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OCD and Other Gods

Written by Dr. Christian Komor.
Paperback, 107 pages
$15.00
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Copyright 2000 by Christian R. Komor, Psy.D. All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission from the author except in case of brief quotations embodied in critical articles and reviews.

Publisher: The Saint George Press
Grand Rapids, Michigan

CHAPTER ONE: WAKING UP IN THE GARDEN

You do not need to leave your room.
Remain sitting at your table and listen.
Do not even listen, simply wait.
Do not even wait, be quite still and solitary.
The world will freely offer itself to you to be unmasked.
It has no choice, it will roll in ecstasy at your feet.
- Franz Kafka

We are living at this very moment in the Garden of Eden. Surrounding us is a world of unbelievable beauty, peace, and utter fulfillment created, many of us believe, by a loving God. We can see and experience the hand of grace in the sunlight glistening off the water, the wind drifting through the trees, the rains nurturing the earth. Even better, we have an amazing variety of fellow creatures to share this with. Truly our world is a garden of delights waiting to be experienced. Each moment we are alive on this earth holds the potential for joy, fulfillment and serenity. Life is inherently designed to be a wonderful experience.

If you have Obsessive-Compulsive Disorder (OCD) as I do, or any of the other OC-Spectrum disorders, you may not always be enjoying this garden of ours so much. In fact, when you look around you might often see only weeds and decay. This is not unusual for those with OCD, a neuro-behavioral disorder and one of a "spectrum" of related brain problems referred to by researchers and clinicians as "OC-Spectrum disorders". These disorders include, but are not limited to: Hypochondriasis, Body Dysmorphic Disorder, Trichotillomania, Compulsive Hoarding, Gilles de Tourettes Disorder, and Self-Mutilation. All are lifelong afflictions on the order of diabetes or epilepsy. OCD itself is considered one of the four most disabling psychological disorders and is experienced by more than 6.5 million people in the U.S. alone. OC-Spectrum disorders can range from being so severe that the individual is literally immobilized by a ritual for weeks on end, to occasional intrusive thoughts of having to go back and check if the garage door is closed.

A Continuum of Compulsion

While in this book we will be focusing on understanding and recovering from the OC-Spectrum disorders which appear in the Diagnostic and Statistical Manual of Mental Disorders, it is my observation that OC-Spectrum disorders represent the extreme end of a continuum of self-loss. This continuum is characterized by compulsivity. Elsewhere on this continuum lie such problems as work addiction, Type-A behavior, Obsessive-Compulsive Personality Disorder (OCPD) and even the "hurry sickness" so prevalent in our society today. (See below.)

This image shows the progression from a Healthy Being to one with OCD. A Healthy Person falls to Perfectionism, which leads to Hurry Sickness, which leads to Type A Behavior, which leads to OCPD and finally to OC-Specturm Disorders.

The reasons that I am stressing this point at the outset is because of my belief that it is compulsion that is the common denominator between all of the disorders and lifestyles we will be discussing. More important, it is compulsion that continues to drive us out of the garden of joy and aliveness that this world can be for us. Much like an addiction, compulsion leads us further and further away from our true self and the experience of spontaneous living while promising us safety and security it can never deliver. Compulsivity encourages us to become human doings rather than human beings. It robs us of our ability to experience the aliveness that can only come through spontaneity and being.

Anyone who has struggled with Obsessive-Compulsive Disorder or other compulsive dysfunctions knows how compulsions can come to replace natural spontaneity, aliveness and ability to approach life from a centered sense of self. Compulsions and "shoulds" can lead us so far away from who we were created to be that our conscious contact with God is blocked. Instead, the compulsions themselves exert God-like control over our lives. They become, in a sense, "other gods" that we worship through our rituals and compulsions. Perhaps it is our life task as obsessive-compulsive persons to find a pathway back to that experience of spontaneity, disinhibition, self-ownership and simply being that lies buried underneath our driveness and compulsions.

What is Healthy Being?

The experience of healthy being -- as contrasted with obsessive-compulsive behavior -- will be discussed in detail in Chapter Seven. For the present, however, it is necessary to establish an operational definition to which we can refer.

It is important to understand that the power of being is within us from birth and does not disappear, but rather is covered over by compulsivity - either taught by society and significant others or generated from misfiring neurons in our brains (or both!). Healthy being is the polar opposite of obsessive-compulsive behavior and (paradoxically) is re-discovered and embraced by the individual as a result of struggles with obsessive-compulsive behavior.

Like the experience of love, healthy being by its very nature tends to elude definition. Webster's defines the term "being" as "One's basic or essential nature." I would add to this excellent description the following:

An experiential way of perceiving and relating to the world characterized by a spontaneous and disinhibited acceptance and expression of self. In healthy being, our expressions of self arise from a centered sense of our basic or essential nature. In healthy being we experience and are motivated by choiceful self-ownership rather than compulsive or ritualistic reactions to core or obsessional fears, or externalized ideas of who we are supposed to be and what we are supposed to accomplish.

Whew. That was a mouthful. Let's just say that the important thing is that there are two modes of living - compulsive and driven versus spontaneous and natural. What we are after in OC-Spectrum recovery is the spontaneous and natural. Sound good?!

When approaching life from the perspective of healthy being, the inherent perfection and spiritual harmony in the natural world can be experienced. In the state of being a powerful feeling of aliveness and connection to our bodies is experienced. The environment seems to come alive and we may be thrilled with the wonderful elements of the natural world. A sense of release and letting go in our relationships is developed so that others are accepted rather than controlled, or treated as objects of dependency. A sense of destiny and an acceptance of the flow of life is also likely to be present along with a deep awareness of one's Higher Power.

Healthy being leads us to:

Make decisions and choices out of self-ownership rather than an externalized ideal of how things "should" look.
Accept all experiences in life as holding potential for personal growth and enhancement.
Carry with us inner resolve to relax fully in all situation - even when it seems we should be tense and upset.
Focus our attention on the present moment rather than our fears and projections regarding the past or future.
Listen to our spontaneous inner voice as opposed to the voice of our obsessions.
Be committed to transparency and congruency in relationships so that we interact with others as our true self, rather than a façade.
Enjoy the process as much or more than attaining goals.
Balance our time between self-care and self-wear.
Be patient and persevering in our approach to life and our own growth process.

Current Perspectives on OC-Spectrum Disorders

Now that we know a little about where we are headed, let's take a look at where we have been and where we are now in the treatment of OC-Spectrum and other compulsive disorders. When I was growing up with OCD in the 1960s the disorder was little studied and patients with OCD were considered largely untreatable. During the mid-1980s and throughout the 1990s research into the causes and treatments for OC-Spectrum disorders escalated dramatically. Folks with OC-Spectrum disorders now have a better than 50/50 shot at achieving a satisfying and enjoyable life. Even with new medications and behavioral therapies, however, OC-Spectrum disorders remain chronic and persistent.

Exposure and response prevention behavior therapy or ERP is currently the "gold standard" for treating obsessions and compulsions. After making a list of all obsessions and compulsions experienced by an individual, they are rank ordered in terms of strength. Starting with items of moderate strength, the individual is then asked to gradually expose themselves to the feared thought or situation and remain in contact with it long enough for habitation to take place. Habituation is simply becoming used to something so that it does not affect you. An example would be slowly getting into a cold lake for a swim and finding, after ten minutes exposure, that the water no longer felt nearly as cold as when you first entered.

Intrepid researchers at UCLA have found that, with hard work ERP can actually cause metabolic changes in our brains, causing them to function more how they were designed. I have known patients and friends with OC-Spectrum disorder who have used ERP and can truly claim to have made great progress in reducing obsessions and compulsions.

While exposure and response prevention behavior therapy, like serotonin-enhancing drugs, is a highly effective way of changing the parts of the brain that are not working correctly that is not the entire story. These techniques assist us in beginning the journey, but can only take us so far on the path. To complete the journey we need to understand the continuum of self-loss that comes through compulsion, and the manner in which our fears fuel that process.

There will be some who fear that this expanded perspective on OC-Spectrum recovery is a step backward towards the days when OCD and its sister disorders were viewed in psychoanalytic terms. I have OCD and I agree that viewing obsessive fears psycho dynamically (traumatic toilet training, poor parenting) is not only silly, but also cruel. Obsessional fears are, as researcher Jeffery Schwartz has put it so aptly, "brain noise". But there is another type of fear that fuels obsessive-compulsive behavior as well. I call these core fears. Unlike obsessional fears, core fears do make sense in the context of the person's life journey. They represent a task, which must be mastered, a journey of self-discovery, which must be taken. If this journey is not made, continual fear is the result and this fear feeds into the OC-Spectrum disorder making it more powerful and disabling and blocking our ability to attain spontaneous being.

So, beginning with the current treatment methodology in psychopharmacology and behavior therapy we are going to extend the OC-Spectrum recovery process to: (1) Include seven additional treatment elements incorporating dozens of different self-care techniques, (2) Identify and learn how to move beyond core fears as well as obsessional fears, (3) Redefine OC-Spectrum recovery as a challenge to regain a foothold in spontaneous being.