Because I Come from a Crazy Family by Edward M. Hallowell

Author:Edward M. Hallowell
Language: eng
Format: epub
Publisher: Bloomsbury Publishing

43.

Although we had little exposure to patients in the first two years, in the second year I was able to take an elective in psychiatry and take on the first patient I ever had.

I was assigned a forty-year-old man with obsessive compulsive disorder. I was just learning what that disorder was, reading a couple of texts as well as MacKinnon and Michels’s classic, The Psychiatric Interview in Clinical Practice.

The patient, Hank, needed more than my knowledge from a text. He was crippled by his condition. He could barely leave his house. It’s not uncommon in severe OCD for people to be such slaves to their compulsions that they can’t even go outdoors, which is another disorder called agoraphobia. Hank had that, too.

He was deeply embarrassed by his compulsions, but he found them impossible to resist. His only means of coping became staying indoors, at home. He’d lost his job as an insurance adjuster. His wife was getting fed up, and his three children were starting to mock him.

He told me his story as we sat in a tiny office, barely big enough for the two of us, that was reserved for medical students and their patients. The office had no window, just a desk and two straight chairs, as well as a telephone.

I was able to read some of Hank’s history before I met him, but not the details of his compulsions. I just knew he’d sought treatment for OCD for a year, and nothing had helped. I was surprised, given all he’d been through, at how friendly Hank was. About five foot ten, with a wiry build, he wore steel-rimmed glasses, a V-neck sweater, and loafers. Until he got into the details of his problem, you’d have had no idea there was anything unusual about him at all.

But then, he got into the specifics. “Doc,” he said, his hands clenching as he proceeded, “I can’t walk past an ashtray without stopping, picking it up, and licking it. If it’s one of these ones that’s secured to the floor, I have to lean down and lick it anyway. Ashtrays are everywhere, so I can’t go anywhere. And then my other compulsion is when I take off my underpants, I have to put my face into them and smell them. This one isn’t so bad because I do it in private, but it’s still disgusting and I hate myself for doing it.”

I wanted to burst out laughing. You’ve gotta be kidding me, was what I was thinking inside. Thank God my childhood training in politeness kept me in check. As it turns out, You’ve gotta be kidding me is pretty much every sane person’s honest response when they hear the story of a person who has a serious mental illness.

But as he continued to talk, and I saw how ashamed he was and how constricted his life had become, my initial naïve reaction changed to empathy and concern. Hank was really suffering. I also was worried because I had no idea how I could possibly help him.

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