Addiction 101, Part 11: Control and OCD

Addiction 101, Part 11: Control and OCD

After reading the title of this post, you probably wanted to skip over it – BORING snoozer. Well this topic is anything BUT boring. Hang onto your hats, Sisters.

Do you like mystery, thriller stories? One of the most popular genres of horror films is the who-dunnit shock thriller where, at the very end of the movie, you find out the bad guy was the person you least expected!! We find this entertaining because it’s so hard to believe. These movies take our emotions on more twists and turns than a roller coaster. Like in the movie clip below, Mr. Brooks isn’t just the successful, charming business man that he appears to be:

https://youtu.be/k4NIuw3JaXw

In my support group, we refer to our partners as a bad boy or a good guy. The bad boys are more “out there” with their acting out. They yell, cuss you out, run off, refuse to participate in therapy. With the bad boys, it’s heartbreak and disappointment all the way to the bitter end. That wouldn’t make a good movie. It’s a tragedy. We’d all leave the theater feeling hopeless and sad. Bad-boy-turned-good — now that’s a better story! I wish there were more movies like this out there, but again, somewhat predictable for a movie. Thankfully, there are some couples in the recovery world who made this transition and share their stories! This is the kind of transformation every betrayed wife hopes for. I love these stories!

Then we have the good-guy-in-public-only but a jerk at home with his family. Some movie titles do come to mind with this plot– Glass Castle, Not Without My Daughter, Sleeping with the Enemy. These movies are sad, but the silver lining is always the woman escaping the situation. Those aren’t the guys I’m talking about in this post, however. I’m talking about (seeming) thoroughly good guys. You don’t see cracks. “You never would have guessed it was him” guy. Now these are the movies we like to be spooked and shocked by. Again, very thrilling for a movie but not so much in real life!

It really sucks to be a betrayed wife actually stuck in one of these Jekyll-Hyde tales. Frankly, people don’t know what to do with this much contradiction in one person. When the tatted-up, edgy pastor from New York City cheats on his wife, we’re not too surprised…. But when Bill Hybels or Ravi Zacharias cheats, it stops us in our tracks. We struggle to process that story. The best we can figure is that his “good guy” image was a lie all along. He never believed what he was teaching. My coach says, “It’s harder to heal when you’ve been harmed through apparent kindness.” The human brain simply doesn’t know where to go with that storyline, so we freeze. I call it a “mindf*ck.” Heck, the entire church wants to ignore the fact that King David was a sexual perpetrator. It’s too confusing. Samson was bold in his acting out then had a change of heart. THAT we understand. But not King David who had walked so close to God for so long. Where did his reckless sin come from?!

Once again, I’ll have to turn to one of my favorite addiction experts, Maia Szalavitz, for some insight. “While those who are the most impulsive and eager to try new things are at highest risk, the odds of addiction are also elevated in those who are compulsive and fear novelty. It is extremes of personality and temperament—some of which are associated with talents, not deficits—that elevates risk. Giftedness and high IQ, for instance, are linked with higher rates of illegal drug use than having average intelligence.” Szalavitz was herself a brilliant ivy league college student who ended up selling and taking the most dangerous illegal drugs. We consider addicts to be out of control while we consider “control freaks” as some of the most conscientious people among us. However, this isn’t what research is bearing out. While our society tends to think that the more self control a person has, the healthier they are, what we see play out is that those with extreme under control as well as over control are the most maladapted. Under control individuals (impulsive) struggle to start things while over control individuals (compulsive) struggle to stop things. So if they begin using addictions to self soothe, their brains lock down on routines hard. Health is found near the middle of those extremes, slightly closer to the over control side. Could these extremes explain the bad boy-good guy split? Perhaps. Pia Mellody says some people are out of control with being in control while others are in control of being out of control. That’s an important concept.

Over control individuals tend to be seen as responsible and successful. They finish their homework, get good jobs, pay their bills, and keep their belongings put in place. However, they tend to be very private, if not withdrawn. If they struggle with addiction, you will not know about it. These individuals are threat-sensitive. They’re more high strung and anxious. Because of this, they’re missing a lot of human connection that would otherwise stabilize and calm their nervous system. The most effective tool at calming a disrupted human nervous system is another, more-calm human nervous system. We humans are doing this all of the time through a sort of invisible neural wi-fi. We co-regulate each other. Over control individuals are missing out on this experience. They’re left to self-soothe, self-protect, and regulate with inanimate things. It’s easy to see how this hole gets deeper and deeper, especially once someone is sitting on secrets.

If I had a ven diagram comparing addiction to obsessive compulsive disorder, there would be a lot of overlap. Relapse, obsessive thinking, compulsivity, not living according to your values. There’s an addictive cycle and a compulsive cycle. If you get too close to the cycle, you fall in. What’s happening on the brain level is someone gets an intrusive thought (your hands are contaminated). That happens to everyone. For a healthy brain, the terrible thought would slip into the subconscious automatically after a corrective thought. But for OCDers, it doesn’t. It sticks and becomes an obsession. The more they think about the thought, even to dismiss it, the stronger it gets. The only way to get relief is to act out in some way (wash those hands a lot!) . That’s where the compulsive behavior comes in. They feel relief for a while until the obsessive thought comes back. If you know anything about the addiction cycle, this should sound very familiar. Many researchers believe that OCD and addiction stimulate the same parts of the brain.

Like most mental health issues, including addiction, the public opinion on the matter is far from the truth. This leaves sufferers and their loved ones feeling like dangerous monsters or failures. There is much more to OCD than being a neat freak or being picky. OCD is created by an over-active alarm system in the brain. There are actually over 100 themes of OCD. These themes are usually around very important topics like harm, germs, relationships, sexual issues, or faith. Just like mental illness and addiction, the foundational causes can be biological or trauma or a combination of the two. Like addicts, OCDers tend to have high levels of dissociation and can even experience a state called depersonalization. Also, there’s very good treatment called ERP – Exposure and Response Prevention Therapy as well as ACT – Acceptance and Commitment Therapy.

Where OCD and addiction differ is that where addicts enjoy engaging in the compulsive acting out and OCDers feel compelled to follow through on the behaviors to stop the obsessive thoughts to get relief as opposed to pleasure. (The $10 words are ego syntonic – I want to do this – and ego dystonic – I don’t want to do this.)

“There is a way in which impulse control disorders [sex addiction] and OCD are the exact opposites: One involves giving in to an urge; the other, fighting it off. … Because of this inverse relationship, it has been suggested that impulse control disorders and OCD may represent over-excitation and under-excitation of the same brain system. … Thus, the two disorders could be related in the same way as hypothyroidism and hyperthyroidism are – at opposite ends of a single spectrum of physiologic activity. Against this hypothesis, however, is the puzzling fact that some people have both disorders at the same time.” from “Tormenting Thoughts and Secret Rituals” by Ian Osborn, M.D.

Our first therapist, not a CSAT, recommended Phil see a psychiatrist for an antidepressant. (As long as I’ve known Phil everyone judges his quiet, nearly-asleep body language as depressed or detached when internally he’s actually hypervigilant and anxious.) The first psychiatrist he saw diagnosed him with learned Obsessive Compulsive Personality Disorder. Less than a year later, when we finally made it to a CSAT, he independently diagnosed him with OCPD as well. He attended a 30 week class for over control with another CSAT called RO-DBT. RO-DBT, Radically Open Dialectical Behavioral Therapy, is really a brilliant approach. It teaches over control people how to turn on their social signaling systems, how to make your insides match your outsides, and many other things. Part of Phil’s story is intrusive thoughts. He hasn’t completely teased out the parts of his story related to addiction versus over control and OCD-type thinking. However, some of the principles behind OCD treatment have been very helpful. For example, when he has an intrusive thought or an opportunity for lust comes along, he doesn’t freak out (as much). He just says “that’s irrelevant to me” and he allows the thought to slip into subconsciousness rather than beating himself up. I am thankful that our marriage therapist told me that addiction treatment for people with over control issues takes longer. Phil has such a propensity to control things and not move. The low pace gets me down at times.

Along with the slow pace, I often have to work at processing the Jekyll-Hyde part of our story. When I say that Phil was always a conscientious father and even a good husband, I mean it. He was attentive to our marriage, even in addiction. All through his addiction, we had wonderful dates. I often heard from friends, “I wish my husband would take me out for coffee just to talk.” Four months before Dday, I was attending a doctor’s appointment with him where the doctor made a reference to the late Hugh Hefner in passing. I would have let the reference slip into my subconscious, but not Phil. In the name of precision and “goodness,” he HAD to correct the doctor. Phil’s response was “Hugh Hefner is now in hell.” Of course, we had no idea what this doctor’s view on the after life is…. This “goody two shoes” rule follower was the man I had lived with for over two decades. He was utterly predictable. He was a truth-teller and a compulsive “confessor” (Ok, now I know that’s not a good thing…) If he spoiled his appetite with a bag of peanuts before dinner, he’d tell me. He was a leader at our church and a good example. I never would have guessed he had been a consumer of the likes of Hefner’s work for many months after over 12 years of sobriety. This dichotomy hit me like a freight train on Dday. I’m still not finished processing what I’ve experienced up close and personal.

Louis Stevenson wrote, The Strange Case of Dr. Jekyll and Mr. Hyde, based on a real man! In fact he was a well-known cabinet maker, William Brodie, who built the cabinet that stood in Stevenson’s room as a child in the 1700s. Brodie was well respected with a pleasant voice. He secretly made copies of the keys to the cabinets he made, which he later used to go back and rob his former clients. This was a huge ordeal in the town because it was such a shock. Brodie was hanged for his crimes. The story made such an impact on young Stevenson that he wrote about it as an adult. The story endures to this day because we are horrified yet transfixed by this anomalous behavior.

If you are currently reeling from betrayal with an added layer of being betrayed by a “good guy,” I know how very confused and alone you feel. Addiction in the OCD community (or self-controlled religious community) is still very taboo. I had the chance recently to ask a prominent OCD therapist if there was good addiction treatment in the OCD community. She said it’s still very much not being confronted, which is sad because half of her clients also struggle with addiction. HALF. Phil says he knows there are other Christian, good guy sex addicts out there. They’re just not “outing themselves” (an RO-DBT term). We can’t hope for the frog-turned-prince or beauty and the beast story that other betrayed spouses are wanting to see. We had our prince already! We are looking for a different story. Pinocchio – a lying puppet who becomes a real live boy who’s a son – or the Velveteen Rabbit – who is transformed into a normal, real bunny. Not perfect, just real and known.

Resources:

Carol Ann Ross, therapist who is an RO-DBT practitioner and a CSAT (the only one in the country that I know about)

Dr. Ian Osborn, OCD specialist

Tormenting Thoughts and Secret Rituals

Article: The Addictive Personality Isn’t What You Think It Is

Article about addiction and autism

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