“She Works Hard For The Recovery!”

A Ban Book: A notebook used to track my, daily, submits and resists to compulsions. At the time, my bans included, 1. Info Seeking, 2. Superstitious Behaviors, 3. Checking, 4. Perfecting, 5. Skin Picking, 6. Reassurance Seeking, 7. Avoidance and Distraction and 8. Hand Washing. The expectation was clear. Every time I completed a compulsion, or resisted one, I marked a tally in the book.

It took me a few weeks to adjust to this process. I quickly learned how to be discreet, as the documentation was constant. We’re talking hundreds of tallies each day. What did these compulsions look like for me? 1. Info Seeking – “researching” EVERYTHING on the internet to find the optimal product or solution. I would also “research” any symptom I was experiencing, headache, nosebleed, numbness and tingling, etc., to verify that it wasn’t a heart attack, stroke or cancer. 2. Superstitious Behaviors – safe numbers were 7 and 8 and bad numbers were anything divisible by 3 (3, 6, 9, etc.). When drinking water, I would gulp 8 times. If anything in my life represented a divisible of 3 (touching something, having a certain number of items, etc.), I would alter it. I said a 15-20 minute prayer every night, asking for protection, for myself and my family, from anything that could possibly harm us, including spider bites, hurricanes, plane crashes and cancer. The list went on and on. 3. Checking – after my children fell asleep, I would sit in their rooms and monitor their breathing. I would observe their chest rise and fall and I would feel for warm breath coming out of their nose. I submitted to this compulsion from the day they were born, until they turned 7 and 9. I would repeatedly check to ensure I turned off/unplugged anything that could start a fire (hair straightener, stove, toaster, etc.). I would reread pages in books to ensure I didn’t miss anything. 4. Perfecting – EVERYTHING! The way I talked, how I looked, the choices I made, my surroundings and the educational/career outcomes I produced. 5. Skin Picking, a body-focused repetitive behavior, or BFRB – I would pick at the healthy skin on my thumbs, until they were bleeding. I would pick at pimples and scabs, gouging at the skin until I felt the impurity was removed. 6. Reassurance Seeking – I would seek reassurance from myself and others. I would ruminate on scenarios until I was convinced I did the “right” thing. I would, repeatedly, ask others for reassurance. Any time we were going to fly, I would ask my husband several times per day, starting about a week before the flight, if I was going to die. 7. Avoidance and Distraction – this was my OCD’s bread and butter. When experiencing an intrusive thought, I would immediately jump ship. I would mimic typing words on a computer, count the ceiling tiles, or recite as many colors as I could think of. Anything to avoid the intrusive thought and the debilitating anxiety that came with it. 8. Hand Washing – I washed my hands every time I touched something “contaminated” or when they felt “sticky”. I was washing my hands approximately 50-75 times per day; somedays up to 100 times. My hands were so dry, that they cracked and bled daily. No moisturizer was going to fix this problem.

Next up… Exposure Response Prevention (ERP). This therapy is considered the “gold” standard for OCD treatment. It is an evidenced-based behavioral therapy. The “exposure” refers to purposefully exposing yourself to intrusive thoughts, images, objects and situations (obsessions) that cause anxiety. The “response prevention” refers to the act of consciously not engaging in the compulsive behaviors (compulsions) once the obsession is triggered. The idea is that continuous exposure will, over time, decrease the anxiety in relation to the obsession.

Now that we had all the pieces, the exposure hierarchy, the ban book and ERP education, it was time to work. I started with the exposures that were ranked a 2-3 for an anxiety rating. These included looking at a crooked lampshade in my house and not fixing it, touching the home toilet seat with one finger, running my hand through my hair and not checking, taking one sip of a diet soda, and touching a plastic bag. There were many, many more, but I’ll keep it at this for now. Next up, a day in the “treatment” life of Brooke Miller.


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