This is a summary, select quotations, and responses from myself to Jonathan D. Huppert and Jedidiah Siev’s article “Treating Scrupulosity in Religious Individuals Using Cognitive-Behavioral Therapy” as published in Cognitive and Behavioral Practice 17 (2010) pp. 382-392.

It is perhaps the best article I have read for practitioners or patients on the treatment of scrupulosity.

The Meat

• “Treating religious patients with scrupulosity raises a number of unique clinical challenges for many clinicians. For example, how does one distinguish normal beliefs from pathological scrupulosity? How does one adapt exposures to a religious patient whose fears are related to sinning? How far should one go in exposures in such cases? How and when does one include clergy in treatment?” – pg. 382.
  • As someone who suffers from scrupulosity this issue of discerning what is normal belief and what is pathological is very difficult, and is (from my perspective) what sets scrupulosity apart from other forms of OCD – in which the individual is generally aware of the unreasonableness of their actions.
• “…the presence of religious symptoms in OCD predicts poorer treatment outcomes according to some studies (Alonso et al., 2001; Ferrao et al., 2006; Mataix-Cols, Marks, Greist, Kobak, & Baer, 2002; Rufer, Grothusen, Mab, Peter, & Hand, 2005) but not others (Abramowitz, Franklin, Schwartz, & Furr, 2003).” – pg. 382.
  • I’d like to read more on this, as my personal experience is that my more generic OCD symptoms respond well to medication but scrupulous symptoms are much more resilient. I have not experienced ERP, other than self-instituted.
• “…healthy members of the religious community, including clergy, may inadvertently reinforce rituals by offering reassurance or expressing admiration for the rituals, a process somewhat analogous to the positive reinforcement received by individuals with eating disorders for losing weight.” – pg. 382.
  • This is very true and one of the challenges for all ministers. Interestingly, Dr. Ian Osborn in his book Can Christianity Cure Obsessive-Compulsive Disorder?  suggests the prevalence of OCD in contemporary society may be the result of changes in society, meaning that this problem may not have been as rampant before 1500 or perhaps 1000 AD. I’m unsure that I agree with this hypothesis.
  • It should be noted that clergy have not always been unequipped to deal with scrupulosity. While the techniques may have at times been primitive, soul care in church history has provided for the care of the scrupulous, it is more recently when Christianity cut itself off from much of its history that these methods where lost.^[1]
• “Hence, although the choice of exposure and response prevention (EX/RP), a first-line treatment for OCD, is indicated in the literature for treating OCD…, its implementation for religious patients with scrupulosity necessitates nuanced modifications…” – pg. 382.
• “The core fear across religions within scrupulosity is related to a fear of sinning. At the same time, the typical manifestation of scrupulosity differs by religion. Whereas displeasing God, going to hell, and devil worship are common obsessional themes among scrupulous devout Christians…, especially born-again, Protestant, or Pentecostal, obsessional themes among scrupulous ultra-Orthodox Jews more closely follow the forms of general OCD themes, such as contamination/washing and doubting/checking… For example, a patient may fear contamination and wash excessively, but in the case of scrupulosity, the feared contamination is religious (e.g., dietary or menstrual impurity, cleanliness before prayer).” – pg. 383.
• “…how does one distinguish OCD from strict, devout observance?…The most straightforward, obvious answer is by asking the patient whether others in their religious community have the same beliefs and behaviors.” – pg. 384.
  • This is very useful. In general the individual will be practicing beliefs in a way not practiced by others – even if they are in a strict / legalistic religious community^[2]. One difficulty though is that some practices are not well-known as to frequency. For example, who prays and how often do they pray and what do their prayers consist of?
• “Our stance (once OCD is clearly identified as the main presenting problem) is that OCD attaches itself to each individual’s most important or core values, but is not caused by those values (cf. Rachman, 1998). Thus, the fact that they have scrupulosity and not a fear of contamination or of being responsible for something horrible happening like a house burning down is because they view serving God and adhering faithfully to religion as high priorities.” – pg. 385.
  • This is comforting. For the scrupulous our fears oftentimes circle around whether we are doing what is appropriate/necessary/good in our relationship with God (which I usually counter by emphasizing God and His grace/power). Yet, still, it is comforting to think that the reason I struggle with these doubts is b/c OCD centers on what is core to my life.
• “They include the idea that OCD fears are not latent desires to be an apostate; to the contrary, they are OCD’s method of turning the patient’s own core values against himself or herself (the response to which—as in judo—is to harness the power of the attack against the aggressor; in the case of OCD to accept the thought. That is, to say to oneself, “I accept the risk of this sin,” thus not engaging in a mental battle with the OCD).” – pg. 385.
  • In my case I suppose this might look something like, “I accept the risk that by not entering into single-focused prayer^[3] I am disappointing God.” The good news for me is that while I may disappoint God, God is bigger than me and saved me in spite of, not because of who I am.
• “This distinction between true awe of God accompanied by a desire to serve Him versus obsessional fear of God resonates well with many patients. According to most religious systems, the service of God is not supposed to lead to suffering, but to a sense of peace, connection, and fulfillment. The extent to which a patient’s experience is inconsistent with this can indicate that religious awe—and even fear—has been appropriated by OCD.” – pg. 385.
  • I disagree with the statement that “the service of God is not supposed to lead to suffering” but agree that it should lead to a “sense of peace, connection, and fulfillment” – I do not think these are mutually exclusive. Suffering is a significant part of the Christian’s experience as we resist temptation and experience God’s refining fire at work within us, healing us and making us whole.
  • On the other hand, I do agree that I can see my OCD is self-centered…That is, it focuses on my self and what I need to do to make things better rather than upon who God is and what He is doing in my life. I unthrone God and throne myself in a very subtle way. I also lack the ability to truly demonstrate love and care for those around me…so while I may avoid most sins of commission, I am greatly offending in sins of omission.
• “…it is best to avoid antagonizing religious individuals with concepts that they may find counter to their belief system, such as the evolutionary function of anxiety. Instead, one can discuss what function anxiety serves, or why God created people to experience anxiety.” – pg. 385.
  • YES! The theory of why we have anxiety from an evolutionary perspective is not necessary to treating anxiety and is a significant stumbling block for many Christians.
• “…explaining the effects of thought suppression is extremely important, with particular implications for many religious individuals. The patient may resist exposure to thoughts deemed unacceptable on religious grounds; however, by accepting them and allowing them to exist in his or her mind, the patient will actually reduce the long-term frequency and intensity of such thoughts (e.g., blasphemy).” – pg. 385.
  • This is akin to the old joke, “Don’t think about purple elephants….What are you thinking about?” (Purple Elephants). When we focus our attention on not thinking about something, we automatically draw it to mind. I oftentimes occur thought replacement – focusing on something else instead of the negative thought (e.g. moving from contemplation of my sinfulness to God’s glory and grace). I hypothesize that this is not always possible however and sometimes accepting the thought may be the only way forward.
• “At first, the prospect of accepting sinful thoughts seems at odds with the notion found in many religions that they should be stopped or annulled, and generally we find it unhelpful to attempt to dissuade patients who believe otherwise that thoughts are morally inconsequential. Indeed, there is some evidence that religiously normative beliefs about the moral importance of thoughts are unrelated to OCD (Siev, Chambless, & Huppert, 2010). Rather, we encourage patients to consider the differences between intentional and unintentional thoughts, and between intentional thoughts for the purpose of enjoyment and those for the purpose of treatment (i.e., exposures).” – pg. 385.
  • The problem here, from my perspective, is that we (the scrupulous) underestimate rather than overestimate the sinful nature of our thoughts. Our thoughts are much worse and our minds more depraved than we imagine…while this thrusts us initially into despair, it also free us – b/c we recognize that God is the only means by which we can be freed of them and our own petty attempts to free ourselves are not working and will not work.
• “Overcorrection is an important EX/RP technique. By tolerating more extreme exposures than are necessary in typical daily living, patients provide themselves with room for backsliding without impact on functioning, and more importantly, conservative tests of the likelihood of their feared consequences coming to fruition.” – pg. 386.
• “Knowing that a patient washes or checks is insufficient to design effective exposures, for which one must understand the core fears and the function of the rituals at the most basic level possible.” – pg. 386.
  • This is something I have thought of in other words, but which appeared fresh to me as written here.
• “How does one encourage a religious patient to accept the risk of sin?…we make a clear distinction between risking the possibility of sin with normative behavior and purposefully sinning. The former is a natural part of life—one cannot live life without some level of risk—and in EX/RP we increase the level of risk without going to the point that the level of risk is forbidden by religious law…we do not believe it is of value for a therapist to encourage a religious patient truly to sin or even to say “I am sinning” while taking a risk.” – pg. 386.
• “Even this approach is not readily accepted by all devout patients. Some argue that living a religious life requires avoiding not only sin, but any behavior that approaches sin. There is Talmudic precedent, for example, to set up boundaries and fence-laws to distance oneself from sin (Mishnah Avot, 1:1).” – pg. 386.
• “If necessary, the therapist can try to establish that for individuals with OCD, distancing from sin has become a goal in its own right, ironically more than serving God, and therefore tolerating acceptable risk of sin facilitates the service of God.” – pp. 386-7.
  • Very true.
• “…most religions have a concept of forgiveness for sins, which inherently suggests that one will inadvertently sin.” – 387.
  • Yes, though I am not sure this is particularly helpful to the scrupulous. I know that Scripture indicates that I will sin, that I am not perfect but am being perfected by God, yet the question that always haunts is, “Am I willingly giving in to this sin?” At some level it seems that I must be willingly giving in to the sin…so I am not sure I can see it as an “inadvertent sin.” Again, this is depressing but also freeing – in that I am again pressed back in dependence upon Christ rather than myself for justification and perfection.
• “…it can be more effective to evaluate the relative value in (a) striving to achieve good acts and a positive relationship with God and to religion by accepting a risk of sin, versus (b) excessive and distressing pursuit of absolute avoidance of one sin at the expense of other sins or opportunities for positive religious experiences (e.g., excessive ritualistic prayer interfering with religious study or at the expense of helping others).” – pg. 387.
  • This echoes my thoughts on the commission of sins versus the omission of sins and that it can be demonstrated to the scrupulous that they are entering into more sins of omission by embracing their scrupulosity than they would otherwise commit actively.
• “Imaginal exposure is particularly indicated when OCD fears are difficult to confront or disconfirm in vivo, and can be helpful in treating scrupulosity in general, and in leading patients to tolerate acceptable risks. In such cases, the goal of the imaginal exposure is to create scenarios that depict engaging in relatively low-risk behaviors that end up causing extreme consequences. For example, one might create a script in which the patient refrains from cancelling a negative thought with compulsive prayer, opting for the long-term goal of satisfaction with life and religion instead of compulsive behavior to neutralize the risk that the thought was truly sinful. The scenario would continue based on the patient’s idiographic fears—that eventually the community rejects them for being evil, that they die and are judged to damnation for not having repented for that one thought, or that the decision to risk sin initiated a downward spiral into a life of sin. Conducted as such, imaginal exposure is an exposure to the feared consequence, but also a means for experiential cognitive challenging. In the context of imagining the consequences of sin, the patient may recognize their efforts to avoid even the possibility of inadvertent sin as excessive or inconsistent with their religious beliefs.” – pg. 387.
  • I wonder, do those without OCD/scrupulosity feel the same anxiety as I (and I suspect other scrupulous individuals) feel when simply reading this?
• “…outside the context of treatment, clergy can inadvertently or unknowingly make recommendations that perpetuate a religious OCD patient’s anxiety. Unhelpful responses from clergy include telling a patient that they will burn in hell for evil thoughts that must be purged, suggesting that more meaningful or intensive prayer or study of their religious canon will reduce intrusive thoughts, stating that psychologists have no business dealing with issues related to spirituality, suggesting rituals to cancel intrusive thoughts…, suggesting that the patient is correct in not taking risks of sinning, and encouraging overt avoidance. In other cases, the clergy provides direct reassurance in a way that facilitates the vicious cycle of obsessions and compulsive reassurance seeking.” – pg. 387.
  • It is important for us as ministers to humbly engage those we are ministering to. It is too easy to apply blanket methods of interacting with those struggling spiritually, whereas each individual requires the unique ministry God allows us to provide via the power of His Holy Spirit.
  • If we are good listeners, I think we will hear many of the subtleties in folks problems and more readily address the problems they are actually facing rather than the problems  we project or infer upon them.
• “To whatever extent possible, we encourage the patient to stop asking any questions related to their OCD concerns and instead to accept the doubt…” – pg. 389.
  • It is important for a minister to refuse to enable the scrupulous. Not only can this consume all the minister’s time, but it will have no beneficial patient (other than some short-lived and ultimately negative relief).
• “Sara reported that she understood that she needed help, although at many times she wished she just were not Jewish, in which case she would not have such problems.” – pg. 389
  • I can echo that. “If I was not a Christian I would not have to struggle with not…”
• “The therapist asked the patient whether (a) others agree that such risks are forbidden, and (b) whether there were other things she was not doing that were preferable to continual cleaning and washing rituals.” – pg. 390.
• On pg. 390 the authors discuss constructing a fear hierarchy in which we rank how severely each potential action or thought causes anxiety and then attempt to battle these thoughts/actions. This seems like a very useful tool in treating OCD generally and scrupulosity specifically.
• “These instructions shifted the burden of proof from demonstrating that something was permissible (e.g., via consultation with the rabbi) to demonstrating that something was questionable before asking.” – pg. 390.
  • This goes along with the Ten Commandments for the Scrupulous.
• “It was communicated that she needs to learn to “trust her soul” (i.e., to trust her implicit intuition) and not seek explicit reassurance by asking questions, checking, washing, or mental reviewing.” – pg. 391.
  • I am not sure I would want to use the phrase “trust her soul” but rather “trust God.” The scrupulous attempt to remove all doubt – but their is always doubt and risk. This may in part be a failure to trust oneself (as created in the image of God) but also is a failure to trust in God (who created us and will communicate us in strong enough means to exemplify His message).

1. ^[1] I am not suggesting that we should follow all the traditions of the ages, but I do think that it is a mistake to write off what has been learned in prior generations. ↩
2. ^[2] Though if the leader(s) of the community are scrupulous, it is possible that they will only be matching the intensity of the religious community. ↩
3. ^[3] By this I mean prayer in which my sole attention and energies are focused on prayer, not the “always” praying that many others think of, which to my scrupulous mind oftentimes seems too close to “not praying.” ↩

In any case, this last week has been rough. Charity casually remarked, “Makes sense, its another holiday.” It is true, the last time I was panicking this badly was over Christmas. I’m interested to see whether on Monday or Tuesday everything has cleared up.

For the time being not only has the anxiety and depression been back but the chronic pain in my legs has flared up as well – are they related? Not sure…Only time will tell.

It makes me think of one good friend in particular who struggles with anxiety. This individual will ask for reassurance about the same topic repeatedly – every few minutes, over days, and months…and when the issue finally resolves itself another anxiety pops up to take its place and the cycle repeats itself.

No matter how much reassurance I or anyone else may give this individual it is never enough and can never be enough…sometimes that is how I feel.

My brother, Paul, is getting married soon and asked me to be his best man. I said yes, of course, and am completely honored – but, I feel anxiety pulsing through my veins. Then there is the couple I’ll be marrying soon – now I ask myself where the blood is, as it is evident that only anxiety could be pumping through me.

Don’t get me wrong. There is nothing I want to do more than serve as my brother’s best man and marry this couple. I sometimes don’t want to share these anxieties b/c I know that then sometimes people won’t ask me to do something for them like this – and I don’t want that to happen. For all the pain and anxiety I experience, I still want to live and to give…and I would be deeply saddened if someone didn’t ask me to be their best man or to marry them b/c they were worried about the pain and anxiety it would cause me.

I think I’ve gotten fairly good at saying “no” and “I’m not able to.” I’d much rather folks asked me and I had to say no, than for folks to try and save me from the pain and anxiety by never asking in the first place….and realistically, if I avoided everything that stressed me out and made me anxious, I’d just stay inside all day and do absolutely nothing involving other people…and I don’t think anyone wants that (I don’t).

Tangentially, if folks began doing this (or are doing this), it is unlikely that they are avoiding asking me for stressful things…b/c not even I can predict what will cause me anxiety or grief…and oftentimes what seems minuscule will be a bigger issue than some major stressor.

(big) Stuff that freaks Charity (my wife) out I am able to take in stride, but minor little items sometimes send me into a complete psychological paralysis…

….I think I am about to get my two good hours out of today. It has been rough being physically sick in addition to psychologically ill. Usually I can work for two hours at a time (when I am struggling only psychologically) and then need a break…but now, I find myself with two hours in an entire day. Interestingly, the more ill I feel physically oftentimes the less ill I feel psychologically. I think my bodies’ concern for my immediate physical health overwhelms all senses regarding emotional health.

And now I remember why I began writing this post…after having strayed so far. So I know one of the things that causes me anxiety is when I need to think about something intently (e.g. bachelor party). I want to think about it, but as soon as I begin thinking about it I feel anxiety, depression, and cerebral fog settle in. Then I push it off only to increase the anxiety by lessening the period in which I have to prepare such and such.

David Allen’s book Getting Things Done has been very helpful in this arena as has Asana which has helped me practically implement GTD. I’ve also read several good books on ADD – which appears to be part of my issue in addition to OCD and depression.

So, I continue to read and search…hoping for a cure, or at least a better quality of life…now my research is not only psychological but also physical, as I attempt to get back my health. Today was spent largely in bed with my legs elevated. It feels like there is some sort of waste in them, that is draining out when elevated…but put them back down and they begin to fill again…sit down and its like inserting a dam and I’ll pay for it later.

No real news from the doctors at this juncture. This morning I went in for more bloodwork – this time to test my adrenal functioning. Thursday I have an appointment with an ophthalmologist b/c my eyesight has been deterioriating, and then sometime I have another neurological appointment to get EMGs and etc. Also hoping to get a second opinion from a rheumatologist and would love to get a SPECT scan for the mental health issues, but don’t even know where to begin in looking for that…

So that is where I am at. Yes, I struggle with depression a lot  but in spite of all of the above I’m not feeling particularly depressed right now. I just finished watching a gritty foreign film about the drug trade which reminds me that my suffering is small in comparison to many and how much I desire to relieve suffering, not just my own.

Over the past number of days, even though still on a maintenance dose of prednisone, I could feel myself slipping back into depression. It was agonizing to slowly watch my mood slip away from me…to know that I was falling back into a dark hole. Granted, that hole is where I live most of my life – but after being in the daylight it is so much harder to return to the darkness.

Yesterday it finally hit with all its fury, an awesome terror of darkness. Every desire within me was sucked out and I felt like I was drifting on a sea to which there was no end, with no wind, no purpose, no hope.

I will not pretend that at moments like these death appears like a ray of sunshine, a relief from all that is misery. I know, I know, “don’t talk like that” but it is true. All I can see of life in those moments is the miserable challenge of going on…and there is not much (realistic) hope when the darkness subsides – for it is only the dark darkness that ever lifts, the darkness itself is ever present – and so I move from absolute and utter turmoil to a manageable turmoil – a sublimated turmoil which can be hidden behind a smile, forgotten with a laugh, departed for a time – but which always returns…like a friend who will not take the hint and leave one alone.

So, now, I am back to the darkness. The dark darkness has lifted, but it is still dark. And some would say to me, “How can I have the passion for learning you do?” Just find the darkness and it will drive you. You’ll learn everything you can in hope that there is some respite from the darkness. The darkness is the taskmaster that drives me…

February 11th, 2002:

Crap! I hate my life. Why must I always be convicted of the smallest nothings? Why cannot I live like any other normal person? Why must I be such an idiot? I hate my life. I wish for the sweet peace of death and eternity with Christ where I will no more sin nor have to worry about sin nor worry about my past deeds. I hate this!

In the past several days I have asked Phil if he was offended by my (jokingly) calling him a heathen b/c he had his ear pierced, told a guy I said things about Dr. —– which I shouldn’t have (don’t even remember his name),^[1] and told my mom that I did not watch the Matrix for the reasons I told her I did.^[2] Now I am convicted about such things as playing too roughly with my siblings and scaring…Jeremiah’s little brother, I don’t even remember his name.^[3]

Ohh God, how much longer must I suffer under this conviction? How much longer before I may have peace? Will you always turn your face from me and give me no wisdom? Must I always be lost in this pit? Why have you forsaken me? I seek your face and yet feel as if it is hid from me. I push on every day behind the mask of peace and serenity and yet within my soul is the utmost turmoil. Can I have no peace? Will you not allow me to move on? What am I to do with these matters? What can I do to rectify them? How can I in any way make better what I have done. I feel like swearing Lord, I want to let loose, I want to die. I do not want life anymore, Father, please will you give me snakes and rocks? Can I have bread and wine? Must I always seek and never find? When I knock on the door will you never answer? Ohh, God, please. Forgive me for my trespasses and show me the way that I am to go. I feel so guilty! And all I want to do is swear. I do not want to speak to you, I do not want to speak to you. I type this now b/c I am afraid as soon as I get on my knees I will lose the desire and stand again. OHHH GOD!!! GOD DO YOU HEAR ME? MUST I EVER STAND THIS WAY? PLEASE HELP ME! GOD!!! PLEASE!!!

Okay, I have to clean my room, but I ask for your help. Am I to press on? God? God? God?

I know you’re out there…I know you hear me….I know you love me….I just don’t feel like it. Ohhh God, please. Please. Please. Please.

Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Please. Give me peace by life or death, O Lord, I beg of you. Amen. May your will be done on earth as it is in heaven. Forgive me for my anger. Amen.

1. ^[1] I was unhappy with the class and did not like the way the teacher taught it. ↩
2. ^[2] I have no remembrance of what reasons I gave and whether they were accurate or not… ↩
3. ^[3] I don’t think the scaring was intentional, the memory is so faint – I think I walked into a room or something and he just happened to be frightened by the surprise of my presence. ↩

In the sense of OCD this seems somewhat intuitive. The brain locks itself into a cycle of hyperactivity…but with ADD it seems less obvious. If the brain is “hyperactive” then shouldn’t focus increase? But in fact focus decreases, or at least the ability to volitionally choose what one will focus on decreases.

Similarly, depression seems to have some correlations, at least to Dr. Daniel G. Amen with overactivity in the brain…but this usually results in reduced feeling, reduced appetites, reduced motivation, and so on. This seems counter-intuitive.

I think this well describes the way I experience my brain as functioning. Lets take a look at what might be a typical “free” day for me (I’ve bolded those items which are pertinent to this particularly post, but also included other aspects which are interesting, although I am not sure how they figure into this…):

• I awaken groggily. I do not awaken feeling refreshed or awake, it is a struggle to get out of bed.^[1]
• I begin reading – email, websites, books. I dive into whatever material might interest me.
• As I continue to read and learn I experience a significant number of thoughts operating simultaneously – all productive. I make intuitive connections between topics. I feel energetic and inspired.
• Reading or working on whatever eventually gives way to a feel of being overwhelmed, listlessness, and depression. I experience existential angst. I feel uncertain about my ability to know or understand, hopeless in my ability to change or lead, I feel overwhelmed by the act of existence.
• I want to relieve my existential angst, so I seek diversion – a tv show, a movie, a video game, a chore, or sleep.
• Upon awakening I usually feel somewhat refreshed and repeat the learning, working, experience until I again experience this existential angst and stop, relieve existential angst, and repeat.
• This cycle may continue throughout the day and night. If I am interacted with during a period of stability I will respond well, but I have extreme difficulty being sociable when I am attempting to relieve the existential angst.
• This is made the more confusing by the fact that alternatingly, the work / learning can relieve angst rather than cause it – in fact, it usually does so for a period of time until it doesn’t…at which point it becomes again overwhelming.

Now, at one level I view this as being the natural result of learning / working – the suffering of existential angst. At another level, one might ask if this existential angst is caused by the overheating of the brain – at which time I then embark on emergency cool-down measures, and when the brain has cooled sufficiently I reengage it.

As someone who works in IT, the commonalities with my experiences with computers are interesting. For example, we oftentimes see computers which can run a certain process effectively – but that over time or with increased stress will fail. Placed into a state of rest (or even just rebooted) they will be able to pick up the pace again.

Even more interesting is that there is sub-optimal functioning at which the system is at rest (being relatively unproductive), a state of optimal productivity (at which it is accomplishing much), a state of over-optimal productivity (a  slope which leads to overheating and crash), and the state of crashing/crashed.

Ideally, one would desire to remain (whether as an individual or a computer system) at the level of optimal productivity – but it seems that some law inclines us towards increasing productivity which eventually results in a loss of productivity.

Now, the question is, how do we correct such improper functioning? The temptation is to provide pat answers with simplistic explanations. Please don’t – those make me angry.^[2] If it was quite that simple I am sure I would have gotten it all figured out and settled already. On the other hand, I believe that most things are relatively simple to comprehend but difficult to exercise.

[Consider this somewhat free-flowing thought, I am not here writing in my usual prepared way in which I carefully consider or edit my thoughts...which I do quite frequently, but rather this being a stream of consciousness in which I am expressing emotion which I recognize may not be the "way it ought to be," - but I think before something can become the way it ought to be, we must acknowledge the way it is.]

Now, there is an additional difficulty – at least for me. That is that social interactions can be a means of augmenting my functionality, but they also cause me to overheat. Charity likes to talk through problems when they occur, I like to cool off first. It is not that I am emotionally volatile, but rather that I feel a certain almost physical sensation of being overheated. My brain is foggy and requires cooling down before it will be able to think logically or reasonably about what it feels.

At this juncture most folks just want me to express my feelings – “tell me how you feel” – the difficulty here is that one cannot readily describe what one feels. if one where to vocalize it it might look something like:

“BZZZZZZZZZZZZ. Buzz. Pop….Stop. Turn. Red. Flashing. Frozen. Running. Interrupt. Sky…Dash. Defeat. Death. Victory. BUZZZZZ. Fog. Mist. Incapable. Enable. Anger. Sorrow. Flip. I need to finish project x at work. Why are the dishes….? Buzzz. Leave me alone. Help. Go away. Come closer. What? I didn’t hear you. Wait, I did hear you, my ears have just not yet shared with my brain. Processing. Why does it take so long to hear?”

But that is so short, repeat that over and over with variation a thousand times and one begins to get a picture. It is not just the randomness and the pain, but the consistency and duration of it which are distracting and frustrating.

….

I enjoy interacting with people – though not over small talk. I hate small talk, small talk makes me want to crawl out of my skin. I want to talk about substance. Or we can talk about just about anything as long as I am doing something else. Let me clean, build, work, and I will talk small.

But mainly I prefer substance. Talk to me about theology, philosophy, social justice, politics, history, science, fiction, the brain, the world, anything which makes my brain come alive.

But then there is this point at which, even if I am enjoying myself I experience the overheating or the inability to continue on. I find this time period to be about 2 hrs., though occasionally it may extend longer (very rarely) to 4 hrs. At this juncture my ability to care dissipates.

This makes it somewhat difficult to maintain friendships. Friends like to spend long periods of time together. I don’t. I can’t. Spending more than a few hours together is painful. I like frequenter, shorter episodes of interaction. Let us simply existence together, with interaction occurring naturally – but at mutually agreed upon times. Let us not be dependent upon each other – but mutually enjoy one another. You cannot need me to be there, instead simply enjoy me there. I need the ability to float and flit about to my own compass, experiencing life without interaction until at some magical moment we both or all feel the need to interact at the same time and then that experience may come and pass, and when it is gone it is gone and there is no use holding onto it though it is likely to reoccur if given enough time.

…..

One way I’ve found to cope with this overheating is to play video games while working on something else…so I read or write while playing a video game. This is frustrating b/c I would rather just work and be more productive – but I may be able to go eight or twelve hours alternating frequently between gaming and working (I do turn-based wargame, which lend themselves to short turns punctuated by waiting as the other player/computer completes their turn) – whereas left to intense occupation with one task it is unlikely I will survive more than 4 hrs. – oftentimes only 2.

….

I try to keep what I call “experiential” books around me at all times. These are books which do not (usually) significantly increase my knowledge but which allow me to process truths. I read a lot of Max Lucado, I reread Mark Rutland, I read poetry by MacDonald and others – in these works I find experience of truth which settles the brain and calms the heart.

….

One reason I collect books is so that I have them when the time comes…when I need them. Many are knowledge acquisition but many are experiential. I have more books on prayer – well books of prayers – than most libraries…more books on grace than most churches…I have so many b/c I need them so frequently.

….

So how to get better?

1. First, I do not know that there is a “whole” to which I may achieve in this life. I am “better” – probably “better” than I have ever been, yet I am not “whole.” Yet, the inability to become “whole” does not mean that I don’t yet strive to become “better.”
2. At some juncture I’d love to have some SPECT scans done and perhaps some blood tests to evaluate functional anomalies and incorrect levels of various chemicals within my body. Both of these are rather cutting edge diagnoses which are not commonly available. Understanding better the exact combination of misfunctions can be helpful in better reacting against and overcoming these challenges.
3. I have to accept my limitations – which I am much better at doing now than I have been in the past. I no longer push myself to be like everyone else in the same way I used to.
4. There is a need to increase the margin in my life. Dr. Richard Swenson has written an excellent book of the same name on this topic. I have to recognize that when left with inadequate margin in my life I will first sacrifice relationships and diet.
5. I am not sure that I can change this…my felt need for knowledge and solitude is greater than my felt need for relationships or health…and my attempts to bring the latter before the former in my current existence has been futile on a multitude of occasions over a number of years.
6. The only real answer I then see is to increase the margin – thereby allowing me to pay proper attention to health and diet b/c there is time around the “other necessities” of knowledge and solitude.

So, what does all that mean? It means a lot of things…but if I boil it down to two things…I think it means.

a. I’m going to try and move to being uni-vocational. Maybe others can be bi-vocational, God bless them, but it isn’t for me.

b. I’m going to buy that pill box I keep talking about until I can build my super-intelligent pill dispenser, b/c I won’t take the supplements I need (much less eat right) if it takes too much time and diverts me from my felt needs of knowledge and solitude.

1. ^[1] Interestingly, in the past I would feel extremely depressed when I first woke up, this has passed. I think since I have been taking ADD medications…but maybe the timing is coincidental. This depression was overwhelming but I knew if I could get into the shower within ten minutes it would evaporate almost entirely…and so I did…but I realized lately that I do not feel this way anymore. ↩
2. ^[2] I’m not here suggesting I don’t want help, or that others don’t want help when experiencing such difficulties…rather I am trying to express the experiential feeling one has when offered help by someone who is not presently in a situation of experiential angst. There is a certain resistance which the sufferer must overcome, but there is also a certain humility, patience, and empathy which the “helper” may bring that can ease this process. Further, vulnerability is usually useful – but not surface vulnerability. An individual feels alive when empathized with in a meaningful way. ↩

I’ve been struggling hardcore with depression for the last few weeks. It comes on in waves, hitting me like a steamroller and then passing over…then it is back again. There is a constant dysthymic depression that always haunts me, but these times when the curtain is pulled and I descend into major depressive are the most frustrating.

What causes it? Good question. I don’t know. There are so many theories, so many plausible causes. Stress is certainly a big contributor and anything that destroys my routine causes stress – which the installation of a new HVAC system at the house and the Thanksgiving/Christmas holidays certainly do.

I don’t want to be or mean to be a grinch…but the holidays are literally painful for me.

Image via Wikipedia

Today I saw a story on Yahoo! about a retired teacher, Stephanie Sinkin, who was hoarding cats. The police and SPCA have found twenty living but extremely malnourished cats and five dead cats – and expect to find more dead cats on a secondary sweep of the house.

I have a tender spot for animals, the older I get the more tender this spot seems to get. I currently have four cats and I love them dearly…even if they do occasionally drive me nuts scratching furniture, knocking down papers, whining, and sometimes defecating in unfortunate locations. It makes me sad and angry to think of animals being abandoned or abused.

Since getting married Charity and I have fostered or adopted seven cats. Of these seven, six came from extremely rough circumstances:

• Charity found Hermione wandering down a highway as a small kitten. She was extremely malnourished with a rough and sickly brown coat of fur.
• Barclay was found with some siblings in a dumpster – a few siblings where dead, but she survived.
• Talbott was found outside, covered in fleas, she would be blind, deaf, and mute for her short life (a little over a year) and remained kitten-sized her entire life.
• George and his siblings wandered into my dad’s house (through a cat door) after being left by an unknown bypasser along with a bag of food on a stone wall on his property.

I say this to reinforce the compassion I feel for animals and the angst I feel when they are hurt or abused…but I also want to reflect on the angst of an individual like Stephanie Sinkin. While I do not know Ms. Sinkin personally nor am I aware of all the details of this particular case it appears evident from the article mentioned above that Ms. Sinkin is likely suffering from some severe mental distress – possibly a form of obsessive-compulsive disorder focused around hoarding. There is a good article over on Wikipedia on animal hoarding as a mental disorder.

I’m not sure what should be done in a case like this. I’m not sure that mental disorders excuse our actions. On the other hand, I think the primary endeavor should be upon helping Ms. Sinkin to get well…and I think, if she gets well, she will likely care for many more animals well in the future than have been lost to her illness in the past.

I sorrow for the animal lives that have been lost and I sorrow also for Ms. Sinkin, knowing that if she does experience recuperation from her illness she will experience deep remorse and regret over the loss of animal life that occurred under her watch.

Finally, I’d note that the greatest tragedy (in my humble opinion) is neither the loss of animal life nor the remorse Ms. Sinkin will face, but rather the failure of society and the community to intervene in this situation.

I am an amateur student of chaos theory and systems theory – which teach me that everything matters and that “no man is an island” as the saying goes. I take this as a challenge to be more intentional in loving others – especially the difficult ones…and I recognize that I myself need this sort of love from others as well.

Related articles

• Hundreds of Dogs Rescued From Ohio Hoarder (carsdonationshelpingpets.wordpress.com)
• Animal hoarding (cbc.ca)
• Confessions: Animal Hoarding on Animal Planet Tonight (animals.change.org)
• Animal ‘Hoarding’ Often Tied to Mental Illness (cherished79.wordpress.com)
• Animal ‘Hoarding’ Often Tied to Mental Illness (nlm.nih.gov)
• Ex-renter sought in cat hoarding at N. Philly rowhouse (philly.com)
• Pets may reduce children’s allergy risk (cbsnews.com)
• Inside the World of Animal Hoarders (abcnews.go.com)
• Metro SPCA overrun by cats (cbc.ca)
• Is it Stuff, Clutter or Hoarding? (parentdwellings.com)