Thoughts on Therapy
Thoughts on Therapy
The universe speaks and I try my best to listen and respond. To the someone, somewhere who needs to hear about our family’s experiences with Obsessive Compulsive Disorder: This is for you. You may have OCD, or you may know someone with the disorder. Maybe you struggle with a different, but related challenge. Either way, you need to hear this story. So, we will share… bits and pieces here and there, high level experiences, and the deep and darkest moments we have endured, each in its own time as we are prompted. I pray this information empowers you to find the resources you need.
Our First Encounter with Psychology
I remember my daughter’s first foray into the world of psychology. Technically it was “our” first foray. She was young, struggling with debilitating anxiety and strange repetitive behaviors. Trademarks, we later learned, of OCD. So, I made the appointment. She was highly resistant, but, begrudgingly, she went.
We stepped into the small dark office together. She sat directly across from him on a faded blue couch. He presented her with several “tests.” One required her to finish adages well-known by most adults. She knew them all except one: “A rolling stone gathers _______.” So, she made an educated and creative guess. I wish I could remember what she said, I’m sure it was clever, but all I remember is the ever so slight up-curve at the end of his lips. She had impressed him, and all three of us knew it.
At the end of the session, the psychiatrist told me she was brilliant and totally functional. And, as long as she was functional, he refused to diagnose and treat her. As we walked to the car, she was triumphant (therapy was still stigmatized in her ten-year-old mind). “See Mom,” she said, “there’s nothing wrong with me.” But I looked at her cracked and bleeding hands and I thought about the places I knew she could and couldn’t allow herself to walk, and I knew the truth. I wanted to march back in, scream my questions at the arrogant doctor: “How much suffering does it take to be “non-functional,” what must she endure before you will help?” But instead I drove away quietly. I watched the picturesque setting play across my window: his office next to the horse stables and training grounds, the simple scene at odds with the raging fire in my heart.
We took Breigh to the Semel Institute at UCLA. They knew far more about the disorder. But they too were captivated by her ability to communicate. She was articulate, self-analytical, and gave them a window into the brain of someone coping with child-onset OCD. Once again, she managed to turn the tables. She became a case study, a resource for them, instead of them being a resource for her. Once again, I felt the familiar coals burning inside me.
Armed with a bit more knowledge, we worked with a clinician to get her started on antidepressants. Still, both Breighlin and the clinician were resistant. By the end of Breighlin’s 7th grade year we had exhausted more of the many resources we would burn through. And still we found no traction, no help.
A Little Self-Motivation and a Lot of Boldness
And then, we had a breakthrough. I say we, but really, the change was all her. She had a standard wellness check with her pediatrician, Dr. Rich Macias. Dr. Macias was special. He had his patients’ best interests at heart. We could feel his genuine love and concern. He never insisted, but invited my kids to call him Dr. Rich and they always felt comfortable doing so.
At the end of this particular visit in to Dr. Rich, after all the “well child” boxes had been checked, Breighlin, very matter of factly, said to the doctor, “Dr. Rich, I think it’s time to try an SSRI to treat my OCD.” Dr. Rich’s head immediately swung towards me. He glared at me as if I had put Breighlin up to this. I shrugged my shoulders as if to say, “I have no idea what she’s up to.” Last I checked, she saw medicine as an enemy, something that would change who she was. So, he swung back around to Breigh and asked, “Okay, Breigh, what’s an SSRI and why do you think it will help your OCD?”
She, replied, businesslike, with surety in her 12-year-old voice, that an SSRI was a “‘selective seretonin re-uptake inhibitor,’ which blocked the re-uptake of seretonin, the brain’s feel good hormone, allowing more seretonin to remain in the system which would then allow the patient to feel better. “
Again, he looked at me, and again, I shrugged and shook my head indicating that I had nothing to do with this request. Dr. Rich continued to prod, except now he was amused. He uncovered that Breighlin had done her 7th grade research paper on the topic of OCD and had learned much about her condition in the process.
He asked Breigh which medication she would recommend and she more than confidently responded by telling him that Prozac was the gold standard treatment for pediatric patients. Dr. Rich was now chuckling audibly. But he couldn’t disagree. He was left ONLY to concur with her diagnosis and treatment recommendations, and that day Breighlin began pharmacological treatment for her OCD. Dr. Rich started her on a very low dose of prozac acknowledging that it would be likely that he would need to titrate the dose up from there. This was just a starting point. “Of course,” he said, “Breigh could have told me that.” 😉
Curves in the Psychology Path
With the introduction of the Prozac, we saw changes in Breigh’s OCD. There were still seemingly endless adjustments to be made. But it was something that helped – the first something that helped. We loved Dr. Rich even more after that day, if that were possible. To finally have someone on our team, on our side, as our advocate, was perhaps the most powerful prescription of the day!
As Breighlin grew through her teenage and young adult years, we went through mental health professional after mental health professional. One introduced us to exposure and response prevention therapy, an effective and intensive treatment for the disorder, and a revelation in her treatment. He was on the right track, something still wasn’t quite right. So we moved forward, step by step.
Breighlin was introduced to the world of psychiatrists: mental health doctors who emphasized pharmacology. They treated her for ADD, putting her on stimulants that exacerbated the problem. Another wanted to try EMDR – Eye Movement Desensitization and Reprocessing, a valuable technique for many struggling with PTSD and other disorders, but not the right treatment for Breigh’s OCD.
20 years. That’s how long it took us to find what she needed. The funny thing is, it wasn’t even Breigh’s OCD that led us to her. My daughter went through a painful divorce. In the process, she was inspired to find a therapist who could help her with both her grief and her disorder. Now, with a far greater understanding of the therapies available to her, and with a humble heart, she scoured the internet for a therapist who met all her needs. She knew she needed a holistic approach.
Clear Expression of Desires
So, she made a list. Her requirements: med management, the ability to prescribe, experience with behavior therapy, experience with OCD and anxiety, spirituality, proximity. At first, we thought she was looking for a unicorn. But in the end, she found her miracle. Intensive online research led her to a specific Licensed Mental Health Nurse Practitioner, one who had both professional and personal experience with OCD. This was a title we’d never heard before we met this provider, but she was a perfect fit, and she helped Breighlin find a balance she’d never known before.
Therapy is hard. It doesn’t always feel good. Our instinct is to run and then to abandon the therapy when efforts don’t immediately produce the desired result. It’s a delicate balance, finding the right fit, one that requires incredible insight, self-analysis, and inspiration. Therapy, like life, is a journey of self-discovery. It’s about finding out who you are and what works for you.
Hope In Comfort and Help for Others
I hope our story gives you some insight into your own, whatever challenge you face. And most importantly, we hope our story gives you hope: hope that there is help for you, hope that things will get better, hope to keep searching and keep trying. Twenty years was a long time to explore and experiment, but the happiness we’ve found is worth every second.