Friday, February 25, 2011

Cryer's 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.

8 comments:

  1. I haven't read the book yet, but I did order it. I'm just waiting for it to be send with the book I pre-ordered.

    Great post, Sarah. I love your analyses of books with characters potentially dealing with mental disorders. I learn so much from them.

    ReplyDelete
  2. Wow - great post, as usual. I seriously learn so much here.:)

    *also, not related, but your beta notes rock.*

    ReplyDelete
  3. man i have to stop following you! everytime you discuss a book it ends up increasing my tbr list!!!!
    so- have you ever seen monk? that show makes it out that monk's ocd is the reason he notices all those details, so it's interesting to hear that that's not the ocd but the person- i had that misunderstood!
    there's a gal in my family with ocd. i remember when she was diagnosed. she called me, apalled by the diagnosis, and asked if i could possibly believe that she had ocd. i had to say that i wasn't surprised. the sweetheart made a manual for her husband on the correct rituals to follow while cleaning the house, because he wasn't doing it right, and she had to redo everything he did before she could go to sleep! so the whole "they understand that their compulsions are abnormal" thing surprised me too!
    thanks again for teaching us something new! (like usual!)

    ReplyDelete
  4. OCD is fascinating. I need to put this on the TBR.

    ReplyDelete
  5. Stina and Carolyn--Like Lisa McMann's other work, Cryer's Cross is a quick, suspenseful read. I hope you enjoy it!

    Jenn--thanks!

    aspiring_x--as usual, you bring up fantastic points! I admit I have not seen Monk because I do not watch much television. However, let's think about this: first, there are many smart, observant folks who do not have OCD. And second, my guess is that dude would still be smart, observant, and detail-oriented even if he got effective treatment for the OCD. OCD causes suffering. It prevents people from doing things they love, from enjoying their lives. Without that distress, without those intrusive thoughts, without those crippling rituals, the person is better off, and will still have all his/her strengths. In fact, he/she would be better able to use them because the disorder wouldn't be getting in the way. Yes, anxiety, to a certain point, is useful. It improves motivation and performance. But if it gets too high, it reduces performance and gets in the way.

    And, just so you know--there IS a specifier in the OCD criteria called "with poor insight", and that would mean the person is less aware that what she is doing is problematic. Also, she wouldn't have to be aware all the time, just "at some point" in the episode.

    ReplyDelete
  6. I haven't read the book, but it sounds good.

    ReplyDelete
  7. I haven't had a chance to read the book yet. I do however live with a guy who has OCPD. He's more compulsive in the way he has to have things go a certain way. No deviating away from the plans he's made etc. I think in any situation like this being aware of what the person needs in order to have a relatively normal life, makes it easier to understand. (Hugs)Indigo

    ReplyDelete
  8. ...I definitely have a mild case of it. It kicked in around high school. I had to line my shoes before bed and tap them. I had to straighten the faucet perfectly and read aloud "Hot, Cold, Pull On." And I had to tap my light switch three times while counting aloud. (Also applicable to closing bottles, knocking on wood, etc.) When I got horrible anxiety in college I started mentally saying a mantra to convince myself everything was really all right, but that somehow evolved into making things all right by saying the mantra.

    I started learning to take control of it by reading books that happened to have OCD in it. Watching how the characters struggled and coped helped. I still have plenty of the tendencies left, and they become much more pronounced when my life gets stressful...but most of the time, I'm able to limit myself to the ones that I actually find useful. (Like not being able to go to bed without flossing, brushing my teeth, and gargling. These are good things to do for the sake of my teeth! But the fact remains that I start getting a sense of doom and woe-for-all-things-I-love if I don't do them.)

    ReplyDelete