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Therapy Success Stories
Graduate OCD Sufferers Speak Out


Graduate Story #14

Embracing Change (Joe Cianciotto)


My name is Joe Cianciotto and I have had OCD for most of my life. I can not speak for anyone else and only myself, but the single most important ingredient to any success I have achieved in my recovery is due to discovering and embracing something as simple as making mindful and consciousness choices. 


Let me explain.


The gold standard for behavioral modification has been Exposure Response Prevention. The basic principal of ERP is to identify those situations that cause the sufferer anxiety and to then purposely expose oneself to them without any avoidance behaviors. What makes this particularly challenging for OCD sufferers like me is that the danger mechanism from the brain does not correlate to just one moment or one situation, like a phobia of confined places or heights. Rather it is the never-ending mechanism of our brains warning us that we are in danger all of the time. And as we retreat further from these life processes through avoidance, there is a never ending cadre of new dangers our mind conjures up that further tightens the grip of this disorder. In fact the irony of what I learned about Obsessive Compulsive Disorder is that the specific content of our OCD spike is actually irrelevant. Instead it is our brain’s attempt to attach meaning to misfiring of the brain that only reinforces and escalates the feeling of danger, which seems to never go away. 


This is where choice comes in.


As a novice to understanding my disorder, I thought that with any spike, giving in was a fait accompli.


Fortunately in the course of my therapy at the center I was able learn that each incidence of my OCD symptom actually consists of three separate components.  The first is what you think (the story your brain tells you), the second is how you feel (the sensation your body produces in correlation to a thought) and the third is the choice that you make in response to these stimuli.  By embracing choice you shatter the illusion that you have to act on what your brain tells you and what your gut makes you feel. To me this seemed to be insanity because I had only ever perceived this experience to be solely how I felt and what I thought. And when I left my first session that this finally sunk in I felt completely free and on the path to my recovery…until about an hour later when I was confronted with the next OCD spike my brain put in front of me and I folded like a deck of cards.


See I made the most common mistake that comes with intellectually understanding this disorder. And that is that the understanding Obsessive Compulsive Disorder by itself is enough to beat it. The reality is that you can know all there is about OCD, but until you take that leap and embrace choice your journey hasn’t even started, not even by a single step. 


Finally ready to try this, I worked with Dr. Steven Phillipson to create a hierarchy of challenges from the most reasonable of exposures I was willing to expose myself to all the way up to the things I could not imagine being able to endure. And just like that we focused on the little wins. And by doing this it created a foundation for me of fortitude that had everything to do with ignoring my thoughts and my feelings as I made my commitment to embracing choice.


My brain confronted with the strength of my commitment to choice soon loosened up and I found that what seemed so difficult a short time ago was now at times almost easy. In this phase of my OCD recovery it was like the confines of my existence went from a one-bedroom apartment to a 40-acre college campus. 


It’s funny though, as I enjoyed these greater freedoms it amazes me how fast I fell back into believing that the reason I was able to take on so much more was because I now felt less anxiety and was less challenged. That of course was true and a byproduct of the work we were doing but it wasn’t nor should it have been the goal. In that I took my eye off of the ball, which was to gauge my recovery on the choices I was willing to make and not how I felt. The bottom didn’t fall out immediately, however as I was still doing good work and actively engaged in curriculum of my exposure therapy.


However, it wasn’t until a few months later that my contamination OCD was severely spiked, do to life circumstances outside of my control, that caused me to feel like all of my work had fallen to the wayside.  In looking back at it, it was probably one of the worst “feeling” and negatively thinking of times in my life with the disorder. Suddenly challenges that were sixes now felt like nines and tens. What I didn’t realize at the time is that I was fortunate to have had a background and history of embracing choice and doing good work with my psychologist. So the tools weren’t truly gone, I just had lost faith that they were there. In that time of crisis, a dear friend and fellow sufferer who had overcome her OCD to the point of remission bared her soul to me. This person that was always the picture of fortitude to me, confided that she too had been in it as deep as I was, if not worse. The difference was she one hundred percent made the commitment to give herself completely over to choice with reckless abandon. She told me that in a figurative sense you just have to stand in front of traffic and in spite of the alarms going off CHOOSE to leap. I remember that, because in that moment where the world had fallen apart around me, I did just that. I realized that being swallowed whole by OCD was worse than anything my OCD would tell me to worry about, so screw it I might as well just leap.


There was nothing graceful about it. I still felt like garbage and my brain was telling me my world was falling apart, except I made the choice to go the top of my hierarchy and immediately take on those spikes. I thought, if everything had become a ten, well then I might as well go after the things that were really tens to start with. And as dark as that time in my life was in doing that I experienced what it meant to embrace choice when your brain and your nervous system is screaming bloody murder the other way. It was definitely a rocky road, but by taking it one hour at a time and actively making a commitment and acting in a way that reflected a life based upon choice it wasn’t long that I was back where I needed to be. 


The lesson here is not that everyone with OCD has to reach a moment of despair like I did to achieve recovery. Sure, for me it was a moment of clarity, however one that would have been useless had I not doggedly chosen to then do the difficult work day in and day out to show my brain who the gatekeeper ultimately was.


It’s funny, while writing this essay, I stopped to go out to the grocery store like I do every Sunday. And as I was in the car thinking about this article and how good I felt about myself for writing it, I drove over a pothole, and was hit with an OCD spike that made me feel like I needed to look in the rear window of my car to see if I hit anything. And in this moment, it was crystal clear that recovery is not about grandiose statements and pontifications rather the multitude of opportunities before us each day to make the choices that show our brain and our gut, who is really in charge. 


And no, I didn’t look back.

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