brave, to confront his OCD and work past it. It’s true, in this case, that a coward dies a thousand times before his death, but the valiant fight off OCD right now!
Howard Hughes’s germ-backflow theory is similar to an obsession described by Jenny, a professional woman in her early 30s with a longtime involvement in ecological and environmental issues. While working for a U.S. government agency in Moscow, she developed the obsession that radiation could spread and attach itself to things. This was only a few years after the Chernobyl nuclear disaster, so, as is true with many OCD thoughts, there was a small element of logic. However, Jenny’s reasoning was totally illogical. “When people would come in from Kiev or Chernobyl, I’d worry that radiation would just come off of them and contaminate my things. Any logic that I tried to infuse about the physics of radiation was not working. It was kind of a basic contamination fear.”
Always, what she really worried about was that she, in turn, was going to contaminate others. She began to keep separate in her closet those clothes that were still okay to wear when she was around friends. These were the clothes that she’d never worn when around someone who’d been near Chernobyl. Certain books and papers had to be disposed of. “I threw away perfectly good things because I thought they were contaminated. I didn’t want people getting them out of the trash, so I would rip them up to make themunusable.” She became afraid to phone home, in fear that the “radiation” would somehow travel over the telephone lines.
ONE HOARDS, ANOTHER SCRUBS
With regard to the form of OCD and the content of OCD, it is certainly possible that a person’s life experience plays a role, especially in the content of that person’s irrational fears. Many of my patients believe this. Jenny, for example, wonders whether she might have been subliminally affected by a film on the bombing of Hiroshima that she saw on television when she was 12. She still recalls it vividly: “I couldn’t sleep. I kept thinking of burnt hands reaching up from behind my pillow and of faces with burnt skin sagging, faces staring at me.”
Jenny’s first OCD thoughts—of feeling compelled to tell people inappropriate things—date from early childhood. By her teenage years, OCD was a monster that had a real stranglehold on her. This moving diary entry was written when she was 18:
You are the awful…the awful. It has gone too far. There is no message, no inspiration, just pain. So that all else that is so fine is dulled. You are the duller, the awful…what fault mine? Possibly that I let you do this to me? No, I had no control. You took power of me, the fear holds me. Take your awful fingers from my mind…you awful…you be damned in heaven, hell the better. I hate it. I hate it. I hate it. I want to be free.
Using Four-Step self-directed therapy in combination with Prozac to make it a little easier, Jenny is now able to control her OCD. She is no longer afraid to mail letters because of some wild idea that they are contaminated. She forces herself to wear all the clothes in her closet. She says she would have no qualms about driving past a nuclear power plant or working near a nuclear reactor. One day recently, while cleaning out her office at a medical complex, Jenny came across a box in which were stored old cardboard covers for lab slides. “I had an idea that there were diseases in there. Well, I brought them out and put them on my desk and touched them andsaid, ‘This is ridiculous. Pathogens die within seconds. It’s not me—it’s my OCD.’” She was able to put the absurd thought aside.
At UCLA, we have provided scientific evidence that OCD is related to a chemical imbalance in the brain, that critical parts of the brains of people with OCD use too much energy because the brain circuitry is out of whack. This is true across the spectrum of people with OCD. But OCD presents itself in a huge
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