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5.0 out of 5 stars
the therapy of trust, July 18, 2011
This review is from: Can Christianity Cure Obsessive-Compulsive Disorder?: A Psychiatrist Explores the Role of Faith in Treatment (Paperback)
As a Christian who has been affected by obsessive-compulsive disorder (OCD) since the age of fourteen, I was biased against this book because of its title. The last thing the church needs is more of the dangerous just-have-faith-and-your-mental-disorder-will-disappear nonsense. I was even more skeptical when I was told that the author had made his case on the basis of three historical figures, from diverse centuries, whom he alleged had all overcome OCD through faith. I expected to this book to be weak, at best.
What a pleasant surprise to find that, aside from the misleading title, this volume is actually a thoughtful work on the Christian's practical response to living with OCD. It is not the author's intent to offer easy answers, false hope, or quack cures. He does not denigrate nor seek to replace the conventional treatments of medication and cognitive-behavioral therapy, which are respectfully and ably described with examples from his own practice as a psychiatrist who specializes in the treatment of OCD. Rather, Dr. Osborn seeks to explore the intricate interrelationship between obsessive-compulsive disorder and faith. That relationship is depicted as a two-way street in which the experience of OCD challenges, shapes, and ultimately strengthens the Christian's faith, while faith becomes a valuable tool for coping with obsessive fears and the resulting anxiety and depression.
This "reciprocal relationship" is depicted through the biographies of "three of the greatest luminaries in the history of the Christian religion - Martin Luther, John Bunyan, and Saint Therese of Lisieux." The author devotes a full chapter to each biography. Quoting extensively from their own writings, he demonstrates that all three displayed the classic symptoms of what is now recognized as obsessive-compulsive disorder, or OCD, "and all found the same way to overcome it through centering their lives on a single magnificent Christian truth." For Martin Luther, it was faith alone; for John Bunyan, the righteousness of Jesus Christ; for Saint Therese, the "Little Way" of childlike dependence on God's mercy. All three found that their desperate internal struggles forced them to look outside of themselves for assurance. In so doing, each transferred the responsibility - for both eternal salvation and day-to-day struggles with obsessions - from self to God. Dr. Osborn contends that this transfer of responsibility is a highly effective treatment for OCD, consistent with modern research on cognitive-behavioral therapy.
In standard cognitive-behavioral therapy, a person with OCD learns to recognize the obsessions as symptoms of a brain disorder rather than as being realistic concerns, and to refrain from performing compulsive behaviors in response to such obsessions. Many people with OCD know that their intrusive, obsessive thoughts are not rational, and yet they can't help feeling threatened by the thoughts and taking on the responsibility for neutralizing or "undoing" them through the performance of compulsive behaviors. As psychologist Paul Salkovskis says, "Intrusive thoughts are mistakenly interpreted as indicating that a person may be responsible for harm to self or others" - harm that can only be avoided by the repetitive mental or physical actions known as compulsions. By learning to understand that the obsessive thoughts are the meaningless reflection of a malfunctioning brain, and that they do not represent any actual danger, these individuals find freedom from the crushing weight of unwarranted personal responsibility. No longer must they check the stove repetitively to ensure that it does not erupt into flames and burn the house down; an intrusive thought about the stove is now a symptom, not a clarion call to action.
Some OCD researchers, including the renowned expert Dr. Stanley Rachman, have experimented with another means of freeing their patients from bondage to their obsessions: urging such patients to transfer responsibility to someone else. For example, the compulsive stove-checker mentioned above may agree to hand over all responsibility for the stove's maintenance to another person, and no longer hold herself accountable for any disasters concerning it. Dr. Rachman has found that such a course of treatment may lead "within minutes to completely normal use of the stove." However, this transfer of responsibility is generally unworkable as it requires that the OCD sufferer have a trusted friend who is willing and able to assume responsibility for his or her worst fears. Few mortals would or could take on such a burden indefinitely.
Dr. Osborn posits that responsibility for obsessions and their feared outcomes may instead be transferred to God in a faith-based "therapy of trust." This approach is similar to cognitive-behavioral therapy in that it begins by recognizing obsessions for what they are, and discourages the knee-jerk reaction of performing compulsive behaviors. Yet the focus and the motivation is different. Standard therapy emphasizes rational thinking, "to question the truth of an obsession at the moment it strikes, and to replace it with a more logical and realistic assessment of the situation." Ironically, arguing with thoughts inside your head may quickly become a compulsion in itself, and like all other compulsions, it ultimately reinforces and worsens OCD rather than ameliorating it. I know this from experience, as "arguing" with the thoughts was one of my own compulsions in the early days. Rather than gaining freedom from my intrusive thoughts, I became more enslaved. The responsibility for "logically" challenging them was more than I could bear, and more than my family could bear.
Dr. Osborn must have been thinking of patients in a similar situation when he wrote, "Obsessionals, in fact, have great difficulty in believing any fact that directly opposes one of their obsessions. OCD sufferers cannot even take as a fact what they see with their own eyes: they can stare straight at a light switch, see that it is off, and yet fear that it is on. It is a fact that OCD sufferers have a hard time believing in facts." I was never obsessed with light switches, but otherwise this is a very good description of me when I was first diagnosed with OCD.
Although I never heard the phrase "therapy of trust" before reading Dr. Osborn's work, I can see now that my best counselors have instinctively guided me to it. In the therapy of trust, the focus is not on what you know, or how confidently you know it, but Who you know. It is a simple yet radical shift in perspective. Trusting God is a matter of the heart and the will; it goes so much deeper down than whatever passes through the brain at any given moment. It is necessary to trust Him absolutely, with no conditions whatever, and to trust Him fully, yielding all responsibility for the outcome up to Him. Such an attitude of trust is not merely a technique to be used as needed; it must become a habit of mind. After half a lifetime with OCD, I'm still developing that habit, but the need to protect myself from the dangerous intrusive thoughts is no longer all consuming, even on the rare occasions when my medication fails to prevent such intrusions. I am freed from such responsibility because God assumes it all.
This faith-based treatment really does work, and it is not new. Luther, Bunyan, and Therese each seemed to have developed his or her own variation of it, long before any real help or guidance was available to the OCD sufferer. Luther, in particular, seems to have had almost no support at all; Bunyan and Therese also fought most of their battles alone. This pattern doesn`t surprise me; even today, OCD can be a very isolating disease. Few people understand it, and the uninformed can easily do more harm than good.
I find it fascinating that while these three apparently received so little, they gave so much of themselves to building up other believers; their personal experiences of suffering were the raw material with which they transformed the world. Luther was so unflaggingly productive that some of his biographers have suspected him of also having manic-depressive disorder; yet his dynamic and disciplined energy was not typical of uncontrollable mania, and speak instead to his great dedication. Bunyan bared his soul in both autobiographical and allegorical writing; in the classic Pilgrim's Progress he embodies his own experiences of crushing personal responsibility, depression, and despair in the now well-known images of a burden, a valley of deepest darkness, and a giant's castle. Therese was only 24 and largely unknown when she died of tuberculosis, yet her the impact of her posthumous works - including her autobiography - has been so great that she is recognized as a Doctor of the Church and a beloved saint.
Dr. Osborn suggests that the church needs people with OCD to serve as reminders of what we all should know but so quickly forget: that we do not save ourselves, but must depend upon God alone. He sees in the "illness" of OCD a potentially curative power - a possibility of renewal and healing not only for the identified patient but for the church as a whole. "Obsessive-compulsive disorder sufferers, at times, think differently from other people. It is the pathological aspect of their thinking that is the subject of clinical inquiry. Yet there is, quite possibly, a powerfully creative aspect to their cognitive tendencies that we neglect, a creativity fueled by the unusually vivid real-life quality of certain of their thoughts." What an amazing shift in perspective that is - from the obvious "pathology" and "disorder" caused by OCD to the hidden potential for great insights and creative breakthroughs.
In conclusion, this book offers tremendous hope to Christians with OCD - not so much hopes of a "cure" which may or may not happen, but of an opportunity to display the grace of God while finding practical relief from the sufferings imposed by the disorder. And perhaps to build up the church along the way.
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