Darkest Just Before The Dawn

Chapter 4: Refocus

"Ms. Lerner, I'd like you to leave the room please. We'll be done in about an hour," Dr. Skinner tells my mother.

"May I ask why? I'd like to be present," she insists.

"It's in Dawn's best interest. I've found that the child will be more open without the parents present, so please, if you could--" He starts.

"Yeah sure," she cuts him off and leaves the office.

"How was school today, Dawn?" Dr. Skinner asks to start our session.

"It was okay," I respond.

"Why just okay?" He follows up.

"Some of the kids talk about me, and the teachers don't know how to handle my OCD. So on top of my urges, I have that to deal with too. It's distracting me from my school work," I explain to Dr. Skinner.

"I see. What kind of urges do you have?" He inquires.

"Usually it's to wash my hands, or to enter a room a certain way, but sometimes it's just counting things," I explain.

"And what makes you follow through with these urges? Why do you feel compelled to do these things?" He follows up.

"If I don't do these things, something bad will happen. I don't know what, but I can just feel it. I need to stay clean and organised to keep things balanced," I answer him.

Dr. Skinner takes a moment to jot down a few notes. I take the moment to count the 158 strokes of his pen as he writes.

"I want to try something with you. Other doctors would just prescribe you some pills and send you on your way. Between you and me, the pills don't do anything of significance. I'd like to try a 4 step process that I've been researching myself. The idea is to exercise identifying your urges and suppressing them. The process will be hard for you at first, but with repetition it should become easier, allowing you to eventually phase out, or ignore, your obsessions," Dr. Skinner annotates.

"What are the 4 steps?" I ask, with genuine curiosity.

"Step 1 is relabel. You'll need to condition your brain to recognize your obsessions. You'll want to literally make mental notes when you have the urge to wash your hands or count things. Convince yourself, this is an obsession, or, this is a compulsive urge. You could even say out loud, I don't feel like my hands are dirty, I'm having an obsession that my hands are dirty. Distance your obsessions from reality. They're never going to go away, they're a part of you now, but if you understand that they aren't real, you can ignore them," he assures me.

"Step 2 is reattribute. It's pretty much an extension of step 1. It's reminding youself that your OCD thoughts aren't meaningful. They're just false messages from your brain. 'It's not me, it's my OCD' needs to be your new motto. You're working toward a deep understanding of why the urge to count the tiles or why the thought of dirty hands can be so powerful and overwhelming. If you know the thought makes no sense, why should you respond to it? Understanding why the thought is so strong and why it won't go away is the key to increasing your willpower and enabling you to fight off the urge to wash or count. The goal is to learn to reattribute the intensity of the thought or urge to its real cause, to recognize that the feeling and the discomfort are due to a biochemical imbalance in the brain. It is OCD, a medical condition. Acknowledging it as such is the first step toward developing a deeper understanding that these symptoms are not what they seem to be. You'll learn not to take them at face value," he further explains.

"Step 3 is the most important one. Refocus. This is the one where you have some real work to do. The idea is to shift your OCD attention to another behavior or task. Your brain is supposed to do this on its own, but the OCD won't allow it. So you'll need to shift your brain into manual gear and do it yourself. You must train yourself in a new method of responding to the thoughts and urges, redirecting your attention to something other than the OCD symptoms. The goal is to stop responding to the OCD symptoms while acknowledging that, for the short term, these uncomfortable feelings will continue to bother you. You'll begin to be able to work around them by doing another behavior. You'll learn that even though the OCD feeling is there, it doesn't have to control what you do. You make the decision about what you're going to do, rather than just responding to OCD thoughts and urges as a robot would. By refocusing, you reclaim your decision-making power. Those biochemical glitches in your brain are no longer running the show," he continues.