In 2013, the BBC rounded up half a dozen teenagers with obsessive-compulsive disorder (OCD) and followed them as they attended intensive therapies to help them overcome their unwanted thoughts and repetitive behaviors.
There was Imogen, a seventeen-year-old girl who had a compulsive need to tap every surface she walked past; if she failed to do so, she was flooded with horrible thoughts of her family dying. There was Josh, who needed to do everything with both sides of his body—shake a person’s hand with both his right and his left hand, eat his food with each hand, step through a doorway with both feet, and so on. If he didn’t “equalize” his two sides, he suffered from severe panic attacks. And then there was Jack, a classic germophobe who refused to leave his house without wearing gloves, boiled all his water before drinking it, and refused to eat food not cleaned and prepared himself.
OCD is a terrible neurological and genetic disorder that cannot be cured. At best, it can be managed. And, as we’ll see, managing the disorder comes down to managing one’s values.
The first thing the psychiatrists on this project do is tell the kids that they’re to accept the imperfections of their compulsive desires. What that means, as one example, is that when Imogen becomes flooded with horrible thoughts of her family dying, she is to accept that her family may actually die and that there’s nothing she can do about it; simply put, she is told that what happens to her is not her fault. Josh is forced to accept that over the long term, “equalizing” all of his behaviors to make them symmetrical is actually destroying his life more than occasional panic attacks would. And Jack is reminded that no matter what he does, germs are always present and always infecting him.
The goal is to get the kids to recognize that their values are not rational—that in fact their values are not even theirs, but rather are the disorder’s—and that by fulfilling these irrational values they are actually harming their ability to function in life.
The next step is to encourage the kids to choose a value that is more important than their OCD value and to focus on that. For Josh, it’s the possibility of not having to hide his disorder from his friends and family all the time, the prospect of having a normal, functioning social life. For Imogen, it’s the idea of taking control over her own thoughts and feelings and being happy again. And for Jack, it’s the ability to leave his house for long periods of time without suffering traumatic episodes.
With these new values held front and center in their minds, the teenagers set out on intensive desensitization exercises that force them to live out their new values. Panic attacks ensue; tears are shed; Jack punches an array of inanimate objects and then immediately washes his hands. But by the end of the documentary, major progress has been made. Imogen no longer needs to tap every surface she comes across. She says, “There are still monsters in the back of my mind, and there probably always will be, but they’re getting quieter now.” Josh is able to go periods of twenty-five to thirty minutes without “equalizing” his behaviors between both sides of his body. And Jack, who makes perhaps the most improvement, is actually able to go out to restaurants and drink out of bottles and glasses without washing them first. Jack sums up well what he learned: “I didn’t choose this life; I didn’t choose this horrible, horrible condition. But I get to choose how to live with it; I have to choose how to live with it.”
A lot of people treat being born with a disadvantage, whether OCD or small stature or something very different, as though they were screwed out of something highly valuable. They feel that there’s nothing they can do about it, so they avoid responsibility for their situation. They figure, “I didn’t choose my crappy genetics, so it’s not my fault if things go wrong.”
And it’s true, it’s not their fault.
But it’s still their responsibility.
Back in college, I had a bit of a delusional fantasy of becoming a professional poker player. I won money and everything, and it was fun, but after almost a year of serious play, I quit. The lifestyle of staying up all night staring at a computer screen, winning thousands of dollars one day and then losing most of it the next, wasn’t for me, and it wasn’t exactly the most healthy or emotionally stable means of earning a living. But my time playing poker had a surprisingly profound influence on the way I see life.
The beauty of poker is that while luck is always involved, luck doesn’t dictate the long-term results of the game. A person can get dealt terrible cards and beat someone who was dealt great cards. Sure, the person who gets dealt great cards has a higher likelihood of winning the hand, but ultimately the winner is determined by—yup, you guessed it—the choices each player makes throughout play.
I see life in the same terms. We all get dealt cards. Some of us get better cards than others. And while it’s easy to get hung up on our cards, and feel we got screwed over, the real game lies in the choices we make with those cards, the risks we decide to take, and the consequences we choose to live with. People who consistently make the best choices in the situations they’re given are the ones who eventually come out ahead in poker, just as in life. And it’s not necessarily the people with the best cards.
There are those who suffer psychologically and emotionally from neurological and/or genetic deficiencies. But this changes nothing. Sure, they inherited a bad hand and are not to blame. No more than the short guy wanting to get a date is to blame for being short. Or the person who got robbed is to blame for being robbed. But it’s still their responsibility. Whether they choose to seek psychiatric treatment, undergo therapy, or do nothing, the choice is ultimately theirs to make. There are those who suffer through bad childhoods. There are those who are abused and violated and screwed over, physically, emotionally, financially. They are not to blame for their problems and their hindrances, but they are still responsible—always responsible—to move on despite their problems and to make the best choices they can, given their circumstances.
And let’s be honest here. If you were to add up all of the people who have some psychiatric disorder, struggle with depression or suicidal thoughts, have been subjected to neglect or abuse, have dealt with tragedy or the death of a loved one, and have survived serious health issues, accidents, or trauma—if you were to round up all of those people and put them in the room, well, you’d probably have to round up everyone, because nobody makes it through life without collecting a few scars on the way out.
Sure, some people get saddled with worse problems than others. And some people are legitimately victimized in horrible ways. But as much as this may upset us or disturb us, it ultimately changes nothing about the responsibility equation of our individual situation.