Saturday, August 02, 2008

Can Christianity Cure OCD?

Can Christianity Cure Obsessive-Compulsive Disorder: A Psychiatrist Explores the Role of Faith in Treatment, by Ian Osborn, MD.

Excellent book; terrible title. Exactly the sort of title I would pass by in a bookstore, and in fact did pass by when a friend sent a link to the volume two months ago. What are these people thinking? Don’t they know that Christians with OCD or other interior battles have seen such things a dozen times before, all containing cliché-ridden bad advice from people who just don’t get it? Hey Christian! Why not use that obsessiveness to memorize Scripture, eh? That’ll get Satan on the run! And while you’re at it, here are some short prayers that will allow you to claim victory in the Name of Jesus! All together on the chorus now:
Trust and obey, for there’s no other way…
I can’t tell you how much I have come to hate such people. They are not well-meaning – they are arrogant.

The Epilogue’s title might have been better for the book: “How Obsessive-Compulsive Disorder Saved Christianity.” That has echoes of the popular books How The Irish Saved Civilization, and How the Catholic Church Built Western Civilization. Such a title doesn’t hint at treatment, true, but most people with OCD would be curious and give it a look, even if they weren’t religious.

Ian Osborn gets it. He acknowledges how Christianity has sometimes caused or worsened OCD, and makes careful distinctions in what he advocates. He has been through it himself and now practices at an OCD clinic. He is up on the research; he sees connections between current brain science and the behavior of great figures in the church over the centuries.

In particular, he focuses on Martin Luther, John Bunyan, and Therese of Lisieux, the Little Flower beloved of Roman Catholics. He illustrates from their autobiographical details how each had severe OCD, the terrible advice they often received from other Christians, and how their search for relief from their tormenting thoughts led each independently to a stunningly similar theology, despite their different religious traditions.

As these three would be a good start for anyone’s all-star team of the faith over the last 500 years, we do well to pay attention even if there were no modern connection. But when that theological solution accords with many of the recent advances in cognitive-behavioral treatment specific to OCD and the neurological glitches related to obsessions, we have some powerful stuff here.

I tried to read the book straight through, finding so many previously-unseen connections to my own OCD* that I sought eagerly for more. Yet time and again, I found myself staring out silently, preoccupied with following one of those thoughts through my own experience. As I finished the book, I turned back again to the beginning, this time with a highlighter. Perhaps if I had kept up with OCD research Osborn’s book might have been less arresting, but much was new, and stunning. Thought-action fusion: I had never heard of it but recognized it on sight. Inflated responsibility; add-on obsessions; fixed action patterns. I had known these since childhood and now knew their names. Obsessions and compulsions that had slipped away unnoticed when I went on fluoxetine two decades ago now waved cheerily back at me, stripped of their previous intimidation.

I suspect that non-Christians might also get significant benefit from the book, as might those who suffer from conditions similar to OCD, such as phobias or addictions. The language and concepts are not far off from what one would read in 12-Step literature, and parts of the treatment bear significant similarity to some Steps. I imagine that Osborn’s earlier book, Tormenting Thoughts and Secret Rituals would provide less barrier to a nonreligious person, and he writes approvingly of Jeffrey Schwartz’s Brain Lock, but I haven’t read those and can’t comment.

The Christian clichés come with meat on their bones here. Dr. Osborn emphasizes that trust in God is integral to the treatment, but he describes how that looks in the specific context of OCD. He uses the term “faith” but uses Martin Buber’s distinction between trust in someone and belief that something is true. Finally, you can reflect on where the church would have gone were it not for the corrective of these three giants of the faith and their tormenting obsessions.

*My Y-BOC score in the 1980's was 26. I now score a 14, which seems -heh- normal to me.


Anonymous said...

This is an incredible book. I highly recommend it to family members of OCD sufferers. I finally have some idea of what AVI's been going through all these years.

Dubbahdee said...

What is a Y-BOC score? What does it mean, and how do those number stack up?

Assistant Village Idiot said...

The Yale-Brown Obsessive Compulsive Scale runs from 0-40. 0-7 is subclinical (most people score around 4), Mild OCD is 8-15; Moderate is 16-23; Severe is 24-31; Extreme is 32-40. They are approximations, not like a lab test. All self-report tests have the weakness that the subject might be shading the truth or outright lying; might not perceive her- or himself accurately; or might vary slightly depending on current mood.