Dr. Nelson appears in the doorway. I don’t know if I crack a smile, but a blip of happiness jumps inside me when I see her. Without looking at my mom, I push up out of the chair and walk toward her. “Hi!” I say in a remarkably chipper tone.
As we settle into our seats in her warm office, she rubs her hands together. “All right, all right, all right. Let me see that homework, eh? I’m very interested to learn what’s going on inside that head of yours.” She has her arm extended toward me, wiggling her fingers over the carpet. I pull the folded sheets out of my waistband, and I realize how warm they are, and how strange this might look. Keeping my papers hidden in my pants like a spy. But Dr. Nelson continues to beckon for them and takes them out of my hand as if I brought them in a leather-bound briefcase. A dense cloud rises in my chest, and I have an almost overwhelming urge to thank her. Thank you for not raising your eyebrows. Thank you for letting that strange moment pass without a comment. Thank you for being you. Thank you for helping me.
She is looking down at the lists, the lid of her pen in her mouth, nodding. I watch her eyes scan through each line. “Mmm, okay,” she mumbles to herself. “Yes, yes, I remember that one.” Her words become garbled under her lips, but I see her eyes open wide, then her head tilt, as she reacts and thinks.
“Well. Okay, then.” She taps the papers on the top of her thigh to align them in her hands. “Very good work, Allison. And I have to say, quite an impressive list,” she says with a small laugh as she sits back in her chair. “I’m going to go as far as saying this is the most obsessions I have ever seen in one patient—at your age, at least.”
A beam of light shines from my face. The most . . . ever? Me? Oh, Dr. Nelson, you shouldn’t have! What an honor! I know that the more obsessions I have, the more battles I have to fight in the future, but I still feel special, despite the implications. Maybe she’ll always remember me. Maybe I’ll always be her “toughest” patient. If I can’t excel in school anymore, at least I can excel at OCD.
“Now that we’ve captured most of your concerns here”—she places her splayed fingertips on the sheets—“we can go through them and try to decide where we want to start. So, looking through here, it seems like there are some general themes. Like, for example, there seem to be a lot of food items. Uh”—she runs her eyes down the page—“apples, potatoes. Gum, granola bars. Bartering food? What’s that?”
“Oh, um, that’s when I trade food to protect myself after stepping on a crack or when I need more steps when I run out.”
“Huh, right.” She gives a slow nod. “That sounds like its own thing, not really related to food, at least not in this way. Let me make a note,” she mumbles as she scribbles in between the rows. “Okay, so we’ve got food. Then, it looks like school-related things: calculator, studying, notebook paper.” I’m nodding so hard at her that she blurs out of focus. “Right. I agree. That’s very important. Maybe the most important, but let’s keep going. Uhhhh”—she lets her voice drag out as she keeps moving down the list—“all right, how about hygiene? Or, okay, wait, not just that. Let’s call it . . . Bed, Bath, and Beyond. Hairbrush, hair dryer, soap, clothes. Makeup. Toothbrush.” She lifts her eyebrows at me, clearly tickled by her own cleverness. I can’t help but give her a small smile in return. It’s not funny, but it’s funny.
“And, of course, not everything is going to fit into one of these main categories. For example, you have here standing up. Then there’s talking and/or angry furniture.” She reads the words matter-of-factly.
“Well, those two are related.” I hold my index and middle finger apart in the air and then bring them together. “They’re kind of the same thing.”
“Which ones?”
“Standing up and talking furniture.”
“Oh, interesting. How so?”
“Well, sometimes the furniture, mostly chairs and couches, don’t like being sat on. They shoot out this angry static and it’s high-pitched and hurts my ears and makes my head pound. I can just tell they’re dangerous and that something bad will happen to me if I sit on them. Or even if you stand too close, because the cancer waves can spread pretty far. At least a few inches.”
“Hmm, okay.” She draws a curved line between their rows on the paper and makes a small note.
“So I usually just stand because it’s safer. And then sometimes—well, always—I need to stand on one foot. It just feels better. So that’s what that one is. I think it’s on the second page.”
Dr. Nelson flips through the sheets. “Yep, I see it. Making a note.” Again her pen wags quickly in the air. “Okay, well, anyway, you get what I was saying. There will be these big general categories, but also many completely separate fears and issues that we can handle individually as needed.” She pauses here, resting her hands on her lap. “Do you have any questions?”
Uh, nope. I shake my head at her, wide-eyed.
“Okay. Now that we’ve reviewed your lists, it’s your turn to tell me where you want to start. Of the things we talked about, of all the things you wrote down for homework, which one bothers you the most? Or, in other words, if you could choose to get rid of one of these categories or fears first, which one would it be?”
It’s like bringing a starving person to a buffet. Amazed by the huge menu of options, I just stare at them in awe. But, soon, one concern rises above all others. “My schoolwork,” I say to Dr. Nelson. Over the past few months, I have set fire to what was once my foolproof five-year plan. The fast track to a northeastern college with centuries-old stone buildings and US presidents as alumni. But I could still rescue my life. If I could start next semester with a clear head, and a pencil, calculator, and notebook paper, I could redeem my GPA and turn this loose cannon around. There is still a chance, but only if we act now.
“I think that’s a good choice, Allison. I really do. Both for your stress level and your own sense of confidence. Getting that back on track will help immensely in many ways. Good, and then what? We’ll start chipping away at school-related items, but let’s also decide on your next priority.”
“Oh, definitely Bed, Bath, and Beyond.” I grin slightly against my will. School is the most important. School is life. School is college. School is future. But the harsh truth is you don’t lose your friends for failing chemistry. No one stares at you for bad grades. Everyone stares at you when you wear flannel cat pajamas in the cafeteria.
CHAPTER 22
There is traffic, and the early-afternoon sun glares off the rearview window of the red Pontiac in front of us. “Come on!” my mother yells angrily at the line of cars, her knuckles white against the steering wheel. “What’s happening! We’re going to be late!” I have never known my mother to raise her voice, except over the past few months. We are on our way to my third appointment with Dr. Nelson, and although I feel the claws on my brain loosening, even though there is now a silver lining around my clouds, I have yet to make any signs of outward improvement. I’m still counting, tiptoeing. All of the above.
My mother frantically jabs at the radio presets before mashing it off with her thumb. I can feel her stress emanating over the center console. She would never say it out loud, but I know it’s been almost impossible for her to leave work so often to ferry me to these appointments. She moves meetings, takes phone calls at night, pecks away on her laptop until the early-morning hours. She doesn’t complain, would never complain, but the stress oozes out through her skin.
We pull up to the brick town house and ease to a stop and I hop from the car. The buzzing uncertainty I felt prior to my previous therapist appointments is gone today. I’ve strangely been looking forward to seeing Dr. Nelson. Virginia. She isn’t Sara or Jenny, but in her own and maybe more powerful way, she’s my friend. I almost skip from the car to her nondescript front door. The bland, beige waiting room that was so unappealing a few days ago now greets me with a rush of warm air and the familiar lemon air freshener.
“Well, hello there, Allison!” Dr. Nelson sends me a gleaming smile from
behind her desk. A blue, lumpy cardigan hangs from her thin shoulders. It’s endearingly obvious she knit it herself. My heart swells with fondness, and I feel a sudden sense of gratitude. Just entering her office has forced the dark clouds hanging above my shoulders to part. A few rays of sun are able to peek through into my chronically overcast life.
“Hi, Dr. Nelson!” A switch has flipped inside me and I’m suddenly in conversation mode. Ready to chat and smile and laugh. “Oh my gosh, guess what! I heard the funniest thing on the radio on the way here. I have to tell you all about it. So there was this guy . . .” I trot past her desk toward her office without an invitation, my oversized flannel pants flapping in the air as I talk to her over my shoulder. Moving down the hallway, I pass the small kitchen with an array of snacks and a refrigerator filled with bottled water. I pause to examine the buffet of treats. Snack-size candy bars, miniature bags of peanuts. Although today was fairly successful (I was able to eat a piece of toast at breakfast as well as a bag of carrots at lunch), my stomach still snarls greedily for more. I scan the possibilities until my eyes are snagged on a basket of pretzels and my mind clinches tight. Pretzels, pretzels, pretzels. Cancer, cancer, cancer.
Walking up the hallway behind me, Dr. Nelson interrupts. “And?” Pulled from the blaring alarms, I turn to look at her. Pretzels. Cancer. Pretzels. Cancer.
“And what?”
Her forehead scrunches slightly. “And what happened to the guy? From the radio. You just kind of stopped midsentence.”
“Oh, right.” I know I need to keep talking, to tell her the rest of the story, but the pretzels. They’re staring.
I feel my right foot slowly rising into the air so I’m perched on one leg. There is a dangerous cloud spreading up and outward from the kitchen. I hold my breath without thinking about it, just to be safe. Dr. Nelson’s warm presence fades, and it’s only me and the pretzels in the room. Death. Death. Death.
Suddenly there is a soft hand on my upper back. “Let’s sit down in my office, shall we?” Her voice is calm and level, but I can tell she has sensed something. She’s trying to goad me out of my trance. “Come along now.” Both her hands on my shoulders—it’s not quite a push but more of a forceful suggestion. This way.
Her voice pulls my eyes from the cancerous snack, and, holding my breath, I reluctantly follow her down the hallway. Turning to close the door to her office, I see my mom, hunched over, typing on her laptop.
• • •
I slide my eyes toward the small clock on the wall above Dr. Nelson’s head and smile to myself. Her sitting in her high-backed brown chair, me perched stiffly on the cushion across from her, we’ve spent the first twenty minutes of the appointment swapping gossip like old friends over dinner. With stories of Samuelson, cross-country practice, and Sam, it almost feels like the long phone conversations I used to have with Sara and Jenny, and I’m glowing with happiness. I know that she’s my doctor, and older than my mom, but it feels so good to talk to someone again.
I see Dr. Nelson looking at the clock as well, and, realizing the time, she clears her throat. “Well, well, enough chit-chat for today, I think.” She smiles at me. “Time to get to work, wouldn’t you say?” Flipping open the manila folder on her lap, she thumbs through a small pile of paper and continues to talk. “For our last appointment, you put together that rather impressive list of all of your obsessions. Three pages of them. We will use these lists over the next few weeks to choose different obsessions to target and overcome.” She glances at me. I nod at her silently. “You’ll also remember that we went through the list and talked a little bit about your priorities. You said your first goal was to be able to do your schoolwork again. Getting your grades up seems to be the most important initial step.” Again, a nod. Eye contact. “Well, today we are going to pick what specific obsession you want to work on first.” She closes her folder and hands me a photocopy of the three-page list of obsessions. “If we look through here, I think there are a few of these that make more sense than others to start with. We are looking for something small, simple.”
My eyes skim over the black-and-white sheets of paper, and an ache appears deep in my head. Despite the pumping heater, I shiver slightly underneath my tattered running shirt. The handwriting scrawled across the paper is messy and frantic, nothing like the loopy, bubbly style I perfected during the first few weeks of school. Gently rubbing the edges of the paper, I examine the list. Each individual obsession, each line of text on the page, is a serious threat to the life of someone I love. And the pages are filled, covered, with them. There is nothing small or simple here. Just reading the words “peaches” and “calculator” sets off the panic alarms. A low buzzing threatens to overcome my thoughts, a million bees swarming into action, ready to protect their hive of obsessions. My eyes focus on the curves of the letters, the swish of the s and the cross of the t. They spell death.
With my extended silence, she continues. “Okay, well, here, let’s try this. I’ll list out some of the obsessions from the list that affect your schoolwork, and we can narrow it down from there. . . .” Her voice trails off. I can feel her eyes on me but I cannot tear my stare from the sheets of paper, which have now grown heavy as boulders on my lap. What have I done? What have I done? “Allison, hey, up here.” She snaps once. I drag my gaze up to her face. My mouth is open, my eyes wide. “We’re going to go through this together. We’re only picking one.”
My heart is pounding in my throat. It shakes my entire body. What have I done?
“Okay, starting from the top. Limitations on paper. It says you are only allowed to use a certain number of sheets of notebook paper to finish your homework or do a school assignment, and it’s usually not enough. That could be a useful one. Also, let’s see, your computer. That could be good? It would be very helpful for your schoolwork.” She tilts her head to the side in consideration and raises her eyes to me hopefully.
“Absolutely not! Not the computer!” I yell the words before I even know I’ve thought them. “Are you crazy? I can’t just use the computer.” I am surprised at the surging annoyance I feel toward her, a powerful sense of disappointment. In my mind I see the keyboard, the mouse, the monitor all sitting silently, covered with a thin layer of dust, on my desk. They practically glow with cancer. “That’s not an option.” I scowl at her. I guess she doesn’t actually understand my beast after all. She doesn’t know what she is suggesting.
“Okay, that’s fine, that’s fine. We will leave that one for later.” She casts her eyes downward and pretends not to notice my hurt expression.
“Yeah,” I retort, “much later.” She makes a small scribbled note beside the entry for computer on the list.
“Other options: counting your steps. It’s not necessarily schoolwork, but it would make the school day much easier for you. One less thing to focus on. Hmm . . .” She pauses as she scans the list, a crease between her brows. “Oh, here, what about pencils and pens?” She lifts her head quickly and we lock eyes.
I wait for the emergency alarm in my head to call the troops to battle, but, to my surprise, the corridors of my mind are silent. The objection that has formed in my mouth sits quietly, patiently. I wait for a few seconds, swaying slightly as I try to sit perfectly still, but there are no warning messages.
“Huh,” I say out loud, as much to myself and my brain as to Dr. Nelson. “Yeah, I mean, I guess that could work.” I’m stunned by my own eerie silence, and the words come out slowly, as if trying not to wake the sleeping monster. “All of the other things like my computer and notebook paper are important, but they do me no good if I can’t write. I need pencils.”
Dr. Nelson nods enthusiastically and claps her hands together. Now we can begin. “Wonderful, just wonderful.” She flips to a clean page on her legal pad and scribbles as she smiles at me. “There is one main type of therapy that is used to treat those with OCD. It’s called Exposure Response Prevention, or ERP.” With a few creaking noises, she lifts herself from her chair and shuffl
es over to the easel, which holds up an enormous pad of white paper. “Its name is pretty self-explanatory. With Exposure Response Prevention, we expose you to the source of your anxiety or fear—in this case pencils—and prevent you from responding with your normal compulsions.” As she talks, she writes ERP on the easel and underlines each letter for emphasis. “Typically, we find this to be most effective in combination with pharmaceuticals, but”—I shake my head vigorously and move to interrupt—“yes, I know, but as you have expressed before, that is not something you are interested in at the moment.” My shoulders relax. “ERP will still be effective without medication, it will just be a bit more challenging and perhaps take a while longer.” I look at her with a blank face. She is trying to goad me into the same conversation I had with Dr. Adams, but I refuse to bite. Medicine is not an option. A brain on medicine is a brain on the path to cancer. “I completely respect your feelings on the topic, and I am not here to push you into anything. Just know medication is something we can revisit at any time, if you change your mind.” I give her the eye roll that gets me in so much trouble with my mom. Without a response, she returns to her easel.
“Anyway, let’s get started. If this were a normal situation, if we weren’t doing ERP, and I took out a pencil right now, what would happen? How would you feel? What would you do?”
“If you took out a pencil right now? Oh, wow, that’s scary.” Looking off into the corner, I think back to sitting in a quiet classroom, the tiny noise of scribbling pencils surrounding me, and the tumor sprouting to angry life in my gray matter. “I would get a splitting headache immediately—that is always the first alarm. It feels like my brain is being both squeezed in a clamp and torn apart at the same time. I would hold my breath and stand on one foot, just because it makes me feel better. I guess, then, I would be told what I needed to do in order to undo the danger of the pencil. It’s hard to predict what it will be from one time to the next. But I would have to give up something useful or important. I would also maybe pray and do my hand gesture. A few times. I would probably increase the number of Bible pages I read that night too. Just to be safe.” I’ve told her that I have compulsions involving religion, but I haven’t admitted that part of me still feels like these thoughts might be delivered from the heavens. That despite being diagnosed with a mental illness, I’m not completely sure that that’s the full truth. But I know there’s no way I could say that aloud.
Obsessed Page 23
