Anxiety and ocd treatment center of philadelphia

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Cryers Cross A Heroine with OCD

Cryer's Cross, by Lisa McMann, is the story of sixteen-year-old Kendall, who lives in a small town in Montana that is rocked by the summertime disappearance of a girl named Tiffany. Searches turn up nothing, and eventually folks give up hope. Kendall and her boyfriend, Nico, start their senior year in the town's one-room schoolhouse, and although Tiffany is missed, things are approaching normal again.

Until Nico disappears, too.

Kendall has Obsessive Compulsive Disorder (OCD), and in some ways, it's like another character in the book. Both villain and sidekick. The author does a skillful job of depicting that double-edge I discussed on Monday.

According to the DSM-IV-TR, the diagnostic criteria for OCD are as follows:

First, you have to have obsessions, compulsions, or both.

An obsession is defined by the following (must have all four):

1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
2. the thoughts, impulses, or images are not simply excessive worries about real-life problems 
3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from outisde, like "thought insertion" you might see in someone with schizophrenia)

A compulsion (must have both of the following):

1. repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession or according to rules that must be applied rigidly
2. the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive

Kendall does have repetitive thoughts: "And when your brain has a glitch and its lap counter is broken, the same thoughts whir around on an endless loop." I love that description, though it hints at how exhausting it must be to deal with OCD on a daily basis.

However, what Kendall primarily appears to be dealing with is compulsions. She counts. She checks. She has to get to school early to make sure everything in the room is just so, or she can't concentrate or function during the day. Throughout the book, you see Kendall dealing with this need to complete these activities.

Even though she knows they're irrational. And that's another part of the diagnostic criteria. The person has to recognize that the obsessions or compulsions are excessive and unreasonable.

Another criterion: the obsessions or compulsions have to cause significant distress, take up a lot of time, or really interfere with the person's routine. In other words, they have to cause impairment. THAT'S WHAT MAKES IT A DISORDER. For Kendall--she's got to get to school really early. She can't manage to stop counting or performing rituals until certain things happen. Even when she's tired and wants to rest. Even though she knows people will think she's nuts. Even though she WANTS to stop. She can't stop. It gets in her way.

Now, back to that double-edge. OCD, along with all the other mental disorders, is nothing but a problem. I actually don't believe the disorder comes with any upsides. HOWEVER, I totally believe the PERSON who has the disorder has many upsides, including more adaptive qualities that are related to the out-of-control tendencies that cause so much suffering.

Take Kendall. She's determined. Organized. Disciplined. She's learned that by keeping her body active with dance and soccer, she can quiet some of those thoughts. She strives for HEALTH every day. She wants to be well. Although she gets frustrated with the OCD and what it does to her, she doesn't hate herself. And yes, she notices details and catches things other people miss. But I actually don't think that's part of the disorder. That's part of the girl herself.

OCD can be conquered. The right medication is helpful but often isn't enough. Cognitive-behavioral therapy to change the thoughts and tackle the compulsions has been shown to yield long-term, positive results.

Anyway, one of the things I liked about Cryer's Cross was that it has this supernatural/paranormal element. Unlike most books that include a character with a significant mental illness, this book is not a straight-up contemporary. It's not an issue book. It's not about OCD. And yet the main character is realistically portrayed as a quietly strong-willed girl with a diagnosed mental disorder. And she is indisputably the heroine of the story.

So ... have you read Cryer's Cross? What did you think of it? And do you know someone with OCD? I'll bet you do. It's thought to affect 5-6 MILLION Americans, and that number includes Lisa McMann's daughter, Kennedy, to whom the book is dedicated.