The Narrative Cure? On Writing My Way Toward Sanity

Marie Holmes

“You’re a writer,” said the therapist. And before I could offer the caveats of my very limited publications and earnings, he said, “Why don’t you try writing, instead?”

In cognitive behavioral therapy (CBT) to treat my obsessive-compulsive disorder (OCD), I had been making audio recordings detailing my darkest fears and listening to them every day on repeat. If that sounds like a strange sort of therapy, that’s precisely how it felt. No matter how many times I did it or was reassured that studies had shown it to be effective, I couldn’t normalize paying such ritual attention to worries that everyone around me agreed were crazy. I certainly didn’t want to write about them. OCD brought me shame, not creative energy, and I think mental illness prevents more art than it inspires.

This stripe of CBT is called exposure and response prevention. The idea is that by exposing yourself to your triggers, you learn to ride the cresting wave of your anxiety until it reaches its natural lull, rather than trying to numb it with behaviors that only serve to reinforce your fear. Over time, if therapy is successful, you learn to cope in the absence of those behaviors, and the frequency and intensity of your fear decline.

The classic OCD patient is afraid of germs and engages in compulsive hand-washing or other behaviors to protect herself from the threat of serious disease. That wasn’t me. I was another fairly common, though less renowned, kind of patient: the mother whose worries have grown pathological.

Postpartum depression is part of our cultural lexicon, but many people don’t know that women who have recently given birth are also at an increased risk of developing OCD. We hover over car seats and bassinets, our wild fears chewing holes in the normal function of our gray matter.

We’ve all heard stories about the power of a mother’s instincts: I just knew there was something wrong with my child, they say, traveling from doctor to doctor until one finally believes them. Women whose sage intuition saved their children’s lives. But there are other stories. Women whose instincts went awry, whose gut feelings failed them, whose attempts at protection turned destructive. I experienced it like a kind of faulty wiring, where my brain reacted to innocuous, everyday things like it would a raging blaze.

The hormonal tsunami of my second pregnancy and birth weakened whatever psychological defenses I had—which, admittedly, were probably few—and my worries weighed on me with an urgency and a ferocity like never before. I didn’t know what day it was or remember when I’d last showered, but my mind identified with laser-like precision any potential harbinger of disease in my preschooler or my infant.

A bruise? Leukemia.

A sore foot? Juvenile rheumatoid arthritis.

A cough? Heart failure.

Thirst? Type one diabetes.

At least several times a day, and sometimes hourly, my body descended into the kind of physiological response that a normal parent might experience if a doctor delivered one of these diagnoses. My stomach fell, my heart galloped, my breath quickened, and I became light-headed from the extra oxygen. It felt like being on an airplane that suddenly drops in altitude, again and again, day after day, bracing for a crash that never came. I was condemned to never-ending repetitions of the same ride.

Knowing that it was all in my head, knowing—and of course I knew to the hundredth—the tiny probability of any of these illnesses actually befalling my children, did nothing to counter my fear. The symptoms and names of the diseases ran on a loop in my mind, punctuated by the refrain, What if? What if?

I managed to care for my children, but between the parenting and the panic, there wasn’t much left. My marriage was strained, and the fulfillment I had once found in writing was a distant memory.

If I were a hand washer, the exposure portion of my therapy might have meant using a public doorknob. But, my worries being what they were, this part of the treatment involved imagining my fears made real. It was like walking onto that airplane and buckling in for the dive. Each audio recording had me telling the story of a dreaded diagnosis, and, it was true, each time I listened to it, I felt a little less anxious. But I was still a long way from a cure.

I was also supposed to block my usual response to my triggers, which was to compulsively scan my children for symptoms. Again, if germs were my fear, the therapy would involve touching the doorknob and then not washing my hands, forcing myself to cope with the anxiety. But I could hardly manage to glance at my children’s innocent faces without seeking foreboding signs. My compulsive checking was a silent, secret scourge that I found impossible to halt. Either I couldn’t stop scanning for evidence of disease, or I was refusing to try. The question of where to place the blame remained unanswered, and in the end, it didn’t much matter.

Rather than kick me out of the low-cost training clinic I had found, my student therapist kindly suggested that we first try to double down on my exposure efforts. What, he asked, could make the exposures feel more real? What could reproduce the anxiety I felt when I detected a symptom of illness in one of my children? What would provoke the truest emotional response?

Hadn’t I said something about writing?

I immediately resisted his suggestion. There was no way, I said, that I could write a new scenario every day instead of listening to the audio recordings. I had two small children and a full-time job. I simply did not have time to write, CBT exercises or anything else.

If I had time to listen to audio recordings while I was on the train, my therapist gently reasoned, surely I could use that same time to write, even just using the notepad app on my phone.

I’ll note here that the CBT therapists I worked with were all very positive thinking and solution oriented. In other words, they were nothing like me. They were unwavering in their belief that any problem could be named and worked around, or at least eroded somewhat with persistent effort. There were a lot of handouts with charts and tables. Everything had to be recorded, my levels of anxiety rated on a hundred-point scale. I sneered at all of this. I did not consider my anguish quantifiable.

I was, on the one hand, somewhat attached to the idea that my condition was so complex as to resist therapeutic efforts. But I was also miserable, reduced to a gutting surge of adrenaline every time my son asked for a simple glass of water.

So I agreed to try. Every morning during my subway commute, I called upon all of my literary resources and tapped out the most frightening scene I could imagine: the diagnosis foreshadowed in the first symptom, the interminable wait at the brightly lit doctor’s office, her brisk manner and the pained note of surprise in her voice, the terror overtaking me like a great ball of light and my knees hitting the floor. Then I emailed it to my therapist (for accountability’s sake) and promptly deleted it from my phone, lest my children ever find proof of what a strange and broken person their mother is.

It wasn’t how I’d imagined using my MFA, but it changed my life.

Slowly, the incidence and intensity of my anxiety continued to decrease, enough so that after almost a year in CBT, I was declared fit to “graduate.” I was better. At least a little bit. I still spent time every day worrying about my kids, and this worry still caused tension in my marriage, but there was more time for the interstitial goo, from gray-eyed exhaustion to the cadence of my daughter’s laughter. Months later, when I weaned her and started a new medication, an antidepressant frequently used to treat OCD, the grip of my obsessive fears lifted somewhat more.

The secondary effect of my CBT, though, was both swift and remarkable. I had never written anything other than text messages and emails on my phone before. For reasons that were nothing more than childhood associations, I correlated “real” writing with a full keyboard, a chair, and a table. In addition, I had always assumed I needed a several-hour stretch to write anything of substance, and the CBT exercises proved this simply wasn’t true. I could, when pressed, write a full scene—a pretty decent one, some days—in the span of one thirty-minute subway ride.

Freed from these imaginary constraints on my writing, I decided to try out this new process on some of my neglected creative projects. I tapped out the words with my thumbs, day after day, my progress slow and uncertain. When I finally had a finished draft, I was surprised at the quality of the work. It was good stuff. Perhaps my best.

I submitted that first essay to a blog, thinking that there was a real chance of acceptance. When it was rejected, I was crushed. In my attempts to return to sanity, I had found my way back to writing, and I longed for the validation that comes with being given an audience.

A couple of months later, I submitted the same essay elsewhere. An editor quickly wrote back to me with an acceptance. It was a more prestigious outlet, and higher paying, than the blog I had tried first. Or anywhere else I’d been published, for that matter.

This new arrangement had me regularly writing for the first time since becoming a mother five years earlier. I wrote seated, I wrote one handed, I wrote leaning against the subway car doors, right into the sign that says not to. I paused sometimes when I arrived at the station, disrupting pedestrian traffic, in order to finish a sentence. I wrote more personal essays, a number of which I managed to publish, and completed a draft of a short story.

I used the story as a work sample for a literary fellowship that I had applied to for several years running. This time, I won. Never again could I use the excuse that I was too busy to write, when this, my most successful work, had been crafted during the span of my commute.

I hold no gratitude for my OCD. I don’t think that it taught me any special lessons or provided me with any compelling insight. I did find, however, that it is possible for me, perhaps for anyone, to write their way toward equilibrium—not a steadiness so much as a relief from the feeling of tipping into freefall.

Marie Holmes has written for Scary Mommy, Good Housekeeping, Cosmopolitan, the Washington Post, and other publications. She has received awards from Gival Press and the Bronx Writers Center, and was an Emerging Writer Fellow at the Center for Fiction. She lives in New York City with her wife and their two children. Reach her at @holmes_marie and read more of her work at www.marieholmeswriter.com.