violence.

IP: Exactly! But more so what I was scared of was the fear of seeing white everywhere.

IR: And what do you think would happen if you see white everywhere?

IP: I would stay with these thoughts forever.

IR: Then what?

IP: Then… (Pause)…I don’t know…Just the thought of being stuck with something that I don’t want horrified me.

IR: Isn’t it true that you were also worried about going crazy when this happened?

IP: I guess so. This was always part of my violent obsessions.

IR: You mean going crazy, losing control, and hurting other people or yourself.

IP: Yes!

IR: Do you remember any physical or mental ritual to avoid white or the thought of white in this particular incident?

IP: No. I was just too busy avoiding the thought of white. And whenever I saw white, I turned the other way, if it was possible.

IR: And what happened when it wasn’t possible?

IP: I told myself something like this: This will soon go away, try to think other things.

IR: Did this help?

IP: Very little. But again, I didn’t know what to do.

Session 4: Duration 40 minutes

IR: In the previous session we talked about one of your particular mental obsessions. Were there any specific places or events associated with this experience?

IP: Not really. These types of mental obsessions can occur anytime and anywhere; this is why work and social gatherings were the places of hellish experiences. I would spend great deal of effort and energy just to act normal.

IR: You did not tell anything to anyone about your struggles?

IP: No. Even people who are very close to me did not know my problems. It was very important for me to keep OCD private.

IR: Why?

IP: I did not think that anyone would understand my sufferings. I also greatly feared that people wouldn’t feel safe or comfortable around me if they knew the content of my thoughts. Why would they? I even had a hard time understanding those thoughts I was having myself.

IR: What about the rituals?

IP: I was painfully aware of the unreasonableness of the rituals.

IR: And yet, you felt compelled to perform them to keep your sanity.

IP: Right. Without them, I felt sure that I would cross over and go crazy.

IR: Tell me more about this feeling of going crazy.

IP: The most unbearable aspect of going crazy is the thought of losing control and harming people around me. This was also the most horrifying aspect of having OCD. I also remember that my intolerance to uncertainty was unbearable.

IR: (pause)… I think what you meant to say is you were questioning whether you had something other than OCD and this uncertainty made you very uncomfortable ; you wanted to have an answer, now!

IP: Yes, I remember obsessing for days whether my thoughts are really OCD. At one point, I felt that I would be more relieved to have OCD than being an immoral or psychotic person. Because the latter meant that I would be much closer to acting on my obsessive fears, which I dreaded the most.

IR: It didn’t occur you that this fear was itself OCD?! You knew psychotics do not fear of having violent thoughts.

IP: Yes, but just any like other obsessions, this cognitive knowing did not change how I felt.

IR: So your fear of having this thought is like a self-fulfilling prophecy. Because you are having this violent thought; there is always possibility that you might be a psycho.

IP: Exactly! And you and I both know that this did not feel like just possibility—it felt real.

Session 5: Duration 78 minutes

IR: Now let’s dig a little deeper into the experience of obsessive compulsive thinking and behavior. Let’s start with the general, then move on to details. What exactly did you obsess about? And what thoughts and feelings were accompanied with it?

IP: My obsessive-compulsive thoughts and behaviors have never been confined to one area (moralistic obsessions, wild obsessions, checking obsessions, and so on). I always remember having strong feelings of isolation along with feeling unreal and damned. To be a self-sufficient person has always been very important to me. I felt helpless when I could do nothing to stop relentless replays of unwanted thoughts/images in my head. My mind would always race with disconnected thoughts. I do not remember being completely free of chest pain, cold sweats, and a suffocating feeling. Sleep is the only time I would get some relief from OCD; although it, too, would occasionally be interrupted by anxiety attacks.

IR: You said moralistic obsessions, wild obsessions, and checking obsessions. Let’s talk more on that. These are various OCD focus areas; let’s give one example for each? Start with moralistic obsessions.

IP: Am I a good person? Is this the right thing to do? I could spend hours finding answers to these questions.

IR: What about wild obsessions?

IP: We both know that these were the scariest ones. They would sneak up on us in most inopportune times and places.

IR: Yes, now I am thinking of a vivid example of that. Do you remember the time