Like many OCD sufferers, I have been through several therapists in my time as a certifiably mad person. But this is the first time a therapist has retired on me.
My first therapist was a kind, mumsy woman with the most fantastic curly blond hair, who was an expert in cognitive behavioural therapy, or CBT. Bog-standard CBT is now frankly old hat in the psychology world, but to me it was revolutionary. This first therapist, let’s call her Jenny, did the life-saving work of convincing me that I didn’t have to take every insane thought that entered my brain as a gospel command. But, after a while, it became clear that, with a serious OCD-er like me, Jenny was out of her depth. So I moved on to the big guns—an OCD specialist.
It can’t be easy to be an OCD specialist. From lucky friends that have received other forms of therapy, I have heard much about sessions in which therapists validate their emotions and experiences as well as gently challenge them. However, for those of us with OCD, the gold standard of treatment is a specialised form of CBT often called “exposure and response prevention” (ERP), where the therapist purposely exposes us clients to the things that terrify us and that we are trying to avoid. As you can imagine, this can be a distressing process for everyone involved. And being the stubborn mule that I am, this friction has at times created a somewhat adversarial relationship between me and my therapists.
When exposed to something that triggers my obsessive worries, I can try to manage my anxiety by doing something called “reassurance seeking”. When I’m reassurance seeking, I rather skilfully and manipulatively extract reassurance from the people around me by bringing my obsessive worries up in conversation.
I regard myself as something of a world champion reassurance seeker. I can quietly bring almost any conversation round to the topic I’m worried about and can extract reassurance from even the most unlikely sources. This can make my relationship with my therapists, whose entire job is to not to give me the reassurance I’m angling for, feel like a match between two sporting opponents. My OCD therapist must be skilful and determined enough to outsmart my OCD, even when my OCD is deploying its most ingenious tactics.
The first specialist I saw—my second therapist ever—was a quietly spoken, erudite man who knew the science of OCD better than anyone, but he was not able to get a grip on my particular brand of madness. This was no fault of his own. The lack of progress we made was largely down to the fact that I was simply not ready to do the hard work that is required for recovery. I was still bargaining with the OCD devil, hoping for reprieve without serious effort.
It was my third therapist—let’s call her Jane—who, a solid six years after my diagnosis, cracked the conundrum. And it is Jane who told me a couple of weeks ago that she is retiring. In the more than five years we have worked together, Jane carefully trod the delicate balance between exposing me to my fears and being kind enough to keep me motivated. Jane gave me the skills I needed to live a different kind of life, a life that wasn’t dictated by the whims of the merciless tyrant that resides in my brain. Oh, and she also has great hair and wears iconic glasses.
Over the last two years I didn’t see Jane regularly, because, like all therapists worth their salt, she has given me the tools to dig myself out of most of my relapses on my own. Only the peskiest of OCD thoughts can now get through my carefully stitched safety net, in which case I can send her an SOS text along the lines of “I’ve gone a bit mad again, do you have any sessions available?” Jane has kindly supplied me with the details of the next soon-to-be-long-suffering professional, who I hope will agree to be my backstop against insanity for the next five years. As OCD is a chronic illness, I suspect I will always need one. But my time with Jane has come to an end.
What do you say to the person who gave you your life back, when they are retiring? How do you thank a person who taught you that the world is not only, as you feared, a dark and dangerous place but also a beautiful one? How do you say goodbye to someone who has borne witness to your darkest thoughts, your most challenging behaviours, your deepest secrets? I don’t know the answer to any of these questions. But I do know that, while I’m sad Jane is retiring, I will cope without her. And that, for any therapist, is the mark of a job well done. Happy retirement, Jane!
