by Jeff Bell
As for OCD treatment options, it seems they are every bit as varied as the theories regarding the disorder’s cause. I shudder to read that until the 1950s, lobotomies were routinely performed in severe cases, and that in the decades that followed, hospitalization was common. My head fills with visions of mad scientists strapping me to a bed so they can take their scalpels to my frontal lobes. Fortunately, I read on to learn that today’s treatment alternatives are significantly less severe and tend to fall into two often overlapping approaches: (1) cognitive behavioral therapy, in which OCs learn to confront their obsessive thoughts and curb their compulsive reactions to them, and (2) drug treatment, in which various psychopharmaceuticals are used to alter the neurotransmission process.
I know I’ll never, under any circumstances, allow myself to be drugged. (I can’t trust myself now; how could I have any confidence at all in my judgment while spaced out on pills?) But this cognitive therapy: how bad could it be? With eyes bloodshot from hours of reading and a head throbbing from far too much information processing, I decide to make a phone call and find out.
“O-C Foundation. How can I help you?”
“Yes. Right. Thank you. I … uh … I’ve been doing some reading, and I … well, I’m not sure, but I …”
The woman taking my call in Connecticut listens patiently, then, with a warmth in her voice that puts me at ease right away, asks what she can do.
“I… uh … guess I need someone to point me in the right direction,” I say.
“Well, you’ve come to the right place,” my new best friend in the world tells me, then proceeds to suggest a number of resources right here in the Bay Area.
By the time we hang up, I have a name and number for a local OCD specialist at UC San Francisco who might be able to take on another client. Her name is Dr. Jacqueline Persons, and two phone connections later, I have an appointment to meet her at her office in Oakland.
Dr. Y calls me at home the following morning.
“Have you got a minute?” she asks.
“Uh, yeah, sure.” In four months of working together, never once have we spoken outside of her office.
“I’ve been talking to a few colleagues, and, well, they seem to think there might be something to your theory.”
“Really?” I say, trying my hardest not to sound like a smart-ass. I can only imagine how difficult it must have been for her to pick up the phone.
“Yeah. Anyway, I just thought you should know.”
No award from the Associated Press could ever mean more to me than this particular recognition of my investigative reporting.
nine
fast-forward 1 day
I have my little speech all rehearsed and ready to go.
“Thank you for seeing me so soon, Jackie,” I say, making sure she notices my deliberate use of her first name only. I’ve had it with therapist power-plays, and after researching Dr. Jacqueline Persons’s long list of academic and professional credentials, I’m not about to take any chances this time around. My first words to her are a carefully launched trial balloon which, to my great relief, she chooses not to shoot down.
“You sounded pretty stressed on the phone,” she says without even a hint of offense taken over my lack of formality. “Hopefully, we can get right to work.”
“I’d like that. But first there’s something I’ve got to put on the table.”
“Go for it.”
Jackie has a smile on her face, a playful, almost impish one that seems to tease, I know exactly what you’re going to tell me next.
“Listen,” I say, “You need to understand that I have no interest in telling you about my childhood.”
“Really?”
“Really.”
“Good, because I have no interest in hearing about it.”
Jackie is looking right into my eyes, showing me, I think, that she is serious about this. Her expression is oddly familiar, much like one of Samantha’s when I’m trying to test her and get caught in the act. Something less tangible, but just as pronounced, also reminds me of Sam: She has that same down-to-earth, Real McCoy, This-is-who-I-am-take-it-or-leave-it ease about her, and I can just tell she shares Sam’s commitment to living life to its fullest. The rest of her story I can only guess: Early forties, probably. Earthy but sophisticated, with her long jet-black hair and stylish yet understated clothes. Could be an art dealer, if I didn’t know otherwise. Married, judging by the ring. A mother of a young kid, based on a few office decorations.
“I’m a behavior therapist,” Jackie says, her eyes still locked on mine. “As such, I’m far less concerned about how you came by your problems than I am about helping you do something about them.”
I like this. I like her. I think I can shelve the rest of my speech.
We spend the next forty-five minutes talking about my various challenges and about the nuts and bolts of cognitive behavioral therapy. “This isn’t going to be much fun,” Jackie tells me, and I learn she’s not kidding when she describes the mechanics of something called exposure/response prevention, a form of calculated torture—she refers to it as therapy—in which an obsessive-compulsive is exposed to a high-anxiety trigger and then prevented from responding to it with typical compulsions.
“Take your driving issues,” Jackie says. “We may have you run over some loose manhole covers, then keep you from going back for a look.”
“And you’re going to charge me for this horror?”
“You bet,” she says, with a disarming smile.
The idea, Jackie explains, is to desensitize me to my obsessive fears and help me break my compulsive habits, like driving in circles and checking everything around me, even reviewing things in my head again and again.
“This is hard work, Jeff,” she tells me for the third or fourth time. “That’s why a lot of my patients choose to go on medication to help take off the edge.”
And there it is. The other shoe falling. Right on cue. Right on top of me. Splat. I am trapped in my chair now, feeling the pressure, wanting like hell to bolt from her office.
Jackie recites a string of reasons to try meds, reasons I’m now quite familiar with from my OCD research. She pauses and looks up at me, seeming to have no problem translating my body language. “Listen,” she says, “it’s entirely your choice. I’m just saying I think you should consider it.”
“Not a chance,” I tell her. I’ve seen One Flew Over the Cuckoo’s Nest. No way am I going to let myself become some drugged-out vegetable, standing in line for my daily Dixie cup of assorted tablets, dependent on chemical compounds to get me through my day. Besides, psychiatric pills are for the serious nutcases. Does she really think I’m one of them?
An hour and ten minutes after starting our session, I notice that we’ve exceeded our scheduled time by fifteen minutes.
“Aren’t you supposed to kick me out?” I ask, recalling my sessions with Drs. X and Y that ended mid-sentence at the stroke of a clock.
“Yeah, probably, but you were on a roll.”
All things considered, I like this woman, Jackie Persons.
“You up for coming back?” she asks.
“Yeah.”
“And you’re serious about doing the hard work?”
I tell her I am, but I know I’m just trying to sound brave.
On Tuesday morning, four days after my first meeting with Jackie and two days before my next scheduled one, the unthinkable happens: I lose sight of a pedestrian who is “in my care.” It happens as I’m making a left turn at a busy intersection. A disheveled homeless guy steps into the crosswalk moments after my rear tires cross the second white line. I know this because I watch him in my rearview mirror, much as I watch every person on foot who winds up in front of, behind, or next to my car, all of whom are logically my direct responsibilities forever. But this guy just disappears. One second he’s there, the next he’s gone. I never get to verify that he has safely made it to the other curb. In at least a year of meticulous pedestrian tracking, never
even once before have I lost sight of a single walker.
I slow my car to a crawl, check all my mirrors. But it’s almost lunchtime and the sidewalks are packed. Picking this guy out of the sea of people I can see in every direction will never be possible. I loop around the block and find a parking spot. At least ten minutes have passed, though, and none of the vagrants I spot looks anything like the one I remember. I comb the whole area for signs of a medical response team. I scour the street and sidewalk for blood or other evidence of a deadly accident. I make my way back and forth across the crosswalk, pausing for the signal each time, trying to get a sense of the timing involved in crossing the street.
This is OCD, I try to tell myself. Surely I would have seen, heard, or felt something if I’d hit this guy.
Bullshit, Doubt counters. How can you ever be certain?
I ponder the question for the next thirty-six hours, a good many of which I spend hounding Samantha for reassurance. My poor wife. She was so encouraged, so hopeful after my first hour with Jackie. Now here we are back at square one, as I beg her to walk through all the what-if? scenarios. When Sam tells me for the last time that I’ve got to move on, I lock myself in my room and play back my virtual tape of the incident. I see my car moving into the intersection. I see the homeless guy stepping off the curb. I see the throng of frenzied business types. I see myself looking in the rearview mirror. But then the tape ends cold. So I rewind it once again, searching in desperation for images I might have missed. Nothing. So I rewind again. And again. And again. Mental reviewing, Jackie called this whole compulsion of mine. As if slapping some clinical label on it could somehow help.
At Channel 2 Wednesday night, I come up with a plan. I will go through the news wires, looking for items about local hit-and-runs. I know such a crime would garner at least a few lines of copy; therefore, in the absence of any relevant stories, I can safely assume that my homeless guy simply vanished into thin air. A search of the afternoon Bay Area wires comes up empty. Nothing involving unexplained accidents or plowed-down pedestrians. That familiar rush of relief shoots through my body like blasts of hot air defrosting my every fear-frozen cell. But I should check the morning wires too, I decide, just to be sure. So I do, and seconds later, I discover a story slug that leaves me gasping for breath: “Body Found.”
In a mad panic, I scan the nine lines of copy and learn that the unidentified body was discovered at about eight o’clock Tuesday night, at a curb not all that far from where I’d driven. The man, believed to be in his fifties, was wearing a shirt that was rolled up to his chest, as if the body had been dragged. According to a quote from the coroner’s office, the body showed no signs of trauma but bore what appeared to be a fresh needle mark on one arm.
A map. I need a damn map. Need to measure how far the cited location is from my busy intersection. Damn it, just as I feared: less than a mile. Several blocks, according to my dog-eared Thomas Guide. Given this piece of evidence and the mere nine hours separating my driving scare and the body’s discovery, I know I’m in trouble. If there’d ever been any chance that my fears were simply OCD obsessions, that prospect no longer exists. I am, I am certain, a cold-blooded killer.
Staring at the news copy in front of me, I notice there’s a media contact number for reporters wanting more information—a listing for the local coroner’s office.
There you go, Doubt suggests.
No! I will not stoop to this new low. I will not allow myself to call under the guise of doing a story on….
Shit.
I jot down the seven digits.
“You’re—you’re kidding me—right?”
Dr. Jacqueline Persons is in stitches, all but slapping her knee and wiping tears from the corners of her eyes.
“I’m sorry,” she says after seeing the shock on my face. “Go on. Please. Really. This is good.”
I don’t know what the hell to say now. I’m paying this woman more than a hundred bucks an hour and she’s laughing at me? This should tick me off big time; but instead, somehow, it seems to put me at ease.
“Let me just make sure I’m following this one,” Jackie says. “You lost a guy you were tracking in your rearview mirror, and nine hours later a junkie shows up in a gutter three blocks away, and now you’re convinced you somehow did the guy in?”
“Well, yeah, I guess.” It all sounds so stupid when she throws it back at me like this, and now I think I get what’s she’s doing here: trying to make me recognize the absurdity of what I’m telling her.
“You don’t really believe you killed that guy?”
“I could have,” I protest, still not ready to give up.
“Right. And his body bounced three blocks to a curb where it landed on a hypodermic needle and was then mysteriously dragged another few feet for good measure?”
“I don’t know—”
“Jeff, this is O-C-D!”
Jackie is laughing again, and I try to join her. But it’s tears that come out and shake my whole torso.
“So why the hell does this all feel so real?” I ask when I can finally string together a sentence.
“Ahh, emotional reasoning,” Jackie says and goes on to explain it like this: My misfiring brain reacts to a nonsensical thought with a biochemical fear-response generally reserved in “normal” people for logical scares, like a bear attack or an impending train collision. Because this fear-response is, in fact, very real, it lends a certain credibility to whatever trigger I’ve associated with it. In simpler terms, it feels as if something horrible has happened, therefore my deductive reasoning concludes that something horrible has indeed happened.
Intellectually, this makes sense to me. But intellect is the bullied little brother of emotion. It counts for little in the throes of panic. Perhaps this is why I want nothing more in the world than to call the coroner’s office when I walk out of here—this, despite understanding at some level just how disastrous that would be.
Five days later I am back in Jackie’s office, hanging my head low as she asks how I’m doing with the whole Bouncing Body episode. I’m supposed to be reporting all my successes today, showing her how serious I am about tackling my OCD. Instead, I’m copping to a laundry list of checking activities: The trips back to the intersection and surrounding area. The daily inspections of my car, bumper to bumper. The countless checks of the news wires for follow-up stories. And, of course, the endless playbacks of my virtual tapes of the incident.
Jackie grabs a yellow legal pad from her desk, and I get nervous. Here we go, I think, with images of her two predecessors and all their note-taking coming to mind. But Jackie has other plans. She lists all the checking drills I’ve just described and asks me to name every other compulsive urge that I’m battling. Then she has me rate them on a scale of zero to 100, in terms of my perceived need to follow through on each. Soon we’ve got a list of fifteen items ranging from 30 to 80. Next, I’m supposed to pick three of these compulsions that I can promise I won’t act on for at least another week.
I pledge: (1) not to confess to the police, (2) not to call the coroner, and (3) not to return to the busy intersection.
“Good,” Jackie says. “Now we’re going to take some of these other items and put limits on them.”
By the time I leave Jackie’s office, I’ve committed to a whole series of daily caps: three discussions with Samantha about the incident, twelve checks of the Channel 2 wires for “body” stories, one bumper-to-bumper car inspection, and two five-minute stretches of mental reviewing.
This is just OCD.
But what if it’s not?
Jackie’s voice and Doubt’s are battling it out in my head as I try in vain to hide from them both. It’s mid-morning, and I am fighting to keep my hands off the phone in front of me. Less than twenty-four hours have passed since I made my commitments to Jackie, but already I know my willpower is broken. I need to call the coroner. Need to hear firsthand that the man with the bouncing body did, in fact, die of an overdose. I’ve got a p
lan all worked out, and when I can fight the urge no longer, I pick up the receiver and put my plan into action.
“Coroner’s Office.”
“Yeah, hi, this is Jeff Bell calling with KCBS Radio.”
“KCBS? What can we do for you guys today?”
“Well, I’m looking to do a story about unresolved deaths in the area and was hoping to talk with someone from your staff.”
The receptionist disappears to find a staff assistant to help me. Last chance, I think to myself. Still not too late to pull out here, save myself from committing this unthinkable breach of journalistic integrity. Hang up the phone. Hang up the—
“Ya-hello.”
This is it, my whole career on the line. Can I really go through with this blatant lie? Really compromise everything I’ve worked for in nine years of broadcasting? Really sell myself out like a hooker trading her own dignity for some quick cash?
It’s the only way, Doubt whispers back.
“Uh, yeah, hi, Jeff Bell here from KCBS.”
The genie is out of the bottle, and there’s no way to put her back in. What else can I do now but resort to my plan? With the cunning and finesse of a veteran con man, I launch into an elaborate story about tracking unexplained deaths for a possible series. I hate myself more with every word that spills out of my mouth.
