Monday, November 15, 2010

Public Transportation and What Coping Means

Hello Friends:

I've been thinking about the differences between dysfunctional-enabling behavior and supporting-coping behavior. These thoughts have been coming to me as I've been taking public transportation more than usual this week.  And public transport gives me the willies (in other words it's chock full of OCD fodder.) So there have been plenty of moments where I could consider if what I was doing was helping me in a positive way, or just allowing me to avoid dealing with the tough realities of a gritty world.

Look at that nice piece of art. All the nice people being nice. A nice, uncrowded car. Nice and calm. Yeah, right. I've never seen a metro car like that unless it was the middle of the night. But this is idealized americana folk art, here. Check out how clean that floor is. No one is coughing or spitting.  And I'll bet there aren't any rats in the station, either. Oh, what a fantasy.

Anyway, I can't touch the bars or rails in a subway car unless I am wearing gloves. I wonder, do the gloves allow me to go about my day in relative peace, or do they enable my mental illness by allowing me to avoid the natural exposure of touching things other people touch? Or both? How about people sneezing on a subway car? I stop breathing for as long as possible. I don't look at anything dirty, since when I'm worked up, looking at something dirty can actually make me think that I am dirty. Let's not talk about what is on the floor. I do not look there or I'd have to throw my shoes out when I got home.  (I take them off right at the door as it is.) So forget about setting a heavy bag down on that tacky surface of dread, I'd rather pull my back out.

Then as soon as I get off of the train, I pull out one of those handi-wipes and scrub my hands. Which have been in gloves, remember? I also wipe off the handles of anything I'm carrying. And then I try really hard to say 'enough' and go about my day. But any day I've been on the subway or metro or T or whatever you call it, isn't going to be one of the days I feel at my best.

This all reminds me of my first therapist telling me that I didn't have to do things that gave me panic attacks. I was having severe attacks after eating canned food. He said I should stop eating it. I was appalled, since I thought that was 'giving in'. I was afraid that if I stopped I'd never start again. I was afraid I'd end up cutting out anything that bothered me, and end up stuck in bed all day in fear of leaving.

It took him a long, long time to get it through my head that I was re-traumatizing myself every time I opened a can. I had to stop. I'm sure you know this stuff yourself - but I had to stop doing the thing that was causing me to panic, give it a rest for a while, and then approach it slowly and methodically. That's the idea of increasing exposures that we've all heard about with regards to phobias and such.  And some OCDs.  Of course, if you have some CPTSD issues on top of it all, it isn't quite so straightforward, but you get the idea.

I don't know if he would have given the same advice to everyone, or if it was just me. But I ended up stopping a lot of activities that caused me high anxiety. I stopped eating anything that made me nervous. I stopped touching things that scared me. I stopped going places that triggered panic attacks. At the same time I started doing really intense CBT, added a lot of walking to my day, continued talk therapy, and against my therapist's advice I refused meds. Looking back, that might not have been the best plan, since I am on them now and am very glad about that. Whatever.

As I felt better, I started trying new things or adding them back into my life. He had been right. I didn't take his words as carte blanche to just drop everything and stop fighting. I kept struggling to do things. Kept challenging myself. I just got smarter about what I could handle on a given day and what I couldn't. For many years I could tell how well I was doing if I had the nerve to eat shrimp or any meat that wasn't cooked to the state of a hockey puck. And now I can touch door handles in almost any place but a hospital or doctor's office. I don't like it, but I can do it.

Life is easier, but still, OCD is disabling. I'm not likely to be able to take a job in a city where riding public transportation is required. The idea of doing that twice a day, and being forced to do it on days when my resources are low, is horrifying. I wish it wasn't. I don't like having my options curtailed by OCD, but I've come to more of an understanding of what I can handle and what I can't. So maybe it just isn't in the cards right now. Maybe in the future, as all my mental illnesses get more and more under control, as my meds stabilize, as I do more exercise, eat better, do my meditation and get good sleep, maybe public transportation will become as simple as eating frozen food. Which I had given up for two years, and now can do without a problem.

BTW, you probably know I still don't open cans. I haven't missed that at all.

Your Hostess With Neuroses

Image credit/info: Subway, Smithsonian American Art Museum


Fellow OCD Sufferer said...

Great post! And an interesting topic. When I was still doing pretty bad, I made a trip to New York just for "fun" with some friends. I remember the subway experience being pretty hard on me, but I suspect I would be better at it now, since I have more experience in not giving into compulsions and gradually seeing that, as I cut back on compulsive activity, facing those harder things does become easier.

You bring up an interesting point - when is it time to push, and when is it time to ease up? Yes avoidance and sanitizing wipes probably do perpetuate the overwhelming feeling that the metro is dirty and that something must be done in response to that, but like you said, sometimes you have to know when to ease up and start again from a slower and more methodical angle.

Something my therapist has told me that has helped me in identifying when to push and when to not push was the idea that if I was going to do an exposure, I also had to be willing to commit to the corresponding response prevention. If I was going to ride a public bus, per say, it would do me little good if I immediately changed clothes when I got home, avoided touching things in the meantime, and put on gobs of hand sanitizer afterward (and trust me, I've done this...). If I got on a bus and reacted that way, I was just further suggesting to myself that the bus really was that dirty and that I could not get through the experience without responding with a lot of really big compulsions. Like you said, easing up and going back to do lesser exposures, but ones for which I was actually willing and felt capable to do the response prevention part for, has really been helpful and allowed me to see more success more consistently.

Amy said...

I ride the subway frequently, and I can easily see how someone with OCD would find it difficult if not terrifying.

Good for you for being so self-aware! Knowing when to push ourselves and when to give ourselves a break is a mature skill that all adults should work toward.

expwoman said...

OCD is such a shapeshifter! I rode the bus to work for 12 years because I was afraid to drive. I do drive now, but I also take the train to therapy, and I notice every time how icky the station is, and that it doesn't disturb me, but that it could, if it was my form of OCD.

There was a blind woman on the train last week, with her guide dog, who was sleeping on the floor, and quite content. I had a moment of envy, for the this kind of peacefulness.

The Blue Morpho said...

Hello Fellow OCD Sufferer - Thanks for the insightful comment, and for reading the post so closely. Glad to hear you are having success with your OCD treatment. I'm also a lot better than I was, but still have ground to cover to be truly functional. Being able to ride the subway without a mental backlash would really be nice :)

The Blue Morpho said...

Hey Amy - Yeah. Ick. But as you say, the ability to find a middle ground, a gray area, is a hard won and extremely valuable skill.

The Blue Morpho said...

Hello Expwoman - I understand the longer for that image ... the peace of being unaware of dirt the way dogs are (or being aware of dirt and liking it, I suppose :) Sometimes ignorance really is bliss.

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