This column offers mental-health and wellness-related information to the Massachusetts legal community. Lawyers Concerned for Lawyers bases the column on questions frequently asked by its clients and help-line callers. The information is general in nature and not meant for treatment. Q:My conveyancing practice and my marriage seem to be suffering because of certain behaviors that I keep repeating. I should be clear that I consider myself happily married and pleased with my practice. Yet I keep feeling drawn to call phone-sex lines, relieved when I hang up and plagued by guilt the next morning. In addition, I can’t stop worrying about whether I may have caught some deadly virus from the mouthpiece of the public phone that I often use for these calls. (This makes no sense, I know.) My concentration is down, and I'm not all there for my family. Is this obsessive-compulsive disorder?
A: We usually think of people with obsessive-compulsive disorder as getting caught up in hand-washing rituals, triple checking that the stove is shut off, etc., but it sounds as if you, too, may be suffering from a variant of OCD. You feel compelled to return to behaviors that you would not otherwise choose and obsessed with thoughts that have minimal rational basis. And these symptoms interfere with your functioning.
Since our take on the problem, in response to your question, is only an educated guess, the first action that we would recommend is to arrange a face-to-face evaluation with a clinician experienced in the area of anxiety disorders. We would be glad to provide an initial evaluation and further referral. Sometimes what appears to be OCD may actually reflect, for example, a neurological disorder or behavioral addiction, which is another way to conceptualize the persistence of those phone calls.
At least three potential forms of therapy may come into play, if the problem is OCD: (1) Cognitive or insight-oriented therapy may help you understand what kinds of internal themes and personal history set the stage for these thoughts and behaviors. (2) Behavioral techniques can be powerful in altering the actual behaviors. (3) To a surprising extent, medications (including the same ones often used to treat depression) will also markedly reduce OCD symptoms for many people.
For additional information and support, call the Obsessive Compulsive Foundation at (203) 315-2190 or visit www.ocfoundation.org.