Even If Talk Is Cheap, Drugs Alone Won’t Work

If a recent story in The New York Times is to be believed, psychiatrists are ditching talk therapy in favor of quick-to-the-draw prescription solutions because insurance companies won’t pay them enough for the broader treatment.

As someone who benefited greatly from both therapy and medication, I find this disturbing.

Mood music:

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From the article, written by Gardiner Harris:

Like many of the nation’s 48,000psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. So Dr. Levin sent the man away with a referral to a less costly therapist and a personal crisis unexplored and unresolved.

Medicine is rapidly changing in the United States from a cottage industry to one dominated by large hospital groups and corporations, but the new efficiencies can be accompanied by a telling loss of intimacy between doctors and patients. And no specialty has suffered this loss more profoundly than psychiatry.

Trained as a traditional psychiatrist at Michael Reese Hospital, a sprawling Chicago medical center that has since closed, Dr. Levin, 68, first established a private practice in 1972, when talk therapy was in its heyday.

Then, like many psychiatrists, he treated 50 to 60 patients in once- or twice-weekly talk-therapy sessions of 45 minutes each. Now, like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names. Then, his goal was to help his patients become happy and fulfilled; now, it is just to keep them functional.

Dr. Levin has found the transition difficult. He now resists helping patients to manage their lives better. “I had to train myself not to get too interested in their problems,” he said, “and not to get sidetracked trying to be a semi-therapist.”

This is tragic on so many levels.

I’ve said it before: Medication (Prozac) has been a critical part of my OCD management. It put my defective brain chemistry into balance and greatly reduced the moments where my brain would pulsate out of control with worry and obsessions until it incapacitated me.

But had I gone on the drug without doing the brutally hard therapy first, I would not be doing anywhere near as well as I am today. I can promise you that.

Mental health is like physical health. There is no magic bullet — or magic pill — fix.  You need a combination of diet, rest and exercise to maintain health as well as any medicine that you may need.

Talk therapy helps you build your coping tools from scratch. They become your lifeline to sanity, especially if the drugs stop working, which can happen in a variety of circumstances.

This is just one more example of the health insurance industry putting the bottom line before wellness. I don’t want to beat on the insurance providers just for the hell of it. The industry does face the genuine problem where treatments are becoming more expensive, especially in a population where many refuse to take care of themselves.

Now that I’ve gotten that out of the way…

There are things one can do to cut costs. But when you cut into the muscle of the treatment — in this case talk therapy — the treatment will bleed to the point of near-death.

Now I know what they’re thinking: People can go to a therapist for talking and the other guy for medication, but now we have another problem. Not everyone can afford both.

In my case, I go to a therapist to talk things out, and a nurse on his staff is authorized and in charge of writing my prescription.

Psychiatry and therapy are not exactly the same beast.

But a good psychiatrist includes the talking part and uses it to maximum effect.

Force them to stop doing that and many people will fall through the cracks.

Fear and Self-Loathing in San Francisco

Just got to my hotel in Santa, Clara, Calif., with a few random memories shifting around in my head — memories that illustrate who I was and who I am now.

Mood music:

It was July 1991 and I was with Sean Marley on my first trip to the west coast. I didn’t really want to go because I was afraid of everything and everyone. But Sean was red h0t about the idea, and back then I was always out to impress the man.

So off we went, on a 10-day California trip that would take us as far north as Eureka and as far south as Los Angeles. We lived in the rental car the whole time except for L.A., where we stayed in a friend’s apartment.

I remember the plane going in for a landing. I looked out the window and saw the Bay Bridge below. It was a gorgeous sight from that height, with the bay glistening in the summer sun. I saw the same view this morning and felt warm and energized. Back then was different. I thought of the Bay Area earthquake two years before, with TV coverage that included a live shot of a piece of the bridge collapsing and a car driving off the newly created edge into the abyss.

I knew we’d be driving over that bridge at least twice.

Terror.

I was afraid of talking to strangers.  I was afraid to go to clubs at night for fear we might get mugged so far from home.

In L.A., we hooked up with a guy who used to live in the Point of Pines in Revere. I didn’t remember him, but he and Sean were tight as kids. Michael was his name. Michael took us to visit a couple of his friends who were living the stereotypical Hollywood lifestyle. They had a band, but sat in their cramped bungalow all day, surrounded by towers of empty beer cans and cigarette boxes, watching all the bad daytime TV they could feast their eyes on.

One of them asked me where we were from. The Boston area, I told him.

“Dude,” he said through the cloud of cigarette smoke encircling his head. “That’s a pretty long way from here.”

The statement filled me with more terror.

A pretty long way from here. From my safe place in the basement apartment at 22 Lynnway, Revere, Mass.

Terror.

That’s pretty much what the trip was. Sean ate it all up and had the time of his life, despite me.

I didn’t know back then that I suffered from OCD-induced fear and anxiety. I was still many years away from the therapy, medication and spiritual conversion. I had no idea what the 12 steps were when I was 21. Too bad, too, because I SHOULD have had the time of my life on that trip, too.

But that’s what fear does. It robs you blind. Robs you of everything that should make life worthwhile.

Thank God I’m done with that shit.

I’ve made this flight many times since then, always on business. But I’ve gotten the chance to enjoy the surroundings and experience the culture along the way.

In small steps, I’ve tried hard to make up for lost time. That gets me in trouble sometimes, because I forget to pace myself. That happened last time I was here in February, and my family paid the price.

Let’s see if I can do better this time.

And maybe one of these days, instead of coming here for work, I can come here for fun. Maybe Erin will live out of a rental car with me for 10 days.

What do you say, honey?

OCD Diaries

The Problem With ‘One Day At A Time’

“One day at a time? You wouldn’t believe the crap that swirls around my head one day at a time.” –Anonymous

Recovering addicts have a saying burned into their brains: “One Day at a Time.” It’s important wisdom to live by. But when the recovering addict has OCD, there’s a big problem.

Mood music:

Let’s look at the meaning of “One Day at a Time.” In the world of 12-step recovery programs, the idea is not to be overwhelmed. Instead of trying to get your arms around everything necessary for recovery a week into the future or a month or year, we subscribe to the idea of just focusing on what we have to do today. Doing this a day at a time makes the clean-up tasks seem a lot less overwhelming.

The problem with an OCD case is that the disorder forces you to do nothing BUT stew over the future. You look at the next week or month and relentlessly play out the potential outcomes of that space of time.

The first time someone told me to take it a day at a time, my first instinct was to punch him in the face.

I had a business trip three weeks away to worry about.

I had a medical test planned for the following month and had all kinds of potentially grim outcomes to worry about.

That’s how guys like me roll.

So how have I managed to keep my addictions largely at bay for well over two years? Simple: I remembered another 12-Step saying (OA saying, more specifically): Fail to plan, plan to fail.”

The Powerfully Recovered website, based on the book of the same title by Anne Wayman, explains it better than I could, so let me share:

One day at a time doesn’t mean we shouldn’t plan

I imagine that this is the very first slogan that found it’s way into the original Alcoholics Anonymous meetings. Can’t you just picture a frantic newcomer talking about how difficult he (and yes, it was only men in the beginning – and the men didn’t think women could be real alcoholics, which is another story…) he was finding sobriety?

I can almost imagine the conversation:

Newcomer: What am I going to do? Next week I have to go to the office Christmas party – how will I ever stay sober there!

Oldtimer (early on, he might have been sober only a week): Slow down, it’s not next week yet. Take it One Day at a Time!

And a slogan is born – because it’s got some real wisdom in it. For in truth, each one of us has only one day at a time – or one hour or one moment. 

Abstaining a moment at a time

In the first few rocky days of recovery, just abstaining for that moment, hour, etc. is truly all we can do. If we can’t do that, there’s no point in worrying about tomorrow, or next week, or whenever. 

The One Day at a Time philosophy has benefits far beyond the early days in recovery. It can keep us grounded in the present – that Holy Instant that is so easy to miss in a busy and productive life.

Planning is okay

Unfortunately, some in 12 Step Groups have taken the philosophy to mean we shouldn’t plan. This is patently false. A major promise of the Program is torestore us to sanity, and that includes the very human blessing and curse – planning. We need to set goals, to make appointments, to design our lives.

But planning doesn’t mean we have to leave One Day at a Time behind – the trick is to watch for expectations. 

It’s one thing to plan and quite another to demand that the plan work out the way we require it too – in that we have no control at all. When our plans bring unintended results – and the often do – all we need do is reevaluate, accept where we are in this moment, and start anew. 

There are a lot of contradictions when you put the sayings “One day at a time” and “Fail to plan, plan to fail” together. It’s like a warm front running into a cold front. You get thunder, lightening and worse. Cars are picked up and wrapped around trees.

But in the end, life is unfair like that. We have to learn to deal.

So even when the OCD in me is planning, planning, planning, I do remember to take my recovery — especially the food plan that helped me break the binging spell — one day at a time.

I can digest life much more fully when the pieces are broken up.

But the push and pull still makes for plenty of confusion.

I Don’t Have Money, But I Have This Bullhorn…

A few months ago I wrote a post about a movie called Machine Man, which deals with a man struggling with OCD.

I mentioned how the film maker, Kellie Madison, was raising money for the film at the grass roots to keep it free of the Hollywood sleaze machine.

This afternoon I saw a message on the movie’s Facebook page saying the money goal hasn’t been met yet:

“Still working on reaching our minimum production goal. Be a part of Machine Man – every donation counts!”

I don’t have money to give right now, but I do have a bullhorn in the shape of this blog.

If you suffer from OCD or know others who do, this could be a groundbreaking, stigma-busting film. Seeing it released would certainly mean a lot to me.

If you can, please help her out. If you don’t have money, spread the word to others who might.

Here’s a press release describing the film and Kellie’s approach:

Veteran Female filmmaker Kellie Madison tackles obsessive compulsive disorder (OCD) with narrative feature film; Kicks off never-been-done-before grassroots campaign to raise awareness and funding

For Immediate Release

FEMALE FILMMAKER TACKLES OBSESSIVE COMPULSIVE DISORDER (OCD) WITH NARRATIVE FEATURE FILM

Writer / Producer / Director Kellie Madison Kicks Off Never-Been-Done-Before Grassroots Campaign to Raise Awareness and Funding

(HOLLYWOOD, CA) – Donald Trump. Howie Mandel. Howard Stern. Each of these men is among the most influential public figures of the world. Yet, most wouldn’t imagine that these powerful people all share a common mental disorder. They, along with millions of others around the globe, suffer from Obsessive Compulsive Disorder (OCD), a neurobiological anxiety disorder characterized by intrusive thoughts (obsessions) and a need to perform repetitive and ritualistic behaviors (compulsions). One in 50 adults currently battle with obsessive and compulsive behavior. One in 25 has dealt with the disorder at some point in their lives.

Just as “Rain Main” brought worldwide awareness to autism and “Children of a Lesser God” eloquently dramatized the trials and tribulations of the hearing impaired, Kellie Madison brings us a narrative film that illuminates the debilitating struggle that millions of people who suffer from OCD go through on a daily basis. “Machine Man,” chronicles the spirited tale of an average man, who struggles with an extraordinary problem, facing his most debilitating fear in order to save the woman he loves.

Far too often, people with OCD suffer in silence because of the shame and stigma associated with this disorder.  Some don’t even recognize what they’re suffering from and are terrified to leave their homes.

To date, a film that addresses the daily debilitating fears associated with OCD has yet to be produced. Film is one of themost powerful mediums for conveying messages to audiences around the world. A feature like “Machine Man” can and will create empathy and awareness for those suffering with OCD. This will ultimately affect change by helping people recognize their disorder and subsequently seek proper treatment.

It takes more than a great script and great talent to get a film off the ground.  It takes funding.  Madison is using her passion for the project to attempt a filming feat no Producer has yet to achieve: raising the entire $2,000,000 budget of the film through philanthropic support from the local community. We need YOUR help in spreading the word.  This grassroots campaign is a unique, ambitious and worthwhile endeavor.  Depending on the level of support, all participants will be rewarded, including the opportunity for a role in the film.  Additionally, partial proceeds will go to the International OCD Foundation.

Kellie Madison, as well as experts from around the country are on board and available for interviews. We would appreciate your help and the opportunity to spread the word about this amazing project.

Fear and Resentment. Resentment and Fear

For mental defects like me, a lot of what goes wrong is driven by fear. One thing I’ve learned in a 12-Step program for addiction is that the root of many fears is resentment.

Mood music:

You don’t have to be an addict to have resentments, of course. Most typical families, work environments and fellowships come packed with people you’re inevitably going to clash with. The more you disagree with someone, the more you’ll resent them.

Then, whenever you face situations where the one or more people you resent are present, you’ll be filled with fear: Fear about potential arguments, fear over whether you’ll look “normal” enough to avoid their ridicule, fear over how you’ll perform in public.

I have plenty of my own examples.

–Fear of arguments when dealing with my mother got so bad I had to put the relationship on ice for the sake of my sanity.

–Fear of Erin leaving me kept me from saying what I needed to say when we’d have the arguments that are part of every marriage.

–Fear of getting jumped and kicked around kept me from continuing my walks along Revere Beach in my early 20s, after the October 1991 incident.

–Though I’ve gotten very close to my stepmom in recent years, we used to clash all the time, which gave me a fear of any family event that required me to be in her presence.

Those fears filled me with all kinds of resentment toward those people and situations. In response, I plunged into addictive behavior with ultra-reckless abandon.

Fear and resentment are what keeps the hole in your soul from closing up. Until you deal with it at the roots, you will never truly be free or sane. That’s why as part of working the 12 steps, we’re supposed to write down all our resentments and work to make amends whenever and wherever possible.

Chapter 5 of the AA big book covers this extensively. Here’s an excerpt, along with an illustration about resentments:

—————-

Resentment is the “number one” offender. It destroys more alcoholics than anything else. From it stem all forms of spiritual disease, for we have been not only mentally and physically ill, we have been spiritually sick. When the spiritual malady is overcome, we straighten out mentally and physically. In dealing with resentments, we set them on paper. We listed people, institutions or principle with who we were angry. We asked ourselves why we were angry. In most cases it was found that our self- esteem, our pocketbooks, our ambitions, our personal relationships, (including sex) were hurt or threatened. So we were sore. We were “burned up.” On our grudge list we set opposite each name our injuries. Was it our self-esteem, our security, our ambi tions, our personal, or sex relations, which had been interfered with? We were usually as definite as this example:

I’m resentful at: The Cause Affects my:
Mr. Brown His attention to my wife.Told my wife of my mistress.Brown may get my job at the office. Sex relations
Self-esteem (fear)
Sex-relations
Self-esteem (fear)
Security
Self-Esteem (fear)
Mrs Jones She’s a nut – she snubbed me.
She committed her husband for drinking.
He’s my friend.
She’s a gossip.
Personal relationship.
Self-esteem (fear)
My employer Unreasonable – Unjust – Overbearing –
Threatens to fire me for drinking and padding my expense account.
Self-esteem (fear)
Security.
My wife Misunderstands and nags.
Likes Brown.
Wants house put in her name.
Pride – personal sex relations – Security (fear)

We went back through our lives. Nothing counted but thoroughness and honesty. When we were finished we considered it carefully. The first thing apparent was that this world and its people were often quite wrong. To conclude that others were wrong w as as far as most of us ever got. The usual outcome was that people continued to wrong us and we stayed sore. Sometimes it was remorse and then we were sore at ourselves. But the more we fought and tried to have our own way, the worse matters got. As i n war, the victor only seemed to win. Our moments of triumph were short-lived.

It is plain that a life which includes deep resentment leads only to futility and unhappiness. To the precise extent that we permit these, do we squander the hours that might have been worth while. But with the alcoholic, whose hope is the maintenanc e and growth of a spiritual experience, this business of resentment is infinitely grave. We found that it is fatal. For when harboring such feeling we shut ourselves off from the sunlight of the Spirit. The insanity of alcohol returns and we drink again. And with us, to drink is to die.

If we were to live, we had to be free of anger. The grouch and the brainstorm were not for us. They may be the dubious luxury of normal men, but for alcoholics these things are poison.

We turned back to the list, for it held the key to the future. We were prepared to look for it from an entirely different angle. We began to see that the world and its people really dominated us. In that state, the wrong-doing of others, fancied or real, had power to actually kill. How could we escape? We saw that these resentments must be mastered, but how? We could not wish them away any more than alcohol.

This was our course: We realized that the people who wronged us were perhaps spiritually sick. Though we did not like their symptoms and the way these disturbed us, they, like ourselves, were sick too. We asked God to help us show them the same tole rance, pity, and patience that we would cheerfully grant a sick friend. When a person offended we said to ourselves, “This is a sick man. How can I be helpful to him? God save me from being angry. Thy will be done.”

We avoid retaliation or argument. We wouldn’t treat sick people that way. If we do, we destroy our chance of being helpful. We cannot be helpful to all people, but at least God will show us how to take a kindly and tolerant view of each and every one.

Referring to our list again. Putting out of our minds the wrongs others had done, we resolutely looked for our own mistakes. Where had we been selfish, dishonest, self-seeking and frightened? Though a situation had not been entirely our fault, we tr ied to disregard the other person involved entirely. Where were we to blame? The inventory was ours, not the other man’s. When we saw our faults we listed them. We placed them before us in black and white. We admitted our wrongs honestly and were willing to set these matters straight.

———————

I’ve done a lot of work to overcome my resentments and, at the very least, keeping those resentments from destroying me.

I’ve been able to path up a lot of relationships with old friends I had lost touch with after one petty falling out or another. I’ve worked at being a better arguer with my wife, though she’ll tell you — and I know — that i still have a lot of work to do. And I’ve done specific things to overcome fear: Getting on planes, walking alone in areas I had feared.

You know the saying: Face your fears.

The issue with my mother is one of the few left unresolved at this point.

Fear hasn’t left me. But it no longer controls me.

I owe much of that to strong support from my wife and children, friends and that 12 step program.

OCD Diaries

Shove That Golf Club Where The Sun Don’t Shine

I’m in a self-righteous lather after reading a column on CNN from Jeff Pearlman, a columnist for SI.com called “A Father’s Day Wish: Dad’s, Wake The Hell Up.”

Jeff is a stay-at-home dad who has heard the stories from moms in his community about how their husbands would never change a diaper or wake their children up for school or clean up their puke.

Mood music:

An excerpt:

The woman started crying.

I didn’t expect this, because, well, why would I? We were two adults, standing in a preschool auditorium, waiting for the year-end musical gala to begin, talking summer plans and Twitter and junk fiction and all things mindless parents talk at mindless events. Then — tears.

“My husband,” she said, “doesn’t care.”

“Uh, about what?” I asked.

The floodgates now open, she told me her husband works from home. But he never drops their daughter off at preschool. He never picks their daughter up at preschool. He never wakes up with their daughter, never puts her to bed, never takes her to a movie or a carnival or a ball game; never comes up with fun daddy-daughter activities. “All he worries about is golf,” the mother said. “Sometimes he’ll take her to the driving range for an hour. But that’s it. …”

Two days later, by mere coincidence, a different mother cornered me. I was sitting in a pizzeria with my son, Emmett, and daughter, Casey, gnawing on a calzone. The woman, another preschool regular who always seems to be dragging around her kids with the worn look of a chain gang inmate, glanced my way and muttered, “My husband would never do that.”

“Do what?” I asked.

“Be out alone with both of the kids at once,” she said. “Never.”

Never?

That dads would carry on this way is of no surprise to me. But hearing about it still makes me angry.

Because it’s like looking in a mirror.

I’ve always been a hands-on dad. I clean up the throw up, bandage the scrapes and read to them daily until they started to read on their own. I still make the lunches, and while I don’t work from home every day, most weeks I get them up, dressed, fed and off to school a couple days a week as a matter of routine.

But when my OCD and addictions were slowly eating my brain, all I wanted to do was lay on the couch and watch TV. I didn’t want to talk. I sure as hell didn’t want to play.

Being a better dad has taken a lot of work. I still have a ways to go. I still get tired and lose my patience with them. I still have moments when I just want to be a vegetable. I’m not as good at watching my mouth around them as I used to be. Sometimes I have a hard time looking up from the computer when they’re trying to tell me something.

But I will never, ever choose golf over my kids.

Nothing against dads who like to have their golf outings. But to prefer golf all the time over family, well.

Fuck you.

We dads must do better than that.

All the blog posts I run Sunday will be about my kids and my father. Not to celebrate me, but to celebrate them.

Because Father’s Day is about them more than about us.

broken_golf_club

Shit Happens When Two OCD Cases Work Together

Let me take you back about 13 years, when two guys with clinical OCD worked together in the same office. I was one of ’em. The other was an old friend named Steve Repsys.

Mood music:

Neither of us knew at the time that we had OCD. It would be many years before we were diagnosed. In the meantime, we worked together for a small weekly newspaper in an office in Chelmsford, Mass. I was the boss and I acted like it.

I was always stressed about just getting the paper done on deadline. Quality didn’t really matter to me. OCD will do that to you: Getting the task done always takes priority over doing it right. Steve was the whipping boy, the sole reporter. I pushed him hard, nearly to the breaking point. He never let me down. But along the way, he would work so hard that his mind would go into loops. One loop involved a worry about finding an apartment. Another was about whether he would get a promotion. All normal things to worry about, except that he was clinically unable to shut up about it.

I carried on the same way about other things. Whenever the going got tough, we would both bitch about everyone who made it possible.

During the small windows of downtime, we would convene in my apartment a few steps away from the office and play Star Wars Trivial Pursuit. Star Wars was very important to us back then.

He eventually went on to another role in the company, and I went to The Eagle-Tribune.

We both got married and had kids. And in recent years, from different states, we’ve come to grips with our mental disease.

Steve and I have been going back and forth sharing our struggles of late, and he recently embarked on a hard-core program to understand his quirks and develop the necessary coping tools. And he was kind enough to write down his experiences to share with you.

So allow me to step back and let Steve take over for the rest of this post:

If you broke your leg, wouldn’t you want to get it treated? Chances are you would get help immediately. Why is it that when it comes to mental illness we let ourselves suffer?

Maybe it’s because in many cases a mental illness isn’t as “obvious” as a broken leg. Maybe it’s embarrassment to admit there might be something not quite right about ourselves. Maybe it’s because the term mental illness conjures up someone in a straightjacket. Whatever the case, mental illness is nothing to fool around with.

I should know. I suffer from OCD.

Most of my life I’ve considered dwelling on things and keeping myself up at night worrying about the future as part of my being. However, after nearly four decades on this earth, I realize I don’t have to live like that anymore. How do I know this? Thanks to strong persuasion from my wife Kara, I recently enrolled in a partial hospitalization program (PHP) to treat mental illness.

All along, the warning signs were there for my OCD. The trouble breathing, difficulty keeping focused, and even chest pains should have alerted me that something was not quite right. When a perceived or a real crisis occurred, I would go into “shut down” mode. Most often I would deal with my problems by trying to sleep hoping they would magically disappear when I woke up.

My obsessive worrying about my family’s finances was gradually driving a wedge between me and my wife. Instead of coming home from work wanting to be a husband to Kara and a dad to my two little girls, I would dwell on the negative. Looking back, I can see why my wife wanted me to get help. At the time, it was hard to see and I thought worrying was something I was supposed to do. I even saw worrying as a badge of honor. The more I worried, the more I thought it proved how much I loved my family.

When my wife first told me about PHP, I thought I didn’t need any help. However, the more I thought about and looked at myself honestly, I realized that maybe I did need help. Worrying was truly running my life.

To no great surprise, an evaluation confirmed that I had OCD. I started PHP immediately. PHP met 9:30 a.m. to 3 p.m. five days a week for three weeks and covered a wide range of topics including medication, support systems, spirituality, music therapy, and cognitive distortions in a small-group setting.

One of the most important realizations about myself came on my third day at PHP. Looking at the sheet for the day, I remember seeing there was a discussion entitled “Victim/Survivor.” I wasn’t looking forward to it, thinking that it dealt with someone who was sexually or physically abused. The discussion did pertain to victims and survivors, but not in the way I thought.

To my surprise, I felt like this talk was made especially for me. We talked about how survivors are proactive and victims are reactive. Survivors display an “I-can-handle this” mentality while victims cop an “it’s-not-fair-and-this-isn’t-shouldn’t be- happening-to me” attitude. I realized that almost all my life I walked around thinking of myself as a victim. “It’s not fair that we pay more in day care than our mortgage,” and “I can’t handle things” were just some of my more constantly consuming thoughts.

This was probably one of the biggest “a-ha” moments in my life. It dawned on me like a ton of bricks that my way of thinking was not productive for me or my family. I don’t know why it took at that particularly moment to come to the conclusion that instead of being an ostrich that puts his head in the sand, I needed to be a problem solver. I’m just glad it did.

Even while I was at PHP my thinking was put to the test. I noticed that I began thinking more in “survivor” terms. During my stint at PHP, my cell phone was going to be shut off for nonpayment. Instead of getting upset about it and thinking how “unfair” it was, I got into problem solver mode. I called up the cell phone company and told them I got paid in a few days and I would be happy to settle the bill when my check went into the bank. Lo and behold, my carrier agreed and the problem was solved.

While that may seem like a small thing, it’s a big deal to me. Prior to PHP, I would have avoided dealing with the situation or even would have asked my wife to take care of it for me. I can’t guarantee that I won’t fall apart in the future if something doesn’t go as planned, but at least I have new found coping skills at my disposal.

The three-week program greatly helped me in other ways as well. During my time at PHP I learned how important goals are (in fact we started the day off by making daily goals) and that I benefit when I have structure in my life.

In addition, I realize that it’s important to know what triggers my OCD. Now that I know what sets me off (my finances), I can pull out some of the tricks I learned at PHP to extinguish my OCD thinking.

After attending PHP, I realize that I’m not miraculously “cured” from my OCD thinking. I realize that OCD will always be with me, but I don’t need to be a slave to it. I now have a toolbox that’s filled with many instruments to keep my OCD at bay.

PHP showed me that life is always going to be filled with obstacles and problems but I hold the keys to controlling my life.

Readings From The Book Of Crap, Volume 2

I’ve been observing amazing acts of stupidity in recent weeks.

Mood music:

When I do, my first instinct is to keep it to myself. Nobody likes a whiner, and I’m no exception. But when the poop pile gets too high and starts to stink up the room for everyone else, I need to kick open the door and vent the fumes.

So please indulge me as I tell a few unnamed people how they’re making the world a harder place for the rest of us.

This isn’t meant to hurt feelings, though I’m sure it will anyway. It IS meant to knock some sense into people who are capable of doing good but waste time on petty bullshit.

–To the parent among those in my children’s school and scout community who thinks it’s perfectly fine to use his friends as weapons against his ex in divorce proceedings, stop it. You’re making the other grown-ups uneasy and making some of them feel betrayed that you would use them like bullets. This makes the rest of us leery about being your friend. When all you’re friends are gone, you’re all done.

–To the folks who quibble over whether the street walker they pick on is a deranged Vietnam Vet or just a well-to-do guy who lives on the sidewalk for fun, stop it. You’re stupid to think it even matters if he got his mental illness in a war zone or not. The guy has a mental illness and deserves compassion. Instead, you “liked” a Facebook page dedicated to making fun of him.

–To the health insurers who label mental health care as a luxury instead of a necessity, cutting sufferers off from the things that can make them well again: The only way to describe what you do is evil. This is partly why people with mental illnesses can’t get better.

–To those who suffer from mental illness and do nothing about it: You are also contributing to the stigma. When you don’t do your job and you hide from people who love you, you are hurting everyone around you more than yourself. I know because I used to be just like you. It’s time to take a leap of faith and do something that scares you.

–To the fellow church-goers who think themselves more morally pure than everyone else and are quick to judge others, you are missing the whole point of your faith. Go back to Sunday school and get it right.

–To the folks who go on Facebook and Twitter to bitch about how mean the boss is or how unfair a family member is, stop. For one thing, your boss is probably on Facebook too, and they will fire you over your public airing of grievances.

–To those who dismiss all addicts as idiots who either need sense knocked into them or need to be locked away. Sometimes they do. But addiction is a disease, not an attitude problem. The only attitude problem I’m noticing is yours.

–To those who write off suicides as damned souls: True, suicide is a mortal sin. But those who do it are often so mentally ill that they’re not doing it in a moment of sanity or clarity. They have fallen to a disease. When you oversimplify their actions as the stuff of quitters or sinners, you do more harm than good to those who need help for mental illness, not ridicule. You’re also forgetting that you sin with the best and worst of ’em.

I feel better now. And since I didn’t name names, nobody got hurt. If you noticed yourself in here and you are hurt, don’t blame me. You got some work to do.

Marital Differences in Style, Part 2

Last week, my wife Erin and I shared some dirty laundry about our differences in writing styles. We’re back for round two. This week isn’t as removed from my usual subject matter as last week, because my approach to writing today is far different from the days when my OCD ran out of control. See Erin’s full post on her blog, “The Writing Resource.”

Mood music (“Right Write Now,” Van Halen):

Like last week, I’m pulling out parts of Erin’s post, which you can find on her blog, “The Writing Resource.” Her parts are in italics.

4. Outline your idea.

I know, outlines are tedious. Outlines are what your sixth grade English teacher made you do for your essay assignment. At this point, though, you should have tons of notes on your idea. If you start writing now, you might quickly get lost in the process: Which idea is most important? What do you think about this point or that argument? What do I really think about what I’ve learned?

I’m pretty sure Bill would say he doesn’t use outlines. Writing one or more stories a day, you train yourself to organize your ideas quickly in your head. It may not be something he writes down, but you’d better believe he’s got some idea of how he’s going to tell his story before he starts writing it.

Five years ago I was a relentless outline writer. I would approach them like a draftsman would approach the design for a house. I would rewrite the outline two to four times. I would send my editors each version, to the point where their eyes probably glazed over.

I’m not sure when I stopped doing outlines, but I’m a lot happier as a result.

Today, when I have an idea or the research and reporting to put a story together, I dive right in. Call it the “ready, fire, aim” approach or the “shoot first, ask questions later” tactic, but that’s how I roll.

I type furiously, heavy metal music grinding away at my ears (I always have the headphones on when I write). Then I go back and see if I left behind any typos and other mistakes. I clean those up and that’s that.

It’s not that I see outlines as a useless exercise. I don’t. It’s that I no longer see the need to write out the outlines. Once I’m ready to write, I already know what my lead paragraph is, and the rest flows from there.

It may be that outlining was a compulsion that went away as I got a grip on the OCD. Or it could simply be that I’ve been doing this for 17 years and I can pretty much write in my sleep.

5. Write your first draft

If you’ve been following this process so far, you’ll actually be writing the fifth draft of your idea. See how far you’ve come in your writing already?

 The more work you put into the first four steps, the easier this step will be. Again, you may not use everything in your outline. You may go back and grab something from your notes. You may discover a hole you hadn’t seen before, and do more research. All of that is fine. Writing can be circular sometimes.

For me, once I’m writing a draft, I try to write it all at once, making notes of where I need to go back if necessary. Everything’s fresh in my mind, ready to jump onto the page. This is where I get really irritated if I’m interrupted. Yet if I’ve got a good outline and I do have to break away from the writing, I’m fine. It might take me a little bit to reorient myself, but I’ve got the road map to get me where I’m going.

Erin and I aren’t that much at odds here. The differences is that once I start writing, I don’t approach it as a draft. I’m going for the kill. I’m writing what I expect to be the final version.

Obviously it doesn’t always work that way, because on the first read back I see things to fix. But most of the time, particularly with hard news stories, there’s a formula that’s etched inside my skull: There’s the lead, the nut graph and the rule from there is that every paragraph that follows must relate back to the nut graph, which the more academic among you might call the thesis paragraph.

6. Read through and rewrite.

Don’t think that because you now have sentences and paragraphs that you’re done. If you can let your draft sit for a day or even an hour, do so. Taking a break will help you see your draft with fresh eyes.

 Read through your draft, and then start rewriting. This is where the art comes is and is what most people think of as writing. Sharpen your focus, tighten copy, play with word choices, question whether you need a comma here or there, think about sentence breaks. Put your words into their best clothes, wash their faces, comb their hair.

How much should you rewrite? Until you’re satisfied with it or until you run out of time. Deadlines can be a great motivator for getting the work done, and they can also tell you when you’re done.

Actually, if I have sentences and paragraphs I am pretty much done. As Erin says, deadlines can be a great motivator and I’ve been living with deadlines since the beginning. Even when there isn’t a real deadline, I write as if there were. When I set a time limit for myself, I’m more likely to bang out cleaner copy the first time around.

There’s no science to this. It’s simply how it works for me.

I do engage in a little rewriting. Typically it involves scouring for basic typos and finding passive sentences to turn into the active voice. But that’s it.

Once it’s out of my head, it’s done.

That either makes me freakishly polished as a writer or just plain reckless.

Writing is a lot of work, and what most people think of as writing is just a small part of it. If you go straight from the idea to rewriting, you’ll end up frustrated and with nothing to show for it. Dig in and do the work, and you’ll be much happier with the results.

It is a lot of work, but the notion that you’ll end up with zero if you go straight from the idea to rewriting doesn’t work for me. I do agree you have to dig in and do the work. You have to do your homework on the subject matter before you write.

If you start writing based on an idea that’s not backed up with solid research, you won’t have much worth reading.