Wednesday, April 8, 2009

Rituals...(Books - Kissing Doorknobs by Terry Spencer Hesser & Total Constant Order by Crissa-Jean Chappell)

Little Passover fact: In order for matzah (the unleavened bread eaten by Jews at Passover) to be considered kosher for Passover, it must be fully baked within 18 minutes of coming into contact with water. This is because, according to the Talmud, the leavening process begins after that point. I mention this not merely in the spirit of the holiday, but because I have been thinking about ritual, having read a couple of books about pediatric obsessive-compulsive disorder in preparation for a class presentation and have learned that one person's meaningful ritual is another person's compulsion. OCD can afflict children or adults and consists of recurrent thoughts or impulses that don't arise in a proportionate way from real-life problems and generally cause a great deal of anxiety. The person then tries to suppress these thoughts with ritualistic behavior. For example a person can become excessively worried about infection and wash their hands until they bleed. Other rituals can include counting, touching objects in a certain order, or praying. The diagnostic manual is specific about the clinician's responsibility to interpret the behavior in the context of that patient's cultural norms.

Having been home with a nasty little fluish thing, I read two books for young adult readers about OCD - Kissing Doorknobs by Terry Spencer Hesser and Total Constant Order by Crissa-Jean Chappell. Kissing Doorknobs is the more overtly explanatory of the two, but it is still a good story. Tara, the young heroine, is a believably written young character, and this book handles the experience of having symptoms without knowing what is wrong with you very sensitively. I appreciated how it explored Tara's experience of her illness in the different contexts of her life: friends, school, and family. I felt like the book strained a little to include every possible symptom, every possible misdiagnosis, and the most popular forms of therapy used to treat OCD (Exposure and Cognitive Behavioral Therapy) but on the other hand, if it is your goal to have any young reader who might have this illness but not know it recognize themselves, then this book gives them a good chance of being able to say "that's me!" What I enjoyed most about Total Constant Order was how imaginative and well written it was. While Fin does have OCD and that is the subject of the story, I found it wore that mission less on its sleeve. It told a story about a young girl whose parents recently moved from Vermont to Florida, and if that weren't enough displacement, they then got divorced. So there is a lot of uncertainty in Fin's world to propel her anxiety and her propensity to cope with those feelings with ritual behaviors (incidentally her doctor chooses talk therapy and medication). Even if Fin didn't have a diagnosis, she definitely is having the outsider experience. She is befriended by another outsider, a young man named Thayer and their friendship was the highlight of this book. Chappell is really able to evoke the magic of finding someone at that age who "gets" you when you believe no one will. It's a delightful read. Both these books would help a young person who is experiencing some of the symptoms of OCD gain some insight into themselves and destigmatize seeking help.

Happy Passover, if you're celebrating.


christina said...

I really enjoyed how you introduced OCD through rituals. Isn't it funny how something nonchalant in one's life can become turmoil for another?

Overall when I was in grad school I found that I wasn't a big fan of CBT, and found myself leaning more toward Narrative Therapy. Still, CBT has it's place in a practitioner's room, and OCD is whole-heartedly one of those times.

But I really liked to say thanks for the reviews too. Both seem like worthwhile books, and I know of a student in particular that I might recommend them too.

Ted said...

Thanks, Christina. Yes, OCD does seem to be the course of choice in this case. If the insurance industry had its way, it would be every case! Glad the reviews were useful.