Denise’s Diary: My Treatment Plan

After working on my eating disorder at the residential treatment program, I moved on to receive treatment specifically addressing my OCD at the same facility. The treatment of my OCD included medication, Exposure-Response Prevention and Behavior Therapy.

When I arrived at OCD Lake House #4 (my favorite number—I don’t know how I would have reacted if I were placed in Lake house #5), I was taken to my room and OH MY GOD! I, being an extreme perfectionist, was placed in a room with a young lady who had trash, clothes, and who knows what else all over the floor. For all I know there were living things under her bed. Her dresser drawers were half open with clothes hanging out, her bed was unmade, and there was junk all over her dresser. In my head, it was absolutely disgusting. I had to walk through this complete mess to get to the closet (which I had sole access to, since her belongings were on the floor). If any of you remember the show The Odd Couple, I was Felix and she was Oscar! My bed was made perfectly with my matching blanket and pillows, clothes were folded and in the proper drawers, pictures and trinkets symmetrically placed on my dresser and nightstand, and clothes hung in the closet. How would I possibly survive in this room without either cleaning her side or going crazy? Until recently, I believed this was part of my treatment plan, being exposed to complete messy chaos. But after speaking with one of doctors he assured me they would not do that to anyone.

I was in a house where the pictures were hung crooked on the walls “on purpose,” dirty dishes were left in the sink “on purpose,” and crumbs left unwiped all over the table “on purpose.” I had a hard enough time with my own crumbs, but damned if I was going to eat where other peoples’ crumbs were scattered over the table. This proved to be very difficult for me, but I did find friendship with a nun named Tracy, who became my ally. She would stand guard at the kitchen door while I would frantically wash the dishes and wipe down the counters—which was like committing a capital crime. It felt good, it felt necessary, and we never let anyone know who was behind the cleaning.

Another thing that drove me completely to anger was how we were never given a definite answer when we would ask a question of the staff. “Maybe, Maybe Not,” would be their answer. I needed definite, I longed for definite. But I was never given that. I understand now that this was all part of my treatment plan, but at the time it made no real sense. This disease made no real sense!

When beginning my therapy, I was asked to develop a hierarchy. It began by listing a situation that causes the least amount of anxiety and gradually moves to more difficult ones.


Here are some examples:

  • Leaving clothes hang out of my dresser drawers
  • Messing up the orderly way items were arranged on my dresser (e.g., lay pictures down)
  • Wearing clothes that did not match (Why would I not match my clothes, oh whatever!)
  • Touching something dirty and not washing my hands
  • Going out without makeup
  • Wearing two different color socks
  • Leaving a picture hanging crooked on the wall and not straightening it
  • Not wiping the table after eating
  • Leaving dirty dishes in the sink
  • Leaving a piece of garbage on the floor for several days without picking it up
  • Walking through a doorway without having to do it twice (remember I do everything in even numbers)
  • Buying one of an item, instead of an even number

For me these were the “easier” things. They definitely caused me to feel quite uncomfortable, but I was able to get them under control. They were not going to cause any harm to people I loved—they were just going to make me uneasy because I love things neat, clean, and organized. My real fears were facing anything remotely related to death.

For example:

  • Seeing a cemetery on a TV show or the news without bathing and then cleaning the room that the TV was in
  • Going to the cemetery where my brother and dad were buried
  • Visiting a funeral home without bathing
  • Touching or riding in a hearse without bathing
  • Going to a cemetery and not bathing
  • Seeing a high school ring and not showering
  • Looking at my high school yearbook and not bathing
  • Saying or thinking the name of The Guy
  • Driving down a couple of forbidden streets where certain people lived
  • Seeing contaminated people without showering
  • Driving past one certain cemetery
  • Going to THE cemetery

I only addressed one of my severe obsessions and that was while in treatment for my eating disorder. It was visiting my dad and brother’s graves, which I talked about earlier. I have been visiting them once or twice a year since I took the initial step. I am very proud of myself for this accomplishment.

I was discharged before I finished my less stressful list, never even coming close to the tough stuff. The money was gone and my insurance did not cover residential treatment for mental health issues and we were paying out of pocket (I witnessed many beautiful people having to leave treatment for reasons due to lack of insurance company’s coverage). The money was gone and, so I thought, were my hopes for recovery from my OCD.

Now it was up to me to put what I learned to good use. Would I possibly face my most feared contaminants on my own? Not in this lifetime! I can say for myself that if I would have been taken to one certain cemetery, I probably would have committed suicide. This stuff was scarier than I can even explain. Exposing me to certain things would have led me to believe that everyone I cared for would die, and at that time I was not about to take a chance.

I was not allowed nearly enough time to really learn the exposure-response prevention process and in a way I was glad because I didn’t have to face my greatest fears, but the sad part was that I didn’t have to face my greatest fears. Would I ever beat this demon?

My medication has been crucial in reducing the constant torturous thoughts that chant demands in my head.

But not at first. As I touched on previously, when I originally agreed to try medication, I only took it for three days and decided it may not be the answer. I felt as though I were wearing a clear astronaut helmet and things were happening around me, but I could not fully be a part of it. My head felt very thick, very hazy, and I was so extremely tired all the time. So, I decided medication was not for me. I didn’t realize that these medications did not produce immediate results. They generally take several weeks to truly work.

It wasn’t until fifteen years later that I gave medication a second chance.

My medication has been an absolute God Send. I can truly say that taking it every day as prescribed has decreased my symptoms more than I can explain. I originally was prescribed Lexapro for depression, but it has been crucial in treating my OCD as well. When I was initially given the option to try medication, I was totally against it; not only did I fear the feeling of living in a fog, but I was deathly afraid that it would cover up my fears and I would come in contact with a contaminant and I would not bathe or perform my rituals. I was afraid I would lose control and didn’t know what would happen to the people I loved. Shortly after I began taking it, it was evident that it did not take away my fears, but it lessened their intensity and decreased the worry and anxiety. I have had thoughts of trying to go off it because I feel my depression is controlled, but I have made the decision to continue with it just because of my OCD.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s