March 27, 2020
Dear Adam—and you:
I write from Madison, Wisconsin. On Tuesday, Governor Evers announced that he’ll issue a “safer-at-home” order, much like the shelter-in-place order that began last week in California. My dad, who lives in San Francisco and is recovering from lung cancer, has been at home even longer. He and my stepmom are prepared to stay there for months if necessary. When I spoke to them last night, they told me about the things they’re doing to stay positive, like learning new recipes for the Instant Pot. Over the weekend, they attended a cocktail party with two other couples, where everyone opened a bottle of wine along with FaceTime.
Of course, they’re frightened too, like I am: for those who are elderly or have preexisting conditions (really, for all of us); for those who work in healthcare and shipping, pharmacies and grocery stories, warehouses and restaurants; for those making do without resources—antibacterial wipes and hand sanitizer as well as enduring employment, the ability to work from home, documentation, childcare, a financial cushion; for the local, national, and international economies. There is so much we don’t know: how the virus manifests, how to treat it, how best to protect ourselves and others.
I still feel like I’m not doing it right. On our call, my dad mentioned that he had spoken with my ninety-two-year-old grandfather, who shared his technique for dealing with mail. On the day the mail arrives, Grampa puts it outside in a box marked “Four Days.” The next day, he moves it to a box marked “Three Days,” then “Two Days,” and so on. Today, after returning from the grocery store (no sugar, no flour, no half-and-half; two teenagers in masks loaded their arms with canned soup; red onions rolled across the floor of the empty produce section), I felt paralyzed. I had read somewhere that it was best to soak vegetables in a bleach-and-water solution, but that didn’t sound good for anyone’s health. I knew to wash my hands for twenty seconds, but should I also disinfect my keys, which I’d touched after leaving the store? Should I wash my hands before or after disinfecting my keys? If after, should I clean the Clorox bottle, whose trigger I would have depressed with an unsanitized finger in order to sanitize everything else?
This rabbit hole feels endless, and it is familiar to me.
In 2016, I sent a draft of my second novel to my agent. She was excited about the first three sections, but she felt that the fourth—written from the perspective of Varya, the eldest of four siblings who are told, by a maybe-psychic, the supposed dates of their deaths—wasn’t working. My agent didn’t understand why Varya, despite having received the furthest date of death, lived with the most caution. It took months of headbanging and writer’s block before I was able to write what I had known about Varya but been reluctant to make explicit:
“It’s not a question of seeing something is clean,” she said. “It’s a question of feeling it’s clean.”
“And what if you don’t?” the therapist asked. “Feel something’s clean?”
Varya paused. The truth was that she did not know exactly what would happen; she simply felt a constant foreboding, the sense that ruin loomed behind her like a shadow, and that the rituals could continue to forestall it.
When I finished the scene, my entire body was tense. I recognized those words. I was afraid of them, for I knew they were true: not just for my character, but for me. I also knew, with the same inward surety, that I had found the heart of the novel.
For years, I had avoided touching other people. I crossed to the other side of the street if I saw a group of schoolchildren. I didn’t let the back of my head touch the headrests on airplanes; in fact, I didn’t let the back of my head touch anything, which meant that I keeled forward, my shoulders braced, whether I was sitting on the bus or on a couch at a friend’s house. These behaviors were not always part of me. They began when I was fourteen, after a traumatic health experience. Occasionally, I wondered if I had Obsessive-Compulsive Disorder; online, I read that the diagnosis encompasses both obsessive thoughts and the compulsive, irrational behaviors one performs to manage them. But the therapist I saw as a teenager was not a specialist, and she diagnosed me with generalized anxiety. When I was thirty, I shared my suspicion with a different therapist, who asked if I had considered Exposure Therapy.
Exposure Therapy—also known as Exposure and Response Prevention (ERP)—is a first-line treatment choice for OCD, but I had never seriously considered it. I didn’t think I could do it because it requires patients to move toward the object of their fear. Avoidance and self-soothing rituals reinforce the brain’s belief that something is dangerous. During ERP, patients are exposed repeatedly, in doses of increasing size and severity, to the source of their anxiety. At the same time, they’re taught to resist engaging in the compulsions—such as handwashing, checking, or seeking reassurance—that make them feel safe. Through this process, the theory goes, one habituates to the object of fear. The goal is not to eradicate the feared stimulus from a patient’s life, which is usually impossible, but to increase their tolerance for discomfort.
My therapist found an academic article from the 1960s about a teenager girl who developed OCD after undergoing the same health event I did—and whose symptoms vastly decreased after exposure therapy. Because the source of my obsessiveness was not a generalized fear of contamination but a very specific one, it was revelatory to read about someone else with the same experience. Six months after my novel came out, I made an appointment with Dr. K, a psychologist trained in ERP.
I anticipated the appointment with equal parts dread and eagerness, which I know, in hindsight, was an eagerness to be understood. Emboldened by the fact that Dr. K was a stranger, I described my symptoms more honestly to him than I had to anyone before. He listened carefully. When I finished, he told me that I fit the prototype for OCD clearly, and that I would be an ideal candidate for exposure therapy. In the parking lot, I cried with relief. I had thought I would feel shame if I were finally diagnosed. Instead, I felt seen. To Dr. K, the behaviors that had tormented me for almost two decades made sense.
Over the course of the next year, I met with Dr. K weekly. We started small: I merely wrote the object of my fear, over and over again, on a piece of paper. I could barely stand to look at the words. When I could, I recorded myself speaking them, and I listened to the recordings daily. Later assignments took me out of his office, into the world. Slowly, slowly, I did things and went places that I had avoided for over half of my life. I unlearned behaviors that I thought would never leave me. I told myself that every time I succeeded in quashing an obsessive thought or resisting a compulsion, I was adding a brick to the new reality—the new self—I was building; when I engaged in old behaviors, I was taking a brick away. Many times, I took bricks away. But I kept going back. I kept trying again. This work is still a daily practice. But now, almost two years after I first entered Dr. K’s office and one year after our sessions ended, I am no longer ruled by OCD. On the subject of my former trigger, I feel a neutrality that astonishes me. Well, I hope I don’t have to deal with that, I think, but if I do, I know I can handle it.
Dr. K once told me that OCD is often described as an allergy to uncertainty. This made perfect sense to me. Underlying the specific fear that dominated my OCD was a more elemental one: a fear of loss, of the vulnerability of the body, of the fact that so much of human being is beyond our control.
I’ve returned to this thought frequently over the past few weeks. Part of the reason COVID-19 is so frightening is because it is—in our contemporary age—unprecedented. We are suspended in a global state of uncertainty. We don’t know how much worse the epidemic will become or how long it will last. We only have so much control. In OCD, the belief that one’s actions can prevent tragedy or disaster may be a fiction, but there’s a reason it’s so compelling.
Toward the end of our time together, Dr. K suggested a name for the state of not-knowing. He called it “the gap.” In the gap lives everything that is agonizing about life: uncertainty and chance, misfortune and bad luck, grief and loss. But the gap also contains everything that is wondrous: sacred mystery, unforeseen happiness, delightful surprise. Freedom, too—for if we knew everything that was to happen in our lives, the joy as well as the sorrow, who would want to act it out?
“We live in the gap,” said Dr. K. Which means that the only way to close the gap—the only time we have all the answers—is in death.
I don’t mean to make a one-to-one comparison between COVID-19 and OCD; that would be reductive and inaccurate. The precautionary measures I took to appease my OCD were irrational and unnecessary. The precautionary measures that we are now being asked to take—to stay home, to practice social distancing, not only for our own health but for that of our fellow people—are rational and urgent.
But when I find myself struggling to tolerate the uncertainty of this period—how many lives we will lose, how long we’ll be quarantined, what damage our world will be left with—I try to bring myself back to the present, where those questions have not yet been answered, for worse or for better. I try to live in the gap, which is the only place we have.
I’ll see you there.
In lieu of payment, our friends and contributors to the Corona Correspondences are dedicating donations to nonprofits and independent businesses in their communities. Benjamin’s contribution will be directed to DAiS.