🧠 #104: Distress tolerance homework

🧠 #104: Distress tolerance homework

This week’s update shares about my therapist and me being symptomatic together, giving my wife a gift of flexibility, and a realization about feeling like I’m always being tested.

These weekly updates share life with OCD as part of my Mental Work Health project to reduce stigma around mental health, especially at work.

Something hard

My therapy session last week was an interesting one. Both my therapist and I share an OCD diagnosis, and both of us have been struggling lately.

At the time of my appointment, I was having a rough patch. My therapist had texted that she would be late, but I went over anyway. I was going to be doing the same thing regardless, so I might as well do it at her office—curled up doing sudoku, like I described last week. One of her symptoms is struggling with time, so I ended up waiting for a while, but it really didn’t matter to me.

When she got there, I told her about the difficulty of my positive spike the week before. It helped that I had written about it and processed it already.

Earlier in my therapy career, I could not have alone done the processing, and had the realization that the positive spike and subsequent crash was a normal and expected part of life. At this point, I will often hear her voice in my head asking me questions or pointing out the obvious that was previously opaque to me.

As we discussed how things were going, she gave me some homework. She said that I’m just about at the point where my medication should be kicking in, and I should be able to work on skills again without getting overwhelmed. Both of us need to go back to the basics and focus on the fundamentals of combating OCD.

The core of the recovery is distress tolerance, typically practiced through exposure and response prevention (ERP) therapy. Instead of running away from what is scaring me, I need to lean into it.

It is such a help and comfort to have a therapist who truly understands me. Because we share a diagnosis, I don’t have to struggle to explain to her what I am feeling or experiencing. She can usually describe it more clearly than I can, just anticipating what I am likely going through.

I don’t wish these struggles on anyone. But I’ve also learned that all of us have our own struggles. They may look different, but they are no less valid, and no less difficult. We’re all in this together.

Something good

Last week was my wedding anniversary. I wasn’t as prepared for it as I wanted to be, but I still wanted to do something to make it a special occasion.

I was discussing my goals for the week with my mastermind group as part of my Accelerator membership at The Focus Course. They asked what I could do practically that my wife would appreciate.

Immediately I had the thought to take the day off with and spend it home with the family doing projects around the house. But that sounded hard.

As I mentioned last week, I have been struggling the last little while with my OCD, and adding extra uncertainty didn’t sound like the best idea.

But my schedule was clear and I knew it would be meaningful if I could do it. And if I had to retreat for a bit, I figured it’s the thought that counts.

So when I went home that night, I told my wife I was going to take the next day off with no plans or expectations. I was just available to do whatever.

Ironically, that evening I got totally overwhelmed by the kids and had to head up to my room for a while. I was a little nervous about taking off the next day, and how things would go.

But I got up the next day, and just engaged. We tackled some household projects we’ve been wanting to do, and just worked together throughout the day. In the evening, we took the kids to Cornbelly’s, a local fair-type activity, which they loved. Finally, we went out to a nice family-owned Italian restaurant for a delicious dinner and talked for a while.

It was a glorious day.

And contrary to my expectations, it was not nearly as difficult as I thought. As I look back on my mood tracker, it was actually the best day of the week.

I was grateful to my mastermind group for the encouragement to turn my vague intention into a practical plan that was both meaningful and enjoyable.

I realized the gift I had really given my wife that day was the gift of flexibility. We were able to spend the day however it happened, without plans or expectations. That is typically extremely difficult for me, and I felt a deep sense of satisfaction at being able to do it.

Something else

I had a realization last week that made me laugh.

As I mentioned earlier, I waited for a while for my therapist to arrive for my therapy session last week. I played sudoku while I waited, which wasn’t quite enough to quiet all the internal chatter.

I started thinking about what I was going to tell my therapist about how things had been going. That’s usually a wasted effort, unless I had a major event that I needed help working through.

When I first started therapy, I would take in a printed outline of everything I wanted to talk about. My therapist invariably asked questions that got us off discussing something else, which I learned later was a deliberate exercise to build my tolerance for uncertainty.

As I thought about what I wanted to discuss, I started to think about the fact that she was late. I knew that this too was often a deliberate choice on her part to keep me guessing and uncertain.

I wondered if her being so late that day was a test. Maybe I was supposed to be saying something about it. Maybe she was doing it just to see what it took for me to get upset with her. Maybe I wasn’t passing the test yet by staying calm and understanding every time.

The distress of that possibility pooled in my gut and I recognized its taste and texture on other thoughts flitting around in my mind. A lot of thoughts. I began to be overwhelmed by the weight of all those possibilities for failure.

The thought clearly came to me—“I wish all of life was not a test.”

I realized that in nearly every area of my life, I felt scrutinized and judged for failing. Constantly.

Then it hit me.

I was trying to be right. All the time.

As soon as this became clear, I started laughing. Of course I was trying to be right—that is the core of my OCD. I feel immense pressure to do the right thing, and have to figure out what that right thing is in any situation so that I can do it.

When we started my therapy session, I told my therapist about my realization that I felt like all of life was a constant test. She starting laughing immediately.

So you realized that you have you OCD? Good for you.

As she has told me time and time again, insight is one of the first casualties when OCD flares up and I am symptomatic. Observations that would be totally clear to anyone else become impossible for me.

Jocko talks about this as a storm cloud that hangs over you. Anyone outside of it can see that the storm is just around you, and you could get out of it. But when you’re in it, it’s nearly impossible to see clearly what is happening.

The key to get out of this is just what Jocko says—get outside yourself and help someone else. Some days this is harder than others, but this is the goal.

Wrap up

The last few weeks have been rough, but I am starting to come up for air. I was reminded this week of how important self-compassion is. Like so many people, I find myself being much harder on me than I would be on anyone that I love or care about. Let’s both you and I this week try to be extra kind to ourselves. Whatever we’re going through, that will help us navigate it.

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