Teaching with OCD

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Obsessive-Compulsive Disorder or OCD can overwhelm your brain and fill it with spiraling thoughts that feel beyond your control. If you aren’t careful it can take over your life. I remember when I was first diagnosed I thought teaching with OCD was impossible. Over the years and after a lot of therapy, I found a way to manage my OCD in my professional life, and I would love to share what I’ve learned with you.

My therapist once said she’d like to send all of her patients to my job. In her opinion, constantly being around kids with autism, who tended to grab body parts, act impulsive, or disregard cleanliness was the best treatment. My OCD was set off daily. 

When I first started working with a student on the spectrum, I’d been diagnosed less than a year ago. I had just started grad school and had my first part-time job helping implement a student’s home therapy program. 

I wasn’t on medication and had no idea how to not compulse, just that I wasn’t supposed to do it. At the time learning to breathe underwater would have been easier. 

Cut to know, I don’t remember the last time I compulsed. Despite the fact that there’s a pandemic and I’ve never been under more stress. My job doesn’t trigger my OCD anymore. 

That didn’t happen magically. That took a lot of work, and today I’m going to share with you how I did it. 

This is off-topic of what I usually talk about, but I remember when I first started teaching, I scoured the internet trying to find this blog post. It wasn’t there, so I thought I’d write it myself.

What is OCD?

OCD or obsessive-compulsive disorder is a no-fault brain disorder. The last time I checked, it is not technically considered an anxiety disorder. The way it works is something triggers you or sets you off.

You then can’t stop thinking about it.

Even if you try. 

Don’t ever suggest someone with OCD just let it go. Trust me, obsessing about something is uncomfortable. If we could stop, we would. 

This obsession builds up in your brain. You can’t let it go, and it creates a lot of anxiety. So much anxiety you think it’s going to kill you.

So you compulse to make the anxiety go away. That calms you down, for a while.

However, compulsing tricks your brain into thinking the anxiety was real in the first place. Therefore it will come back, maybe in a few minutes or days, and next time it will be worse.

For example, once I was hiking with my mom and my sister in Rocky Mountain National Park. As part of the trail, you had to scramble up the waterfall. We scrambled up and ate our lunch. It was gorgeous.

Then on our way back down, I saw someone had fallen. There was blood on the rocks, mixing with the water. That meant it was everywhere. I was paralyzed with fear.

If I touched that I would get HIV or hepatitis. My life would be destroyed because I touched some rocks. 

It took a lot of coaxing for my family to get me down. 

When we made it to the bottom of the waterfall, I immediately started asking my sister and mom, if she thought I’d touched the blood.

That was the only topic of conversation I would engage with for the two-hour hike back to the trailhead. I asked them to reassure me so many times, I consider it a miracle they didn’t kill me. Especially, considering how we were in the woods. There were plenty of places to hide my body.

How Do You Treat OCD?

Believe it or not, we people with OCD are actually pretty lucky, at least when it comes to mental health disorders. I say this as someone who works with children with autism, for whom there is no clear treatment plan that consistently works and gets results. 

The gold standard for treating OCD is to use a combination of ERP and ACT.

What is ERP?

Sadly ERP is nothing like ESP. We will not be learning how to make psychic predictions. 

ERP stands for Exposure Response Prevention. It sucks, and I hate it. It also is the reason I am doing as well as I am, so I also love it. 

The theory behind it is, with the help and support of your therapist, you trigger your OCD. That’s the E (exposure). 

You put yourself in or create a situation where you begin obsessing. 

If I were to do an exposure for the waterfall example, I would go hiking that trail again or imagine being on the waterfall and seeing the blood.

Then comes the RP (response prevention). After purposefully triggering an obsession your therapist then helps you learn to not compulse. 

The theory behind it is that stopping the compulsion prevents you from training your brain to worry about the obsession. 

Your anxiety spikes. It gets worse, but after twenty minutes of not compulsing, your brain realizes you aren’t immediately going to die and your anxiety goes down. 

If I were doing an Exposure for the waterfall example, I would have to imagine walking over the bloody rocks without asking if it was safe or seeking reassurance when I got down. 

It’s hard, and it sucks, but it works.

What is ACT?

ACT stands for Acceptance Commitment Therapy. Basically, it is about accepting things as they are and not doing anything about them. So in ACT therapy, you learn to not act but accept. 

My mother was a Buddhist and I think of ACT as basically Buddhism but without the spiritual element. The exercises for act encourage meditation and acceptance. Noticing thoughts and stimuli but not engaging with them or judging them. 

You see why it works well when combined with ERP. Nocompulsing allowed. You might get a horrible disease and die from some blood on the rocks. There is nothing you can do about it. 

ACT teaches you to accept the possibility that the obsession is real.

Eventually…

It takes time. You don’t dive right in with ERP, but start small. 

However, over time, when combined with ACT, ERP is over 90% effective at treating OCD.

That is why I say we are lucky compared with a lot of other people with no-fault brain disorders. 

Our treatment plan sucks but if you stick with it, you do get better.

Is Teaching With OCD Possible?

At first, I didn’t think I could be a teacher with OCD. My therapist told me otherwise. She said changing my life to accommodate my OCD was no better than letting myself live a life filled with compulsions.

She was right, and I’m so glad I listened to her and didn’t just get a desk job. 

When you have OCD you need to live a life based on your values, not your feelings. I value helping children. Teaching fulfills my life, even if I have to do it with OCD nagging me. 

If you are teaching with OCD make sure you are on a path that you find fulfilling and that adds value to your life. 

Make decisions for yourself and your students based on your beliefs and experience. Don’t do something just because OCD thinks it’s a good idea. I have done it many times, and it has never ended well for me or my student. 

Try to ask yourself what you would do if OCD was not a factor in your life.

Choose a Trusted Person

Part of me can’t believe I wrote that last sentence. 

I said to my therapist, too many times for me to count, that I don’t know what I would do without OCD because it’s been around so long it just feels like part of who I am.

Those are the times when I don’t know where the OCD ends and the rest of my brain begins. 

The first thing I did, when I started my professional career, was find an understanding and compassionate mentor. She and I have gone on to work several cases together, and she is one of my best friends. 

When I was confident I could trust her and she wouldn’t judge me, I told her about my diagnosis. She was full of a lot of compassion and said if there was ever anything I need to ask.

When I get stuck and can’t decide what to do out of fear of compulsing, I go to her. This is a technique my therapist suggested. I call it “Ask one person.”

I get to ask one person in my industry how to handle something. Then my therapist and I consider their response to be standard. Asking anymore we consider a compulsion. 

To be clear, I’m not asking my friend to make the decision for her. Just using her thoughts to establish what a typical person might choose. I’m still responsible for compulsing or not compulsing and making my own decisions. 

This system has worked well for me. If it sounds doable to you, talk to your therapist and start trying to think of who your one person can be.

Be Kind to Yourself

While the treatment might be incredibly effective, it doesn’t work overnight. These things take time.

Often people with OCD don’t seek treatment until they’re homebound, unable to hold a job, or truly stuck.

If you’re reading this, and you’re able to teach with OCD you are on the right path towards recovery. Living a normal life is within your grasp and you aren’t as alone as you think.

Books and resources on OCD

It’s Nobody’s Fault by Harold S. Koplewicz (not about OCD specifically but No-Fault Brain Disorders)

The Man Who Couldn’t Stop by David Adam (nonfiction)

Turtle All the Way Down by John Green (fiction and good for teens)

Mindfulness Workbook for OCD

Anxiety and Phobia Workbook

International OCD Foundation (websites and conferences)

The Mighty (website)

Final Thoughts

Normally I focus on writing about being a SEIT or one on one interventionist on the blog, but this topic is so important to me, I had to share. 

Remember, don’t let your OCD rule your life. You are still a worthwhile teacher with a lot to offer your students. Teaching with OCD is completely possible. 

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