You love them. They’re an addict. How to not break down.
The summer I was 14, my brain flooded with disturbing words and images, hundreds of times each day. These thoughts included scenes of violence and murder, blasphemy, fornication, and verbal abuse.
The more I tried to push them out, the stronger they became, until they inhabited my every waking moment. Even when I slept, my dreams were drenched with blood. I’d wake up screaming and shaking, convinced my racing heart was about to explode inside my chest. I felt so desperate for a reprieve, I began contemplating self-harm. By the time September rolled around, I was paralyzed by severe anxiety and depression.
The afternoon of the first day of my sophomore year of high school was also the first time I met with a therapist. In a tremulous voice, I revealed every thought I had in gory detail. When I was done, I braced myself, expecting her to say I needed to be committed to a hospital, that I was a danger to myself and to others. Instead, she smiled and said something that saved me from the brink: “You are not crazy.”
She explained that I had Obsessive Compulsive Disorder. Most people associate OCD with repetitive and ritualistic behaviors such as hand washing, but the disorder can also manifest as a relentless repetition of disturbing thoughts rather than compulsive behaviors. Known as Pure Obsessional OCD, (or sometimes just Pure O) it still has not entered social awareness as much as the compulsive counterpart of the disorder, perhaps due to the extreme shame of those suffering from it and the stigma of even admitting to having such thoughts, no matter how involuntarily. In my case, I had a trauma history that primed me for developing this Pure O. My mother had been a drug addict since I was a young child and was prone to violent outbursts and abusive behavior, including attempting to stab my stepfather with a butcher knife and dragging me around our home by my hair while waving a pair of scissors.
As a pre-teen, I developed an affinity for horror movies as an escape from my reality, especially the slasher flicks that defined ‘80s cinema. I stopped being able to stomach these films the year before the OCD developed because the pain of the victims in these films hit too close to home. My mind had already stored an impressive library of grisly images that would soon besiege me nonstop.
As part of my treatment, I was prescribed a daily dose of Prozac and Xanax that successfully stabilized me. My night terrors abated and I could sleep a full eight hours again uninterrupted, while my panic attacks mostly subsided. While the thoughts lessened somewhat in frequency and duration, they still appeared much more often than felt comfortable. So I remained isolated and withdrawn, ashamed of myself, and terrified others might find out about the horrors that occurred inside my head.
Then, something changed.
A month into the school year, my English teacher asked me to try out for the Christmas play. Hesitant at first, I attended the tryouts and landed the part of Ghost of Christmas Present in “A Christmas Carol”. I delved into the role and began making fast friends with my co-actors. Not two weeks into our rehearsals, I began to notice a significant shift. The violent thoughts had waned to only a few times a day, demoting them from relentless torture status to small annoyance. Instead, my busy brain latched onto the script, replaying the scenes in my head until I memorized every detail. For the first time since starting high school, I looked forward to something every day and felt optimistic about my future. By spring, after a gradual weaning, I was completely off of my medication. I remained an active participant in drama club until graduating high school.
It turns out I stumbled onto something of therapeutic value without even knowing it. A large body of research indicates that partaking in drama and other expressive arts can be especially helpful for those suffering from the fallouts of trauma and who struggle with many forms of mental illness, including OCD.
“Expressive therapy [such as drama] allows a person to get out of their head,” says Dede Booth, a registered expressive arts therapist at the OCD Institute at McLean Hospital. “By engaging in a physical art-making activity, the mind is literally shifting from the concrete thinking side of our brain to the creative side of our brain.”
Booth notes that engaging in an expressive art can interrupt ruminative thinking and help patients focus on the present, which can be very useful in treating OCD.
“Expressive therapy is a process that can be used to practice skills of mindfulness, creating distance from OCD thoughts, and increasing cognitive flexibility,” she says.
Read more: Helpful tips for riding out a panic attack
Dr. Joseph Spinazzola, the executive director of the Trauma Center at the Justice Resources Institute in Massachusetts, also believes in the transformative power of theater. Spinazzola runs Trauma Drama, a research-based intervention program that incorporates theatre as therapy for the adolescents enrolled in affiliated schools.
“[Theatre] seems to provide a very embodied experience where participants can reflect on trauma and adversity in their lives in a vivid way, but in a safe environment,” says Spinazzola. “The program helps foster a healthier sense of self-esteem and identity, while offering the teenagers a forum in which they can feel connected as part of a supportive community.”
Mimi Sullivan, Ph.D. candidate in Social Work at Widener University, is researching the impacts of Trauma Drama on JRI students for her dissertation. She notes that virtually all of the participants she surveyed offered positive feedback about the program—many credit it as a pivotal game-changer. Sullivan also measured heart rate variability of participants and found that those who suffered from hyperarousal prior to being enrolled in Trauma Drama experienced a “calming effect” as a result of their involvement. Conversely, those who were more withdrawn before arriving at Trauma Drama experienced an uptick in heart rate and tended to adopt more outgoing behaviors by the end.
“Drama does so well to mold itself around people’s experience and feel relevant to each person for different reasons,” says Sullivan. “It’s a very powerful intervention that changes the way they [the students] view the world and literally saves lives.”
I know it saved mine. Nearly 25 years after my first visit to the therapist’s office, I am still off medication and have managed my OCD mostly through the techniques I learned on the stage. While it may not work for everyone, theatre healed much of me that was hurting.
Artwork by CHRIS MARKLAND