Chapter 24
Mom calls me out of school for the rest of the week and takes an emergency leave at work.
My whole body fills with relief when she tells me.
I won’t have to face Forrest or the rest of my friends just yet.
Even though I know it will be all right if I tell Jayden and Makayla what’s been going on, I’m still not completely sure.
Part of me is still scared, still whispering to me about how it could all go wrong.
I try not to listen, I try to block the voice out, but it doesn’t really work.
She emails her therapist and gets a list of recommendations for people who work with teens and take our health insurance.
I don’t leave the house the entire weekend; I’m afraid if I go out the thoughts will come back and I’ll lose control this time.
To keep my brain as quiet as I can, I watch hours and hours of shows and movies.
On Monday, Mom calls me out of class again, then emails my teachers and asks them for extensions on all my missing work. It feels good to be babied.
On Tuesday, Mom drives me to my appointment with the first therapist on the list.
“Remember,” she says once we’re parked. “If you don’t like her, we have more options.”
I nod. We get out of the car and make our way inside.
It’s a newer office building in one of the neighborhoods in North Seattle, nestled on a side street, next to a community garden.
The elevator takes us up to the seventh floor, and we step off into a waiting room lined with windows, a hallway stretching away from it on either side.
I can see doors spaced along it, and a few people wait in chairs for their appointments.
We’ve been sitting for only a few moments when a woman appears. “Sidney?” she says. Mom squeezes my arm, and I stand, moving toward the therapist.
“Hi there,” she says with a warm smile, her eyes crinkling. “I’m Tracy.”
“Hi,” I say, following her. She’s a few inches shorter than me, her hair cut like Shar’s but brunette. She’s dressed in classic Seattle wear: dark jeans and a black fleece jacket open over a crew-neck shirt.
“My pronouns are she/her,” she says.
“They/them,” I answer.
“Great.” She pushes open a door farther down the hallway and we walk into her office. It’s a small room, but cozy, a dark green two-seater couch against one wall, with a bright yellow accent rug and a round wooden coffee table.
“Tea?” she asks, turning on the electric kettle on her desk, which sits against the wall opposite the couch. She sits in the office chair and spins to face me.
“Sure.” I sit down on the edge of the couch. “I didn’t know therapists made their clients tea.”
She chuckles. “It’s not required, but I like to. I have some fidgets there too, if you want one.” She points out the bowl on the coffee table, and I lean forward, rifling through it until I pick up a squishy rubber cat. It reminds me of Brekky.
“Chamomile or peppermint?” she asks, and I pick chamomile. A moment later, a steaming mug sits in front of me, and Tracy is peering at me over her own cup.
“So. Tell me what’s on your mind. Your mom gave me the rundown, but I’d love to hear it in your words.”
“Yeah.” I nod. It feels easier, somehow, to open my mouth this time and say the words. “So. I’ve been having these . . . thoughts.”
I tell Tracy the whole story, the way I told it to Anna.
She asks me questions here and there, about what the voices sound like, where they come from, if I see the images in my head or in the world around me, how I react when I have the thoughts.
She asks about what’s happening in my life, if there’s anything stressing me out or weighing on me, so I tell her about Dad, and about Forrest, and the Queer Alliance, and my homework.
When I’m done, she takes a sip of her tea. “Have you ever heard of obsessive-compulsive disorder?” she asks.
“OCD?” I frown. “Yeah . . . that’s when you’re like, a clean freak, right? Like, you can’t stand germs and have to wash your hands a lot.”
“Not exactly,” she says. “There is what’s called contamination OCD, where the primary fear is of being, well .
. . contaminated somehow, often by germs. For people with that subset of OCD, they have a lot of thoughts or mental images about this fear, this obsession, and they engage in actions—rituals, or compulsions—to try and manage those thoughts. ”
“I don’t have that,” I say.
“Yeah, it doesn’t sound like you do. But there are other OCD obsessions too.
Anything you can think of can be an obsession.
So someone might be obsessed with the idea that harm could come to someone they love.
They’re having a lot of thoughts about it, a lot of fear and maybe mental images of how that harm could happen, or inner voices telling them it will, and their compulsions might revolve around trying to prevent that harm or ensure that it hasn’t happened.
The compulsions can be external, like having to call that person to make sure they’re OK, or they might be internal, like reviewing your last interactions with that person or the route they might take to work or the activities they do every day, to figure out whether they’re all right or how they might potentially come to harm.
” She turns the mug in her hands, watching me.
“That’s . . . me,” I say slowly. “It happens a lot.”
Tracy nods. “Rejection or abandonment could be another obsession. Or suicide.”
When she says that word, it’s like my whole body lights up from my toes to the top of my head. “You mean . . . I don’t actually want to kill myself?”
“You’ve told me you don’t want to.”
“I don’t.” I shake my head. “But why would I have those thoughts?”
“That’s what happens with OCD,” she says. “That’s why it’s so tricky. It convinces us that our thoughts are our reality—or that they could be. That there’s meaning behind these thoughts. They’re called intrusive thoughts.”
“I know that phrase,” I say. “Like—I let the intrusive thoughts win!”
Tracy smiles. “Totally. But the meme isn’t accurate to what intrusive thoughts actually are. They’re not the random, benign impulses we get. Intrusive thoughts are opposite our values, opposite what we actually want and think and feel and believe. And everyone has them.”
“Really?”
“Yep.” She nods.
“Everyone has them,” I repeat. “Everyone has random thoughts about jumping in front of a train. Or their dad getting killed in a freak car accident. Or all their friends turning on them.”
“I know.” She leans forward in her chair.
“But it’s true. The difference is, most people say ‘oh, that was a weird thought,’ and move on.
With OCD, we give that thought meaning. We think it says something about us.
And it’s usually to do with something deeply important to us, which is why it’s so distressing. ”
“Oh.” I’m kind of hearing what she’s saying, but I’m still stuck on that part where everyone has thoughts like mine. Except not everyone freaks out over them. “Why does MY brain have to do this? Like, what went wrong?”
“Nothing is wrong with you,” she says. “No one really knows for sure what causes OCD. Like a lot of things, it’s probably a combination of nature and nurture.”
“Do you have OCD?” I ask.
“I do!” She raises her mug. “Cheers to both of us.”
I snort and lean forward, grabbing my mug. It’s still warm, and the taste of the tea is calming. “Cool, so how do I make it stop?”
“That’s a great question,” Tracy says. “We don’t.
Trying to stop the thoughts can be a compulsion, and engaging in compulsions makes the obsessions worse, even if it initially helps.
Instead, we work on accepting the thoughts, accepting the uncertainty of what could happen, and . . . we just let them be and move on.”
“I have to accept . . . that Shar might get killed?” I raise my eyebrows. “I have to accept that my brain plays me little horror movies about all the ways I could commit suicide?”
“Yup.” Tracy nods. “It’s easier said than done, I know, and there are other tools that come into play besides mindfulness and acceptance.
The gold standard of OCD treatment is exposure and response prevention, where we help you experience your fears without doing compulsions.
That helps teach your brain to process your intrusive thoughts as just thoughts. ”
“What about the voices, though? And the images . . . they just feel so real.” I swallow, staring down at the mug. “Are you sure I’m not crazy?”
“There’s nothing wrong with having a mental health condition,” Tracy says.
“And certainty isn’t the point. But I can tell you what you’ve told me: The voices are inside you, not something you hear externally.
The images are in your mind, not something you’re seeing outside yourself.
The thoughts and images you’re experiencing are very upsetting to you and not aligned with your values or what you actually know or want or believe.
That’s OCD. If you were hearing and seeing things externally, or if you wanted to die, that would be a different conversation and a different diagnosis. ”
I nod. “OK.”
“We’re almost at time,” she says gently. “But I want you to know this doesn’t have to be your experience forever. Successful treatment is very possible. And medication is something we can try too.”
I nod again, and set my mug back on the coffee table. “Thanks,” I say. Something inside me settles, like a cat finding the perfect place to curl up. I have a diagnosis now. And it’s something she can treat.
I don’t have to feel this way forever.
The first thing I do when I get home is text Anna. So . . . apparently I have OCD.