During the first two years of treatment, Jill made tremendous changes. At first volatile, angry, intolerant of me, constantly feeling persecuted but covering it up with contempt and dismissal, she gradually relaxed. These intense negative feelings eased, she performed better and enjoyed her work more, and she began to have more satisfying relationships. 

But she still complained about "my hyperactive brain". She could not stop the endless and oppressive hypothesizing over issues large and small. Her head spun out a relentless stream of alternate possibilities, "what if"s, and "maybe"s, none of which ever contributed to her decision-making or her happiness. This is obsessing, plain and simple, We had both hoped it would diminish as her general anxiety level went down. The emotional tone had changed from harsh negativity (such as "see?! I can't decide anything! I don't know anything!") to a more neutral tone of merely reciting and endlessly reviewing the alternatives, but the obsessing itself continued. Rather reluctantly, she consulted a psychiatrist and began a low dose of medication. 

The change has been remarkable and immensely gratifying to Jill. She comes into sessions with the same issues as before, but we can work towards understanding and resolution with far less distraction and agonizing on her part. Outside of treatment, she feels more relaxed, thinks more clearly, enjoys everything more, and makes decisions with much greater ease. 

Will Jill be on medication forever? That depends entirely on how she feels. Many people need medication for a time, but then can stop taking it with no ill effects. When can she stop? When she wants to. She will decide when she feels calm and strong enough to weather life without the aid of the medication. Is it possible she will never be able to quiet the obsessing without medication? Yes. That is unfortunate, but to my mind no more so than the case of someone who has to take thyroid medication all his life to control his metabolism, or eye drops to keep glaucoma away. You have to remember to do it and sometimes there are side effects, but the rewards are more than worth it. 

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