OCD

Reflections on Relapse

I am currently working my way through what could be called an OCD relapse.

For the last few years I’ve felt a steadily increasing sense of wellness and confidence. My ability to interrupt my obsessions and compulsions has grown, and I’ve felt more and more at home in my body, my life, and even my mind. I’ve been practicing Exposure Response Prevention techniques, mindfulness meditation, and lots of movement forms. I felt like I was beginning to move beyond my OCD as a defining feature of my life.

And then, seemingly out of the blue, a wave of turbulent OCD thoughts, behaviors, fears, and intense anxiety overwhelmed me. I unraveled. I felt right back at square one, and like I had to basically start over. It was a huge struggle just to get through each day. I was devastated. It had felt so good to be expanding beyond my fear and mental vigilance. And now that state of expansion felt a million miles away.

And this has happened before. Many times. Periods of expansion and strengthening have given way to sudden OCD relapses over and over. And each time it’s happened, I feel like I’ve done something wrong.

Part of that feeling of wrong seems to be the OCD talking, as my particular obsessions are all about how I’ve done the worst thing imaginable and will be punished for it—usually after death. That part of the feeling of “wrong” I’m going to label as my OCD thought and not engage with it. But there’s another side to the feelings that the relapses are my fault. This side has to do with how I understand growth over the long-term in living with this disorder.

As I walk my way through this particular relapse, step by step, I’ve been having some insights into the way I conceptualize progress on this path. I am starting to see that a lot of my concepts are not so skillful, and might actually be feeding the extreme growth and relapse cycles. As part of that, I’m going to stop using the word “relapse” here, and instead switch to “flare-up,” which feels more workable to me. For me, “relapse” connotes a moving backwards and a failure of sorts. It awakens my shame and self-judgement.  I don’t judge a “flare-up” in the same way, because it is something out of my immediate control and has a life of its own. It connotes a surge of energy or a weather system passing through that I ride out as best I can. It’s still something I don’t completely understand, and therefore is uncomfortable. But in my uncertainty about why I’m having the flare-up experience and what caused it, there is the opportunity to practice relaxing with mystery and trusting that there is some deeper, growth-inducing process unfolding.

Some questions I’m reflecting on:

  • What if this intense experience of OCD overwhelm, that I conceptualize as a mistake and a falling backwards on my path, is actually something different? What if it is exactly the next step forward on my road to healing, and so actually is good news, however painful it might be?
  • What if my OCD flare-ups aren’t an enemy, but actually a reliable friend that uses awkward and painful means to get my attention when something is out of balance?
  • What if these flare-ups will happen no matter how well I practice, train, work on myself, and do my ERP exercises? What if there is a mysterious and transcendent aspect to them that I can never completely understand or control? What if they are coming from a place of wisdom that is helping guide me on my path?
  • Is my deep fear of what I call a relapse actually conditioning the relapse to happen? I don’t want to feel the pain of intense OCD thoughts and behaviors, and so in my desperation to avoid them, am I unwittingly inviting them in?

In this recent flare-up I could feel a distinct difference between two ways of holding the experience in my mind. The first, which is more in line with how I’ve held these experiences in the past, involves seeing this as the result of a series of mistakes I made, and as steps backwards on my path. In this view the flare-up could have been avoided, and now I just have to bear down and work harder to get out of it. In this view I feel sorry for myself and am motivated to prove I can get through this and “effort” my way back to some kind of “normal functioning.” I feel mad at myself and judge myself as weak when I hold this view.

The other view I’ve been experimenting with contextualizes this flare-up as the next step of my growth as an evolving human being. In this view everything that arises is part of my path. It’s happening for a reason, even though I can’t see that reason clearly yet. In this view there is no blame, but rather a willingness to work with whatever arises, for however long it takes to feel back in harmony with my life again. In this view, there isn’t a “normal” that I have strayed from, nor a way that things could have been any different than they are.

There are a number of things that my flare-ups push me to do in order to get by moment by moment, in the midst of the worst terror and mental constrictions. I’m wondering if these practices could be seen as prescriptions from the more the primal parts of me of me that are unleashing the OCD—reminders to bring myself back into balance. Could I practice these behaviors more in the calmer times, as a way of building up my sense of balance and strength in a lasting way? And could I use the absence of these behaviors in my life as red flags to alert me that I might be moving out of balance? The practices I notice that I automatically take on when under fire from intense OCD onslaughts include:

  • Slowing down. Trying to come back to what my teacher Stephen Levine called “Just this much” as he held up his thumb and pointer finger, half an inch apart. Stephen said that all growth and healing happens in “just this much.”
  • Reaching out to friends, family, and colleagues. Being more honest about what is going on with me. Coming out about having OCD and the struggles it provokes.
  • Making a conscious effort to connect to my husband more. Spending time just being together. Sometimes talking about what is hard for me in this moment, but mostly just connecting in any way possible.
  • Connecting with our three dogs. Just sitting with them makes a big difference. Letting their animal wisdom carry me when I can’t carry myself. Appreciating them in my life. Letting them be reminders of simplicity and presence.
  • Clarifying my daily mindfulness practices. Sometimes as things are more ordinary I start taking on too many daily practices, making them overwhelming to approach each day. I want to learn so many things and develop so many parts of myself that I add in meditation, tai chi, yoga, music practice, dancing, singing, chanting, and/or all sorts of things. Or I do the opposite and reduce my daily practices to almost nothing. In flare-up times I try to come back to the essential practices that most support me staying grounded and calm. This is usually some form of movement, like Tai Chi and dance, and some gentle form of meditation.
  • Focusing more sustainably on my professional work. I am a performing artist and a teacher of dance. Often when things are not in crisis, I take on too many projects and get very caught up in growing my career and receiving validation from all the professional communities that I’m a part of. In these tough times I come back to just what is right before me—to the classes I am teaching right now and the individual students in those classes, and the performances that are already scheduled, or easily set up. I let go of a great deal of striving and ambition for my career to be bigger and more noticeable than it is. I simplify. I experience a lot of gratitude for having a place to go to do what I love, and help others at the same time.
  • Getting in touch with empathy and compassion. When I am in a lot of mental pain, I become sensitized to others in pain, and it makes a big difference for me to take time to be with them as they are, to offer whatever support I can, and to not try to push them to feel differently than they do. I relate deeply to my students, friends, and colleagues who are struggling and I take time to let them know and to be together in whatever ways we can.
  • Practicing trust. Trust in the process. Trust in myself. Trust in the communities around me. Trust in the Universe. Trust in nature. Trust in impermanence. This flare-up will change and pass. I’m not gonna be able to figure it all out or fix it in my own timeline. I need to trust. And trust happens moment by moment. It’s an experience, but even more, it’s a practice.
  • Coming back to simple creative practices. Rather than focusing on the huge projects I am directing or choreographing, I return to the simple creative practices I can do on my own or with a few other people. Writing this essay is one example. Working on small sections of performance pieces with my company, students, and/or just myself. Letting go of needing my work to be extraordinary, and instead just trying to tap into the energy of the present moment, as it channels through creative outlets. Appreciating the practice of creativity without much thought about finished products.
  • Letting whatever I am doing be enough. I have strong tendencies to act from a place of “not enoughness.” This manifests in my ordinary life by over-working, over-striving for recognition, competitiveness with my peers, and getting caught up in ideals. In my OCD moments, this manifests as trying to have the “right” thought, practice mindfulness in the “right” way, do ERP in the “right way, etc. When I’m struggling intensely with obsessions and compulsions, and there is a moment of calm for whatever reason, I deeply appreciate it. These moments of calm don’t come because I’m doing all the right things. They just seem to come sometimes, usually when I get so exhausted from trying too hard, and just give up “fixing” my mental state.  In these moments of calm, I appreciate simply being, exactly as I am, in the middle of all the messiness and unresolved parts of my life.
  • Doing what works. The more I get into planning and thinking through all the possible ramifications of strategies for managing my flare-ups, the more confused and desperate I feel. Conversely, the more I can go day by day, hour by hour, moment by moment, and just see what is helping me to feel calmer and more grounded right now, the better things seem to go. I have such strong desires to plan out the future. I’m really good at planning. I’m good at thinking about all the possible outcomes and what might be a wise safeguard to put in place ahead of time. While this is a great skill to have, it easily leads to the illusion that I can somehow control what’s going to happen and plan my way through life. When the OCD gets really intense, I have to slow that whole process down and feel my way through, bit by bit. I have to let go of the plans I made, and sometimes even do the opposite. I have to trust that somehow, I’ll know what is appropriate in the next moment, even if my OCD thoughts are screaming in my head and it’s nearly impossible to hear my “still small voice within.”
  • Letting go of the small stuff. Sometimes it takes an immense amount of effort just to function moment to moment when my OCD is especially active. At those times, with my mind exhausted, I become acutely aware of anything extra that I can skip.
  • Trying new things. My OCD gets so encrusted with habit. Doing something new helps me to shift some of its unconscious momentum. I just learned how to knit and am loving this new tool for being with my anxiety.

Each of the above practices is something I can bring into my life when I’m not having an OCD flare-up. Yet, I easily forget about these when my life feels relatively smooth. Might I be less likely to have flare-ups if I’m practicing these behaviors on an ongoing basis? Might I be able to sense the approaching energy of a flare-up earlier, and have the time to head it off?

As I re-vision the causes and purpose of my OCD flare-ups, I’m reflecting on the role of intuition in the healing process. From one point of view, my recent flare-up was totally predictable. I had been making lots of progress in my ERP and mindfulness practices, and was experiencing my OCD as a smaller and smaller part of my life. I decided to try reducing my medication, as I’d been increasingly curious about how much I needed it anymore. I had been taking 300 mg of Zoloft a day, and over the course of 18 months I slowly reduced to 50mg, and then took the plunge into going medication free. This was a month before one of the largest dance/theater/music performance shows I’ve ever directed. The show was 49 hours long, split over 5 days, and intended to give the performers and audience members the opportunity to play with notions of time and duration. We hoped to use performance to access non-ordinary states of consciousness that we thought would be transformative and insightful. I debated about doing the final withdrawal from medication before this show, as I knew it would be a very stressful project. But I also knew that I tend to feel my most OCD-free as I’m working on a show, so this seemed like it could be the perfect time. Plus, I had a few smaller shows in the next couple of months, so I knew I had something else to focus on in case I went off the rails without my meds.

In general, I felt fine without medication. Those first few weeks brought on greater sensitivity, greater access to my emotions, and perhaps some added anxiety. However, the anxiety seemed directly related to the huge undertaking I was in charge of—coordinating over 100 performers, a technical crew, publicity, the creation of my own choreography, and much more. During the 49-hour performance there were moments of OCD flare-up, but they were brief and I was able to re-focus my attention to the tasks at hand and re-engage with the community of artists I was working with. Afterwards, I had a few days of relaxation, and then the OCD ramped up very quickly. It knocked me off balance and into intense fear. I felt back in “relapse” and I was in despair. I hate this experience and had tried so hard to avoid it. But again, the reasons for the difficulty were pretty clear: stopping medication, doing a very intense and stressful creative project, suddenly having a full week off at the close of the project, and to top it off, my husband was away on a meditation retreat so I wasn’t able to even talk with him for 7 days. From the outside, this all sounds like a perfect recipe for falling apart.

However, throughout the year of planning my performance and the reducing of my medication, I kept checking in with myself, my therapist, and collaborators. I felt like I was following my intuition as clearly as I could. I thought it all through many times and tried to lay the groundwork for the support I’d need throughout the performance and beyond. I practiced and planned and discussed.

So, did I make a mistake with this? Was my intuition clouded by my ambition and my desires to be medication-free? Perhaps there are elements of that. I often get into a semi-manic state as I approach a major artistic project. It feels so good to be in the creative flow that I start to ignore some basic needs for balance and grounding. I get over-focused on the piece of art itself and forget about my mental health needs.

Or was my intuition actually right on track? Was I following a deeper wisdom that led me through all of this and landed me in this OCD flare-up? Did I need this flare-up to go to the next level of my growth, whatever that might be?

I’m so used to blaming and judging myself harshly when things don’t work out the way I wanted. My pattern has been to do this to the extreme when in the midst of the flare-up.

But I’m sensing another way of understanding this–a more expansive view, that is rooted in a deep trust of my inner unfolding, and the unfolding of all of creation. When I look for a moment that my experience crossed over from positive to negative (or from “normal” to “relapse”) I can’t find it. It’s a continuum. When I hold all that I am experiencing right now, no matter how uncomfortable, in a sense of openness and curiosity, I feel much more at home.

The clearest message I’m getting so far of the lesson I need to learn from this flare-up is to include more open space in my life, and to allow for whatever arises, especially anxiety and obsessing. I’ve gotten so skilled at engaging in activities to re-focus my attention while the obsessions and compulsions pass, that I very easily go into avoidance mode. I believe my flare-up is now telling me I need to have a more intimate relationship with my anxiety on a regular basis. When I start over-filling my schedule, or over-filling my down time with activities, that can be a reminder to pull back and allow for the uncertainty of openness.

Another clear message that this particular flare-up has given me is the encouragement to look more closely at my lifelong pattern of flare-ups. I realize that my OCD has flared-up like this every few years, since I was a teenager. The pattern goes something like this: there’s a flare-up, then a period of intensive work on myself, then a relaxing into my new-found coping skills and a sense that I’ve solved that OCD problem, then some kind of falling asleep and drifting into old, unconscious patterns of avoidance and over-doing, then another flare-up and it starts all over again. I feel resolved to bring more consciousness to this dynamic and to uproot its entrenchment in my psyche.

I like to set up an intention when going into a major performance project or other intense process. With my recent 49-hour project, my intention going in was to practice “trust.” I kept saying “trust” to myself like a mantra throughout the experience, and it’s been the word that’s come up most often in my flare-up afterwards. I’m reminded that one can’t experience trust without doubt and fear first. And to experience a lot of trust, then one must have a lot of doubt and a lot of fear. Perhaps I was ready for a more advanced lesson on trust than I realized. I thought I was just learning how to trust the outcomes of a hugely complicated project I’m in charge of. But maybe I’ve been called to learn a more profound trust in myself and the Universe. As I tell my students, we can’t have learning without discomfort, because learning is about approaching something that was previously unknown to us, and this means stretching beyond what is comfortable.

The more I reflect on it, the more this flare-up feels like growth, rather than “relapse.” I’m in touch with my intuition in a more immediate way. I’m more able to stay with uncomfortable, groundless, and queasy states of being. I’m learning to relax more with uncertainty, and to let myself not-know why my experience is unfolding in this way. I feel more humble. I feel more connected to other people in my life, with all their gifts and difficulties. There’s a growing sense of gratitude for all the things that are working in my life, that I too easily forget about when I’m in pain.

I’m still very much in the middle of the process, so I expect there’ll be lots more learning to come. I’m very curious to hear if there are others out there that resonate with any of what I have shared, and if you wrestle with similar questions. Please reach out – eric.ray.kupers@gmail.com. I’d love to discuss further.

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