Wednesday, September 30, 2015

She Couldn't Stop Thinking About SEX

Naturally, our interest in this case is purely clinical. What could be more clinical than a woman who, for ten years, from the age of 15 to 25 could not stop herself from thinking about SEX?

Rose Bretecher (a pseudonym) was suffering from what the Daily Mail called “uncontrollable thoughts of a highly sexual nature.” She told her own story in the Guardian two years ago.

Clinically speaking, she was suffering from obsessive-compulsive disorder, aka OCD. For those who want to explore the clinical implications in depth, Bretecher has now written a book called: Pure.

The Daily Mail offers a clinical description of her condition:

A woman has described how a rare strain of obsessive compulsive disorder (OCD) meant she was plagued with continuous sexual thoughts for more than a decade. Most OCD sufferers wash their hands continually or find their minds assailed by less lurid thoughts.

Rose Bretécher, 29, from London, says the condition hampered much of her young adult life after her first vision of a naked boy aged 15 until she finally underwent therapy to overcome the hallucinations and anxieties that left her unable to live normally in 2013.

When she was 15 Bretecher had a vision of a naked boy. It was downhill from there.

The Daily Mail reports:

The freelance writer says that she experienced her first 'vision' of a naked boy aged 15 after a happy, Catholic upbringing. 

She describes how the image plagued her and she could not get it to disappear.

In a blog for the charity OCD Action, she wrote: 'I was just suddenly plunged into full blown obsessive fears, 24 hours a day, every day. 

'Fears that I may have committed a paedophilic act in my past without realising. Fears that the graphic mental images I was experiencing were proof of my depravity.'

It was an incident that would spark a decade of visual disturbances that would leave her seeing her friends topless, strangers copulating or even new colleagues completely naked. 

Sitting down to watch a Ray Mears survival programme, for example, she saw a rock face replaced by the sight of vaginas sculpted across the wall.  

The memoir reveals that the more Bretécher tried to rid herself of the images, the more likely it was they would appear. 

She told ES Magazine: 'The obsession is the thought and the compulsion is the attempt to explain away or get rid of the thought. The more you do, the worse the obsessions become.'

Like the time she ran into Jake Gyllenhaal:

I met Jake Gyllenhaal on a music video shoot and watched his face melt into a chubby vagina in my vision. I sat in the Melbourne mansion belonging to the founders of Lonely Planet, imagining them fucking across the patio. I nearly overdosed.

Apparently, Gyllenhaal’s chubby vagina face sent her into a suicidal spiral that caused her to pursue treatment options seriously.

Before then, she had been spending years trying to self-treat the condition.

From a clinical perspective, one would have to say that she was not repressing her thoughts about sexuality. It was almost as though she had had a Freudian interpretation application implanted in her brain. Whatever she saw, she interpreted it in sexual terms. Better than that, she tried to rid herself of the thoughts by psychoanalyzing them. She imagined that perhaps she had repressed an experience where she had sexually abused a child.

Bretecher describes the process in the Guardian:

In a bid to answer it and purge the anxiety, I began to dissect my memory for clues about my identity. I analysed every pretend kiss and cuddle I'd had at sleepovers; when my friends and I had re-enacted Neighbours weddings, pressing our faces together and giggling at the "kiss the bride" bit. Or when we'd renamed Barbie and Ken as Fanny and Dick and made them "make babies" in a shoebox. All these filthy sparkles of a child's imagination were twisted into something threatening, because they seemed to support my obsessive fears about my capacity for depravity.

Obviously, it made everything worse. When she tried medication, it did not do much more good.

Neither did religion:

Church was the worst. There was the penitential rite, the confession and absolution. Mea culpa. My fault. There I was, every week, a child, saying the words and trembling: "I confess to almighty God, and to you, my brothers and sisters, that I have greatly sinned, in my thoughts and in my words". I was at fault because God had said so. Barbie and Ken had been my fault, kiss-the-bride had been my fault. My thoughts, even, my unstoppable thoughts – they, too, were my fault.

Note the easy coalescence of religion and psychoanalysis. Both taught her to blame herself, as though the thoughts were all her fault, an expression of a repressed trauma.

She even tried psychoanalysis. She writes in the Guardian:

Eventually I went to the doctor with my self-diagnosis. First I got referred for person-centred therapy, in which a counsellor tried to get me to come to terms with my latent homosexuality. Then I went for psychodynamic therapy, where I was diagnosed with pure O before being prompted to explore and analyse the route of my thoughts, à la Freud – effectively encouraging me to engage in compulsive soul searching. This was the wrong approach: analysis only made my obsessive thoughts more deeply entrenched.

What is called cognitive restructuring therapy was not very helpful either:

Then, after a six-month wait, I received cognitive restructuring therapy, which used rationalisation to prove that my thoughts couldn't be true, based on x, y, z evidence. While highly effective in the treatment of depression and some other anxiety disorders, cognitive restructuring of obsessive compulsive thoughts is woefully detrimental, for the cyclical rumination it encourages. You cannot out-logic OCD.

What does interest us, clinically speaking, is this: which of the different kinds of therapy really worked? You might have guessed, it was a variant on cognitive/behavioral treatment, one that was more suited to anxiety disorders than to depression. Rather than try to escape and avoid the images, she learned how to face them:

I chose an OCD specialist at a world-leading centre for the treatment of anxiety disorders in New York. Every Monday for a year I had a 45-minute session of exposure and response prevention (ERP) therapy on Skype, in which I was exposed to sexual images of gradually increasing explicitness. I had to let my thoughts wash over me unresisted, while my anxiety shouted and screamed and had me ripping my cuticles in strips from my thumbs.

I was a studious patient, diligently watching porn three times a day for months and months. I watched so much porn I could identify the production company by the luxuriance of pubic muffs or lack thereof. Eventually, thanks to an awe-inspiring phenomenon called neuroplasticity – which means we can bring about physical changes in our brains' neural pathways and synapses by changing our behaviour – I began to get used to the anxiety and to relax my need for an answer.

In the past four months since I finished therapy, there have been moments when the pure O has lifted, imperceptibly, like rising light, and I've had no thoughts in my mind; felt nothing but the quiet joy of concentration or the shimmer of my boyfriend's touch. If it wasn't for the comparative cacophony of pure O, I wonder, would these moments feel so impossibly beautiful in their sheer, simple unthinkingness?

One appreciates the fact that the author wrote her story under a pseudonym. One likes to imaging that the pictures accompanying the articles are stock photos. 


KCFleming said...

In this case, she was already having nearly continuous internal images of porn, so how do you suppose the external images reduced that occurrence?

Stuart Schneiderman said...

I imagine that putting the images outside of her head helped somewhat. I also believe that the point of the therapy was to make something involuntary voluntary. Rather than feeling that she had no control over what was going on in her mind, the willful watching of the images gave her some agency. If she could control watching them she could also control turning them off.

KCFleming said...

I had suspected she became inured to the external images, bored by them, so that the internal images were no longer able to produce anxiety at all.

Promoting agency makes complete sense.
Wonderful idea, that, "make something involuntary voluntary".

Stuart Schneiderman said...

I agree that the boredom factor must have played a role. After all, this type of therapy is based on the idea that overexposure tends to desensitize one to the power of... for example, a phobic object.