What Do You Say After You Say You're Sorry? (Coming to terms after you recover from OCD)

A phenomenon exists among those who suffer from OCD that is commonly seen when they have reached a certain point in their recovery process. It may sometimes even occur prior to that recovery. It involves a feeling of guilt and depression arising from the way the sufferer 's illness has negatively affected the lives of those around him or her. This is different from the guilt that often accompanies OCD. Those who are acquainted with OCD know that it is frequently accompanied by an inflated sense of responsibility for the well-being of others. It causes sufferers to compulsively protect those around them. It is usually unrealistic and even magical, and the thoughts tell the sufferer that he or she is responsible for things no one would ever dream of.

When OCD occurs, within your family or among your close friends by way of yourself, it is likely that yours is not the only life affected by it. Unless your OCD is one of the types that you can keep hidden, it can cause those around you a wide variety of upsets and worries. These can result from some of the following situations, to name a few:

  • Watching helplessly as you suffer with your worrisome thoughts, maddening compulsions, and depressed moods.

  • Having to give up a lot of their personal time, and physical and emotional energy, if they are forced to take part in your rituals.

  • Enduring your anger if they interfere with or refuse to help you with compulsive routines, or answer hundreds of repetitive questions.

  • Being forced to severely limit the ways they are allowed to live or the places they can go to avoid triggering your symptoms.

  • Having to materially support you in your disability.

  • Having to take up your daily responsibilities for you around the house, doing chores, or functioning as wage earners or parents.

  • Putting their dreams and plans on hold in order to take care of you.

Usually, when you are in the midst of your symptoms, it is possible to fall into one of two scenarios that can cover any or all of the above. One is that you have become self-centered in your pursuit of relief from anxiety and are oblivious to the stress and upset you are causing those around you. The other is that you are aware, but are so caught up in the symptoms, that you really don't have the time to do anything about it, because you are living moment to moment, trying to hang on and keep up with the demands of the illness.

Obviously, none of this is likely to win you much goodwill. You may begin to become aware of these issues at some point, most likely at the point of recovery or as you are nearing recovery. It is probably because you now have the time to think and can allow yourself to ponder the impact your illness has had on those close to you.

For instance, your marriage may have been weakened and damaged during the period of illness. The well spouse has had his or her life controlled by you and had to put personal plans aside. Your relation-ship with your children may now be more distant because of your being cut off from them, or they, too, may be angry at you for having controlled their lives and kept them from living as other children do. You may have also taken up a lot of the attention that would have gone to them instead. Witnessing your upsets may have upset them too. If you are one of several children in a family, your illness may have forced your parents to spend more of their time with you, and this has caused them to neglect your siblings who may now feel resentful toward you. Even if your family has been understanding and supportive, it can sometimes be another source of guilty feelings. Your friends may hardly know you any more if you have lost regular contact with them or they may now be avoiding you because you have behaved in ways that weren't average.

Where do you begin? How do you pick up these pieces? How do you now regard yourself? Having had your self-image and your relationships beaten up by the illness, I suggest that you not worsen things by mentally beating yourself up even further. Many of you may have already done this. Someone once said that guilt is only useful if it leads to some kind of change. Telling yourself how rotten and miserable you are as a person for having had an illness will hardly help you rebuild your life.

Let's get one important point straight. You did not ask for your illness - it was an accident waiting to happen. You are no more to blame than if you had developed diabetes. We can all agree that it would have been wonderful if you had been able to bravely bear up under the illness and fight off all the symptoms yourself without letting them touch anyone else's life. But, you didn't, and neither can most people. You may have eventually shown your courage by admitting that it was too much for you and then getting help. You showed it again by working your way through your treatment and putting up with all its difficulties until you reached your goal. Even if you haven't begun this recovery process yet, you may still be contemplating it.

You may say: "Okay, so I wasn't responsible for having OCD, but I still feel responsible for not having done more to keep it from affecting everyone else's life. I should have done more. I should have admitted that I had a problem. I should have gone for help sooner. I should have had the insight." It's true that you were and are responsible for helping yourself and for taking control of your illness, but why should anything have happened differently. It's always easy to sit and decide what you should have done in the past. "Shoulds" don't exist in the real world. In a fatalistic way, given all the circumstances of who you were, what your illness was, and what your environment was, things couldn't have happened much differently, otherwise they would have. It makes no sense to keep saying, "If only.." It also makes no sense to demand that things ought to have been different than they were. Things happened the way they did, period. Since you cannot change the past, your only reasonable choice is to accept it. Accepting something doesn't mean liking it. It means recognizing that something really exists, or has existed. Not accepting means that you will continue to feel disturbed about the past events, and they will have control over your life.

Along with the hard work of accepting past events, you must also accept yourself, both as you are now and as you were. You can change what you are (within reason), but you cannot change what you were. You had OCD. You could have handled it better, but you didn't. It affected others negatively. You must accept that you were and are an imperfect, mistake-making human being, just like everyone else. As such, you will continue to periodically err throughout your life. This won't change. You will need to allow for this as you move into life in the everyday world. It will also be the basis for forgiving yourself. If your OCD has been of the perfectionistic variety, this may be an extra difficult task for you. Accepting imperfection can also help maintain your recovery - everyone has slips now and then, and getting disturbed about them can lead to a relapse.

The message here is not that you should have no feelings for past problems. Having feelings is part of being human - they are natural and normal. However, it is best when they are in keeping with the event, and not all out of proportion. They should not be allowed to become yet another source of disturbance.

So what should you be feeling? I suggest that feeling sadness and regret are most appropriate. You can live with sad-ness and regret, and can find a place to put them within yourself. What you cannot easily live with is depression and self-hatred. At least, not if your goal is to recover and stay in recovery. It would be ironic if a self-induced depression for past behavior were allowed to sabotage your present recovery causing even further distress to those around you.

Beyond healing your behavior, there is a distinct and important type of healing that will result from forgiving yourself. To do this, you may actually have to go through a period of mourning, when you grieve for the fully functional life you wish you had had. It will help if you express all those upset feelings and recognize their existence by facing them. You will probably have to come to grips with the anger first. By this, I mean your anger at yourself and the OCD. The extreme sadness tends to follow once you are past the anger. You may always feel a sadness; however, it will ease somewhat in time. Therapy can be a good place to work through your anger, grief, and sadness. They will not last forever. When you finally come to the bottom of these emotions, you will hopefully be able to collect and to forgive yourself, and to begin putting your emotional and physical energy into living a more productive life.

What about the others in your life? Suppose they don't forgive or forget so easily? They may not. Remember, it is not in your power to control them or tell them how to feel or think. It's possible that, by concentrating on your recovery you can perhaps win them over someday. Perhaps. Understand that it may be a long time before they begin to trust you again and to stop scanning everything you do or say for signs that you are having symptoms or are relapsing.

If things in the past went too far or were beyond their own limits of tolerance, some of the damage may be beyond anyone's abilities to repair. Spouses sometimes ask for divorce. Children and relatives do become distant. Friends can refuse to answer your calls or letters, or may politely put you off. This is all as extremely dislikable and unwanted as can be, but it must be tolerated if you cannot change things. What choice do you have? Just like a person whose home has been hit by a tornado, you will need to begin clearing up the wreckage and to start rebuilding your life, it may have to be based on new relationships. Sometimes, a support group can be a good place to start the work of rebuilding your bridges to other people.

Keep in mind that persistence is everything. If you concentrate on living fully and in the present each day, not getting bogged down with your old regrets and resisting your "what-iffing" about the past or future, you can accomplish your healing. With this new sense of balance, you should be able to maintain a recovery.

If you would like to read more about what Dr. Penzel has to say about OCD, take a look at his self-help book, "Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well," (Oxford University Press, 2000). You can learn more about it at www.ocdbook.com