Dear Dr. G,

I'm a highly successful business leader, and I'1000 not using my name because anybody knows information technology. I'chiliad talented, I've worked hard, and I deserve my reputation every bit a power player in the business organisation globe because I'one thousand willing to have risks that others won't. I'm i of the few "Oh yes? But sentinel me!" people who routinely practice the impossible. I'thousand at my best when conventional wisdom and conventional rules merely don't cutting it.

My problem is that the risks I take professionally earn admiration, but those that I take privately — like gambling, getting high, having affairs in one case in a while — are causing embarrassment and humiliation. And information technology's getting worse.

I know I'm a basically good guy, only I have to admit that I have hurt more than a few people along the mode. To be honest, I've even betrayed some of the people who have trusted and cared about me most, and I've lied to cover it upwards.

In my heart, I never meant to hurt anyone. Information technology's just that I've ever washed things my way, and my manner works so incredibly well — at to the lowest degree professionally. The worst part is how much I've hurt my family and friends.

I'k afraid that if I let some shrink kickoff playing around with my personality, I'll lose that competitive border that made me successful in the first place. Only I've got to exercise something. What?

— Exception to the Rules in Los Angeles

Honey Exception,

Here's your pick. Y'all're either immoral or y'all're ill. Pick your poisonous substance. But if you're actually a bad person, I dubiety you would have written.

Over the by x years, I've treated many business leaders with problems painfully similar to yours. All those people were powerful, driven, and successful. They besides injure people without really meaning to. There accept been so many of them lately that I came up with a name for the condition: OCB. You may have heard of OCD, which stands for Obsessive Compulsive Disorder. OCB stands for Obsessive Compulsive Bipolar. It's more of a status than a disorder because OCBs often function quite highly, even though their personal lives are ordinarily a mess.

They differ from pure bipolar (or manic-depressive) people. When bipolar people become manic, they become off the deep stop into psychosis, occasionally breaking the law and ofttimes ending upward in a hospital. Even so, they do it with a grin, because they feel invincible and free when they are manic.

OCBs don't get to those extremes. Their obsessive-compulsive traits piece of work like emergency brakes, pulling them back just earlier they go over either border. People with OCB don't lose impact with reality, just with common sense.

Generally regarded as exceptional because of their formidable abilities, they come up to believe they're exceptions to the rules that employ to anybody else. They tend to condone the possible consequences of their behavior. Sometimes they're even surprised when those consequences are disastrous.

Compelled to seek the exhilaration of their "controlled" mania, their life becomes like a roller coaster. They don't get real joy or delectation on the ride, simply it is exciting, and they're not necessarily unhappy.

It's their friends, partners (usually female, because OCB men outnumber women iv to i), and children who are miserable. It's they who must live with the OCB's unpredictability, his disability to give them undivided attention, his lack of emotional agreement, and his failure to make adept on promises to reform.

One woman compared life with her OCB husband to riding with him in a Porsche, blasting along curvy Mulholland Drive at sixty miles per hour. "He tells me to but cool it — he's in complete control as he downshifts and the tires screech," she said. "He probably does feel more in command, feeling the wheels touching the road while he shifts and accelerates. On the other hand, I don't experience annihilation other than scared silly and totally at his mercy. Sometimes I dig my fingernails into the dashboard, and it irritates the hell out of him."

People with OCB are addicted to excitement and power. Power is the toughest mistress to compete against. In fact the seductive attraction of mistresses is that they brand an OCB man feel powerful and fifty-fifty heroic in ways that his wife or girlfriend no longer does.

When power and excitement are present, OCB people are abrupt, goal-directed, amazingly constructive and productive. When these feelings are missing, they become unfocused, listless, and irritable. It'south the moodiness and their tendency to over-control that prompts psychiatrists to treat them with antidepressants like Prozac, Paxil, or Zoloft (these drugs, called SSRI's, are used to treat depression and OCD, to help people "lighten up").

Frequently this is insufficient, because treating OCB people with just SSRI's is like trying to control boiling water by putting a chapeau on the pot. The hat won't help unless you take the pot off the burn down. In fact, putting a hat on humid water but adds to the pressure. Similarly, giving only an anti-depressant to someone who has a concurrent bipolar component can make matters worse by causing him to become more manic.

What does seem to help is a combination of an SSRI and a mood stabilizer such equally lithium, Tegretol, Depakote, or Lamictal. And if you're in the midst of a sideslip and need brake pads to go on from going out of control, medications like Zyprexa, Geodon, or Abilify can go on you on the road. These medications for bipolar disorders help turn down the flame or from going off a cliff.

Psychiatrists are increasingly using combinations of these medications as the complexity of these weather condition has increased.
As the intensity of the OCB lessens, patients find calm and often a new kind of non-frenetic energy. One patient was so relieved, he called me in tears. "I'm normal!" he said. "All my life, I thought normal was for everyone else. You know? Success doesn't make up for feeling like a mental misfit!"

Afterward medications have effectively stopped the Porsche by removing the keys, individual and couples therapy can assist a patient and partner develop a healthier relationship — now that they have slowed downward plenty to put some emotion into it. Insight therapy might also help, since there'due south usually some childhood corruption, fail or dysfunction that contributes to (simply lonely doesn't crusade) OCB.

Pretty soon OCB people listen better, are more "present" and see the quality of all their relationships improve. 1 treated dad started to cry as he told me virtually reading his 5-year-former a bedtime story. For the first fourth dimension, he was emotionally "in that location," not just mouthing the words with his listen miles away.

In that location are a couple final reasons to get your OCB taken intendance of sooner rather than later — peace of heed and increasing your chances of getting into heaven. Years ago I made house calls to a corporate giant dying of cancer. He also had OCB, having thought he was above the consequences of booze and cigarettes. A few weeks before he died, he talked about something that had been tormenting him. "I don't call back I've e'er done anything important in life," he said. I tried to reassure him that he had started an industry, created hundreds if not thousands of jobs, and had a lot to be proud of. He idea I was trying to dispense him into a solace he didn't deserve. "Yep sure," he said, "but what almost the two wives I ruined and my three loser kids on drugs who'll never amount to annihilation?"

Because he was similar other people with OCB and never meant to injure anyone, I'chiliad sure he fabricated it into sky. Simply information technology probably wasn't a slam dunk.

OCB's Muddied Dozen
Sound similar anyone y'all know?

  • Powerful, charismatic, larger-than-life; takes professional person and creative risks and often succeeds because his exceptional instincts and abilities override professional shortcomings.
  • Fiercely competitive; a terrible and frequently vindictive loser.
  • Superficially compassionate and empathic in public, but mercurial and evasive when it comes to deep emotional closeness.
  • Emotionally distant and cold towards spouse, who sees through his cocky-serving veneer and often views him contemptuously as an opportunistic liar; non plain afar, but usually mentally preoccupied when with his children (cell-phone dad).
  • Oftentimes married to a strong woman who keeps him grounded early in the relationship; later resentment develops as he feels spouse try to control him.
  • Surrounds self with sycophants; if he has affairs, they're usually with emotionally dependent, needy women who make him feel like a hero (although the women may turn out to have ulterior motives).
  • Does not feel he is doing annihilation wrong if he is not consciously doing anything to injure anyone.
  • Longstanding pattern, usually dating back to higher, of driven, controlled and controlling beliefs, periodically interrupted by impulsive and reckless behavior.
  • Long history of seeking out heady and risky situations that provide an adrenaline rush.
  • Grandiosity, usually manifested as reckless behavior with a disregard for consequences and even surprise when negative ones occur.
  • Depression ordinarily expressed as moodiness, impatience, badgerer, irritability and emotional withdrawal.
  • Dabbles with cocaine or speed (rarely reaching the need for rehab), which helps him to feel powerful and effective; causes him to be confused with people who have Attention Deficit Disorder.
    If you've observed six or more than of the above traits over a period of many years, there is a loftier likelihood of OCB.

If you've observed six or more of the above traits over a period of many years, there is a high likelihood of OCB.