"An Autumn of Obsessive Compulsive Disorder" by Monica Kavanaugh
One step. One step. One step. There are 13 stairs, one railing and two lights illuminating the brown carpet on either side. I take two steps, two steps, I return to the first step. I am on the last step, the last step and I run back to the top to start over. The white tile at the end of the staircase tunnel is where I need to be, but I cannot get there. One step, two step, three step. I close my eyes, I open my eyes, I close them and repeat.
It began with the staircase. Each day approaching the stairs became a more difficult task. I just got stuck. Stepping on each step became a matter of desperation, and if I could not do it perfectly then I would do it again. I got stuck on the stairs, in the hallway, the doorway. I could cross the hallway if I ran, but if I ran I would have to do it twice. Over and over. I just knew that I had to. Like a snowball rolling down a mountain side, everything I saw became an opportunity for a ritual, for nonstop thoughts. If I made a mistake in my homework I would cross it out once, twice, scribble it until the pencil tip reached the dull end. Just getting into the car required that I open and close the door several times until my mom turned the lock. The feeling of constant uneasiness overtook me.
That fall marked the beginning of my illness, and with each day the thoughts began to become more vivid and complex in my mind. Swear words became attached to actions that involved the use of my hands—writing, using an eating utensil, dressing myself, brushing my hair. Repeating an action four times was a four letter swear word. As a consequence for not completing an action to satisfaction, the swear words would repeat themselves over and over. I sat in front of my homework for hours, wrestling with the fear of using the pencil. If I picked it up, I could be sure a cascade of f-words and s-words would fill my mind to an extent from which I could not recover. Brushing my teeth involved holding my toothbrush, which again, would release these offensive words. My hands were the source of the click track of obscenities, so my most logical solution was to stop using them altogether. I held my hands in a tight fist.
My family tells me that I was 10 years old that fall, but I tell them I don’t remember. I was paralyzed and consumed by tantalizing thoughts that were tangled deep within me. I was never exactly sure what the consequences would be for standing up to my anxieties—death, eternal damnation, failure, errors, contamination. I was not about to tempt the fates to find out. To those on the outside, I grew reserved and quiet. On the inside I was preoccupied with fear and disquiet. That I could not stop ritualizing only served to make me feel more helpless. Somewhere between the weeks of not eating, walking backwards through hallways and climbing up and down my bunk bed ladder for hours before getting into bed, my mom took me to Miss Sheryl. It was in her small, windowless office that I began to identify these thoughts as obsessions and compulsions.
I am not sure at which point my obsessions and compulsions started taking on a new form, but before I could stop it, my OCD became intertwined with my faith. My family had always been religious and stressed the importance of taking religious commitments seriously. I became profoundly aware and increasingly fearful of sin. Everything became a sin, or a possibility for sin. My thoughts were not logical, and there was a rational side of me that knew this, but I could not resist the obsessions. I was particularly worried about the Communion fast. I would stop eating the day before Sunday Mass to ensure that there was no food in my stomach before receiving the Eucharist. My thoughts would become conflicted when my mom would tell me to eat breakfast before Mass. On one hand, I needed to obey my mother. On the other, I was fearful of breaking the fast. This created tremendous amounts of anxiety in me each Sunday. Which was the lesser sin? To avoid being asked to eat breakfast, I would stand at the top of the staircase until the car was just pulling out of the driveway. I would then run as fast as I could down the stairs and out the door before anyone could stop me.
The first step, Miss Sheryl told me, was to create a list of the things that made me anxious. They called this “Cognitive Behavioural Therapy,” something to “help me feel better”. My hands were clenched shut, so my mom instructed me to open my hands, take the piece of chalk, and listen to what Miss Sheryl was asking of me. My words were scribbles on the brown chalkboard. At first it was difficult to separate my compulsions from my everyday actions. At this point they were one in the same to me, there was no difference. We identified sources of anxiety that fuelled my obsessions and compulsions- utensils, stairwells, car windows, the number 4, sin, eating. We ordered them in a triangle from easiest at the bottom, to hardest at the top. My mom sat with me at each session, reminding me: “This is not you, it’s your OCD,” she would say.
One very prominent obsession that remained with me while the others came and went was the idea that I had to obey my mother. From the beginning of my illness, my mother exhibited tremendous patience; she helped me do the daily tasks that I myself could not do. When I was stuck on a thought, my mother would take my hand and verbally or physically walk me through. I believe I began to associate the fulfilment of an obsession or compulsion with obeying my mother. In order for the thoughts to go away, all I needed to do was do as she said. For those first few months, this created more problems than good. “Go pick up your shoes,” she would say. I would run as fast as I could to the shoes, fearful that if I did not do as she told me as quickly as I could, the thoughts would begin nagging again. A simple “do your homework” or “go get dressed” became an agonizing sprint around the house. There was absolutely no rationale behind my actions and I spent my days dashing from one command to the next. My mother could have asked me to do anything and I would have obeyed blindly.
That fall when my OCD was at its worst, this idea grew into something much more dangerous. It began to be that I would not do anything until I was told by my mother to do it. Get out of bed, get dressed, brush my teeth, comb my hair, walk through the hallway, get into the car, eat meals. My mother had to walk me through my day, commanding me each step of the way. I dutifully obeyed for fear of a horrible consequence if I did not. At 10 years old my mother had to dress me, feed me, help me use the bathroom. There was nothing that I could do on my own- I had to wait for her to give the command. When my mother gave me steps out of order or skipped a specific step altogether, it caused me to lapse into fits of anxiety. “Eat your lunch!” she would tell me. But how do I eat it? A rational part of me knew that I needed to use my fork, but my OCD was telling me otherwise. Mom did not tell me to use my fork. How do I eat my lunch? Before I knew it my face was planted in my plate, chips and sandwich spilling all over the table and into my lap. These episodes were idiosyncratic, consuming and intense.
The triangle that I had drawn in Miss Sheryl’s office was taped to our refrigerator door. I had to start to tackle my obsessions and compulsions one at a time, beginning with the things that caused me least anxiety, the things I was “good” at. We all agreed that I would start small – opening doors with my hands, instead of with my elbows or not opening them at all. When my mom and I got home that day from my appointment, I had to confront my first door—the front door. I stood on the mat twitching and twisting while mom stood behind me. I knew that I had to turn the handle, Miss Sheryl told me to. Exposure. This is what she called it, confronting what made me anxious. When I come in contact with what made me anxious, I had to choose to not do the compulsive behaviour. I shove my clenched fist into the door handle, push it down and run through the door as fast as I can.
Beginning with the door handle began the long process of exposure and response. My mom would remind me each time I got stuck, “It’s not you, it’s your OCD”. Sometimes I turned the handle, sometimes I did not. I had to exercise my mind to confront my fear of opening doors, to make the commitment to not give in to my anxiety and to continue to do so until I could open doors without associating any negative consequences or anxiety to it at all. To my sisters, it was just a door. To me, it was like crossing a street and seeing a truck speeding toward you. At the end of the day I was exhausted and overcome. This was just one compulsion on my triangle of over forty.
With a change in my focal point would come changes in the stimuli of my rituals. Miss Sheryl and I were constantly re-evaluating what caused me most anxiety, what set my OCD into motion. I was particularly worried about protecting myself from germs. Contamination is a common source of distress for individuals with OCD, but my fear would take on new forms weekly. One week it would be that I was worried about what I was breathing in. Soon I began to associate everything around me with giving off a “smell.” I would walk around with my shirt covering my nose and mouth. There were chances for new stimuli all around me, the school lunchroom, close spaces, food, people talking, everywhere I went they followed. Smells became associated with the ritual of covering my mouth, waving my hand in front of my face or backing away abruptly. For example, when my mom would stand over me to check my school work, I could feel her breath on my ear and it would set off a chain of anxieties. Did her breath touch me? I would jump up and wave my hand. What if her breath is still in the air around me? If I finished one ritual and saw an opportunity for another, I would be required to start again. Over and over and over.
My obsessions and compulsions were most frustrating for my family. No one, not even I myself, fully understood why I would ladle my soup with my hands, or flip the light switch on and off until the bulb ran out. I didn’t like it when my family pointed out and vocalized my obsessions and compulsions; it aggravated me and often made them worse. They didn’t know what was going on in my mind to cause me to do such things. My sisters could only see and recognize the outward manifestations of my OCD. They would taunt me when I was stuck in a ritual, or physically force me to open my hands when they were clenched. Because she attended the meetings with Miss Sheryl, my mom had a better understanding of how to control my OCD when things got out of hand. However the lack of logic behind my actions often caused her too to become frustrated and confused.
In the midst of my treatment, somewhere in the middle of my triangle, Miss Sheryl asked me if my family could come to her office for a day. She told me that this was so that I could describe what is going on in my head, and help them know what to do to help me get better. At this point I was working on exposure to much more difficult anxieties and needed the support of my family. This meeting was a time for me to explain my triangle to my family and for them to see all of the obsessions and compulsions that plagued me, not just the ones they observed at home. I told them about the four letter words that I associated with using my hands, how sins were associated with obeying mom and about the tremendous fear I felt when I disobeyed her. As I was talking through my anxieties, my father, who up until this time had been rather passive in my treatment, began to cry. At 10 years old I was too young to understand the magnitude by which my OCD was affecting me. A new light was shed on my OCD, and my family was given the knowledge by which to pull me out of the depths from which my obsessions and compulsions had plunged me.
The next stage of my treatment involved approaching the deeply rooted anxieties, the fears that underlined all of my eccentricities and rituals. These included the religious preoccupations that I had, namely, sin and the fear of sinning. Every action was a result of my fear of sinning. It was irrational, but I was afraid of breathing for fear that I would be breathing in something that was unclean. I was afraid of using my hands for fear that doing so would cause me to use a four letter word that was offensive. I was afraid of disobeying my parents, for fear that I would be disobeying the 4th Commandment, “Thou shalt honour thy father and mother.” Miss Sheryl and I had to “rewire” my thoughts, or that is how she phrased it. We tried this first with the four letter words. Instead of trying to push away the four letter words, or associate them with something bad, I was told I should desensitize myself to them. When I went to pick up a spoon, this time I would confront the f-word and s-word, holding tightly to the spoon and not letting it go to restart the ritual. My mom would repeat to me, “this is not a sin, this is not a sin”. Because I did not believe her, she took me to our priest, who also reassured me that what I was doing was not a sin, however I still remained sceptical. Not even this was enough reassurance for my thoughts to go away.
Initially, this was a very scary process. But, we started out slowly, with me in control. If I felt overwhelmed, and often times I did, Miss Sheryl told me to call her. She gave me her office phone number, her home phone number. She was available anytime I needed to be walked through a situation that I could not get myself out of. If I would not call her myself, my mom would. I think it was important that I was in control of my treatment, as I had little control over any other area in my life. With the constant reassurance of my mother, Miss Sheryl and my family, I “built up my strength,” much like one would do by lifting weights, starting with lighter weights first and then moving to heavier and heavier weights as things get easier. I made my treatment my own, and with the help of my family I worked my way up the triangle that hung on our refrigerator as a constant reminder that I must never take a moments rest. From the start of my treatment I had set with Miss Sheryl a list of incentives for successfully overcoming an anxiety on the list. As I began to progress, I was able to be rewarded for my hard work with a candy bar or a movie.
I began remembering again that spring. I had spent all of fall and winter waging a battle in my mind, obsessions on one side and compulsions on the other. But come springtime, I emerged an entirely different person. The constant fighting and dragging between poles exhausted me and set me apart from my peers. I was not the cheerful, easy going individual I used to be. But rather, I had become anxious, reserved and sceptical of what the world had to offer. Although Miss Sheryl taught me how to confront my fears, to talk back to my compulsions and to do away with my obsessions, my OCD has not gone away. My OCD simply follows me as I take a new course in life. The difference now is that I am prepared; I know how to recognize and retaliate.
What are rituals? Sometimes I imagine them to be like a virus, a foreign invader. They plant themselves into a corner of my being and grow until they have overtaken me. The rituals are demanding, and unforgiving. I’ve got to work hard and they won’t give me a break, they do not let up. They do not allow for any logical thinking, for any error. If there is more than one way to view something, the rituals insist that I choose the most difficult. They demand strict obedience, and if it’s not right, they demand that I do it again. Finishing one ritual only leads to another. One step, one step, two steps, four.
Works Consulted
Rapoport, Judith L. The Boy Who Couldn't Stop Washing: The Experience & Treatment of
Obsessive-compulsive Disorder. New York: Dutton, 1989. Print.
Van, Ornum William. A Thousand Frightening Fantasies: Understanding and Healing
Scrupulosity and Obsessive Compulsive Disorder. New York: Crossroad Pub., 1997. Print.
One step. One step. One step. There are 13 stairs, one railing and two lights illuminating the brown carpet on either side. I take two steps, two steps, I return to the first step. I am on the last step, the last step and I run back to the top to start over. The white tile at the end of the staircase tunnel is where I need to be, but I cannot get there. One step, two step, three step. I close my eyes, I open my eyes, I close them and repeat.
It began with the staircase. Each day approaching the stairs became a more difficult task. I just got stuck. Stepping on each step became a matter of desperation, and if I could not do it perfectly then I would do it again. I got stuck on the stairs, in the hallway, the doorway. I could cross the hallway if I ran, but if I ran I would have to do it twice. Over and over. I just knew that I had to. Like a snowball rolling down a mountain side, everything I saw became an opportunity for a ritual, for nonstop thoughts. If I made a mistake in my homework I would cross it out once, twice, scribble it until the pencil tip reached the dull end. Just getting into the car required that I open and close the door several times until my mom turned the lock. The feeling of constant uneasiness overtook me.
That fall marked the beginning of my illness, and with each day the thoughts began to become more vivid and complex in my mind. Swear words became attached to actions that involved the use of my hands—writing, using an eating utensil, dressing myself, brushing my hair. Repeating an action four times was a four letter swear word. As a consequence for not completing an action to satisfaction, the swear words would repeat themselves over and over. I sat in front of my homework for hours, wrestling with the fear of using the pencil. If I picked it up, I could be sure a cascade of f-words and s-words would fill my mind to an extent from which I could not recover. Brushing my teeth involved holding my toothbrush, which again, would release these offensive words. My hands were the source of the click track of obscenities, so my most logical solution was to stop using them altogether. I held my hands in a tight fist.
My family tells me that I was 10 years old that fall, but I tell them I don’t remember. I was paralyzed and consumed by tantalizing thoughts that were tangled deep within me. I was never exactly sure what the consequences would be for standing up to my anxieties—death, eternal damnation, failure, errors, contamination. I was not about to tempt the fates to find out. To those on the outside, I grew reserved and quiet. On the inside I was preoccupied with fear and disquiet. That I could not stop ritualizing only served to make me feel more helpless. Somewhere between the weeks of not eating, walking backwards through hallways and climbing up and down my bunk bed ladder for hours before getting into bed, my mom took me to Miss Sheryl. It was in her small, windowless office that I began to identify these thoughts as obsessions and compulsions.
I am not sure at which point my obsessions and compulsions started taking on a new form, but before I could stop it, my OCD became intertwined with my faith. My family had always been religious and stressed the importance of taking religious commitments seriously. I became profoundly aware and increasingly fearful of sin. Everything became a sin, or a possibility for sin. My thoughts were not logical, and there was a rational side of me that knew this, but I could not resist the obsessions. I was particularly worried about the Communion fast. I would stop eating the day before Sunday Mass to ensure that there was no food in my stomach before receiving the Eucharist. My thoughts would become conflicted when my mom would tell me to eat breakfast before Mass. On one hand, I needed to obey my mother. On the other, I was fearful of breaking the fast. This created tremendous amounts of anxiety in me each Sunday. Which was the lesser sin? To avoid being asked to eat breakfast, I would stand at the top of the staircase until the car was just pulling out of the driveway. I would then run as fast as I could down the stairs and out the door before anyone could stop me.
The first step, Miss Sheryl told me, was to create a list of the things that made me anxious. They called this “Cognitive Behavioural Therapy,” something to “help me feel better”. My hands were clenched shut, so my mom instructed me to open my hands, take the piece of chalk, and listen to what Miss Sheryl was asking of me. My words were scribbles on the brown chalkboard. At first it was difficult to separate my compulsions from my everyday actions. At this point they were one in the same to me, there was no difference. We identified sources of anxiety that fuelled my obsessions and compulsions- utensils, stairwells, car windows, the number 4, sin, eating. We ordered them in a triangle from easiest at the bottom, to hardest at the top. My mom sat with me at each session, reminding me: “This is not you, it’s your OCD,” she would say.
One very prominent obsession that remained with me while the others came and went was the idea that I had to obey my mother. From the beginning of my illness, my mother exhibited tremendous patience; she helped me do the daily tasks that I myself could not do. When I was stuck on a thought, my mother would take my hand and verbally or physically walk me through. I believe I began to associate the fulfilment of an obsession or compulsion with obeying my mother. In order for the thoughts to go away, all I needed to do was do as she said. For those first few months, this created more problems than good. “Go pick up your shoes,” she would say. I would run as fast as I could to the shoes, fearful that if I did not do as she told me as quickly as I could, the thoughts would begin nagging again. A simple “do your homework” or “go get dressed” became an agonizing sprint around the house. There was absolutely no rationale behind my actions and I spent my days dashing from one command to the next. My mother could have asked me to do anything and I would have obeyed blindly.
That fall when my OCD was at its worst, this idea grew into something much more dangerous. It began to be that I would not do anything until I was told by my mother to do it. Get out of bed, get dressed, brush my teeth, comb my hair, walk through the hallway, get into the car, eat meals. My mother had to walk me through my day, commanding me each step of the way. I dutifully obeyed for fear of a horrible consequence if I did not. At 10 years old my mother had to dress me, feed me, help me use the bathroom. There was nothing that I could do on my own- I had to wait for her to give the command. When my mother gave me steps out of order or skipped a specific step altogether, it caused me to lapse into fits of anxiety. “Eat your lunch!” she would tell me. But how do I eat it? A rational part of me knew that I needed to use my fork, but my OCD was telling me otherwise. Mom did not tell me to use my fork. How do I eat my lunch? Before I knew it my face was planted in my plate, chips and sandwich spilling all over the table and into my lap. These episodes were idiosyncratic, consuming and intense.
The triangle that I had drawn in Miss Sheryl’s office was taped to our refrigerator door. I had to start to tackle my obsessions and compulsions one at a time, beginning with the things that caused me least anxiety, the things I was “good” at. We all agreed that I would start small – opening doors with my hands, instead of with my elbows or not opening them at all. When my mom and I got home that day from my appointment, I had to confront my first door—the front door. I stood on the mat twitching and twisting while mom stood behind me. I knew that I had to turn the handle, Miss Sheryl told me to. Exposure. This is what she called it, confronting what made me anxious. When I come in contact with what made me anxious, I had to choose to not do the compulsive behaviour. I shove my clenched fist into the door handle, push it down and run through the door as fast as I can.
Beginning with the door handle began the long process of exposure and response. My mom would remind me each time I got stuck, “It’s not you, it’s your OCD”. Sometimes I turned the handle, sometimes I did not. I had to exercise my mind to confront my fear of opening doors, to make the commitment to not give in to my anxiety and to continue to do so until I could open doors without associating any negative consequences or anxiety to it at all. To my sisters, it was just a door. To me, it was like crossing a street and seeing a truck speeding toward you. At the end of the day I was exhausted and overcome. This was just one compulsion on my triangle of over forty.
With a change in my focal point would come changes in the stimuli of my rituals. Miss Sheryl and I were constantly re-evaluating what caused me most anxiety, what set my OCD into motion. I was particularly worried about protecting myself from germs. Contamination is a common source of distress for individuals with OCD, but my fear would take on new forms weekly. One week it would be that I was worried about what I was breathing in. Soon I began to associate everything around me with giving off a “smell.” I would walk around with my shirt covering my nose and mouth. There were chances for new stimuli all around me, the school lunchroom, close spaces, food, people talking, everywhere I went they followed. Smells became associated with the ritual of covering my mouth, waving my hand in front of my face or backing away abruptly. For example, when my mom would stand over me to check my school work, I could feel her breath on my ear and it would set off a chain of anxieties. Did her breath touch me? I would jump up and wave my hand. What if her breath is still in the air around me? If I finished one ritual and saw an opportunity for another, I would be required to start again. Over and over and over.
My obsessions and compulsions were most frustrating for my family. No one, not even I myself, fully understood why I would ladle my soup with my hands, or flip the light switch on and off until the bulb ran out. I didn’t like it when my family pointed out and vocalized my obsessions and compulsions; it aggravated me and often made them worse. They didn’t know what was going on in my mind to cause me to do such things. My sisters could only see and recognize the outward manifestations of my OCD. They would taunt me when I was stuck in a ritual, or physically force me to open my hands when they were clenched. Because she attended the meetings with Miss Sheryl, my mom had a better understanding of how to control my OCD when things got out of hand. However the lack of logic behind my actions often caused her too to become frustrated and confused.
In the midst of my treatment, somewhere in the middle of my triangle, Miss Sheryl asked me if my family could come to her office for a day. She told me that this was so that I could describe what is going on in my head, and help them know what to do to help me get better. At this point I was working on exposure to much more difficult anxieties and needed the support of my family. This meeting was a time for me to explain my triangle to my family and for them to see all of the obsessions and compulsions that plagued me, not just the ones they observed at home. I told them about the four letter words that I associated with using my hands, how sins were associated with obeying mom and about the tremendous fear I felt when I disobeyed her. As I was talking through my anxieties, my father, who up until this time had been rather passive in my treatment, began to cry. At 10 years old I was too young to understand the magnitude by which my OCD was affecting me. A new light was shed on my OCD, and my family was given the knowledge by which to pull me out of the depths from which my obsessions and compulsions had plunged me.
The next stage of my treatment involved approaching the deeply rooted anxieties, the fears that underlined all of my eccentricities and rituals. These included the religious preoccupations that I had, namely, sin and the fear of sinning. Every action was a result of my fear of sinning. It was irrational, but I was afraid of breathing for fear that I would be breathing in something that was unclean. I was afraid of using my hands for fear that doing so would cause me to use a four letter word that was offensive. I was afraid of disobeying my parents, for fear that I would be disobeying the 4th Commandment, “Thou shalt honour thy father and mother.” Miss Sheryl and I had to “rewire” my thoughts, or that is how she phrased it. We tried this first with the four letter words. Instead of trying to push away the four letter words, or associate them with something bad, I was told I should desensitize myself to them. When I went to pick up a spoon, this time I would confront the f-word and s-word, holding tightly to the spoon and not letting it go to restart the ritual. My mom would repeat to me, “this is not a sin, this is not a sin”. Because I did not believe her, she took me to our priest, who also reassured me that what I was doing was not a sin, however I still remained sceptical. Not even this was enough reassurance for my thoughts to go away.
Initially, this was a very scary process. But, we started out slowly, with me in control. If I felt overwhelmed, and often times I did, Miss Sheryl told me to call her. She gave me her office phone number, her home phone number. She was available anytime I needed to be walked through a situation that I could not get myself out of. If I would not call her myself, my mom would. I think it was important that I was in control of my treatment, as I had little control over any other area in my life. With the constant reassurance of my mother, Miss Sheryl and my family, I “built up my strength,” much like one would do by lifting weights, starting with lighter weights first and then moving to heavier and heavier weights as things get easier. I made my treatment my own, and with the help of my family I worked my way up the triangle that hung on our refrigerator as a constant reminder that I must never take a moments rest. From the start of my treatment I had set with Miss Sheryl a list of incentives for successfully overcoming an anxiety on the list. As I began to progress, I was able to be rewarded for my hard work with a candy bar or a movie.
I began remembering again that spring. I had spent all of fall and winter waging a battle in my mind, obsessions on one side and compulsions on the other. But come springtime, I emerged an entirely different person. The constant fighting and dragging between poles exhausted me and set me apart from my peers. I was not the cheerful, easy going individual I used to be. But rather, I had become anxious, reserved and sceptical of what the world had to offer. Although Miss Sheryl taught me how to confront my fears, to talk back to my compulsions and to do away with my obsessions, my OCD has not gone away. My OCD simply follows me as I take a new course in life. The difference now is that I am prepared; I know how to recognize and retaliate.
What are rituals? Sometimes I imagine them to be like a virus, a foreign invader. They plant themselves into a corner of my being and grow until they have overtaken me. The rituals are demanding, and unforgiving. I’ve got to work hard and they won’t give me a break, they do not let up. They do not allow for any logical thinking, for any error. If there is more than one way to view something, the rituals insist that I choose the most difficult. They demand strict obedience, and if it’s not right, they demand that I do it again. Finishing one ritual only leads to another. One step, one step, two steps, four.
Works Consulted
Rapoport, Judith L. The Boy Who Couldn't Stop Washing: The Experience & Treatment of
Obsessive-compulsive Disorder. New York: Dutton, 1989. Print.
Van, Ornum William. A Thousand Frightening Fantasies: Understanding and Healing
Scrupulosity and Obsessive Compulsive Disorder. New York: Crossroad Pub., 1997. Print.