The Firefighter Who Wasn’t Helped To Carry His Own Fire

A Comment on A Recent New York Times Article on OCD

To say the recent New York Times article about Timmy Reen got me fired up would be an understatement. Chronicling the story of a devoted father and firefighter who hid his OCD for years while serving his community, Reen only had to disclose his secret when he refused to take a vaccination during COVID.

In a devastatingly ironic twist of fate, a man who managed to keep his secret for over 35 years now faced a Sophie’s choice: take a vaccination his OCD told him would surely kill him or leave the career that wasn’t just his livelihood but his creative embodiment: the man who couldn’t carry his own fire could at least help others extinguish their own.

But what about the internal fire that nobody ever noticed or put into words?

That’s the part that haunts me reading Mr. Reen’s story most. Like many OCD sufferers, he has a capacity to notice nuance in ways that others easily dismiss. What might, at first blush, seem pathological–as when as a kid he was terrified by not being able to see all eighteen wheels of a passing truck– has, like fire itself, many more dynamic and intriguing dimensions.

There’s a lot more sensitivity, imagination, and empathy involved in OCD that doesn’t get translated into a form that can be carried alone; it desperately needs a validating, nurturing relationship. And that’s where Mr. Reen’s words punched me right in the gut.

Speaking of his aborted efforts at mainstream treatment, known as exposure-response prevention, Mr. Reen lamented that delaying his rituals just overwhelmed him. But it was just six words that stuck with me that echoed all the way back from his childhood, sitting in the car as a six-year old frantically suppressing what might happen if eighteen wheels weren’t counted: “Because I tried to be tough.”

Because Mr. Reen tried to be tough, he “had to spend 15 hours, not eating or drinking, just washing everything.” But he also has to be tough, like many OCD sufferers, by submitting to a treatment whose mission it is to desensitize its patients and make them more alpha in confronting their greatest fears. There’s so little heart and sensitivity granted for starting where the client is and recognizing the beautiful sparks of feeling and imagination struggling to find their voice.

Well-intentioned and successful for 40-60 percent of sufferers, ERP leaves others to watch their metaphorical houses go up in flames. And worst of all, it sends an inadvertent message: if you aren’t tough enough to do this treatment, the blame is on you.

Everybody else seems to thrive as a result of doing treatment, 40-60 percent show significant symptom reduction, and even the 20-30 percent who show minimal or no response, at least, aren’t harmed by it. If the treatment could talk, it might say: what’s the matter with you?

I could identify with Mr. Reen. Although my father wasn’t a firefighter, he was a refugee from Egypt who had a hard time understanding my own periodic bouts of obsessional doubt and rumination, worrying that if I didn’t think or pray a certain way, my mother might be killed. And he—like current treatments—felt like the only recourse was for me to master my feelings by using logic to lord over them and become the rightful king again. Only that never worked, it only made me feel further away from myself and the world.

When I wrote a book about OCD as having an upside most people don’t notice, of having special sparks of feeling and imagination from the very start that can fuel great creativity as shown in the lives of Charles Darwin, Nikola Tesla, Jack Antonoff, John Green, Mara Wilson, Camilla Cabello, and countless others, I wasn’t greeted warmly by the OCD community. Critics online called me an RFK Jr. for spouting unscientific nonsense that only brought the cause back, dishonoring and cheapening the enormous pain of others, offending them beyond repair.

Darwin felt “the world’s pain so acutely, and so persistently,” as biographer Janet Browne writes, he viewed extending one’s heart in compassion to others as “one of the noblest” moral achievements. Dacher Keltner writes that “survival of the kindest," rather than survival of the fittest is a better catchphrase for him. Moved upon hearing this parallel to the Buddha’s teachings, the Dalai Lama declared: “I will now call myself a Darwinian.”

It’s always struck me as funny that a treatment that started as a reaction to the dogmatic psychoanalysts who felt that they could heal everything with only their magic wands should now become its own nemesis. It has also struck me as so unconsciously unkind. ERP has been labelled the gold standard treatment for OCD but it leaves at least forty percent of the OCD population still suffering.

With such a big impact, shouldn’t we have more and better options for OCD? A 2023 analysis found that untreated OCD led to an annual loss of over 8.4 billion dollars in the U.S. alone, primarily due to missed work, decreased productivity, and medical costs. The condition takes an average of fourteen to seventeen years to correctly treat, and I hypothesize that part of this isn’t just lack of psychoeducation, but discomfort with the insensitivity of its only ‘proven’ treatment.

Worst yet, there are other credible treatments, like Inferential Cognitive Behavioral Therapy, which is empirically validated as a standalone treatment, and Acceptance Commitment Therapy, which is empirically validated in combination with ERP, that often get mocked in online forums and privately for their lack of rigor.

What has welled up in me from reading Mr. Reen’s case is the lack of humility and openness we have as a culture to see more nuance and dimension to a disorder that not only causes much heartache, but also comes along with a sensibility of great generosity, imagination, and creativity. I don’t think RFK Jr would be able to articulate or appreciate the nuance in this condition anymore than he did so ruthlessly with autism.

When I speak of OCD, I come from RFK Jr’s father’s perspective when he once declared: “Some men see things as they are and ask why? I dream of things that never were and say why not?” Not surprisingly, it was the quote found underneath my high school graduation photo.

Why not? Why can’t we study and envision more and better treatments for a disorder that burns people up but doesn’t have to? Why can’t we offer more heart and hope to people who aren’t just suffering, but also trying to communicate how much they see and notice that others just don’t quite get? Why can’t we help Mr. Reen see his beauty and his bravery, his brilliance and his grace? Why can’t we help him see that we are indebted to his kind for the better world we all can enjoy while he is on watch?

I believe we can, if we dream it together into reality.

Michael Alcee, PhD. is a clinical psychologist in Tarrytown, NY and author of The Upside of OCD: Flip The Script to Reclaim Your Life.