Thursday, December 21, 2017

'Watching Your Toddler Drink Bathwater From a Hotel Tub', and other sordid tales of OCD exposure therapy

I've always been slightly more than casually OCD.  Not the flip-the-light-switch-seven-times-then-tap-dance-thru-three-choruses-of-I-Could've-Danced-All-Night-before-leaving-the-house kind, but more like the picks-stray-hairs-from-my-pillow-before-laying-down-and-always-on-the-lookout-for-dead-bodies kind.  I can't explain away the hair thing, but you try working for the body pickup service contracted to the medical examiner's office of a major metropolitan city for a year and *not* look for corpses on the side of every road and behind every hydrangea.  They're there, people.

Now, this has always been sort of quirky and cute to most that know me, and those that may have thought otherwise have largely been kind enough to at least refrain from open mockery.  "Oh, that TheUnluckyPath, she sure is hilarious, over there picking microscopic lint fragments off of her dinosaur print Boden top".  But let me tell you, shit got real when Punky arrived four weeks early.  I had what turned out to be straight up post-partum OCD/anxiety that might blow your mind.  I had no idea that this was even a thing.  You learn some (but not near enough) about post-partum depression in med school.  But I swear I had no idea that you could get heightened OCD associated with the perinatal and/or post-partum period.  It was absolutely heinous.  I've never been so terrified in my whole life.  I spent the first eight weeks of my daughter's life expecting to find her dead, in any and all manner of common and/or obscure/tragic/horrifying/violent ways, every single time I left her for a snooze.  And, presumably because I've seen some serious things in my life, I could picture in excruciating detail every single aspect of the fictional scene.  I became nearly-paralyzed by stairs, where I would clutch her to my body and get an iron-grip on the banister like I was free-climbing Half Dome every time I walked out to the garage (down four steps.....just four).  I would imagine that she, at four weeks old, had somehow freakishly developed musculature, climbed out of her crib, and rolled underneath only to suffocate on a blanket that she had carelessly wrapped herself in.  I visualized her tiny electrocuted body lying next to a wall outlet, no joke.  My heart was repeatedly broken day in, day out, every time that I left her and cautiously returned to see what I would find.  Because, even though she was perfectly fine every time I came back(if not sometimes poopy), I imagined her dead in more ways than anyone could ever believe, and it felt so real to me each and every time.  And a little bit of me mourned her faux death, so many times a day.

But that actually wasn't the worst of it.  The worst of it was that, in the majority of instances, when I imagined her death, it was me inflicting it.  It was me hurting her in all of those ways every time.  In the bath tub.  In the kitchen.  In her nursery.  It was so, so shocking and terrifying to have these scenes playing through my fractured, sleep-deprived mind.  The shred of myself that I was still clinging on to still knew that I did not ever want to hurt a single tiny spiky hair on my perfect little peanut's head, but it was so, so hard to reconcile this with the visions that I was constantly having.  I was beyond terrified.  I was so afraid to tell my husband about any of these things, for I didn't know if he would be afraid to leave me alone with her.  A few weeks in to this guilt-and-shame-filled struggle, I remembered an episode of the podcast Invisibilia that I had listened to the year prior.  It was called The Secret History of Thoughts, and it had made quite an impression on me at the time, especially the story about a young, just-married couple.  They had a relatively carefree and easygoing life, until one day out of the blue the guy started having obsessive thoughts of his wife being stabbed to death in their kitchen.  And he was the one doing it.  On one hand, he just *knew* that he had no desire to harm his wife in the least.  But on the other hand he was terrified that he must want to kill her, on some subconscious level, else why would he have such terrible visions?

Turns out, he had a specific subtype of OCD called Harm OCD, in which "an individual experiences intrusive, unwanted, or distressing thoughts of causing harm, and this is inconsistent with the individual's values, beliefs and sense of self.  These obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act." (that's a nice definition provided by the website of the OCD Center of LA)

So, I went back and listened to the episode again, and I felt an immediate sense of relief.  I remembered identifying with it to some degree the first time around, and feeling so deeply sorry for the poor bastard experiencing this terrifying thing.......but now I was was reasonably sure that I had become that poor bastard.  However, at least I had some hope that perhaps I could fix this somehow.  So I committed right then and there to myself that I would admit that I was having these thoughts to my lovely, compassionate therapist at my next appointment.  And, I did.  And doing so was the first step in my journey toward recovery from my post-partum Harm OCD.  And now that Punky is 2.5 years old, I'm back to my slightly more than casual OCD, right where I'm comfortable.

And that brings me to watching my daughter drink hotel bathwater in a borderline sketchy extended stay motel during our cross-country move a few months ago. Having a toddler is a long-haul treatment course of exposure therapy for OCD, which turns out to be very effective for me in dealing with my issues.  Identify the intrusive thought, analyze it and decide if it's valid and why/why not, then accept it or dismiss it as it's happening.  Gives me the sense of control that I need to feel comfortable and safe.  And then I can go about my quirky day.

Watching a toddler eat peanut butter off the floor of an airport.  Standing idly by while my daughter puts her hand in the toilet to retrieve a toy that needed a quick and refreshing swim.  Suppressing a scream as the kid covers the wall in crayon, grinning and singing with unabashed joy.  It's a constant barrage of borderline-horrifying acts of depravity, packaged in an adorable little bundle of cuteness and light.  And on that day a few months back, as I sat back on the yellowed and cracked tiles of that supposedly clean bathroom, I forced myself to let her be a toddler, feeling her way through the world around her and delighting in the new experience.  It was a super gross experience, but she thoroughly enjoyed it nonetheless.  And the reason that I finally got around to writing this five months after the fact is that it dawned on me a couple of nights ago that I haven't checked my pillow for stray hairs before falling (mostly happy and always exhausted) into bed at night since we moved to this new job and house.  There are tons of other stressors in life, including some new ones about kind of hating this new city, but overall life is pretty damn good.  And the older I get, the better of a handle that I have on my weird brain.  It's actually pretty interesting in here most of the time.........  :0)

15 comments:

  1. Thanks for sharing your experience. I had a lot of similar experiences that maybe someday I’ll share too. Thanks again!

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    1. It really helps me to get it out and talk about it. Good luck on your journey <3

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  2. OMG. I don't know where to start. You need to be a dark comedy writer. I am in laughing tears. But I also empathized. Some days I just cannot do escalators. Just yesterday I was walking down a steep dark stairwell, saw an almost dead twitching cockroach, and was like screw the cytology Christmas party I hate barbecue anyway I cannot even go down these stairs right now. I was just talking to my partner who was called in for a 10 pm stat PSR (peripheral blood smear) review last night. The oncologist called her on her way home and said he was so happy she was reviewing it bc he trusted her so much. She did a U-turn, despite having already reported her findings, and reviewed an additional 90 HPF to make sure there were no schistocytes. I think pathology is conducive to OCD personality types:) Glad you are doing well - good to hear from you.

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    1. Yes, I agree - path is definitely perfectly lined up with OCD tendencies. Thankful for canned dx/comments. I have approximately 1000.......>8-0
      Glad to have a fellow traveler......

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    2. "Free climbing Half Dome" I can't stop laughing about that one, I'm going to think about it every time I get shaky on a freaking stairwell. Me too!! I must admit I do not do canned dx/comments. No derm, not much GI. It was hard the first couple of years but I've got all the canning in my brain. I talk so fast the secretaries have to slow down the dictation. I'm like an auctioneer haha.

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    3. It might help you to break the tension to picture it - that's one of the ways my therapist recommended I confront these fears. It breaks up the moment.
      Now, I still haven't figured out how to totally let go and enjoy a pedicure, for the constant fear that I'm going to kick the tech in the face!!!

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    4. Yes I'm going to try it. I had 5 bronchs and three needles before noon yesterday though, was running around crazy. I decided my body was telling me to go to my office and chill for a bit.

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  3. Love this post and "slightly more than casual OCD." Thanks for sharing.

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  4. I loved this post so much. I agree so much about not enough training in medical school about postpartum anything. Thanks for enlightening me to more about the postpartum anxiety and worsening OCD - medically what I’m going to take away from this post is to be on the look out more for this in my postpartum patients. And on a personal note, I think putting your baby to bed is one of the more terrifying things you do with a new baby. I (maybe unwisely) chose to do my Parenting elective project on SIDS and immediately panicked because there were so many dangers I never thought about (swings! Mattress pads! Car seats!) and it’s near impossible to follow every single recommendation so I’m terrified the few rules I am breaking will be the ones that matter - so every time I work on my project while he’s sleeping I immediately go check on him.

    Thanks so much for sharing such a personal issue. I laughed out loud at all the toddler tidbits.

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    1. I’m glad to share, it’s very therapeutic, but more importantly I want more people to be aware. Thank your for taking such good care of your patients!

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  5. I do not particularly consider myself OCD; I rather think I am just “anal” about certain things like lots of people, esp people in fields like medicine. But I could really identify with your idea of toddler as exposure therapy. Having my own toddler made it obvious that I have an issue with crumbs and food messes. I cringe and run over to clean any time she eats!

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  6. Oh, the eating times are the worst :-)

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  7. I hate it when my kid drinks the bath water - it's so gross. I mostly leave the room. We agreed that he MUST stop peeing in the tub. He obliges mostly. LOL! Great post. Thank you for sharing info about a form of OCD that I had never heard of.

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    1. I just chant to myself in my head “in theory, it’s sterile, in theory, it’s sterile, in theory, it’s sterile”......

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