It is about 9 months since starting this blog. A lot has changed over these months. My son has gone from a bedridden psychotic to a competent young man. He is now employed, living with his girlfriend and is only required to see his psychiatrist once a month. The crisis has been resolved.
By his own account he is 95% recovered and is in the best head-space he can ever remember. So why do I think this occurred?
What I now realize is that my son was ready for a cure. His ego was in fragments. He had no energy invested to fight for his own beliefs. He wanted to find someone to give him hope. BDD thinking didn’t work and he wanted to think differently. So he being in such a bad way inadvertently worked in his favour. He had no defences that wanted to dismiss help. He was no longer ego invested to prove he was right to anyone.
We meet the best professor in the field we could have ever hoped for. He had done research work with Katherine Phillips. He had many patients he had treated. He could appreciate my son’s fears and was warm and compassionate. My son knew that the professor knew and in that exchange a bond was formed. The professor’s beliefs were firmly based in reality. My son was able to hear and incorporate the views of the professor without a fight. This had never happened with any other therapist. My son was able to understand reality through his connection to someone he admired and trusted. It is as though he actually got for the first time that the professor was invested in telling him the truth. We all had been but he never understood that.
The medication altered my son’s brain chemistry. Prozac was increased over a month until a therapeutic result was obtained. 60mg worked at around 9 to 10 weeks. The dose was later pulled back to 40mg after a big improvement was already well underway. Had there been no improvement a dose of up to 100mg might have been required. Initially Lyrica was used as an adjunct to manage an intolerable level of anxiety. We moved from 150mg to 300 mg as needed. Some sexual issues and insomnia are side effects needing medication still but they are manageable.
No CBT has ever been offered. As BDD is primarily a thought disorder, originating in the brain chemistry, it was consistent that treating the biochemistry would resolve the thinking. Any residual behaviours would be challenged as thoughts became realistic. That is exactly what happened. He can now tell me no one cares because he doesn’t any more. So almost all his compulsions fell away as his thinking became real.
ACT therapy was the type of approach the case worker who came to the house used. Acting according to what you valued, meant that my son was to keep very busy doing stuff that mattered. He took up cooking with a passion that filled the whole day. He reconnected to all his friends and made regular meetups with them. His enthusiasm for life reignited. So a super effort in time management was required to beat the addiction to intrusive thought attacks.
I can’t underestimate my own contribution as well. I wrote the blogs as we went and he read them. He knew he had to resist compulsions. He still does. Over time it got easier.
So that is our recipe for recovery. Not easy but doable. Keep trying to find your personal recipe. A word of caution. Surgery is not an option to consider, that is the truth.
Hope we have been able to help. Marg