When I was thirty (about twenty years ago), I was troubled by violent and sexual thoughts like Dani Solomon’s. I didn’t know what was happening to me or where the thoughts had come from. Like Dani, I began to avoid the people and activities that triggered the thoughts. I also looked for a therapist, and I found that virtually none of them had heard of symptoms like mine. One I spoke to on the phone was obviously afraid to meet me, and the referring therapist at my HMO asked whether I was hearing voices in my television set telling me to kill people (he thought I was psychotic).
Fortunately, I found a therapist who used a variety of techniques to help me in all areas of my life over a two-year period. We discussed some form of genetic obsessive-compulsive disorder possibly being the reason for my symptoms, but we considered many other possible causes as well.
Not until ten years later, when my librarian sister came across the book The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts, by Lee Baer (Dutton, 2001), did I see my symptoms definitively diagnosed as a form of OCD. Now another ten years have gone by, and this form of OCD is still not on the map of people’s awareness. The problem is that OCD is connected in the minds of the public and most medical professionals with germ phobias and with rituals and behaviors such as counting and hand-washing.
In fact, of the approximately 80 people whom I’ve told the premise of The Babysitter Murders (“It’s about a babysitter who’s tormented by thoughts of harming the child she cares for”), only one person asked, “Is it about OCD?” If I had said “It’s about a teenage girl who can’t function because she’s constantly washing her hands,” I believe almost all of them would have asked that question.
Since I write novels about mental illness anyway, I thought it would be exciting to put this little-known illness on the map. I had been able to go away and heal in private, but what if a character’s most horrifying secret thoughts became public…became known at school…were published on TV and in the newspaper?
The dramatic treatments Dani undergoes in Boston with Dr. Mandel are real. They’re called “exposure and response therapy,” and a wonderful OCD specialist who advised me on the technical aspects of the novel, Kimberly Glazier of Yeshiva University, told me they’re the “gold standard” for treating OCD. One of the paradoxes of this illness is that the only way to get better is to expose yourself to the triggering situations rather than avoid them, and that’s what brings the story to what I hope is an exciting climax.