Long-Term ERP (or How I Learned to Stop Worrying and Love the Dentist)

I noticed it again the other day. I was sitting in the dentist’s chair during the more painful part of a root canal. The drill struck a particularly painful spot, and all of a sudden it happened. Something in my brain told me to use the moment as an ERP training exercise. It was a challenge to habituate myself to the pain. I took a few deep breaths, gave into the pain and let my body relax. Almost instantly the experience changed. It still hurt, but I didn’t care as much. I spent no energy trying to avoid the pain.

(And by the way, if any of the terms like “ERP” or “habituate” are new to you, it might be best to read the Wikipedia entry and then check out the Exposure-Response Prevention section of this blog for first-hand accounts of using this technique to cope with severe OCD symptoms.)

But before we move forward let’s back up. I started trying the Exposure-Response Prevention technique about two years ago. During the worst of my OCD experience I experimented with ERP as a last resort, for hours at a time at first, then daily but for shorter periods, then now only when necessary.  And now ERP has become a sort of built-in defense mechanism. The process has become internalized and is triggered by anxiety.

I can honestly say that after two years of practicing ERP and taking Luvox that my whole experience with OCD symptoms is different. It’s like the dentist’s drill. I still experience OCD anxiety, and I still have obsessive thoughts and ritualistic behavior, but I don’t experience them with the same dread and frequency as before. The majority of my time now is spent between OCD thoughts. As a result, they become even more recognizable, and so on.

You’ll quickly notice that there has been more space between my posts as well. The reason is that I don’t think about OCD as much. There is definitely more to say, but now I have the luxury of talking about the climate instead of the weather. That may change, but it is very reassuring to know that, even if the symptoms get worse in the future, I already have a mechanism for coping with them.

I think it is safe to assume the worst is over. And even if that isn’t true, it’s the first time I’ve been optimistic in a while.

In the meantime, there is plenty to read here on just about any point  in the OCD-Freak-Out spectrum (and also some music videos). I’m happy to answer any post right away.

Be well. Fight back. Win.

The Zero State

A few months ago I became a socialite. Every few days I called every person I knew, and we got together for drinks and conversation. I’ve never felt so easy around people. The conversation was easy, no matter where it went. A close friend of mine from way back would come to my house afterward, and we would stay up all night and talk about cosmology and art. During one of these conversations, we drifted into the “near-death experience,” which I have discussed here very openly and about which I have no shame.

I explained it this way. The fear of dying is very real, probably the height of anxiety. The experience itself is what we I call “the zero state.” It is associated with no feeling. Whatever it is, that thing behind my eyes that knows of its own existence, watches the zero state like a movie but does not interfere. It’s not part of his job description. He is an archivist, an observer. The situation plays out with no fear at all. It is seriously like watching a movie. And once it is over, and you are still alive, there is no flood of emotion, at least as far as suicide is concerned. I assume it’s different if you almost have a car accident. But in this case, there is no feeling at all. The power simply goes out.

Since experiencing this “zero state” I have discussed it with a few friends. I have heard similar stories from those who practice deep meditation and also from those who use psychedelics on a regular basis. I don’t know if these feelings are comparable, but they seem to be explained in a similar way. It is a complete letting go of life and the self. My friend describes it as “the death of the ego,” and I think he has a point. The actor is still acting, but you aren’t the actor. You’re just a guy in the theater whose concern with the plot of this particular film is tenuous and drifting.

When I was around 18 years old, I became what is probably best described as an atheist. I don’t believe in a personal God or afterlife or miracles or any of that. I am, however, profoundly interested in the human experience. I’m a humanist. There, doesn’t that sound better. Anyway, after having an afterlife and then losing it, coincidentally around the same time several friends and family members my age died, I developed a profound fear of death. And this fear, through a long series of ever-shifting obsessions, completely consumed my life for the next 14 years.

During this time there were many moments that I considered “rock bottom.” They came at the end of long bouts of depression or drug binges or terrible breakups. What I didn’t realize at the time was that “rock bottom” is the description we give to a feeling so shitty that it is cathartic. It’s that feeling that things can’t possibly get any worse. When I describe “the zero state,” it is not that at all. It is, in fact, the absolute opposite. It is the total absence of feeling, and it’s profoundly cathartic but in a different way. It’s the feeling that there is nothing more extreme to which you can be exposed, and so by default all other anxieties are less than what you have already felt. It is exposure therapy taken to the utmost extreme.

I suppose my point is simple. Maybe you are like me. Of all the American generations, mine is the most likely not to believe in the stories that brought comfort to our ancestors, that added meaning to every action, consequence to every misdeed, virtue to every act of kindness. I find more comfort from those who are kind in the awareness that their kindness has no meaning, who are “good” for the sake of others and only them, who continue to play a game for which it is impossible to keep score.

If you are one of these, know this. The idea of dying is terrifying, but in the moments around your death, you will not be afraid. So be well. The thing you fear is nothing to fear. You will reach the zero state, and you will feel nothing at all. If a word is needed to describe it, I would call it peace.

(*And now a disclaimer. I was the luckiest person in the world. I sincerely tried to kill myself and got lucky! Do not seek this feeling. Learn from my experience. Do not try this at home. If you must, go meditate or try psychedelics. I hear they help. It was the sincerity of my attempt that helped me reach this conclusion, but there is no way to “experiment” with that feeling. It’s all or nothing. And almost always, it’s all.)

How Am I Not Myself?

All day we act in a way that responds to our environment in an advantageous way, or we act in a way that, though it feels at odds with our initial instinct, validates a belief we have or authenticates some characteristic of ourselves we wish to possess. But it is the rarest fluke of memory and experience that, as we grow older, we sometimes get a chance to figure out why we do something or what we actually believe. These moments are not likely to flatter us, and they carry a different feeling, something that reconciles itself with earlier versions of our personalities, which is to say these realizations seem to be consistent with our past experience.

This week has seemed to present to me some of these observations. For example, I love causes that I can’t win, and I will fight them to the death whether I actually want them to succeed or not. Put another way, I like challenges that lead to no discernible sense of achievement. Once I achieve something, I get bored and depressed. I much prefer to play the game to stalemate or simply lose. Winning gives a sense of closure and raises the stakes for another win. Losing allows for another round.

In a related catharsis, I have learned that it is very easy for me to try on beliefs and take them off again at a moment’s notice. This might be another way of saying that I don’t actually believe in anything except the importance of using beliefs as tools. There is almost nothing I am unable to get obsessively enthusiastic about, and it doesn’t matter much to me which side I play. It’s just the game I like, the participation itself that moves me.

It is maybe difficult to admit to ourselves that we sometimes prefer to live out fantasies, even as we know them to be just that. But I am slowly learning that there is no shame in this. If there are no absolute truths, then there is no harm in selecting a convenient belief for the purpose of reaching a certain outcome. I like to believe sometimes that people are inherently good. Experience never seems to bear this out for very long, but it is a tool I use to give myself an excuse to help people, which is actually a way of helping myself. I do not find this approach immoral in any way. The outcome is the same, and the intentions at the time are completely noble. Because fantasies work best when we are able to give ourselves over so completely that, even if only for a short time, we believe them, we fulfill the criteria for a premeditated moral act.

I am aware that these descriptions paint a portrait that probably seems cold and unfeeling, but the first-hand perspective is just the opposite. Can a moment be authentic and a complete sham at the same time? I believe it can.

Dark Energy

Several weeks have passed, and I realize now that the weight of medicine, the way it warms and covers your mind like a heavy blanket, is a form of self-induced hibernation. This is not to say it isn’t necessary. Sometimes we either hibernate or freeze to death or starve. But, digging my way out, I awoke to find that it was spring and I was starving. So I devoured every conversation, every person, every opportunity. Insatiable, my appetite for everything keeps growing. I require almost no sleep at all. I remember almost everything. I need more of everything all the time, and I am quickly realizing that this place is too small for me.

At the end of last week, on a whim, I wrote a letter to a Senator and another woman who wrote a ballot proposition to legalize marijuana in Mississippi. I don’t use marijuana, and I don’t really care about this issue one way or the other. But it was very obvious that they were trying to sell the idea in way that might work in the Pacific Northwest but never here in a place so conservative. I laid out an eight-point plan to change the way they were handling their communications. Four hours later, I was in charge of marketing for the entire movement. Six days after that, I quit in frustration. It wasn’t enough. I needed more.

I got offered another job this week. In one interview I went from a staff position to a directorship. I have a second interview on Monday, and some part of me is terrified to say yes. It’s not that I’m afraid of the work. Quite the opposite, I wish I were afraid of anything, but I’m not. I just don’t want to get boxed in right now. I’ve lost any sense of fear, nervousness, self-consciousness. I am always confident. And this is a very strange turn of events following on the heels of over ten years as an absolute shut in. I have discussed here in detail the depth of my passivity, how deeply it hurt me to kill an insect, to what lengths I would go to avoid conflict.

But something has shifted. I want conflict. I want it all the time. Not the violent kind, but I keep picking arguments, especially religious ones. I wake up and go to sleep with this dark, aggressive energy that makes me lash out at anything reverent, anyone who thinks they know an absolute truth. I want to shatter their foundations. I want to siphon away the meaning in everyone’s lives and vent it into the vacuum of space. The holidays seem to be making it worse; that and the fact that I recently rejoined the Facebook world, which is the perfect cross-section of people at their most shallow. It’s like I stopped trying to relate to other people. I want to force them to relate to me. And this compulsion has become an addiction.

When there is no outlet for this feeling, my mood grows steadily darker. I have to smooth it out with sleeping pills, which I suppose is an attempt to fill a gap created by putting all my other medications in the drawer. And though it may be counter intuitive, I still feel better than I ever have. The materialist in me says that I actually am a different person. Everyday I find it harder to relate to the person I was only a few weeks ago. Maybe I am a different person entirely. Maybe I am overcompensating for 13 years of hibernation. I went to sleep a prey animal, hiding from the wolves. But when I awoke I was something else. A predator. And I’m fucking starving!

Holiday

For several weeks now I’ve been conducting an experiment. I stopped taking all my medications for a week, which I’m told is a very bad idea. After that week, I started taking them again at a third their original dosages. The results are as follows:

1. I have not shed a tear in over five years. I watched my grandfather gasp to death and rattle horrifically like some inanimate nightmare come to life, and I didn’t cry. I put a gun in my mouth and pulled the trigger, and I didn’t cry. Last week I was lifting weights and watching Jon Stewart and I cried like a baby. Then I cackled like an idiot. Then I cried again. And it was the best thing I remember feeling in almost three years.

2. I have not slept over four hours in a single night in over three weeks. I have not had a nap nor felt sleepy at any point during the day. During this time I have started two new community organizations, relaunched and rebranded my business, made over a dozen new friends, attended at least two gallery openings per week, taught myself to animate using Javascript, come out to my family and friends as an atheist, been nice to my family and my dog, developed for the first time a friendly relationship with my in-laws and in general worked harder and more efficiently than I have at any point in my life. I am also signing up for two classes next spring: piano and physics.

3. I have had no withdrawal symptoms nor have I relapsed into an OCD frenzy. My anxiety is no greater than it was before decreasing the medicine. My head is clearer, and my mind seems to be working much, much faster. I get the impression that I’m waking up from something, as if I’ve been away and have returned. I feel as though I have a personality again. I feel like myself but without some of the darker parts.

4. I feel less empathetic but more eager to help other people, which is a bit strange.

5. The first week off the medication my dreams were horrific. I mean really horrific. I dreamed of violence and murder and guilt. Since then, I dream about game shows and Japanese robots and dead family members and all sorts of randomness, but I haven’t had any more nightmares. Even contexts that could be scary turn out more benign.

6. I have less patience. With my friends, family and coworkers I expect fast responses or I quickly get bored to the brink of anger. Everything is moving fast, and anything that slows it down is an annoyance.

7. I am confident to the point of hazard but not in a physical way. I pick arguments. I am jumping into issues in a reckless way. I have lost my fear of almost everything, at least in terms of social interaction. I still wouldn’t ride a rollercoaster. I’m not insane.

8. My ritualistic tendencies are still there, and I don’t fight them. They exist in a benign state up to this point. I don’t mind counting. I’m not checking myself for tumors. I’m not checking my doors for fear of burglars. But I am caught in a frenzy of repetition that, quite honestly, is not unpleasant.

All things considered, I like my life right now. I never realized how heavy the medication could be, that I was living my life on autopilot. If I’ve learned anything in the last 10 years, it is this. All feeling is better than no feeling. Emptiness is the enemy. Even depression is a positive by comparison. If I die tomorrow, let it be with full awareness of what I am leaving behind. I would rather meet the cold wind with exposed skin and raw nerves than never feel it at all. If I am predisposed to extremes, so be it. I will accept whatever comes, and if it is more than I can handle, I’ll always know that there is a ripcord. But you can’t fall through life with the parachute open because it’s just fucking boring. So I’ll take terminal velocity all the way down.

Be well. Fight back. Burn your comfort zone to the ground.

The Heritage Problem

Mine is a culture like an antebellum home. It sits graceful and squarely proud on miles of cultured lawn. Meticulously preserved, its majestic Corinthian columns always have the smell of fresh paint. And just outside, the scripted signature planted into the ground names this home “Heritage.” The interior is much the same. The great wooden staircases and floor-to-ceiling paintings are a skewed imitation of aristocracy, as if someone decorated based on a second-hand account of Versailles. It is wealth imitating older and greater wealth, culture imitating older and greater culture. But the whole world knows that Heritage is full of basements and attics, dark and full of cobwebs, containing all manner of secrets and savageries.

My family has lived in the American South since at least the 1790s. The French side of my family arrived a little later and settled in Louisiana; the Scottish side settled in Mississippi, in or around Philadelphia. That is all to say, mine is not an outside perspective, at least not geographically. The last five generations of my family were born into and helped to shape the culture and environment in which I now live and attempt to raise my son. And it is exactly because of my son that I now confront the problems of race in Mississippi. How do I raise one of the next generation of Southern men? How do we make them better than ourselves? How do we move the culture forward?

The problem is this: whites in Mississippi are racists. Blacks are racists. Conservatives and Republicans are racists. Liberals and Democrats are racists. Even the “non-racists” are racists. The antagonistic nature of this place is in the roots and in the water. Anyone born in Mississippi soil has its heritage written into their DNA. I consider myself about as progressive as Mississippians come, and I know that I am a racist. I don’t intend to be; I take steps not to be, but the tendency is there, and I admit that. Intellectually, I do not discriminate, but it is in my nature to do so, even if I hate myself as it happens. Each generation before me feels less guilty about this nature. My grandparents were unabashedly and quite blatantly racist. I will share a family secret to illustrate this point: Edgar Ray Killen, infamous KKK member and primary organizer of the Freedom Summer murders, was at my great uncle’s funeral. A whole generation of men on that side of my family died with very dark secrets that still echo around family gatherings.

So, the bar being set so low, I suppose I can say that I am an example of progress. I am not actively trying to murder anyone attempting to change the power structure. And more than that, my wife and I both seek to be a family that is inclusive of everyone. We know that the more time different races and cultures spend around each other, the more they find in common. The difficulty is that the culture separates them. Even the public schools are mostly segregated. In a small town that is about 50% white and 50% black, the opportunities for kids of different races to interact are almost nonexistent.

Put another way, it is like we have new software but are forced to use the old hardware. And so even if we had a perfect grasp of every concept (which we don’t), we still could never use stone tools to make an airplane. The old systems persist, great cultural barriers scouting for change like patinated bronze watchtowers. Atop each stand our grandfathers. And so we wait for them to die. But how many generations will it take before that legacy is gone? And even then, can we separate the blood from the water?

Roche Limit

A loyal little moon. For billions of years it is drawn inch by inch towards its partner. A loner as well, its partner lives far from the starlight but burns with a fierce heat from within. Our little moon, so long a part of this chance pairing, has grown tidally locked, ever baking on one side and forever frozen on the other. And so it has been for a third the life of the universe. But today something is different, something has been stretched too far. The force pulling our little moon to its partner has become greater than the force that holds the little moon together. It has reached its Roche Limit. All at once, it crumbles. Pulled apart, its debris orbits its former partner. A beautiful ring formed out of the detritus of a relationship doomed from its onset by inevitable attraction.

For weeks now there has been something I have been hesitant to admit, especially to myself. But it is true that something in me has reconfigured itself into an older design. The five-month grace period, the most determined, compassionate and productive of my life, has slowly evolved into something else. That thing, present as long as I can remember, is too strong to be avoided with exercise or scheduling strategies. It is fundamental in some way, and I realized as I worked myself ragged in an attempt to “feel normal” that my goal was to feel anything but. Some things are too big to escape. We are bound to them. We are partnered with them for life, and, our fates bound up together, we have no choice but to learn to live with them.

We all orbit something, something seemingly bigger than us or part of us, a lover or potential lover around which our lives revolve, a child, a sense of duty, the journey to advancement, the quest for or prolonging of pride or praise, the approval of a parent, the fear of death. In each of us there is something around which we base ourselves, an imperfection around which our personalities can crystallize. We imitate the thing or become its opposite, but we are never rid of it. It is the bedrock of our deepest selves.

I am somewhat aware of the thing that pulls at me. It isn’t obsessive-compulsive disorder or anything else listed in the DSM (well, maybe it is). Mine is nihilism, a sense of meaninglessness in all things, a bored disgust with most parts of life. Because of this, I spend my life trying to do the opposite of what I feel, trying to find meaning in everything. I do this to hold myself together under the weight of that most final of all philosophies. I make it the goal of my generation to hold the line against this idea. There must be meaning, something more than the flickering flame of human life and understanding.