Monthly Archives: March 2017

Tuesday Q&A: Kimberley Quinlan

Standard

KymQuinlanWelcome to Tuesday Q&A! Today I’m hosting the lovely Kimberley Quinlan, who always makes me feel better whenever she shares a post from her site or comments on anything I post about OCD. She’s wise and thoughtful, and I find her Australian accent very calming (but that’s kind of a side note — her content is what matters most!). See for yourself how wonderful she is.

Although you treat more than just OCD, I know you through the OCD community. How did you decide to focus mostly on anxiety disorders, body-focused repetitive disorders, and eating disorders? From my untrained perspective, they seem to share some similarities, such as compulsive behavior.

While I don’t have OCD, I did have anxiety as a child and adolescent and I had significant anxiety and disordered eating issues in my early adulthood. When I started treating OCD, OCD spectrum disorders and body-focused repetitive behaviors (BFRBs) during my internship, I immediately knew “these are my people.” Being with my clients with OCD brings me so much joy. I get to sit with my clients and we can be perfectly imperfect together. We can cry. We can laugh. We can be vulnerable. We can be strong.

What resonates most for me is my clients’ stories about feeling like you “have” to do a compulsive behavior, despite a deep, inner knowing that it was irrational. This experience is so similar to those who have an eating disorder. Both disorders include an obsession that causes significant anxiety and distress, and both include an array of compulsions that are done to prevent the feared obsession from occurring.

I love the posts you publish on your site, particularly your soothing podcasts. Where did you get the idea to share audio posts as well as blog posts? 

I am a native Australian who moved to the USA in 2001, right after September 11. A few years ago, a friend from Australia emailed me stating that she was struggling with severe anxiety and asked if I could help her. I gave her a list of great books on her specific anxiety and some information about mindfulness, but for days after we connected I wished I could be more helpful.

There are lots of great mindfulness resources out there, but so few are specific to anxiety disorders, BFRBs and eating disorders. I quickly decided I would do a podcast for those who have these specific disorders and have little access to resources. I went out and bought a decent microphone, set it up in my kitchen and I just started talking. It is kind of funny now that I think about it. I think I did my first episode in my PJs while my newborn son was napping.

KymSon

Your practice is in the Los Angeles area, and of course it’s not the only clinic for individuals with OCD to choose from. What advice do you have for people who don’t live in an urban area or within a comfortable driving distance of a provider? How about for those whose insurance doesn’t cover proper treatment for OCD?

There are some wonderful books and online resources (Yahoo forums, e-books, online classes, etc.) out there for those who cannot access face-to-face treatment. The International OCD Foundation (IOCDF) is a great resource for anyone wanting to get down to business and work on their OCD. If you are doing a Google search for resources in your general area, just make sure it focuses on cognitive behavioral therapy (CBT), exposure and response prevention (ERP) and mindfulness.

There are some great options for teletherapy (online therapy) with trained therapists from your home computer or electronic device, if that is financially possible for you. Check the IOCDF website for therapists who are trained to help you and offer this option in their practice. There are some laws that prohibit out-of-state teletherapy, so check with the health care provider first.

Finding a good CBT therapist who uses ERP and who takes insurance can be very difficult.  If you cannot find a therapist trained in CBT and ERP, please do not give up. My best advice is to find an in-network therapist who you feel comfortable with and direct them to the IOCDF for resources to help them to understand how to help you. Also, as mentioned above, there are some great books and workbooks for OCD using CBT and mindfulness.  Bring the workbooks to therapy and go through them together. Having the support of a therapist (or even a friend or family member) can be super helpful and can help you to identify issues that you aren’t aware of.

What would you tell a client who doesn’t think ERP would work because she doesn’t have compulsions such as repetitive hand washing? 

Overt compulsions (behaviors you can see) are not the only kind of compulsions. This is a big misconception. Hollywood has done a great job at portraying OCD as a disorder where one might perform a lot of hand washing or crack jumping, but it rarely shows the other compulsions that come with OCD. Compulsions also include reassurance seeking, avoidance compulsions and mental compulsions. You can do ERP with any of these compulsions. If you tend do to a lot of reassurance seeking, you could challenge yourself to not ask for reassurance and sit with the uncertainty that something bad will happen. If you tend to do mental compulsions, you could write an imaginal exposure about your obsession coming true and read it many times per day, while allowing the physical discomfort of anxiety. If you tend to do avoidance compulsions, you can work to gradually touch or be around your feared object or thought. I have learned that there is always a way to do ERP, and ERP is essential to your treatment. You just have to get creative!

KymFamily

Imagine a parent friend of yours says, “My cousin told me she’s worried she might be a pedophile because she has intrusive thoughts about children. Should I forbid her from being around my kids?”

Oh my stars, no! I cannot tell you how many strange and inappropriate thoughts I have had about my children or my family members’ children. If we are honest with ourselves, I think we all have had them, in some shape or form. The hard part is those with OCD tend to give these thoughts way too much value.

My 5-year-old daughter who doesn’t have OCD told me the other day that she had a “scary nightmare about hurting a kid, but it was while we were in the car coming home from school.” She decided to call these thoughts “day-mares” and she thought that was pretty funny. We give those “day-mares” as much value as we give the nightmares we have during our sleep. I love this idea and I talk with my clients about this too.

Unfortunately, our society is widely uneducated on OCD and how to respond to it.  Stopping the cousin from being around kids will only enforce a faulty belief that her thoughts are valuable and, resultantly, make her OCD worse. In this case, I would tell the cousin to allow the thoughts to be there while she is around the kids. Even better would be to practice having the intrusive thoughts as much as she can. In my office, we play a game called “One-up.” During this game, we take turns coming up with the most scariest thoughts. The goal is to “one-up” each other by making the thought just a little bit more bizarre and frightening than the last one. It’s a great way to practice having scary thoughts without giving too much value to them. I always joke with my clients that my office walls have heard it all.

Do you have any advice for a young person who hasn’t yet told his family or friends that he has OCD? Are there good first steps he can take in “coming out” with OCD?

I love Brene Brown’s idea of trusting those who have filled up his or her “marble jar.” She talks about how her daughter’s elementary teacher uses a glass jar and puts in a marble if the kids are behaving well. If they aren’t behaving well, the teacher takes a marble out.  When the jar is full, the teacher has a party for all the kids. Brene Brown uses this metaphor as a way of determining if we can trust someone. If a friend has shown through many incidences that they can be trusted, their metaphorical jar is full of marbles. Those are the people who I would confide in. If that person has been consistent in showing they can be trusted, and you believe their jar has been full for a while, take a leap of faith and try sharing with them.

That being said, I would be prepared for lots of questions. Try not to take their questions as judgment. The person you shared with might not understand entirely. Try to educate them as much as you can, or refer them to some of the great books or websites out there.

kymDaughter

If you could share just one piece of advice with individuals with OCD, what would it be?

In my opinion, overcoming OCD takes two things: Deep desire and hard work. I have seen so many people get better. They come in to my office having spent years struggling and battling OCD. The ones who conquer OCD are the ones who have a deep desire and they go to work. It’s really very inspiring.

When I started working on my own anxiety in my early 20s, I didn’t have a therapist. I would read every book I could find and write extensive notes. I would take long walks while listening to helpful podcasts about the issues I was dealing with. There are lots of people out there who can lead you in the right direction. Remember, deep desire and hard work is all it takes.

OCD Hope Drive: Jeff Bell & Liz McIngvale

Standard

Have you wanted to dip your toe into advocacy but aren’t sure JeffBellhow? Jeff Bell, founder of The A2A Alliance and founding partner of Project Hope Exchange, and Liz McIngvale, founder of Peace of Mind Foundation, have an idea for you: Leave a 30-second message of hope for others with OCD. Let’s learn more, beginning with Jeff.

Explain Project Hope Exchange.

Project Hope Exchange is a joint initiative of The A2A Alliance and the nonprofit Life Vest Inside. The goal of Project Hope Exchange is to showcase the power of giving hope, and specifically the notion that we get hope by giving hope. What we have built through Project Hope Exchange is an online platform, coupled with what we call our Hopeline, that allows people to leave 30-second messages of encouragement to others battling an adversity that they themselves are either dealing with currently or have dealt with in the past. So, cancer survivors speaking to other cancer survivors, individuals with OCD speaking to others with OCD, or even more broadly, impacted by OCD.

What we have found is that far too often in life, the missing ingredient in recovery is hope. I know this from my own journey through mental health recovery: At my worst I felt hopeless and desperately needed to find that sense of hope to motivate me to get better. What I learned along the way, sort of by stumbling across this principle, is that we help ourselves by helping others. When I found ways to give hope to other people, I found a great deal of hope in that process. So Project Hope Exchange aims to facilitate that. We collect 30-second audio messages — people can leave them through our Hopeline, or they can visit our website, projecthopeexchange.com — we listen to those messages, we vet them, we edit them to 30 seconds if necessary, and we post them by adversity. Our Project Hope Exchange website allows visitors to drill down by adversity and listen to messages from others dealing with that particular adversity and ideally be inspired to leave their own.

OCD HOPE DRIVE - APPEAL - national

This month in particular you’re focusing on OCD with the OCD Hope Drive. Can you tell us a little more about that?

We’re excited to be partnering with Liz McIngvale and the great folks at Peace of Mind to pilot the OCD Hope Drive with the goal of collecting 100 messages of hope from individuals impacted by OCD, in 30 days. One of the things that really excites us about this is providing a pathway to advocacy for people who are in the OCD community. So often people will think of us and say, “I’d like to do something in the OCD advocacy world, what do you suggest?” We think that Project Hope Exchange is a great place for people to taste advocacy. They can do it anonymously; they can do it with just their first name, but we hope that it affords them an opportunity to feel what it’s like to share some encouragement through this hope drive. We’d like for it to be a gateway to advocacy through our OCD ally organizations, Peace of Mind, the International OCD Foundation, or Riley’s Wish.

What would you tell someone who says, “I’m not 100 percent recovered, so I don’t feel like I’m equipped to share a message of hope with someone.”

One of the great fallacies about advocacy is that we can only provide hope when we have reached some certain threshold of recovery. I find that when people are looking for hope, what resonates most are people who are in the trenches with them, someone who can provide the perspective of someone who’s still struggling, still trying to find all the answers but is making some progress and is willing to share the hope afforded by that progress. I really think it’s important that we share our successes as we go and inspire people along the way.

And if they leave a message of hope and they see you at the OCD Conference in San Francisco, now they have a talking point to meet you.

I would love, love, love to meet everybody who leaves a message. I would love for them to share with me personally what that experience was like for them and for those who are interested in exploring other ways to get involved in OCD advocacy, I would love to talk with them about that and help do what I can to facilitate that.

Liz McIngvale

And now let’s hear from Liz! Why did you and the Peace of Mind Foundation get involved with the OCD Hope Drive?

I’ve always worked really closely with Jeff, and I’ve loved our partnership and our ability to work together to make a difference for individuals with OCD. Jeff and I spent a lot of time thinking about different ways and opportunities for us to collaborate to make an overall impact in the OCD community. And this just felt like a really great way to be able to do that. It was simple — people could it from their own home and from really anywhere that they were — and it gave other people a chance to give individuals who are really suffering a lot of hope. That’s something that’s really dear to my heart.

What would you say to someone who asks, “How can my 30-second message of hope make a difference?”

It doesn’t matter how long or short the message is. Being willing to just talk to someone, support someone, be empathetic toward someone with a mental illness gives us hope, so being able to give them a message of hope, whether it’s short and quick or long is irrelevant. At the end of the day, you’re taking the time out of your day to remind us that you believe in us, that there’s hope available for us, and that we can and will have a happy life despite this disorder.

Can you speak a little bit about what messages of hope have done for you and your recovery?

For me, it’s knowing that other people have a diagnosis like I do. That in and of itself is super moving and inspiring. But I think more than anything it’s just the fact that there are people out there who care about me. It doesn’t matter who you are, whether we’re related or I know you: Leaving a message of hope to tell me that it will get better, that you’ve gotten better, or that you’re thinking about me — all of those things inspire me to move forward.

And here’s a question for both Liz and Jeff: Since so many people who will leave a message of hope this month have OCD, an anxiety disorder, they may feel really nervous about doing it, even if it’s anonymous. Do you have any tips for someone who might be feeling like “This needs to be perfect or I shouldn’t do it at all?”

Liz: The biggest thing to remember is that there’s no right or wrong, there’s no black and white. It’s just about giving hope, and you can’t do that in a way that’s not a good way. No matter what you say, it’s going to be meaningful, it’s going to be moving, it’s going to be impactful, because you’re taking time out of your day to share some words that will lift someone else up. Don’t worry about it being perfect, because imperfection isn’t the point. If you have done the act of recording a message, you will inspire and move somebody.

Jeff: It can be challenging on many levels to share a story, even in 30 seconds. Let me start with one of the most challenging components of that, and that’s that “I’m not worthy of providing hope.” We touched on that already in terms of the idea that one needs to be fully recovered before I can share hope. The mere fact that you are willing to put yourself out there, even anonymously, and make an attempt to help other people, that is such a courageous thing to do that that courage alone will inspire people. I want potential participants in the hope drive to know that just stepping out and leaving that message is hugely courageous and will be perceived as such by other people who listen to that message. The second thing is those of us with OCD like to make the world very black and white, either I’m gonna leave the perfect message or it’s gonna be really, really bad. There’s no such thing as a perfect message. The message we want from you, an OCD sufferer, someone impacted by OCD, is simply a heartfelt acknowledgment that this is  difficult but that it’s possible to move forward with recovery and support of others who are dealing with OCD. The third thing from a very practical aspect is that we try to make the interface as user-friendly as possible, so you can do as many different takes as you’d like with your message. You can call, you can listen back to your message, if you don’t like it you can push a button and re-record it and then re-re-record it and re-re-record it, and we only get that message that you decide you’re ready to send to us.

A couple of closing thoughts: If someone is feeling apprehensive about worthiness or ability to leave a message I would encourage them to leave that first message anonymously, give us a couple initials, whatever is comfortable for you, but give yourself a chance to see what it’s like. Push your comfort zone and leave a message anonymously if that’s easier for you, but give yourself the opportunity to see what’s possible when you step into advocacy. Listen to other people’s messages, get an idea of what other people are sharing. We hope that through this drive we will not only collect 100 messages that can inspire other people but help 100 people come to appreciate just how motivating it is to give other people hope.