Dr. Guenther interviewed Sarah Vander Schaaf, freelance writer and speaker who also suffers from OCD, about diagnosis and treatment for college students with OCD.

Original airdate October 30, 2018

Disclaimer: This show is not a substitute for professional counseling, and no relationship is created between the show hosts or guests and any listener. If you feel you’re in need of professional mental health and are a UA student, we encourage you to contact the UA Counseling Center at three four eight three six three. If you are not a UA student, please contact your respective county’s crisis service hotline, or their local mental health agency or insurance company. If it is an emergency situation, please call 911 or go to your nearest emergency room.

Dr. Guenther: Hey, it’s six o’clock and time again for Brain Matters, the official radio show of the UA Counseling Center. We are broadcasting live from the WVUA FM studio, 90.7 The Capstone, on the campus of the University of Alabama.

Dr. Guenther: Good evening, my name is Dr. B.J. Guenther, and I’m the host of the show and in case you don’t know, this show is about mental and physical health issues that affect college students, and in particular UA students. You can listen to us live each Tuesday night at 6:00 p.m. on 90.7 FM or you can go online and listen at wvuafm.ua.edu or you can also download the Crimson White app and click on the 90.7 live streaming link.

Dr. Guenther: As always, we will be taking questions via email, so if you’re listening and you have some questions for myself or my guests, you can email those questions to brainmattersradio@wvuafm.ua.edu. Also, if you have any show ideas for upcoming dates for the rest of this semester, I think we’ve got most of the shows planned out for the rest of this semester, but we definitely need some new show ideas for the spring semester. You can email those. Again the email address is brainmattersradio@wvuafm.ua.edu and of course I’ll always consider using your show topic idea.

Dr. Guenther: The topic of tonight’s show is an interesting one, I have several students I’m working with right now who have been diagnosed with OCD, which stands for Obsessive Compulsive Disorder. I’m titling the show tonight, Navigating College with OCD. In some ways OCD is like other health conditions such as asthma, allergies or diabetes and when properly treated, these chronic conditions are manageable. And are actually managed by millions of people around you. Like these other conditions, OCD requires a commitment to treatment. While there is currently no cure for OCD, cognitive behavior therapy or CBT, can help you better or teach you how to keep your OCD under control.

Dr. Guenther: My guest tonight is joining us by phone, and I’m so happy to have her on the air with us tonight. She is going to talk a lot about, hopefully, her experiences and share some of her ideas about OCD. Sarah Vander Schaaf, and I hope I’m pronouncing that correctly. Sarah is a journalist and playwright. Her work has appeared in numerous national outlets, including the New York Times, Motorrad Blog, Yahoo News and The Huffington Post.

Dr. Guenther: She’s written about mental health for The Washington Post, including pieces on the shortage of child and adolescent psychiatrist, a profiled young man with severe OCD, and reviews the breaks on the adolescent brain and depression. Her personal essay about living with OCD appeared in The Washington Posts’ health section and gained widespread attention prompting her to speak publicly to groups and organizations including NAMI and Vibrant Health in New York, where she hosted several Facebook Live talks with the director of the National Suicide Prevention Lifeline.

Dr. Guenther: Sarah earned her BS from Northwestern University, and her MFA from the University of Alabama’s professional actor training program, housed at the Alabama Shakespeare Festival. She lives in New York, excuse me, she lives in New Jersey with her husband and two daughters, and she’s currently writing her second play. Sarah can you hear me?

Sarah Vander Schaaf: Yes, thank you.

Dr. Guenther: Hey.

Sarah Vander Schaaf: That’s quite an introduction.

Dr. Guenther: Thank you so much. Yes, that was a lot to read and I was so excited to get your email when you agreed to be on the show because, I actually was researching about OCD because I knew I wanted to have a show on OCD. I came across some of the writings that you talked about, I think some of the writings about the young man with severe OCD. I thought well, I’m going to shoot her an email and see if she’ll respond to me. And then I found I you do actually have a degree from the University of Alabama. So that was ironic.

Sarah Vander Schaaf: Isn’t it? I know, and it’s a wonderful coincidence, so thank you for inviting me.

Dr. Guenther: Well, tell us a little bit … I’ve read some of your credentials on the air just in your introduction. But tell us a little bit about why you are so interested in mental health issues and OCD.

Sarah Vander Schaaf: Okay, well there are a few reasons. One of them certainly in terms of writing about OCD, I’ll be honest with you, when I sat with my therapist and she suggested that I write about the experience, the first time she said that, I had such a feeling of dread and fear, and I wasn’t really ready to investigate that story of myself. And then I came to a point a few months later where I was ready.

Sarah Vander Schaaf: It’s so interesting, the power of fear, because I think that epitomizes what the private pain that people with anxiety or OCD are living with. But it’s like this invisible monster and you’re afraid to face it. So for me that’s OCD, when I came to the point first of all, recognizing that there was something going on that didn’t have to be my only way of thinking.

Sarah Vander Schaaf: So for you when you mentioned you had some students who’d recently been diagnosed, I mean I feel like that’s a good gift. Because now they know what they’re dealing with, and I think I spent many years thinking it was just the way life was and the way my brain was. I didn’t know there was something else going on.

Sarah Vander Schaaf: So in any case, when I got to the point where I could face it and write it, I thought it was a sign that I had reached a new point, and that if I could help anyone else, maybe relieve a little of their own private suffering and realize that they could finally [inaudible 00:06:22]. But that was something I could do as a writer, I wanted to do it and I was no longer afraid to. And then mental health as a topic has fascinated me because I think it’s some … what’s the statistic that one in four people have a mental health challenge, which means that in any family of four there’s usually somebody [crosstalk 00:06:50]

Sarah Vander Schaaf: But I don’t accept that it’s a human condition. I don’t know how anyone goes through a full like without at one point facing depression or anxiety or if you have trauma, then panic. I think it’s the nature of being human that we are vulnerable or susceptible to these things. I admire someone who can go through [inaudible 00:07:12], but I suspect it’s probably more common than not.

Dr. Guenther: Well ironically, in doing the research for the show, I watched a few TED Talks, and I one of the TED Talks I found was titled My Hidden … I think it was titled My Hidden Diagnosis of OCD. I don’t know how old she was, she looked to be maybe in her late 20s, maybe early 30s and she talked about for years hiding her compulsive behaviors.

Dr. Guenther: Some of the students who I’m working with now, they’re almost, even me as a therapist, they’re almost embarrassed to talk about their compulsive behaviors because they know that it sounds strange sometimes. Because there are more common behaviors, like Germanophobe and counting. But there’s other stranger, I guess you could say, behaviors and some people are really embarrassed to share that, because they know how it sounds, but even me as a therapist I’ve heard a lot. So I try to make them feel a little more comfortable when they’re sharing that if they feel like it.

Sarah Vander Schaaf: Yes, and it’s interesting you say that, because I think it’s so important for someone going to see the therapist that they know that, that’s a safe space and that’s in so many ways just articulating and sharing it with someone and when you realize that they are kind and that they hear you and they’re not judging you.

Dr. Guenther: That’s right.

Sarah Vander Schaaf: That’s a relief. Huge relief. So I hear what you’re saying and I stuck at that in the sense that if there are young people of any age who are sort of living with their own private fears and pain and afraid of confiding in a therapist-

Dr. Guenther: Yes.

Sarah Vander Schaaf: Then it is something to be encouraged. And I’m sure you’ve heard a wide variety of things and I’ve had people send me private messages, strangers and so forth and share a lot of things. And there’s no shame in that, in having those thoughts. Their interest is the source. That’s the nature of OCD.

Dr. Guenther: That’s right. What are some of the characteristics of OCD? I can sit here and give the definition and I will if I need to. But what are some of the characteristics?

Sarah Vander Schaaf: Well, I thought it’s interesting that it used to be called the doubting disease and I’m sure you know more than I do about the origin. But for me that’s really what epitomizes it. That you have this tremendous sense of doubt and then that doubt can go in a variety of directions. So for me, I doubted that I was healthy and so I had a series of catastrophic fear that would make me thinking, “Oh, I have cancer.” And then wanting to get that test by the mastologist and then I would get tested and then I would doubt that the mastologist had effectively on this one and that idea don’t make another appointment. So that became a circle. But the doubting about a variety of things like terms or getting sick or a fear that a bad thing could happen. And, or that I know that some people have it manifest where they think they might’ve hurt someone-

Dr. Guenther: Yes.

Sarah Vander Schaaf: And repeat in their head for the cycling through. Like did I run someone over and not know it? Or did I hurt myself? Like the very worst thing in the world that you could do, they fear that they may do it-

Dr. Guenther: Yes.

Sarah Vander Schaaf: Throughout their own rationality.

Dr. Guenther: Well, sometimes it’s intrusive thoughts. You mentioned fear of hurting someone. Some other people I have seen in the past, I’ve had intrusive thoughts where they’ve never done anything and they’re never going to do anything, but it’s the thought. And the personnel was watching on T Talk. She mentioned that she used to have like when she would call someone and leave a voicemail message, it would be a normal voice mail message. But then when she would hang up, like you said, she would doubt that she had left the message and instead she kept thinking, “Oh my goodness, did I tell them that I wanted run over their cat with a car?” It was something terrible, and she said, “I would spend four hours a day worrying and having anxiety and being fearful,” about what she may or may not have said.

Sarah Vander Schaaf: Right. I think the young man I interviewed for a while worried that he could have a fever, then he would have a thermometer and check. This is where the compulsion would come in and check temperature and this was in high school and he would carry a thermometer with him that it was perhaps not logical and then he would hide-

Dr. Guenther: Exactly.

Sarah Vander Schaaf: Checking his temperature but that was something he needed to do to confirm that he is not sick, that he didn’t have a temperature.

Dr. Guenther: One of the articles I read was titled Compulsion’s don’t work and the first sentence starts out, “Research shows they’re performing Compulsions actually makes obsessions come back stronger even though it gives you temporary relief, in the long run they actually reinforce the obsessive thoughts.” And I guess that’s true because it is temporary relief, it’s just a vicious cycle.

Sarah Vander Schaaf: Yes it is. I think that touches upon some of the cognitive behavioral therapy strategies that end up helping. And so it’s not so straightforward as it sounds, but when you get to the point where you recognized your desire for the compulsion and you know that it is a temptation but down a rabbit hole.

Dr. Guenther: Exactly.

Sarah Vander Schaaf: And you learn to say even though I don’t want to do this, even though my OCD, is telling me that I’ll feel better if I do, I’m going to choose not to. I’m going to sit with it for a little while and I see if this passes. So for me, for example, I might notice that it’s my… you know what’s interesting is the anxiety could be tricked for it’s from a variety of factors. It’s not directly related to my health, but that’s what I found on it.

Dr. Guenther: Sure.

Sarah Vander Schaaf: And so then if I know at that point and I want to check my skin or make that extra appointment, I just know now that that’s not the path that will lead to actual health progress. So I have learned is that it’s almost like you just say time out.

Dr. Guenther: Yes.

Sarah Vander Schaaf: Let’s not go there right now, to put a time on it. Don’t use that often. Unfortunate that I have a big support system so that I’ve gotten to this place, but if it’s fixed to your point is that it is giving into the impulsive, will absolutely take you down the path and it will be very difficult to then come back.

Dr. Guenther: Well, and does it help when you actually begin to work on the compulsions and the behaviors? Does it help when you feel like you are making some progress or let’s say you talked to yourself, like you just mentioned and tell yourself, “Okay, I’m not going to do this, this time,” and then the anxiety subsides after a while or maybe it never gets worse. Does that help reinforce that, “Hey, this is working?”

Sarah Vander Schaaf: It’s true and maybe that’s what they talk about when they talk about rewiring the [inaudible 00:15:27]. Because we do realize that you have this amazing power to almost change your pathway, change pattern. And one of the biggest gifts I was given was the ability to take very small steps in the beginning. So that I could sense what you’re saying, which is this sense of accomplishment or progress or that the world didn’t fall apart.

Dr. Guenther: Exactly.

Sarah Vander Schaaf: The anxiety to fight it. But I didn’t have to do a big sacrifice first. It might’ve just been, for example, for me wearing a regular baby seat to the pool, expose my skin to the sun, which was kind of a trigger for me. I only had to do that for five minutes at first and put on a cover after-

Dr. Guenther: Sure.

Sarah Vander Schaaf: But eventually now I can go to the pool and sit there for an hour like that. I didn’t have to do the hour the very first time I built up that muscle. And then I would go back to the therapist and talk about how it felt for five minutes. Slowly I had a strategy and eventually learn to sit with the initial anxiety and know that it passed. And then yes, that’s the accomplishment.

Dr. Guenther: How old were you when you were diagnosed?

Sarah Vander Schaaf: That’s what this question is because I was looking at your questions before we started writing. I absolutely was in my late 30s. The typical age says the onset is between nine and 10 or late adolescence, early adulthood. And I suspect that in around nine years old, I exhibited sign and then I probably posted for a while and then it bubbled up again my sophomore year in college and I tucked it away enough, and it wasn’t until I was in my later 30s and my husband says that he could no longer be my sounding board that he didn’t want to be in the role of having to listen to the anxieties and in a sense you could say to them, but in fact it’s just the cycle of exacerbation and then he didn’t want our children to grow up in a home and with the anxiety as an overriding factor.

Dr. Guenther: Exactly.

Sarah Vander Schaaf: Really, that was my wake up call if he hadn’t said that, I don’t know if I would have so directly sought out, very specific help and really said it’s time to make progress.

Dr. Guenther: Almost like an ultimatum, you know?

Sarah Vander Schaaf: Pardon me.

Dr. Guenther: It was almost like an ultimatum, like you’ve got to do something or else.

Sarah Vander Schaaf: Yes. And it was a gift. The other thing is we have the kind of relationship where he very rarely asked me to do something. So when he did, I had to do it and that’s probably a wonderful thing which was that, “Wow, if it means so much that this is affecting him and he’s so tolerant and patient, then I really need to look at this, and figure out how to make progress.” And that’s where I think your work with students late twenties Undergrad, what a gift if they say have the skills to manage their OCD?

Dr. Guenther: Yes.

Sarah Vander Schaaf: They have decades to reap the benefit.

Dr. Guenther: Well and a lot of the research that I’ve read and studied talks about OCD tends to surface for the first time in college. And other people have their first symptoms while they’re away at school. What do you think it is about college that triggers people? Sometimes because I think sometimes like you said, maybe children have OCD tendencies, but they’re able to compensate somehow and people don’t necessarily, either they hide it very well or people just think, “Oh, they’re just being a kid.” They don’t pick that up. But then it becomes an issues most of the time if you’re predisposed to having OCD, that’s when it will surface in college. Why do you think that is?

Sarah Vander Schaaf: Well, that’s a great question. I wonder if maybe multiple things coming together to make it a perfect storm. You know how they talk about the adolescent brain is still developing until like 26. If you have to imagine I assumed that the hormonal chemical changes that are still happening and evolving during that period-

Dr. Guenther: Yes.

Sarah Vander Schaaf: That are beyond our control. And then there are the factors of being away from home and the system of the pattern and security that you have for most of your upbringing and all of a sudden the new environment and in a sense having to make new friends and figure out who you are as students may be facing some setback for the student for the first time that they’ve always had a certain expectation to your earlier years in high school and then not having the structure of nobody’s following up with, are you getting enough sleep, are you having breakfast? There’s no one else so it could feel like a free fall. And then there could be the anxiety, which I don’t know how you feel, but it seems like underneath OCD is severe anxiety.

Dr. Guenther: Yes.

Sarah Vander Schaaf: It may or may not be related to the way in which OCD manifests the [inaudible 00:21:32]. It could be completely related to something else. So the trigger could be very different. The other interesting thing is personally, and I talked to the gentleman that I did a profile on also his OCD comes in seasons.

Dr. Guenther: Who?

Sarah Vander Schaaf: And for him that was November.

Dr. Guenther: Wow!

Sarah Vander Schaaf: And I don’t know what about November.

Dr. Guenther: I don’t know if I’ve ever heard of that. Yes.

Sarah Vander Schaaf: Yes it is interesting because I often have my most sort of free fall moments where I feel like, “Oh oh you know-”

Dr. Guenther: Here it comes yes.

Sarah Vander Schaaf: Yes, exactly. In September and October and it’s always been that way. And you could say is that because of the start of the school year, my therapist also just suggested it’s the change of seasons.

Dr. Guenther: Definitely.

Sarah Vander Schaaf: Mood disorders can be affected by that. I don’t know what it is. I said I noticed that it’s comforting or not comforting, but rather helpful is when you have some patterns like that, then it’s not a surprise, you almost can sit with it again and just say, “okay.”

Dr. Guenther: Here it comes again. I always get like this every year. Yes.

Sarah Vander Schaaf: Yes. And so what can I do? Maybe I don’t know what strategy is, but if they know that they’re in a more vulnerable period, then those are the times to make sure you keep your appointment with your therapist to do the yoga or get enough sleep and all the little things that add up to giving you more protection.

Dr. Guenther: Hey, listen Sara

Sarah Vander Schaaf: There is the idea of what it is about college I do think that it is a test of being a young adult. So one of the first time and the tremendous pressures that come with that.

Dr. Guenther: Yes. And just a huge transition, yes. We’re going to take a quick break if you will stay on the line. Then when you come back, let’s talk a little bit about factors that trigger OCD and also what are the causes, is it inherited? So stay on the line. You’re listening to Brain Matters on 90.7 The Capstone. This is Mary Alice with the high diverse and you’re listening to WVUA-FM

Disclaimer: This show is not a substitute for professional counseling and no relationship is created between the show host or guests and any listener. If you feel you are in need of professional mental health and are a UA student, we encourage you to contact the UA Counseling Center at three four eight three six three. If you are not a UA student, please contact your respective county’s crisis service hotline or their local mental health agency or insurance company. If it is an emergency situation, please call 911 or go to your nearest emergency room.

Dr. Guenther: Hey, you’re back. Listening to brain matters on 90.7 The Capstone. I’m Dr. B.J Guenther. My guest tonight is Sarah Vander Schaaf. Did I pronounce your last name correctly Sarah? I never asked you that.

Sarah Vander Schaaf: Oh No, you’re great. It’s Vander Schaaf.

Dr. Guenther: Oh, sorry.

Sarah Vander Schaaf: You’re so close I can’t even argue with that.

Dr. Guenther: I’ll just say Sarah and Sarah has written many publications. She’s a journalist and a playwright and the reason I became interested and got in touch with Sarah is because of so many of the articles that I’ve started finding where she had published some information about her research and interviews with people or her own experience with OCD. And that’s what we’re talking about tonight. And when we left to take the break, you mentioned seasons of OCD, like maybe people have certain patterns or certain times of the year where it gets worse. I find that some people actually I don’t know how to say this, I’ve had some students who actually major in careers that it seems like it would worsen their OCD symptoms. Now could you guess what majors would be maybe the worst?

Sarah Vander Schaaf: Pre-med, perhaps.

Dr. Guenther: Perhaps nursing. Definitely nursing something where you have to be, if you have a thing with germs and then you major in nursing, wouldn’t you think that would make it worse? I know.

Sarah Vander Schaaf: I wonder if it shows there I was talking to someone else about this too. There is a sense of persistence.

Dr. Guenther: Yes.

Sarah Vander Schaaf: They know that they can move past the OCD or they strongly desire. So they’re almost challenging themselves-

Dr. Guenther: That’s right.

Sarah Vander Schaaf: choosing a vocation that is so constantly-

Dr. Guenther: It’s like constant exposure therapy,

Sarah Vander Schaaf: Right.

Dr. Guenther: But it can also cause tremendous anxiety too if the person is not working with a therapist or it’s so severe or they’re not taking any kind of medication either. I mean, most of the articles I read and most of the people I’ve worked with, they’re more successful taking medication along with talk therapy. That’s what works. And this, I’m thinking about the students I’m working with now. They do take medication, but they also are very good at coming to therapy regularly and practicing what we talk about in our sessions. So that-

Sarah Vander Schaaf: Yes when you say talk therapy, do you mean specifically the behavioral?

Dr. Guenther: Yes.

Sarah Vander Schaaf: Positive behavior.

Dr. Guenther: Yes, exactly.

Sarah Vander Schaaf: Right.

Dr. Guenther: So, okay, back to my question about you. Do you think OCD, is it inherited? Did anybody else in your family have severe anxiety or even OCD?

Sarah Vander Schaaf: Well that specific question and I remember when you do the first session with your psychiatrist and they ask you for a family history. And I started going through it. I was like-

Dr. Guenther: Wow!

Sarah Vander Schaaf: Why wouldn’t I be here? I don’t know if family connect the dots. And I was talking to someone else about this, about medical history and a generation ago cancer was something people didn’t talk about. So, you have a whole generation of people waking up to discover that their grandmother, great grandmother they had X, Y, Z cancer. Why didn’t I know that? I think with mental illness, the stigma with, 50 years ago without the same medications or go back even further in institutions and the same period with it, I think it’s a sad legacy, but we might not know much about some of our families history.

Dr. Guenther: Right.

Sarah Vander Schaaf: Looking at my more immediate family history, I think it’s clear there’s anxiety in the family. I’m not aware of anyone else who used the word OCD and it wasn’t something that was even mentioned as a possibility when I was… and so I went as an adult else ready for something else. I don’t know how uncommon that is. I have said no though who say to me because they confide, they have anxiety OCD and they have. What are you going to do with this? When are you going to talk to them about it? Do you talk to them about it? And so I would be curious to know if you’re doing the early twenties now they come already knowing that family says that. My understanding is the combination of nature and nurture and I think they feed on each other.

Dr. Guenther: Wait, many of my students the ones I’m working with currently. Like you said, many of them, they’ll either say, “I don’t know,” and they don’t talk about it in their family or either their family don’t even know they’re coming to counseling. Or they might say, I think my mom has anxiety, but she’s not being treated for it and doesn’t take medication. Very rarely do I hear somebody say yes. My mother and my sister both are diagnosed with OCD and are treated. So-

Sarah Vander Schaaf: Wow!

Dr. Guenther: Yes.

Sarah Vander Schaaf: If it’s an anxiety, I think when you’re in an environment as a child you know what is a typical amount of anxiety and what is something that could be handled in a different way because you don’t have any suspect and an alternative to raise in an environment with anxiety as a [inaudible 00:30:42]

Dr. Guenther: Well, another thing, let me ask if you’ve heard of this, I’m sure you have doing your research, but I discovered, and I didn’t know this existed in social media, and I probably shouldn’t say this, but I’m going to. That there is a Hashtag OCD and you can actually Hashtag OCD and see people’s near perfect organizations of like their closets or their pantries. It’s almost like it feeds into somebody who has OCD. It almost feeds into that. But I could not believe that. Well, I guess I could believe that, but I had no idea that anything like that existed to. Have you ever heard of that?

Sarah Vander Schaaf: Well I’ve heard about a bit about it. That using the Hashtag or just even using OCD is a trend meaning sort of very organized or extremely concerned that things are in perfect order. And the debate about is it the means of severity of true OCD, is it capture, a reality of OCD where there is a fall on the in the role of appreciating the pain of this disease and where is it simply a cute phrase to mean that you are well organized.

Dr. Guenther: That’s right.

Sarah Vander Schaaf: And another thing recently social media enough to know if there’s a consistent message.

Dr. Guenther: No.

Sarah Vander Schaaf: I don’t know how I think the severity of some forms of OCD is so great that it must be very painful for people to think that culture and society at large thinks of it as a cute little fixations order.

Dr. Guenther: Yes. Definitely. That’s right. Because a lot of people use that term just loosely, for “I’m so OCD,” whatever it is, and they don’t understand. Now there’s really people who struggle with this minute by minute sometimes. I mean my first experience when I was in graduate school, I had no idea really what OCD was. I probably had heard about it but I didn’t study it and I had a friend in graduate school who I studied with and I went to her house and picked her up one night and it took us like 15 minutes to leave the house because she kept going back to the front door, checking the front door and at that point it hit me. I was like, “There is something wrong here.” “I don’t understand what’s.” But I didn’t say anything to her of course, but that was my first experience really knowing somebody who I could tell she was struggling and I don’t even know she ever got diagnosed or was diagnosed, but she had the checking compulsion.

Sarah Vander Schaaf: That’s interesting you say that because I was every Tuesday night I would go to the waiting room dance class. There was a mother there with her daughter who wasn’t in dance, they were waiting while the older sister did it and I was just casually sees the corner of my eyes and mother make her daughter go wash your hands and then come back to the table and then make her sharpen a pencil and then admonished her for something and then maybe make her wash her hands again. And what I was observing was clearly a great deal of anxiety on the side of the mother and I trust my heart went out to the child, but just as you did, I didn’t know how to respond-

Dr. Guenther: Exactly.

Sarah Vander Schaaf: To my friends and I don’t know if they’re, how people who are seeing someone else struggling our posts to-

Dr. Guenther: Address that or even speak up.

Sarah Vander Schaaf: I said to her, “I recognized some of what you’re doing because I feel great anxiety myself. I didn’t. And I sometimes regret not saying something mostly because of the children.”

Dr. Guenther: Yes. And you don’t want it. Sometimes people don’t even realize that they don’t know what they’re doing and you don’t want to embarrass them by pointing it out. You mentioned the sophomore year in college for you is when it popped up again, how did it affect you in college?

Sarah Vander Schaaf: I’m sorry, I missed part of it. How did it affect me?

Dr. Guenther: Yes. You said during your sophomore year it popped up again and I want to know how did OCD affect you while you were in college?

Sarah Vander Schaaf: Right. Well, first of all, I didn’t know what it was. Which I think is one of the reasons why I’m happy that you have this program and that you’re doing this particular episode. People in college actually know what’s going on, they can be accept so many better skills. I guess for me I saw my mentor from high school die of AIDS and that I think that triggered a great amount of anxiety related to health and then a peer who I was not close with shortly after died also, which brought the whole devastating disease very close to home.

Sarah Vander Schaaf: And I internalized the anxiety by limiting a lot of my choices. I think I lost the ability to do some of the creative things that I had previously been able to do. For me that related to my major which was acting and I lost the ability to focus, but I was still able to keep up my grades and sort of persevere and but it caught up to me, but I was definitely subverting it and effective relationship. I didn’t trust myself or be myself capable of being in a real relationship. I think is a last opportunity when you’re in college. So I guess that I think I tried to protect myself. I didn’t have as much clear cut and thoughts and rituals you could say that I had a tremendous amount of anxiety at that time.

Dr. Guenther: I mentioned hiding symptoms. Do you think that it is even possible to hide symptoms?

Sarah Vander Schaaf: I do. I also think it’s possible to keep this extremely private in some of the people I’ve interviewed. You know how sometimes young people will make bargain where they want to throw like a crumpled up piece of paper into a trash can.

Dr. Guenther: Yes.

Sarah Vander Schaaf: If they-

Dr. Guenther: It’s like a game.

Sarah Vander Schaaf: If they miss the basket, then X Y Z happened again if they miss then there will be an earthquake-

Dr. Guenther: Oh my gosh! Yes.

Sarah Vander Schaaf: Yes. Like they’ll completely convinced themselves they have the power through doing this ritual to control various things. And those are what the door close, need to touch things or eat a certain way.

Dr. Guenther: Or wash your hands, not necessarily anybody’s really going to know that necessarily.

Sarah Vander Schaaf: No bargains that you can make. Yes. You’re negotiating with yourself and nobody may know, but I think it takes the pole whether the person doing those rituals knows it or not. You are that much energy is being spent on that and not engaging with your loved ones or engaging in what’s in front of you, finding joy in life. There is a cost to that and even if they’re private.

Dr. Guenther: Okay, I’ve got to ask you this. Have you ever, let me see if I can ask this the right way. Have you ever had to complete a behavior or a ritual and it cost you in other words like it made you late for something or you missed out on something? Do you know what I mean?

Sarah Vander Schaaf: Yes. Somehow a little different, I think it made me… so the answer is no, I’ve never missed the bus-

Dr. Guenther: Exactly. Yes.

Sarah Vander Schaaf: A concert or not been able to leave the house, but I have no other opportunities.

Dr. Guenther: Well, I knew I had-

Sarah Vander Schaaf: My, Yes-

Dr. Guenther: Go ahead.

Sarah Vander Schaaf: Yes I know I’m just thinking because I’ve been the people, I think it would be much to that they’ve literally not been able to leave work.

Dr. Guenther: Yes.

Sarah Vander Schaaf: Getting home to be with her family because they were worried about a task that they thought they didn’t complete.

Dr. Guenther: Sometimes I’ll have students who come in and I don’t know if they actually exhibit other behaviors, but this one sticks out. They can’t complete like a paper because they’re perfectionistic, so it’s never perfect.

Sarah Vander Schaaf: Yes.

Dr. Guenther: And I felt like that has some OCD traits to me. Something feels OCD-ish. This is what I say about that, but I can remember a couple of graduate students that’s what they were facing, I don’t know if it was self sabotage or actual OCD stuff, but it really sounded like that.

Sarah Vander Schaaf: Yes, that reminds me. I interviewed a young man who was from China, but they had come to the United States to go to boarding school and they extremely empowered them obviously and very motivated. And then OCD really set him back. And one thing he mentioned was that, “I think it might’ve been earlier setting for the FAT.” He couldn’t bring himself to open the book.

Dr. Guenther: There you go.

Sarah Vander Schaaf: He was so worried he would contaminate it.

Dr. Guenther: Wow!

Sarah Vander Schaaf: In a sense what it was really about was not doing well and he pushed that into the sphere of the germs contaminating the actual book.

Dr. Guenther: Wow!

Sarah Vander Schaaf: And I think that’s an interesting example because as an outside observer you could really be puzzled and you could think, “What’s going on.” “Are you not motivated or this or that.” And you can see a parent misunderstanding that behavior and it’s so much more complicated because of what it’s connected to.

Dr. Guenther: So much more. One of the articles it said, “OCD is a disease that demands perfection.” And it’s true.

Sarah Vander Schaaf: Well, that’s interesting because in my case I wanted to know with absolute testing that I was healthy.

Dr. Guenther: Yes.

Sarah Vander Schaaf: And none of us know that absolute testing

Dr. Guenther: That’s right.

Sarah Vander Schaaf: So what you’re saying about perfection a lot of my cognitive behavioral therapy is also in some way, it’s more about opening up this idea that you’re always in a constant state of unknowing and not a help. So there is no perfection and being okay with that uncertainty.

Dr. Guenther: Well, disorders that coexists with OCD. Do you think those go along with it such as depression? Did you experience any of that? Of course. We’ve already talked a little bit about anxiety, but some of the other comorbid disorders that I read in some of the research articles and in particular depression.

Sarah Vander Schaaf: Yes. I think that’s a great point. And I think to be sincere one of the things my own psychiatrist talked about was that in a life[inaudible 00:43:25] you could have a phase of depression, phase of anxiety, mental illnesses and have clear boundaries all the time, name of the diagnosis probably less than treating the symptoms. So I would say, there is probably enough of like [inaudible 00:43:46] period of depression. Lots of my experiences, I can’t say anxiety, I used to have panic attacks and that probably one of the most wonderful part of our job of addressing OCD was that going a long with that I was able to panic and I think that on the one hand having co-morbid conditions is more complicated with mental health strategies can be extrapolated and applied.

Sarah Vander Schaaf: The other thing, for example I reviewed a book this could be even assist to your listeners called the anti depressant book written by a psychiatrist at Stanford Towrey and he made also an audio version to listen to and many of the strategies which were very practical strategies for addressing depression. Really have parallels in addressing anxiety also. So I thought that was actually fabulous because in a sense, depending on what you’re dealing with or when one is stronger than the other, a lot of those practical some of it was behavioral, a little bit cognitive. I thought they worked for both.

Dr. Guenther: Well, I’m sitting here thinking couple of more questions for you named the title of that book. Again, the antidepressant book. And who is it by?

Sarah Vander Schaaf: Sorry, it’s by Jacob Towery. I think it’s T-O-W-R-E-Y.

Dr. Guenther: Okay.

Sarah Vander Schaaf: What’s nice is that he decided to even do an audio version because he realized some of his clients,[inaudible 00:45:38], either they like to read, they were too busy to read. Some it was just cumbersome and it’s really great. It’s nice to have the voice, he’s the one telling you the strategies, I guess so, yes just double checking Jacob Towery.

Dr. Guenther: Towery. T-O-W-R-E-Y.

Sarah Vander Schaaf: Anti depressant book.

Dr. Guenther: Okay. Perfect. Do you know of anyone in doing your research? Have you ever met anyone who only had the obsessions but didn’t do the compulsive behaviors?

Sarah Vander Schaaf: No. And I’ve seen that on social media also the Pure O

Dr. Guenther: Yes, the Pure O you’re right. And I did not realize that that was what it was called until I was doing my research for this. And I had one client years ago and he was young. He was probably in his twenties and his was so severe he was going for a consult appointment for surgery, for brain surgery and I believe it was at Johns Hopkins University medical and I never really saw him again. Sometimes you just see people once or twice and the you’ll see them again, but always wondered what happened because he really didn’t have the compulsive behaviors. But he had the obsessions.

Sarah Vander Schaaf: Really? I wonder if in some ways people with that are able, I don’t know if maybe it’s more private in some way?

Dr. Guenther: May be.

Sarah Vander Schaaf: There’s a wonderful organization, I don’t know if you’re familiar with it called the International OCD Foundation and they have a pretty good website iocdf.org and what’s interesting about them is they started, I guess back in the 80s when they were doing the first clinical drug trials, people with OCD and I don’t remember which drug it was, but it was antidepressant. The doctor who was monitoring the drug file thought it would be helpful to get the group of patients together and they formed the group therapy and then out of that grew the foundation and one of the best resources on OCD out there. And they also I mean they have a variety of topics and they have I think a yearly conference for anyone from, people who experience OCD, the caregivers to experts. They’re just a leading organization.

Dr. Guenther: Yes.

Sarah Vander Schaaf: It’s nice to know about it.

Dr. Guenther: International OCD Foundation?

Sarah Vander Schaaf: Yes. International OCD Foundation, IOCDF.

Dr. Guenther: That’s a wonderful resource. Yes. And I’m going to mention that to my students. Yes. Because I’m not sure they are aware of that. One of the students I’m working with, she’s been in treatment. It was more of an intensive outpatient treatment. It was an inpatient, so she may know more about the resources than most people who I’ve worked with. Okay. Last question, Sarah, and then I’ll let you go because I know you’re on eastern time, so it’s a little bit later. What helped, what helped you the most?

Sarah Vander Schaaf: That’s a great question. I’m happy to talk about it because what helped me the most is keeping the framework that keeps me moving forward, I guess you could say. So like you said in the very beginning of the show, there’s not a cure, but there’s a way to manage it. And so I have tried to say, “Oh, maybe I don’t need the antidepressants, maybe I know that I need to know now.” And inevitably I’ve, I just, as they say, it’s fine there, but when I follow that meditation, then I can go to yoga and I can. I’m very good about continuing to put myself in situations that used to trigger the anxiety. For me that’s going to the pool in a regular bathing suit. That sounds silly. But that’s what keeps me from regressing.

Dr. Guenther: Yes.

Sarah Vander Schaaf: So I go see my therapist, I go see my psychiatrist. I take my medicine. I recognize when-

Dr. Guenther: When you’re having like a bad month

Sarah Vander Schaaf: [crosstalk 00:50:14] I recognize that. I back off on things. If I say that the anxiety is up 15 and it leads to trouble. That self care aspect. So I think the biggest thing after you found your team of know people who can provide care is sticking with your plan just because you feel better. That’s absolutely not the time to let go of-

Dr. Guenther: I know, yes. You’re so right. Hey, before I let you go, really quick, what projects are you working on? I know in the intro I mentioned you’re writing your second play, but can you tell us a little bit about that or some upcoming speaking engagements or articles that are going to be released? Any projects you’ve got going right now?

Sarah Vander Schaaf: Thanks for the question.

Dr. Guenther: Sure.

Sarah Vander Schaaf: I know I’m working on my second play, it’s a little complicated, but it’s an adaptation of a book that looks at the end of World War Two and then I’m working on a story right now that actually looked at the generation that we’re raising. The post millennial generation.

Dr. Guenther: Wow!

Sarah Vander Schaaf: Which will probably be the young people who are first years at the University of Alabama.

Dr. Guenther: That’s right.

Sarah Vander Schaaf: Yes. So looking at their world view, they don’t really have an official name yet. They’re not millennials. What are they?

Dr. Guenther: What are they? Yes do Tell. Let me in on it first. Wow! That sounds fascinating and it sounds challenging too. Who comes up with the names for the generations? You could be the first.

Sarah Vander Schaaf: Exactly.

Dr. Guenther: Oh my goodness. Well thank you so much for taking time. I know you’re a busy person and I just appreciate you so much for taking the time out to talk with us here. We’re just the campus run radio show and we just try to do something each week that’s of interest to our students and our listeners in the community. So I really appreciate it Sarah. Thank you so much.

Sarah Vander Schaaf: Oh my pleasure BJ. Thanks for inviting me.

Dr. Guenther: Sure.

Sarah Vander Schaaf: Take care.

Dr. Guenther: Let me make a few announcements before we close the show tonight. Don’t forget, our shows are recorded and podcasted on the audioboom.com website. Just type in Brain Matters and you’ll find some of our past shows. And there’s also a link to audioboom on the Counseling Center’s website it’s at counseling.ua.edu. I need to make an announcement tonight on my production assistant tonight is Lizzie Zeeman and she’s involved with this program. It’s a very good program. It’s about childhood hunger. A serious problem within the United States is childhood hunger and one in five children struggles with food insecurity. To help reduce this number Secret Meals For Hungry Children hosted the Tackle Trivia Tackle Hunger event a couple of weeks ago and wanted to thank those who came out. It was a great benefit that raised money to help pay for nutritional food packs that Secret Meals provides to hungry children on the weekends.

Dr. Guenther: 100% of the money raised will go to the children right here in West Alabama and it only cost $140 to feed one child for an entire school year. If you didn’t get the chance to come to the event or donate, there is still a silent auction going on for an autograph Nick Saban football, that will end November 3rd. So it’ll end this week it sounds like, and if you don’t want to be ED, you can still make a donation to Secret Meals and the details are on the Tackle Trivia Tackle Hunger Facebook event page. There’s no minimum on how much you can donate and any donation will help. So thank you in advance for helping out with this great cause.

Dr. Guenther: Also, want to thank a few people who always make this show possible. Our executive director at the Counseling Center Dr Lee Keyes, Terry Siggers from the office of student media, my production assistant tonight is Lizzie Zealand. And also I want to think the Counseling Center staff, the WVUA staff, and of course my guest tonight, Sarah Vander Schaaf. And I want to mention our show topic next week. It’s going to be an interesting show topic. I don’t really know how this is going to pan out, but I hope it’ll be interesting, but it’s the Man Effect, Defining Masculinity. So if you’re interested, join us next week. And thanks again for listening tonight to Brian Matters on 90.7 The Capstone. Good night.

Disclaimer: This show is not a substitute for professional counseling and no relationship is created between the show host or guests and any listener. If you feel you are in need of professional mental health and are a UA student, we encourage you to contact the UA Counseling Center at three four eight three six three. If you are not a UA student, please contact your respective county’s crisis service hotline or their local mental health agency or insurance company. If it is an emergency situation, please call 911 or go to your nearest emergency room.