Using writing, and meditation, and ice cream, and reading, and dreams,

and a whole lot of other tools to rediscover who I am,

after six years living with a man with OCPD.



Showing posts with label bi-polar. Show all posts
Showing posts with label bi-polar. Show all posts

Thursday, May 19, 2011

How Can I Deny Thee, OCPD?
Let Me Count The Ways

Catherine Zeta-Jones
via Wikimedia Commons
One of the most pernicious aspects of Obsessive-Compulsive Personality Disorder is the fact that those who have it are usually convinced there is nothing wrong with them. With those around them, sure.  They are surrounded by fools and incompetents!  

It's hard for any of us to admit that we might be mentally ill.  There's a big stigma (perhaps it should be called a Stinkma) about having any kind of mental disorder - except for perhaps the "cool" ones, like bi-polar disorder or anorexia.

Note: I am NOT saying it is "cool" to be bi-polar or have an eating disorder.  I know full well, the very deep pain and intense suffering that those with those diseases experience.  Still, the perception in the general public is that there are glamorous models, actors and actresses who have eating disorders, or who are receiving treatment for bi-polar disorder, or substance abuse.  So if these talented, beautiful people have a problem just like ours, it becomes a little easier to admit we suffer from it, too.

There are no "beautiful people" stepping forward and saying, "I have OCPD."  Many people have never even heard of OCPD.  Often, it's confused with OCD, or Asperger's, or autism, and what is true is that some people with OCPD also have some OCD or Asperger characteristics.  They may share a sensory overload with light, sounds, or odors, for example.  They may exhibit similar emotional "meltdowns" when something occurs they did not expect.

Many of the qualities of OCPD are extremely admirable, in small doses.  When cooking, we might not realize that we've added too much salt, but we sure know it when we taste it.  Way too much salt can make food not only unpleasant but inedible.

Here's an example: many women (and some men) with OCPD obsess over a clean house.  They are constantly cleaning, disinfecting, and bleaching things.  This might not seem so bad, until you hear stories about a woman who put so much bleach into her husband's laundry that he had to be medically treated for chemical burns in his crotch.  Twice.  Sometimes an OCPD woman (or man) is so wrapped up in obsessive cleaning 14 hours a day, 7 days a week, that there is no time to socialize with friends, play with the children, or go out to dinner with the spouse.

When partners, co-workers or children first hear about OCPD, there is a thrill of recognition, relief and hope.  This is what the problem is, I'm not going crazy after all, and now my partner/father/co-worker can get treated and things will be better.

Sometimes it works that way, but more often, the person with OCPD will deeply resent getting an amateur diagnosis from his loved one.  S/he will insist the partner is the one with the problem; will look up the condition online and point out triumphantly that s/he doesn't hoard, or obsess about being on time, so you see, s/he couldn't possibly have OCPD.  (Disregarding the other items that are spot-on.)

S/he may agree to go for counseling, and then:
  • Storm out because s/he doesn't like the things the counselor says.
  • Refuse to listen because s/he doesn't think the credentials of the counselor are impressive enough.
  • Listen but only hear part of what the counselor has to say.
  • Out and out reject a professional diagnosis of OCPD and a recommended course of behavior therapy.
The counselor, in turn, may not even use the term OCPD.  Because so many who have it react negatively to "labels," s/he may pussyfoot around, refer to "obsessive-compulsive tendencies" or "overwhelming anxiety."  So in some cases, denial may occur in part because the term OCPD was never officially used in the first place.  We can understand why a counselor might make that choice, because if a patient is willing to accept some therapy, sans label, it would seem better for their well-being than forcing a diagnosis on someone who will then abandon therapy altogether.

Here's some true stories (some details have been changed): 
I finally got my wife to read the book Too Perfect, and when she did she said wow and agreed that OCPD was her all the way. So much so that she actually made an appointment and has been going to a therapist. However,..... when I mention OCPD she gets upset and says not to label her. This coming from a woman who openly admitted that she could identify with the entire book.

My boyfriend knows he's OCPD but hates "labels" and denies having OCPD. When our therapist first brought it up and read the symptoms, I had my mouth hanging open and he had the BIGGEST smile on his face. He was proud!!   Now, he denies it (it's like talking to a crazy person!) and he gets upset whenever i bring it up.

My OCPD wife went to joint counseling last year on threat of separation. When she was diagnosed with OCPD, she didn't accept it and we came to an impasse.

My husband actually found out about OCPD on his own 2 years ago, then made an appointment with a psychiatrist who officially diagnosed him. At the time I thought it was encouraging that he could admit and realize he had OCPD, but now he is in absolute denial and says he has it under control. That the problems all come from our "bad communication" skills.

My wife was diagnosed first by a neuro-psychiatrist after extensive testing with OCD. It was only after I did extensive research that I could bring OCPD to their attention, and now she is being treated for OCPD with medication and therapy.

Recently, the counselor brought up the concept of OCPD.  I later found out from the counselor that my husband wouldn't accept the diagnosis of OCPD, so the counselor took the "symptom approach," i.e. explaining to him how he was obsessive and compulsive. These he accepted. However, now that my husband has convinced himself that he doesn't have OCPD, he is very angry at me for having "imprisoned" him with this diagnosis of my own making for years. Not to mention, as far as I can tell, he's not working very hard on his "symptoms."

My girlfriend had a brain scan done and it was opposite of normal. The guy looked at her and said "how do you sleep at night?" She didn't. She knew something was up but she had no real interest in seeking a fix, something that might even help her feel better. Even her mom suggested getting help. Eventually she did go to therapy and it was about blaming everyone else. As soon as the therapist started scratching the surface she became too busy with work to go any more!!

Five years into the marriage, my husband was diagnosed with OCPD.  Constant conflict between wanting special concessions because "that is the way I am" and the continual denial that anything was wrong with him. This went on for another ten years, until I just could not stay in a war state of mind, all of the time.

Now after all this gloom and doom, is there any hope?  Yes, there is.  This is also a true story: 
I was formally diagnosed 10 years ago, and managed to completely dismiss and ignore it for many years.  My symptoms started to really get worse, to the point where I was making lists to organize my lists! I hated how I felt, was interested in feeling better, and came to learn techniques that addressed the OCPD without ever acknowledging the OCPD. It all comes down to acknowledging and taking responsibility for the chaos in your life, regardless of what the origin of that chaos is.
Having the official label of OCPD can help the partner to understand this is a mental disorder - that it is not us.  It may or may not be helpful to the person who has it.  If they would prefer to call themselves excessively perfectionistic, or "a little bit obsessive about some things," what matters is not whether they accept the label, but if they are willing to do the very hard work of battling the disorder.  


Photo via OIPA

As their loved ones, we need to understand our own boundaries, our own co-dependent tendencies to save the wounded birds.  It is entirely possible, once we stop enabling that they will feel the pain enough to take action about it.

One thing's for sure, nagging, reminding, and "helping," doesn't.

Got an experience with diagnosis and counseling you'd be willing to share? 
 
 

Saturday, March 12, 2011

The Charlie Sheen Dilemma

We've all been watching Charlie Sheen going through what seems to be a full-on bi-polar manic episode in the news - whether we want to or not.  (Full disclosure: I'm not his shrink, so I have no right to officially diagnose him, and am not claiming to - just taking an educated guess.)

from the Santa Monica NAMI walk in Oct 2010
http://www.nami.org/ offers much help & support to
those with mental illness and their loved ones.
I do have a beloved niece who's bi-polar, and many of the behaviors he's exhibiting: the expressions of feeling great, the hyper-activity, the weird nonsensical rhyming (Vatican assassins, anyone?) the long rambling sentences that almost sound logical... they're all too painfully familiar.  My family has been there, done that, got the T-shirt.

Even a layperson can conclude that, at least right now, this bright, talented man is many sandwiches short of a picnic (or in Charlie's case, several hookers short of a brothel.  Then again, maybe in his case...)

What many people don't realize is how limited the options a family has when somebody they love "goes Charlie Sheen."  You can't  "have somebody locked up" involuntarily unless they are an imminent physical danger to themselves or another person - and then, only temporarily.

"Somebody should stop him" is something I've heard.  How?  Football tackle?  Tranquilizer darts?  I would wager that every member of his family, his friends, lawyers and agents have, at one time or another, tried to "talk him down" but somebody who is manic isn't listening to anything but that voice in their head.

According to the letter from Warner Bros:  
 At the outset, let us state the obvious.  Your client has been engaged in dangerously self-destructive conduct and appears to be very ill.  For months before the suspension of production, Mr. Sheen's erratic behavior escalated while his condition deteriorated.  His declining condition undermined the production in numerous and significant ways.  Now, the entire world knows Mr. Sheen's condition from his alarming outbursts over just the last few weeks.  Warner Bros., CBS, and Chuck Lorre have done everything within their powers to get Mr. Sheen the help he so badly and obviously needs - entreating his family and representatives; visiting him at home; offering to rearrange production schedules to accommodate his treatment; and even making an airplane available to take him to a rehabilitation clinic before he reneged on his commitment to enter such a facility.
My beautiful, courageous bi-polar niece is struggling on the best she can, without insurance coverage (she's already consumed her lifetime cap), and certainly without an airplane standing by to take her to a top-notch treatment facility.  She'd have boarded one in a minute, she is battling this thing so desperately hard.

But even if there is all that available, if money is not an object, even if everyone in the family is saying, "Dude, you need help," there is only so much anyone outside the mentally ill person can do.  Sometimes they simply refuse to get help - and you can't make them.  You can beg, plead, reason with them, make ultimatums, bargains - but in the end, a person who has distorted thinking may or may not accept that there is anything wrong with him or her.  Sadly, my OCPD ex-b-f did not.

Usually, the illness is at least partially concealed in public, except in the most egregious of circumstances.  People outside the family don't normally see how, well, crazy, it can get in the home.  I'm not just talking about Bi-Polar Disorder, but Narcissism, Borderline, and yes, Obsessive-Compulsive Personality Disorder. 

Mind you, it's not all tiger blood, machetes and Crazy Rules.  Sometimes the symptoms are just - a little bit bad.  Quirky.  Kind of like a roller coaster; not every hill is the hugundous drop.  Sometimes there are long periods of time when life feels... relatively normal, and everyone hopes whatever was happening in the brain of the unstable person has finally sorted itself out.

Then there's another big drop, and you realize, buckle your seatbelts and pull down the safety bar, here we go again. 

Self-medicating, whether it's with cocaine, alcohol, Ecstacy, or other drugs, doesn't help - but it's important to understand, the drugs aren't usually causing the mental illness.  Sometimes they do, indeed, help the person feel and act more normally.  Other times, they exacerbate the problem and the erratic behavior. 

Mental illness may be partially caused by chemical or hormonal imbalances in the brain, and prescribed medications often help.  But adjusting the dosages, so that the person feels functional and isn't a virtual zombie or sleeping twenty hours a day, and there aren't horrific side effects, is a big challenge to medical professionals.  Certain drugs work beautifully for some people, and have zero effect on others, or over time, the beneficial effects wear off.  Needless to say, it's no fun to the mentally ill person who feels like a guinea pig, either.

If you don't have mental illness in your family (that you know of,) don't get too smug about your good genes, because often it occurs later in life.  What you can do to help, now: 
  • Be kind to everyone you can, especially if you know a friend or loved one is dealing with mental illness in the family.
  • Ask said friend or loved one what you can do to help.  Maybe you can't "make someone well," but maybe you could help with transportation issues for their school-age kids, or help them with homework, or gather and organize papers for their tax return...
  • I won't ask you not to laugh at the Charlie Sheens out there - when somebody is out in public proclaiming, "I'm an F-18, baby," you gotta laugh.  I laughed.  But when you're done laughing, be aware of how awful it is for the family and friends who are dealing with this behind closed doors.  Trust me, it's not all charm and hilarity.
  • Support NAMI and other programs, laws, and state and federal budgets that offer funding, education and support for the mentally ill.  In the 1980's the USA closed many facilities to treat the mentally ill - budget reasons, you know.  So, guess where many end up - in jail, at costs far exceeding those of the original facilities.  We've been penny-wise and pound-foolish.
  • Be aware of the stigma about mental illness, and work to speak more respectfully and mindfully about it.  People are well-aware that society thinks less of those with mental illness, and so, they hesitate to get treatment when symptoms are only beginning (and could most effectively be treated.)

I'm hoping that the one bright side to Charlie Sheen's public meltdown and weird pronouncements in so many recorded venues is, when he comes down, he will realize he really was "out there" and commit himself to a real, long-term treatment facility.

Even if he is a "rock star from Mars."

Your thoughts?