OCD Sufferer Fighting Bad Days with 'Greater Good'
By Kathi Wolfe
Jeff Bell’s voice is as well-known in San Francisco
as the sound of cable cars. Millions of Bay Area residents listen to Bell every
weekday afternoon as he co-anchors the news on KCBS, one of the country’s
most successful all-news radio stations.
What many of them don’t know is that Bell, like
nearly 2.2 million American adults (according to the National Institute of
Mental Health), has obsessive-compulsive disorder, a mental illness that
wasn’t on the cultural radar screen until a few years ago. The TV show
“Monk,” starring Tony Shalhoub as Adrian Monk, the detective with
OCD, has helped to bring the disability into public awareness. The program
debuted on the USA Network in 2002; its final season ends in December. 
People with OCD, an anxiety disorder, have recurrent,
intensely intrusive thoughts that others see as obsessions. The type of
obsessions varies from individual to individual. These obsessions run the gamut
from anxiety about contamination to losing control (for example, a fear of
harming one’s self or others) to perfectionism (for example, worry about
losing things). Other obsessions include unwanted sexual thoughts and
scrupulosity (excessive concern with blasphemy or morality).
Hoping to get rid of these unwanted and, at times,
terrifying obsessions, people with OCD repeatedly -- sometimes for hours daily
-- perform rituals that others see as compulsions. People with
obsessive-compulsive disorder have different types of compulsions. Rituals can
include excessive washing and cleaning, checking (for example, that one has not
harmed oneself or others) and repeating (for instance, tapping or going in or
out of doors repeatedly). Hoarding and constantly mentally reviewing events (to
make sure, for example, that one has not caused harm) are some of the other
compulsions that people with OCD can have.
People often use the words “obsessive” and
“compulsive” to denote personality traits, said International OCD
Foundation executive director Jeff Szymanski.
“The general public often thinks that (to be)
obsessive means having a lot of worries, and that (to be) compulsive is being
detail-oriented,” said Szymanski, an instructor in psychology at Harvard
Medical School. Those are valid descriptions of personal characteristics, but
not of OCD, he said. “They imply that people are OK and can stop (being
obsessive or compulsive) if they want to,” Szymanski added. But someone
with OCD "means having unwanted thoughts and compulsions that are out of
control and cause anxiety.”
In other words, if you arrange CDs eight hours a day or
are a meticulous copy editor, “that’s part of your job, it comes out
of your personality, but it’s not OCD,” Szymanski said.
“Howard Hughes (the reclusive aviator and film
producer) had very severe OCD,” Szymanski said, “He didn’t get
treatment. He stopped wearing clothes – (and kept) empty Kleenex (boxes)
near his feet.” Though having obsessive-compulsive disorder often was a
hardship for people with the illness, the American Psychiatric
Association’s Diagnostic and Statistical Manual didn’t categorize OCD
as a disorder until 1981. Before then, OCD was often called obsessional
neurosis.
People have had OCD since the earliest recorded history,
said Jonathon Abranowitz, professor and associate chair of psychology at the
University of North Carolina at Chapel Hill.
Most experts believe a variety of factors, including a
genetic predisposition and malfunctioning neurotransmitters in the brain,
contributes to the development of OCD.
“It can be as disabling as any mental illness,”
said Alec Pollard, director of the Anxiety Disorder Center of the St. Louis
Behavioral Medicine Institute. “If somebody has a contamination obsession
and is afraid of germs, they may not leave the house. Some kids with severe OCD
can’t go to school. Some adults with severe OCD can’t work.”
OCD usually emerges in childhood, late adolescence or
young adulthood, though it can begin when people are in their 30s or 40s,
Pollard said. “Boys and girls have a little bit different pattern,”
he said. “Boys are more likely to get OCD when they’re under 10 years
old. Girls often become obsessive-compulsive during puberty or when
they’re teenagers. It depends on the individual.”
When Dr. Michael Jenike, chairman of the Scientific
Advisory Board of the International OCD Foundation, started working with
patients in the late 1970s, he thought only a few people were
obsessive-compulsive. He changed his opinion after appearing on "The Larry King
Show" with a patient. “Then I realized it was a much bigger problem. So
many patients with OCD were calling in (to the show)! They needed a place where
they could go (for treatment).”
To help fulfill that need, Jenike, co-author with Terry
Murphy of “Life in Rewind,” founded the Massachusetts General
Hospital Obsessive Compulsive Disorder Institute at McLean Hospital. “I
didn’t want to (go on the ‘Larry King’ show), but it was a way
for people who felt trapped to get out (to realize that others had OCD),”
said Jenike, who now understands how media exposure can be helpful to people
with mental illness.
There are mild to severe forms of obsessive-compulsive
disorder, said Jenike, who has received a Lifetime Achievement Award at the
International OCD Foundation conference. “There is hope for (people with)
even the most severe forms (of OCD).”
Jenike, a professor of psychiatry at Harvard Medical
School, agreed to be brought in for an episode of the A&E show
“Intervention” and “we got the patient to go into
treatment,” he said.
OCD is generally treated with medicine and a type of
cognitive therapy known as “exposure, response, prevention,”
Szymanski said. “As with other mental illnesses, it’s a stereotype
about it being bad parenting or bad character.”
With cognitive therapy, people with OCD are “exposed
to what they’re afraid of,” Szymanski said. “When they realize
that dangerous things don’t happen, their brains start to reduce their
anxiety.” This therapy is difficult because patients “have to make
themselves not do the compulsions they perform to alleviate their anxiety ...
It’s no fun to be anxious.”
Some people with obsessive-compulsive disorder have other
disabilities. Larry Bolger, who has a master's degree in rehabilitation
counseling from Edinboro University in Pennsylvania, has OCD. In 1990, as a
result of a diving accident, he sustained a spinal cord injury. “There is
absolutely a need for rehab professionals to become more familiar with
OCD,” Bolger wrote in an e-mail to Independence Today. “My OCD
affected my spinal cord rehabilitation greatly... There is a need for anybody
involved in the medical profession to know the signs and symptoms of
obsessive-compulsive disorder.”
For Jeff Bell, the KCBS radio news co-anchor, his OCD
began in the early 1970s, when he was a young boy. As Bell recounts in his
memoir “Rewind, Replay, Repeat: A Memoir of Obsessive-Compulsive
Disorder,” he became obsessed with a gray car with a boy in the back seat.
While walking with his mother and sister on the street, Bell saw (or thought he
saw) the boy in the vehicle lean out the window. As the car moved away, Bell
thought he heard the child shout “Heeeeyyyyyy” to him. For days, he
became obsessed with knowing who it was who’d been trying to get his
attention. He couldn’t stop replaying that scene in his mind.
But just as suddenly as it came on, his obsession went
away. According to Bell, it was a form of childhood OCD that lay dormant until
his late twenties.
Bell, who referred to himself as an "overachiever," went
on to college and graduate school, began his career in radio, married his wife,
Samantha, and started a family. Everything went like a Hollywood movie with the
happiest of endings until he turned 29.
One day, Bell took some friends on an outing on his
father’s boat. At one point, the boat got extremely close to a cabin
cruiser, and one of his friends later said he thought Bell's craft might have
"bent the nose of that boat.” Bell became obsessed with confessing the
harm he had done. And that's when things began to “spiral out of
control.”
Bell became obsessed with thoughts that he might harm
other people. To relieve his fears that he might cause injury, he developed
“checking” and “confessing” compulsions. One rainy day
while grocery shopping, he noticed that his umbrella was dripping a bit inside
the store. Bell then told a checkout clerk that the “puddle” left by
his umbrella might be a safety hazard. After the clerk called for someone to
attend to what Bell called an “emergency,” the “puddle” was
nowhere to be found.
“When I drove, I started (constantly) checking my
parking brakes,” Bell said. “(For a time,) I quit driving and took
public transit.”
Walking down the street, Bell felt compelled to pick up
twigs and rocks because he feared they'd be a hazard to someone. “I
didn’t quit work, but I got to the point where I just barely got from
point A to point B and back again.”
The only time Bell felt safe was when he was anchoring the
news. “With OCD, you live in the past and worry about the future,” he
said. “When I was live on the radio, I was living in the moment.”
Like many people with obsessive-compulsive disorder, Bell
spent years hiding his disorder. “Outside my immediate family, I went to
great lengths to cover up my compulsions,” he said. “During my lost
years, my wife was the only person who knew about my OCD.” Covering up was
as exhausting as performing the compulsions, Bell added.
“I started to have trouble leaving my house. My
solution (to the fear caused by his obsessions) was to convince myself that
everything is safe.” Of course, that is never the case, he added.
“I sought help out of desperation,” Bell said.
“I was paranoid about getting caught. I’d park blocks away (from the
therapist’s office) or sneak through an alley, hoping no one would see
me.” The stigma surrounding OCD was a huge roadblock, he added. What, Bell
wondered, would his listeners think if they knew that he, a high-powered radio
reporter and personality, had obsessive-compulsive disorder, a mental illness?
Therapy was a slow, agonizing process for Bell. “One
night, I looked up at the stars and blurted out, ‘Tell me how to turn
around this crazy world and I’ll share my story with anyone who'll
listen.'”
That “bargain with the universe” gave Bell the
motivation he needed to do the work of therapy: exposure, prevention, response.
“I’d generate talk and help people with OCD by telling my story, but
I know I couldn’t write the book if I didn’t have success with the
therapy.”
Bell calls the strategy of being willing to do hard work
for the purpose of helping others “the greater good.” He credited
that, as well as his therapy, with helping him cope with OCD.
Though there is no cure for obsessive-compulsive disorder,
Bell, after much therapy and hard work, is able to manage his OCD today. He
still has “bad days” when he has episodes of obsessions and
compulsions, but he is able to handle his OCD now.
Sometimes, doubt is a necessary part of life, Bell said.
“When you’re a reporter, you need to do fact-checking, or when
you’re e-mailing, you may want to think about whether you should hit
‘send.’” But if you have OCD, doubt becomes your enemy --
penetrating your life and causing anxiety. That’s why OCD is often called
the “doubting disease,” he said. Bell calls his OCD-generated doubt
“my doubt bully.”
“You have to learn to chose the greater (good) of
your goals,” said Bell, author of the new book “When in Doubt Make
Belief: An OCD-Inspired Approach to Living with Uncertainty" and a spokesman
for the International OCD Foundation (formally called the Obsessive Compulsive
Foundation).
“One day I’m in a Borders (bookstore) signing
books. My ‘doubt bully’ tells me that I should compulsively scrub my
hands so I won’t give anyone germs. But intellectually I know I must be of
service and go out of the bathroom to help others by talking about and signing
my books.”
The “greater good” beat the “doubt
bully” that night at Borders, Bell said. “My doubt bully will always
be there urging me to carry out compulsions, (but) you have to learn to live
with uncertainty -- to follow the greater good. We can all benefit from
learning how to face down our fears.”
For more information on OCD, go to:
www.ocfoundation.orgor
www.adaa.org (the Anxiety Disorders
Association of America).
Kathi Wolfe is a Washington, D.C.-area writer and poet.
She writes frequently on disability issues. |
