Dear Dr. Yael,
I am a frum Jew who typically looks forward to yom tov. However lately I find the yomim tovim become excessively challenging for me with anxiety. I also struggle with OCD in general.
For example, a few months ago I left my house to go on vacation. As I slid into the back seat of the taxi, the doubts hit me “Did I turn off the stove?” I try to ignore these thoughts, but, try as I might, I can’t recall turning the gas off. My feelings of uncertainty grow until they become unbearable. Finally, I give in, and tell the taxi driver to turn around. As he waits outside, I turn the gas on and off endlessly. No matter how much I stare at the stove, I can’t be certain that it is off; instead, each check adds to my nagging uncertainty. I can see it is off, but it doesn’t register in my mind. After what feels like hours, I finally drag myself from the stove and back to the taxi. But as I drive away I picture flames engulfing my house because of my carelessness. All through my vacation awful thoughts of my life’s treasures being incinerated torment me. Despite all my efforts, I had a lot of difficulty driving the doubts from my mind, which obviously negatively affected my vacation.
My OCD also flares up before all of the yomim tovim. I know that this is not what Hashem wants from me, but my doubts plague me. I don’t know what to do anymore.
A Reader
Dear A Reader,
Thank you for your letter. I’m so sorry you are suffering so much and hope my response can point you in the right direction. You state that you have OCD, but for those readers who may not know what OCD is, I will give a quick explanation.
The essential feature of Obsessive-Compulsive Disorder (OCD) are recurrent obsessions or compulsions that are severe enough to be time consuming (they take more than one hour a day) or cause marked distress or significant impairment. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable.
Obsessions are persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress.
Compulsions are repetitive behaviors (e.g. hand washing, ordering, checking or mental acts, that is, counting, repeating words silently, etc.) that the person feels compelled to perform in response to an obsession or according to rules that must be carried out rigidly.
OCD responds extremely well to cognitive-behavioral therapy. Research has demonstrated that cognitive-behavioral therapy is indeed most effective in treating OCD. Specifically, the principles of exposure and response prevention are most effective in the treatment of OCD. Simply stated these procedures are to:
1] Confront the issues and things that you fear as often as possible (building up from least feared to most feared)
2] If you feel that you must avoid something – don’t
3] If you feel like you must perform a ritual to feel better – don’t
4] Continue steps 1, 2, and 3 for as long as possible.
[Getting Control-Lee Baer]
In addition to therapy there are medications that are very effective in treating OCD. There are currently many new medications that are effective in the treatment of OCD and a competent psychiatrist can help you find the best one. OCD is usually treated with a combination of medication and cognitive-behavioral therapy, but if caught early or in certain cases, a person can be treated successfully with cognitive-behavioral therapy alone.
OCD generally has a genetic component. Since people try to hide OCD, family members who suffer from OCD may not know that other family members suffer from this disorder as well.
As a therapist who treats OCD, I find that OCD is prevalent in the Orthodox community. I think that being frum entails a certain amount of healthy “checking” and careful behavior. For example the laws of Kashrus, Mikvah, Hilchos Shabbos, Tefillah, etc., all involve precise behavior and punctilious time management. The need for perfection in observance of these halachos can sometimes lead to erroneous OCD behavior. I often consult Rabbonim to help me in the treatment of OCD with respect to Yiddishkeit issues. They will reassure my patients that their OCD behaviors are in fact not indicative of religious observance. Pesach cleaning is also an area where people sometimes exhibit obsessive behavior. Many rabbis give speeches on the actual halachos of cleaning for Pesach as opposed to behavior which is obsessive.
Please try to seek professional help to ascertain if you do, in fact, have OCD. If you do have OCD, you can be treated! OCD is a disease that people feel embarrassed about and attempt valiantly to hide, but there is no need to do that as you are only hurting yourself more by doing this. If you are suffering, know that you are not alone. Please seek help so that the intense anxiety you are experiencing as a result of your OCD will dissipate. Hatzlocha!
