“And how does that make you feel?”
Dr. Y looks troubled as she poses the question to me. Her brow is furrowed, the corners of her mouth are turned down, and she’s leaning so far forward in her chair that I’m afraid she’ll fall out. We’ve known each other less than thirty minutes, yet clearly she’s far more concerned about my feelings than even my oldest and dearest of friends.
“Okay, let’s back up,” she says in response to my silence. “These persistent thoughts of yours, let’s talk about them.”
“Well, they’re always about harm,” I tell her, “harm I may have caused in the past, or harm I may yet cause in the future, always some form of harm stemming from my negligence.”
“Good. And that makes you feeeel …” She wants me to fill in the blank.
“Guilty, I guess.”
“Good! Very good.” Her frown is a smile now, but an awkward, askew, and generally unnatural one. “Okay,” she says. “Now tell me more about your childhood situation.”
It’s a late April morning, and I am back in a psychologist’s office. It turns out Samantha was right after all: I can’t seem to tackle my problems alone. Just two days after my road-cone troubles in Oakland, there I was on my hands and knees in San Bruno, combing our street for fragments of a flashlight battery I’d run over with my car, determined to make sure that no children could be exposed to any sharp or poisonous parts. Then, three days after that, I got so worked up over a tough lane change that I almost didn’t make it to my reporting shift at KCBS. Sam and I later had a big, ugly argument over nothing, prompting me to storm out of the house. After several hours of stewing in my parked car, I came to understand that perhaps she’d been right all along.
And now here I am in the sterile offices of Dr. Y, whose only qualifications I’m familiar with are the ones she listed in the Yellow Pages. Truth is, she had me at the first line that established her gender. Somehow talking with a middle-aged man had been a bit too much like talking with Dad. This time, I was determined to find a female therapist.
At 9:50 we wrap up our session and make arrangements to meet every Monday. Dr. Y’s frown is back as I get up to leave. It strikes me that there’s no rhyme or reason behind the expressions she straps on her face. Her last words to me on my way out the door: “I want you to think this week about how you are feeling.”
What I am feeling by the time I get home is an overwhelming urge to visit Oyster Point Marina. Several months ago, Dad decided to move The Boat across the Bay to Alameda, and at first it seemed the new berthing arrangement would solve all my problems. No longer would I have to see the cabin cruiser every time I went to the boat. But then the notion crossed my mind that I was somehow leaving the scene of a crime, and with each passing week, Doubt’s hit-and-run prosecution has grown that much stronger. Now, the damning evidence tapes again loop in my head daily, and I’ve come to realize that the only way to exonerate myself is to spell out everything in writing for the crew of the cabin cruiser.
When Samantha comes home, I tell her about my big plans.
“You want to leave them a note?” she says. “And just what will that accomplish?”
“It’ll let me know they can reach me if they need to,” I tell her, knowing at some deeper level that what I’m really hoping for is another rush of relief like I got when I confessed my road-cone concerns to the construction crew foreman.
“You know this isn’t about the boat anymore,” Sam says, “if in fact it ever was.”
I say nothing.
“The road cone. The hubcap in Hawaii. That … that old battery you were wigging out over. It’s something new every day, babe. You do see that, don’t you?”
“But if I can just leave this note—”
Sam closes her eyes for a second, then leaves to put Bri down for her nap.
The following Monday, I tell Dr. Y about the note Samantha couldn’t keep me from slipping into the cockpit of the cabin cruiser. She narrows her eyes and asks me to describe my feelings about it.
The Monday after that, I recount a recent afternoon I spent looping my car around downtown San Francisco, looking for the object that had made such a clang beneath my wheels—looking in person, I explain, so I won’t later have to do it in my mind for hours on end.
“Let’s back up to that noise,” she says. “How did you feel when you first heard the clang?”
We do this dance for fifty minutes every Monday for the next two months. In between discussions about my feelings, I answer Dr. Y’s many questions about my youth: Did my parents ever argue? Yes? Oh, how often then? Did I blame myself when there was tension between them? Did I ever experience a sense of helplessness when times weren’t good? Like Dr. X, Dr. Y takes copious notes, though she tends to pontificate far less than he did. Still, every now and then, she stops me midsentence and offers an observation.
“It’s interesting,” she tells me one day after listening to my concern about having bumped into somebody at the station. “You seem to have a very inflated sense of your own power.”
No argument there, I think to myself. When it comes to harming people, I know I’ve got incredible power—Herculean, in fact. I can inflict brain damage with the slightest touch, and impregnate women without even undressing.
You nailed that one, Doc, I want to throw back at her.
By late June, I have spent ten hours and a thousand dollars with Dr. Y. I don’t feel any better. Don’t seem to have anything to show for my investments. But therapy is a slow process, she tells me again and again, so I resolve to keep my Monday appointments. I’ll hang in there for Samantha’s sake, if nothing else.
I sometimes think my memory has been a bit unfair to good ol’ Dr. Y. She is, in my tapes, nothing short of a cartoon caricature, a stereotype reflecting every grudge I long held against traditional psychotherapists and their once widespread ignorance of my particular brand of crazy. The endless questions. The constant probing for some elusive defining moment or event that, once identified, would unlock all my secrets. Take my various quirks, for example: the driving in loops, the urges to confess, the repeated checking and rechecking of everything around me, even my constant mental reviews—they, Dr. Y assured me, were all indications of a much deeper, broader, and far more complex problem. Our challenge in therapy, she explained, was to root out that problem. Clearly this approach is an effective one in treating many kinds of issues. But not mine. Today I’m convinced of this; but even back then, sitting on Dr. Y’s couch week after week, I knew it also, if only in my gut. I knew she was missing something, and I count my blessings to this day that the checker, and the investigative reporter, in me just wouldn’t let it go.
It’s late August now, and Dr. Y is away, wrapping up a three-week vacation. I, on the other hand, am very much on the job, tackling an investigative research project with all the discipline and fervor that, several years ago, had landed me a big award from the Associated Press.
I am camped out in the psychology section of the Oakland Barnes & Noble—probably not such a great idea given its close proximity to the Channel 2 studios. But even this is a risk I’m willing to take to get to the bottom of the story I’m working on—my story, the one Dr. Y can’t seem to sort out.
As I discover right away, bold-lettered subcategories such as “Tape Reviews” or “Confession Urges” or even “Driving Issues” simply don’t exist, so I start at the upper left shelf in the General Psychology area and begin making my way down and across the alphabetical series. For forty-five minutes I scan each and every title, taking an occasional book off the shelf when its title mentions guilt or uncertainty or even general anxiety. But nothing fits. I am not recovering from a broken marriage or grieving over a lost loved one. I am not a victim of child abuse or fighting urges to take my own life. I am, I decide, a true freak of nature battling mental problems beyond the scope of any psychology or self-help book on the market. Perhaps my little research project wasn’t such a brilliant plan after all.
It’s getting late and I’ve nearly exhausted my third bank of books when a bright orange one with the strangest of titles catches my eye. The Boy Who Couldn’t Stop Washing. Something about the words couldn’t stop prompts me to pull the small paperback off the shelf. What I read on the first page of the first chapter knocks me down to my knees, like a swift blow to the back of my legs.
I lose myself in this book for the next five—or is it fifty?—minutes, slowly processing the firsthand account of someone named Dr. S describing an auto accident that never was. Using words that could very well be my own, this thirty-six-year-old Ph.D. explains how he’s driving down the highway one day when, for no logical reason, the thought crosses his mind that maybe he’s hit someone. He knows it’s a ridiculous thought, but he also knows the price he’ll later pay for not checking on it. So he turns his car around and goes back for a look. He checks the side of the road, finds no evidence, and now, greatly relieved, drives off again. Twenty seconds later, though, he’s kicking himself for not inspecting the brush alongside the road. So he heads back once more, and things go from bad to worse as he checks and rechecks the shoulder again and …
I am starting to break down now. And I don’t care. Let the whole damn Channel 2 news department show up and see me like this. I just don’t care. Sure, grown men aren’t supposed to cry, certainly not while sitting on the floor of a busy bookstore. But grown men also aren’t supposed to drive their cars in circles and battle nonsensical thoughts about harming other people. Discovering, as I just have, that at least one other grown man in this world does these things too: that is reason enough to let it all out.
Still, there is much more to read. I force myself to push on to a story about a nine-year-old named Zach who can’t stop washing his hands, and a thirteen-year-old named Arnie who has to mentally review every event of his day.
A kid who plays tapes!
Dr. S and Zach and Arnie and the dozen or so other men, women, and children profiled in the little orange book all have one thing in common, according to its author, Dr. Judith Rapoport: they all battle a “strange and fascinating sickness of ritual and doubts run wild.” Obsessive-compulsive disorder, she calls it. OCD.
I have all but finished reading the book by the time I take it to the cashier and make it my own.
At home two hours later Samantha sees my red eyes and assumes I’ve been spending more time on a cold bathroom floor. I shake my head and silently hand her my copy of The Boy Who Couldn’t Stop Washing. I watch her troubled face as she reads the pages I’ve bookmarked and see in her expressions a reflection of my own witch’s brew of emotions. The confusion. The disbelief. The fear. The hope and the cautious optimism.
“Yeah?” I whisper after a few seconds of silence.
“Yeah,” she says. “No question about it.”
Dr. Y is somewhat less convinced.
“O-C what?” she says after I spend the first fifteen minutes of our session running through the highlights of my life-changing discovery at Barnes & Noble just the day before.
“OCD,” I repeat. “Obsessive-compulsive disorder.”
“And you read about this in a book while I was on vacation?”
“Yeah, I’ve gone through it twice now, and the case studies are so similar to my own experiences, it’s downright eerie.”
Dr. Y bites her lip, then shakes her head, an inch to the left and an inch to the right. She is weighing her words as that awkward smile of hers reappears. Jeff, Jeff, Jeff, I know she wants to say. Patients really shouldn’t try to do the work of a trained psychologist.
“I’m very committed to exploring this whole OCD label,” I tell her when I can’t wait a second longer for her thoughts.
“I can see that,” she says. “I’m just concerned that you’re losing sight of the underlying problems.”
We stare at each other in silence for what seems like forever. And then I make a decision, one I’m not sure I even saw coming when I stepped into her office this morning.
“I think it’s time for me to move on, Dr. Y,” I announce. “I do hope you understand.”
Damn, that felt good, I think on my way to the door. How ironic that the one time I’d really like to share my feelings, I know I can’t because of how hurtful they’d be.
Over the next twenty-four hours, I hole up and read every book on obsessive-compulsive disorder that I can find in the library. With titles like When Once Is Not Enough and Over and Over Again, the books are all so strangely familiar. On their pages I uncover the harsh realities of who and what I am.
The vocabulary comes first, with familiar words taking on whole new meanings that hit close to home. Obsessions, for example. They are, in the lexicon of my new world, intrusive, nonsensical thoughts that produce great distress. And compulsions: they are now and forever more repetitive, hard-to-resist actions or rituals that temporarily reduce this distress.
Other words, too, keep appearing, seemingly with my picture next to their every definition. One of these is checker, which I learn is an obsessive-compulsive whose obsessions tend to involve catastrophic what-if? questions, and whose compulsions entail various forms of physical and mental checking aimed at warding off the imagined catastrophes.
Slowly, everything starts to come together, like a jigsaw puzzle taking form from a box full of jagged pieces of myriad sizes, colors, and shapes. Doubt’s nagging and disturbing questions of me—What if the cabin cruiser sinks? What if the road cone causes an accident? What if you inflicted brain damage on that kid you bumped into?—these are all uncertainty-riddled obsessions that fill me with anxiety. And my relentless “tape reviews,” along with the physical inspections and driving loops and repeated confessions—these are all checking compulsions I’ve adopted in a futile effort to remove the unbearable doubt of these obsessions and make them disappear forever.
Symptoms of a larger problem, Dr. Y? Hmmm. What if maybe the symptoms are the problem?!
From my research I learn that as many as three out of every 100 Americans are believed to be battling this so-called “doubting disease.” But as OCD experts Edna Foa and Reid Wilson explain in their book Stop Obsessing! not all of them are checkers like myself. Some are washers and cleaners, consumed with obsessions about contamination. Others are repeaters, compelled to repeat certain actions. Still others are orderers who require that things around them be arranged in a particular, rigid way. Or hoarders who collect trivial objects and find it impossible to let them go. Or thinking ritualizers who mentally repeat thoughts or images. Or worriers and pure obsessionals who remain locked in repetitious negative thoughts.
Lots of different ways to make an omelet, with lots of different cracked eggs in the pan.
Soon I know enough to write a master’s thesis on the mechanics of OCD and analyze in great detail all of Doubt’s cruel games of mental keep-away. But what I can’t do, even after countless hours of my best investigative reporting, is answer my most pressing question: Why? Why in God’s name do I and the millions of other obsessive-compulsives out there do what we do?
Unfortunately, it seems no one really knows for sure.
Could be abnormalities in my brain’s frontal lobe and/or a portion of the basal ganglia known as the caudate nucleus, according to one book. Could be faulty neurotransmitters, such as serotonin, according to another. The only thing they all appear to agree on is that there’s at least some biological explanation for the way an OC’s thoughts “get stuck” in the transmission process, as evidenced by PET scans and other forms of high-tech brain imaging.
In the absence of cold, hard facts, good investigative reporters look for points of consensus. I find several in my stacks of books: (1) OCD is a chronic anxiety disorder that tends to kick in for most sufferers in early adulthood; (2) Adult OCD is often preceded by childhood symptoms that disappear during adolescent years, in a pattern very much like my own; (3) While OCD’s roots are most likely (at least in part) biological, certain childhood environments (including those marked by parental perfectionism!) may tend to trigger the disorder in children already predisposed to develop its patterns; and (4) There’s absolutely no evidence to suggest that OCD is indicative of any other larger neuroses. In fact, OCD sufferers are acutely and painfully aware of how irrational their thoughts and actions are, unlike people with delusions or other more serious problems.
As for OCD treatment options, it seems they are every bit as varied as the theories regarding the disorder’s cause. I shudder to read that until the 1950s, lobotomies were routinely performed in severe cases, and that in the decades that followed, hospitalization was common. My head fills with visions of mad scientists strapping me to a bed so they can take their scalpels to my frontal lobes. Fortunately, I read on to learn that today’s treatment alternatives are significantly less severe and tend to fall into two often overlapping approaches: (1) cognitive behavioral therapy, in which OCs learn to confront their obsessive thoughts and curb their compulsive reactions to them, and (2) drug treatment, in which various psychopharmaceuticals are used to alter the neurotransmission process.
I know I’ll never, under any circumstances, allow myself to be drugged. (I can’t trust myself now; how could I have any confidence at all in my judgment while spaced out on pills?) But this cognitive therapy: how bad could it be? With eyes bloodshot from hours of reading and a head throbbing from far too much information processing, I decide to make a phone call and find out.
“O-C Foundation. How can I help you?”
“Yes. Right. Thank you. I … uh … I’ve been doing some reading, and I … well, I’m not sure, but I …”
The woman taking my call in Connecticut listens patiently, then, with a warmth in her voice that puts me at ease right away, asks what she can do.
“I… uh … guess I need someone to point me in the right direction,” I say.
“Well, you’ve come to the right place,” my new best friend in the world tells me, then proceeds to suggest a number of resources right here in the Bay Area.
By the time we hang up, I have a name and number for a local OCD specialist at UC San Francisco who might be able to take on another client. Her name is Dr. Jacqueline Persons, and two phone connections later, I have an appointment to meet her at her office in Oakland.
Dr. Y calls me at home the following morning.
“Have you got a minute?” she asks.
“Uh, yeah, sure.” In four months of working together, never once have we spoken outside of her office.
“I’ve been talking to a few colleagues, and, well, they seem to think there might be something to your theory.”
“Really?” I say, trying my hardest not to sound like a smart-ass. I can only imagine how difficult it must have been for her to pick up the phone.
“Yeah. Anyway, I just thought you should know.”
No award from the Associated Press could ever mean more to me than this particular recognition of my investigative reporting.