OCD MASK

Twice a week at Rogers Hospital, Jesse joins the other kids in the OCD program for “experiential therapy” (the inevitable ET). I didn’t know what those two words together mean. It felt jingoistic. So I googled it and learned that it means doing activities that encourage the patient to identify and come to grips more indirectly with “hidden or subconscious issues.” Still felt jingoistic. I’m sure it’s more extensively thought out than I’m describing it, but basically the kids sit around and do stuff together — art, meditation, story telling, I don’t know, basket weaving.

Jesse’s first couple weeks, her behavior during ET was so outrageous that they booted her from it the third week. Our behavioral specialist (you got it, our BS) told me about the plan, and I remarked that this wasn’t going to go over well. Sure enough, when he told Jesse, she folded over in two and wailed, “OH GREAT I’M A FAILURE ALREADY!”

Excellent, excellent. ET in action, helping Jesse come to grips with all new levels of as-yet-unidentified self-loathing, with the  assistance of her trusty BS.

But she went back and has struggled on, week after week, yawping and interrupting through bouts of ET. A few weeks ago, the kids made “OCD masks.” They were each given a white paper mache mask to draw and color on, with instructions. Counterintuitively, the inside of the mask depicts how the child believes others perceive her. The outside of the mask depicts how the child perceives herself.

Jesse brought her mask home recently. Here’s the inside of Jesse’s mask:

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Jesse told me this is intended to show that others see her as “kind of crazy.” She doesn’t mean that in a pejorative way. She means something more along the lines of “kooky,” as in she likes to get goofy and silly, she likes to go a little crazy when she’s having fun, she’s got a lot of pent up energy. So she chose bold primary colors and sharp lines, to show that energy and craziness.

Here’s the outside of Jesse’s mask:

IMG_2115.jpg

I succeeded in not crying when I saw it; I saved those tears for later. I probably didn’t do such a good job of hiding how startled I was. We didn’t talk about it much. She pointed out that there’s a dragon at the top, on the forehead. “I think about dragons. A lot.” She told me she had explained to the other kids that she’s “kind of goth,” so that’s why she chose dark colors. That’s about as far as she was willing to go with me.

Tonight she came home from Rogers and it had been a pretty tough evening. She kicked the back of Anthony’s seat in the car several times on the drive home, and she spit on him during exposures. I was angry and depressed by that, and I gave her the what-for, including saying unnecessarily and cruelly that maybe she’s not ready to go on vacation to see her grandparents, a highly valued trip to the ocean which is coming up asap. She didn’t rage at me, which surprised me a little. She was calm, almost blank, as she picked up her mask and pointed at the outside. “This is how I feel right now, Mommy.”

You would think I would have followed the lead and engaged in a conversation. But no. Instead I said, I don’t care how you feel right now. I care how you act, because that’s what we’re working on, that’s what matters.

Needless to say, not long afterwards I felt like a terrible, horrible, no good, very bad mom.

Technically, I’m right. Cognitive behavior therapy, CBT, is mostly about changing behavior. For little kids especially, the cognitive aspect of this work is secondary. We don’t waste much energy on understanding why; we focus instead on changing how the kid acts, one exposure at a time. When the behavior changes, that circle of connection and causation — thought, feeling, behavior, thought, feeling, behavior — will start to change the why.

But I’m also wrong, and I’m ashamed. Tonight, when Jesse opened the door to tell me what her mask is trying to say, I shoved it closed on her.

I’m not sure why. Maybe I’m just worn out by a hellish year and almost two months of intensive therapy. Or maybe there’s a more hidden motivation. Maybe I’m not sure I can keep it together if Jesse puts into words the inchoate feelings her mask seems to express. I’m not sure I’m strong enough yet to be the unbending shoulder she needs to lean on as she faces those demons. They look awful. They look terrifying.They look so sad.

So I’ll just let this mask haunt me from the kitchen table for a while. Next time Jesse offers to open the door, I’ll try to let it open. She deserves that much.

 

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