The Importance of Treating OCD Earlier: The Washington Post Article on Ethan’s Struggle from Childhood OCD through Adulthood

In people who develop obsessive-compulsive disorder, there are often signs in childhood. However, OCD in children can be hard to distinguish from childhood fears and age-appropriate magical thinking. For OCD Awareness Week, The Washington Post published an article by Sarah Maraniss-Vander Schaaf about the experiences of Ethan, a young man who developed OCD in childhood. It’s an effort to help people look past the stereotypes of people with OCD as being excessively clean and organized or washing their hands excessively. As the writer notes:

“…true OCD is often unspoken. It’s hard to recognize, as well, when growing up in a family where anxiety is normal, or in a school where behavior might be labeled school avoidance, or when no one else talks about the secret rituals that are too private to mention.”

The article traces the development of Ethan’s OCD from early childhood, though college, and the following decade of adulthood. It documents how OCD obsessions and rituals can escalate when left untreated and unchecked, and it provides a sober illustration of how the accommodation by the loved ones of someone with OCD’s obsessions/rituals—however well-meaning—can have disastrous consequences over time.

I’ve written in other posts about how some people with OCD have difficulty accessing appropriate treatments. Ethan was eventually accurately diagnosed and offered effective treatment, but it took several attempts before he was fully willing and able to engage treatment. He was even kicked out of OCD Institute at McLean Hospital, one of the leading residential treatment programs for people with OCD. Ethan didn’t recover from OCD until he was willing to commit to proper treatment—particularly exposure and response prevention. Ms. Maraniss-Vander Schaaf writes:

His improvement came when he accepted CBT and Exposure Response Prevention (ERP). He was taught to develop a new relationship with his thoughts. He learned to live with the uncertainties of life and not push away anxiety with obsessive-compulsive thoughts and actions.

Ethan’s story is inspiring as, even after 2 decades of struggling with severe OCD, he is currently enjoying a productive and independent life. As I work with adults, I don’t often have a full view of how OCD progresses across the lifespan in the clients I see. I found this article of Ethan’s personal journey into OCD illuminating in how it presents a narrative of someone’s struggles with OCD across more than 2 decades, and the way OCD symptoms can change, transform, and evolve over time.

You can read the full article here.

If you or some you know is struggling with anxiety-related problems, please check out the Portland Psychotherapy Anxiety Clinic. If you would like to learn more about my approach to OCD specifically, check out my OCD website.

If you want to learn about OCD, here’s post about a great introductory book, Tompkins’ OCD: A Guide for the Newly Diagnosed.

Resources for self- and other-care in difficult times

Many of us have been impacted by the election results.  Whether you are feeling shock, fear, anger, sadness, confusion, disbelief, or excitement, joy, satisfaction or hope, you are likely not alone.

If you have been struggling, some of these resources might be helpful (thanks to Jennifer Villatte for sharing this list).  I prefaced each with a quote that spoke to me.  I also noticed the urge to provide a more in depth review of each, but eventually decided to practice self-care by calling it good :).  I hope you find something you might be seeking.

Resources for Self-Care in the Face of Social Injustice and Marginalization

“When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.”
What It Really Means to Hold Space for Someone, by Heather Plett
http://upliftconnect.com/hold-space/

“Have you showered in the past day? If not, take a shower right now.”
4 Self-Care Resources for Days When the World is Terrible, by Miriam Zoila Perez
https://www.colorlines.com/articles/4-self-care-resources-days-when-world-terrible

“Oppression is far more effective when the oppressed are also mentally drained and physically ill, so our physical and mental wellness is, in itself, a personal counter-attack on oppression.”
3 Ways to Prioritize Self-Care While Resisting Dehumanization: Because #BlackWellnessMatters, by Akilah S. Richards
http://everydayfeminism.com/2015/07/self-care-resisting-dehumanization/

“There are things you can do for yourself right now to get prepared for the next four (to eight) years.”
What to Do If You’re Trans and Live in America Now, by Jessica Lachenal
http://www.themarysue.com/trans-in-america-2016/

“Anger used as a catalyst for social transformation can go a long way.”
Transforming Anger into Building Solidarity, by Beth Berila
http://www.contemplativepracticesforantioppressionpedagogy.com/blog/transforming-anger-into-building-solidarity-by-beth-berila-phd

“Sometimes saying no is a radical act of self-care that’s as vital to our struggles as the marches, teach-ins, and walk-outs in which we participate.”
5 Self-Care Tips for Activists – ‘Cause Being Woke Shouldn’t Mean Your Spirit’s Broke, by Kim Tran
http://everydayfeminism.com/2016/04/self-care-for-woke-folks/

“The antidote for exhaustion isn’t rest.  It is wholeheartedness.”
What’s Missing When We Talk About Self-Care, by Carmenleah Ascencio
https://www.youtube.com/watch?v=4eX5Wjm4FrE

Resources for Engaging in Difficult Conversations and Being an Ally

“I’m more interested in helping them change their oppressive behavior than publicly shaming them for it.”
Calling In: A Quick Guide on When and How, by Sian Ferguson
http://everydayfeminism.com/2015/01/guide-to-calling-in/

“Comfort IN, dump OUT.”
How not to say the wrong thing – The “Ring Theory” of Comfort, by Susan Silk & Barry Goldman
http://articles.latimes.com/2013/apr/07/opinion/la-oe-0407-silk-ring-theory-20130407

“13. Recognize That Yes, You’re Going to Do it Wrong and 14. Apologize Without Caveats”
30 Ways to Be a Better Ally, by Jamie Utt
http://everydayfeminism.com/2014/01/30-ways-to-be-a-better-ally-in-2014/

“We Center The Voice and Leadership of the Survivor and Oppressed Communities.”
Being An Ally/Building Solidarity, by Southerners On New Ground (S.O.N.G.)
http://southernersonnewground.org/wp-content/uploads/2012/12/SONG-Being-An-Ally-Building-Solidarity.pdf

“Create and Share Art, Support People with Disabilities”
26 Ways to Be in the Struggle Beyond the Streets, by Anderson, Barett, Dixon, Garrido, Kane, Nancherla, Narichania, Narasimham, Rabiyah and Richart
https://issuu.com/nlc.sf.2014/docs/beyondthestreets_final

To those who feel afraid or hurt after the election

For many of us, these are frightening and uncertain times. We at Portland Psychotherapy want to make a declaration of support to the millions of people around the nation and here in Portland that have been targeted, oppressed, attacked, or silenced and to those who feel fearful of what may come.  Portland Psychotherapy does not endorse discrimination in any form and is invested in ensuring the safety of all members of our community.

If you feel marginalized, oppressed, angered, hurt, afraid, ashamed, or stigmatized, we want you to know you are welcome here.  You are all part of the community we love and serve. This is a safe place for you to speak and to be heard. We value you.

The Staff of Portland Psychotherapy

Blue light at night is bad

We have known or suspected for quite some time that there are significant harmful health and environmental consequences associated with excessive light use at night, especially blue-rich light. Advances in technology and the widespread transition to light emitting diodes (LEDs), which emit substantial amounts of blue light, have made this especially important to understand and address.

The American Medical Association (AMA) recently released an important and timely report, providing scientific evidence in support of these concerns. They affirm the potential health hazards of blue-rich light, including its links to increased risks for cancer, diabetes, cardiovascular disease, and circadian rhythm disruption. They also find that blue-rich LED street lighting is five times more disruptive to our sleep than conventional street lighting and that brighter neighborhood lighting is associated with reduced sleep and impaired daytime functioning.

This interesting article outlines some of the AMA’s findings and describes some of the implications.

On an individual level, there are things we can do to minimize the impact on our sleep and our health from light exposure at night.

Here are some suggestions for more healthy and responsible light use:

  • Use “warm-white” or filtered LEDs to minimize blue light emission
  • Choose products with adaptive controls, such as dimmers, timers, and motion sensors
  • Dim or turn off lights during overnight hours
  • Light only the area needed in the minimal amount required
  • Avoid using blue-rich light devices (e-readers, laptop and phone screens, etc.)  in the evening as much as possible (2-3 hours before bedtime)
  • Download an app that filters out the blue light from your devices (http://www.makeuseof.com/tag/get-good-nights-sleep-filtering-phones-blue-light/)

What you need to know about the relationship between PTSD, trauma, and substance abuse

Posttraumatic stress disorder (PTSD) and addiction are two very different challenges that are sometimes experienced at the same time. People are often curious about the ways that these two struggles overlap.  There are actually several ways that PTSD and substance use go together.

Substances as a solution

People who have PTSD struggle with anxiety and fear, isolation, and sleep difficulties.  Substance use can, understandably, seem like a solution.

Using alcohol might help someone who feels on guard all the time to be able to relax.  Benzodiazepines or marijuana might be used to help individuals who suffer from trauma to fall asleep.  People with PTSD may use substances to avoid thoughts, feelings, or memories associated with the traumatic event.

Research suggests that the relief from substances is short-lived and does not permanently improve the experience of individuals with PTSD, even if it does provide some temporary aid.  In fact the reality is quite the opposite – avoiding symptoms actually helps to maintain the symptoms of PTSD in the long run. The more that trauma-related thoughts and feelings are avoided, the worse symptoms become.

PTSD often leads to negative views of other people or the world, and as a result people with PTSD sometimes feel quite disconnected from friends and family. Using alcohol or other substances may seem like a good way to temporarily suspend those negative beliefs and connect with others.  Again, although using substances may temporarily help someone feel the connection to others that they’re craving, this is not a permanent solution and there are often unintended side effects that wreak havoc in their lives.

Substance abuse sometimes causes trauma

Substance use can, unfortunately, lead to further trauma.

Substances themselves can have effects that can be traumatic, for example a terrifying acid trip or an accidental overdose.  In a similar way, when people are under the influence of substances, their inhibitions are lower and so they are more likely to get into situations where traumatic events occur.  It’s common for people who are under the influence of substances not to feel the full impact of the trauma until later.

It’s important to note that it is less common for substance abuse to lead to trauma; much more often individuals have traumatic experiences and then begin using substances as a way to cope.   They may then be more susceptible to those additional traumatic experiences for a number of reasons, including environmental factors and reduced inhibition when under the influence.

Treatment solutions for both PTSD and substance abuse

When considering the co-occurrence of PTSD and substance abuse, it makes a lot of sense that these disorders go together.  Substance use promises quick relief from pain, and the pain of trauma can sometimes seem intolerable.  However, using substances rarely provides any kind of long term relief and can have a number of negative consequences.

The good news is that a number of effective treatments for co-occurring PTSD and substance abuse have been developed and there are specialists who are trained to help.  Treatment with a qualified professional is a critical part of healing and creating the life that those who suffer from trauma and substance abuse desire and deserve.

If you or someone you love is currently struggling, contact our office today to schedule an initial assessment.

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