The discomfort is part of getting you to comfortable
An obsessive-compulsive’s advice on 'reopening anxiety'
When I was a kid, and had gone too long without clipping them, my mother would complain about my “Howard Hughes toenails” (maybe now you begin to see how there was never any alternative for me to a life of jokes premised on morbid, time-obscured references to generationally-anachronistic cultural touchstones). This bleak, dark running joke referred to Hughes’s most disturbed, urine-hoardingest period, during which he had also ceased cutting his nails — a time most people of my vintage might know from the Springfield Casino episode of The Simpsons. When a bearded and long-nailed Mr. Burns snaps out of his Hughes-fugue, Mr. Smithers asks what he ought to do with all those big jars of pee. “Oh, we’ll hang on to those.”
Howard Hughes, the aviator-industrialist-filmmaker-war profiteer, has by now likely been eclipsed by comedian Howie Mandel as the English-speaking world’s most famous obsessive-compulsive. Hughes’s last big cultural moment was his portrayal by Leonardo DiCaprio in Martin Scorcese’s 2004 biopic, The Aviator. For all that film got right about what it feels like to have OCD — for example, the paralyzed terror of standing on the inside of a public washroom, impotently willing some imaginary person on the other side of the door to open it, so that you can leave without touching the handle — it lapsed back into the same lazy Freud-for-books-films-and-television we’re all used to, which must root all mental pathologies in some sort of transgression, innocent or otherwise, inflicted during childhood by a (usually maternal) parent. In the case of The Aviator, the roots of Hughes’s OCD are unconvincingly intimated in a flashback bathing scene with Mommy.
It never occurred to me to blame my own mother for my OCD, either for her too-hot-for-Twitter, now-arguably-ableist toenails jokes or for dying when I was ten, but when I learned, as an adult, that she used to have an elaborate ritual for confirming that all of the stove elements were turned off, I rushed to my psychologist with the news as though I’d found a crumpled, yellowing signed confession related to a cold case we were working. My doctor’s response was almost identical to the one Dr. Melfi had for Tony Soprano when he arrived to a session with the horrified triumph of his discovery that his father, “Johnny Boy” Soprano, had also suffered panic attacks — one of the show’s most realistic therapy scenes in its long run: very mild interest, and then a focus on the patient in front of her.
Tony, at least, had reason to think he’d be chatting about the issue, given that he was receiving talk therapy from his psychiatrist; my doctor, a psychologist, is a cognitive-behavioural therapist, and for those raised on the therapy portrayed in Hollywood movies and New Yorker cartoons, couch-prone dream recitals and lyrical porings over the banks of memory, CBT’s less conversational inclination can be surprising. It’s not that a CBT therapist is uninterested in hearing about their patient’s background, or learning what may have stuck them with their particular combination of pleasure-draining quirks. But they operate on the well-founded and evidence-supported idea that there is no way to reliably talk oneself out of, say, debilitating compulsions, or crippling anxieties. There is no purely intellectual path to comfort. So they work, instead, on equipping patients with the cognitive and behavioural (“There’s your title!”) resources to build their tolerance with anxieties, discomforts, and uncertainties, thereby gradually reducing them over time.
What does any of this have to do with the mostly-wonderful-for-most-of-us announcement earlier this week of the BC government’s multi-step plan for safely reopening the province to social, commercial, recreational, religious, and cultural life over the coming months as the threat of the COVID19 pandemic recedes? My feeling is a lot, especially inasmuch as I could hear my own story so resonantly in the words of those interviewed for a recent CBC piece on those who are anxious about the reopening. According to a poll cited in the write-up, just over half of Canadians are feeling some version of this discomfort — and who can blame them?
We’ve reached an interesting time in journalistic history, when the subjective feelings of our fellow citizens are treated with the objectivity of empirical data (the feelings are real facts on the ground, like a budget or a highway, and can’t be denied) but with the sacrosanctity of religious convictions (the feelings are phenomenologically inaccessible to anyone but the person who has them, and so their validity cannot be questioned, nor their content prodded in any way); like most rules, these ones are imperfectly, unevenly, and even hypocritically applied. As with most cultural phenomena, there are some good reasons for this state of affairs, and some bad ones; the same is true about its effects.
But in a situation like this one, where the feelings are entirely valid while being both ultimately unworkable on a large scale in the long-run (at some point, we have to get back to something like normal, sooner rather than later, and that’s not finally an individual, but a social, decision) as well as potentially being against the interests of the individuals themselves, the typical stance is harder to strike convincingly: all feelings are valid, everybody should just come back at their own pace, do what you feel comfortable with — which is more or less the line of reasoning that the average reader would come away with.
The problem is that once anxiety has entered the picture, we can no longer treat ‘what you feel comfortable with’ as a natural, healthy, or, more importantly, fixed element in the equation. This is, in fact, an inconsistency symptomatic of a larger contradiction between, on the one hand, a new and growing sensitivity to mental illness and, on the other, a commitment to the idea of truth as something rooted in feeling and point of view. The very concession of the reality of psychological or anxiety disorder in principle implies that some feelings are at the very least deeply unhelpful, if not patently wrong and destructive. For someone in a major depressive episode, the advice to do what you feel comfortable with, without any further context, means essentially telling them to stay in bed sixteen hours a day and stop taking phone calls. For someone with OCD, do what you feel comfortable with can mean a lifetime of reassurance-seeking and avoidance behaviours which work to ultimately strengthen the grip of anxiety, despite the short-term relief they may offer.
Now, it’s equally unhelpful to tell the same person in the throes of a major depressive episode to take a salsa class, and a contamination-obsessed OCD patient doesn’t begin their exposure therapy with gloveless midnight alleyway stray needle pick-up shifts. There’s also no precisely correct level of contentment or ease with germs that anyone’s striving for in particular — after more than a decade and a half of treatment for OCD, panic, generalized anxiety, and depression, I know I’ll always be at the sombre end of the dining room dimmer switch of human disposition, and I wouldn’t have touched an Interac PIN-pad without washing my hands afterwards long before any of us had heard about spike proteins or social distancing. But my hands are no longer chapped or bleeding from overwashing, and I’ll tell you this: unlike nearly everything else I’ve overcome in my life, I didn’t talk my way out of that. With support and with guidance, continued, controlled exposure to situations just beyond where I was comfortable helped to expand that category itself — what I was comfortable with — to a vastness I could never have conceived of in the abstract.
I have nothing whatsoever to say in contradiction to the mental health experts interviewed in that piece, who advised patience and generosity (including with ourselves) as we all adjust, at different speeds, to the exultant reopening of our society. And all I have to say to the people interviewed is: I feel you, and I have been there. Grocery shopping, in the early months of the pandemic, for me involved 2am trips to the 24-hour grocery store underwritten by prescription benzodiazepine, until finally my wife decided that she would do the shopping for the household; to my everlasting shame and embarrassment. I think she was worried I was going to get into a fight with somebody, the way I’d reel back and bare my teeth (hard to see under a mask) at any incursion into my 6-foot radius. But I couldn’t handle the panic. I say this to assure any reader, but particularly the trepidatious, that I am at the highest-anxiety end of the COVID-accommodation spectrum, and have been for more than a year.
The only thing I want to add to the conversation is that: just as we all learned, over the past fourteen months, that there were things we were capable of, both socially and individually, that we never would have dreamed we could do until we did them because we had to, so shall it be on the way back in. As has been true all through the pandemic, the best course of action is to follow the letter and spirit of the public health guidelines laid out for your area, rather than trying to figure out a bespoke set of rules for yourself.
I’ve been writing from my experience as an obsessive-compulsive, and as a cognitive-behavioural therapy patient, but I’ll leave you with something from the life of a comedian: stand-up is the kind of thing where, if you do it, people will approach you and tell you that they’re thinking of trying it, too. Almost invariably, people who are considering stepping up on-stage want you to run through all the angles with them, tell them how it’s going to be, and, most of all, tell them if their jokes are going to work. And every single comedian gives those people the same advice: if you want to try stand-up, don’t think about it for too long; the most important thing is to get up on stage and actually find out what it feels like. In six months of one-on-one tutoring, I couldn’t convey to you what you would learn in five minutes standing up on stage in front of actual, breathing people, in your body, telling jokes. It’s harder and it’s easier and it’s more unnatural and more instinctual than you could ever imagine. Every fight or flight impulse in your mind and body are screaming for you not to go out onstage, but if you do it for long enough, you’ll get to a point where you couldn’t even picture not doing it.
To start with, though — when it’s safe, and it’s legal — just go sit in the crowd, first.