Verified by 
Key points
- OCD can result from a disconnection between the mind and the body.
- Learning the art of changing while staying the same is a key to treating OCD.
- OCD helps us to see the paradox of creativity and life itself: working out a third form from seeming opposites.
It all began after a playful fight amongst friends over who knows what. Was it the foul that wasn't called in the basketball game moments before or some long-simmering resentment amongst these two 14-year-old boys who had seemed inseparable since childhood? It didn't really matter because from that day forward my patient Tom was obsessed that he was stricken. An innocent blow to the head was now a rumination set in motion, and from that day forward, nobody could touch him or else he'd be dead.
Such is the way obsessive-compulsive disorder so often strikes. It's almost always about the loss of someone we love or our own very precious, fragile, and meaningful life. And it's almost always about a black-and-white choice of living or dying, having or losing, and never shall the two ever meet again.
But I was working with Tom to recognize just how quickly he cut himself off at the neck, using his gifted and imaginative mind to control and negotiate all that was happening in the real estate underneath that he so often neglected. "There's a body down there with a fuller story, and we need to get that part working with your mind as the best friends they're truly meant to be. Let's see if we can get his story out there on the table, and have them coexist."
It was an unusual request. To see the body and the mind, both such seemingly opposite and antagonistic sides as allies and compatriots was a new revelation to Tom. He sat there intrigued yet skeptical: "Yeah, what can my body do for me? Didn't it already get me in trouble with that fight?"
"Of course, it seems that way on the surface, but psychological growth is almost always an intersection of two opposing natures, just as light itself is both a particle and a wave," I said. "Maybe we just need to get to know your body on the particle level and not only on spiritual frequency of the wave."
So we worked on giving Tom's body a voice, and it talked about its own desire to be more confident, assertive, even tough. But the mind didn't like this because it meant there might be 'messy' run-ins, somebody might get hurt, and then the game felt like it would all be over. In other words, those ambivalences weren't easy to sit with, no less to reconcile.
"Yeah, but maybe we can allow both of these to be there together so we can find a third option. The creative process is always about transforming and it feels a lot like destruction at first," I said.
Tom's mind perked up while his body knew everything I had said in its bones. Life was messier and muddier and for someone with Tom's sensitivity that wasn't always easy to bear, but at least now he had somebody like me to help him carry it. It didn't feel as scary as being alone in his philosophical mind trying to reconcile life and death at every turn.
And he practiced trusting in his body just a little bit more each session, noticing that even when he did have his mind trying to worry and ruminate that it was a reminder that the boundaries were getting blurry again, and it wasn't easy to keep his needs and wants separate from others he really cared about too.
We joked about how challenging it is to be human like this, to allow ourselves to have our own space and others to have it too, and yet to find ways of making true contact. There always seemed to be some stepping on toes or bumping into each other as we attempted to make deeper connections. "Maybe it's just our own human way of chasing our own tails," Tom told me presciently. He was getting it!
Tom was allowing himself and his friends to change while being the same, but he still wondered about where the center held. He was feeling more open, relaxed, and zen about keeping both straight, but sometimes he wondered, was he really losing himself, maybe even the best part of himself?
I reminded him of the plight and beauty of the caterpillar who knows he is changing too. It doesn't feel fair to leave that crawling body, and its many prolegs lose all power and control. But I marvelled at him with a picture of the glorious wings of the monarch butterfly. "You are changing forms but staying the same, our most difficult but essential trick. Look at what's in the middle of this butterfly?"
And he saw it. Smack at the center was the caterpillar form anchoring and centering the butterfly itself. "This is the strange balancing act of gaining and losing, and finding the third."
Tom wanted to understand how this connected to the exposure-response prevention skills he had learned in prior therapy. "Am I avoiding my anxiety and just getting reassurance from you about this?"
I shook my head, smiling. "Actually, you're doing the deepest and most profound exposure-response prevention of all. You're looking at the fundamental hope and grief we have about existing and potentially not-existing, you are holding the strange balance of holding and losing ourselves and each other all of the time. And you are integrating your body and mind, and that is making all of the difference."
It was a necessary human reassurance, in other words, at the ground of existence itself.
The great neurologist Oliver Sacks recognized that when 'illness' changes us, we have to find a way to adapt it to our identity and it becomes as much part of us as anything else. Similarly, OCD had become Tom's strategy for regulating his intensely sensitive nature and provided him with so much, and yet it also sometimes fought other new sides from coming online.
"So, now, I can still hold onto that OCD side like a friend even though at times it can be a bully?"
"Yes, we are taming that side so that it isn't such a bully and so it can collaborate with your body in ways that it can trust. It doesn't have to be a choice between life and death anymore or between either of these sides in you or in others. They can both become best friends again."
Tom was relieved and together we marvelled at the beauty that this butterfly might miss out on if it didn't fulfill its mission of flying and pollinating all of the flowers that make up this wonderful world. How funny it was, we joked together, all along, that the answer was right there in front of us in nature, staring us both right in the face?
