Obsessions, compulsions, intrusive thoughts — and a promotion to soloist. Pacific Northwest Ballet dancer Steven Loch talks about his obsessive-compulsive disorder, and how “the more you talk about mental illness, the less it’s stigmatized.”

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One March afternoon in 2014, a young Pacific Northwest Ballet dancer named Steven Loch finished his first performance of that day’s matinee, walked offstage in full costume and makeup, rushed through the backstage halls to a remote upstairs bathroom, locked the door and curled into a ball on the floor to fend off mental demons.

“I was huddled,” he said, “so I wasn’t open to an attack.”

Loch is a 27-year-old professional ballet dancer, who has been with the company since he graduated from his Texas high school in 2009. This spring, he was promoted from the corps de ballet to soloist. And he is appearing in PNB’s “Emergence” program, running April 13-22. He also has obsessive-compulsive disorder (OCD).

On that afternoon in 2014, Loch was scheduled to dance in the first and last of four short pieces in the “Director’s Choice” program. He finished the first, then spent the middle two on that bathroom floor, listening to an overhead speaker live-broadcasting the music from downstairs, waiting for his cue to run back and force himself through the final piece without losing his composure in front of thousands of people: no tics, no freak-outs, no abandoning his fellow dancers to flee the stage mid-performance.

He succeeded. Then allowed himself to have a full meltdown and spent that night — the first of several — in a psychiatric hospital.

Loch’s OCD had manifested in many ways over the years: obsessing over the color of his teeth; fixating so much on “s” or “t” sounds when people spoke that he couldn’t focus on what they were saying; running his hand around the back of his neck to push imaginary people off his shoulders; having to pick up things like pieces of candy in specific numbers, then changing the numbers because five pieces was “good” for a moment, but a second later five became “bad,” so he’d have to pick up seven, and so on.

Neurologists and psychiatrists admit they still don’t fully understand OCD or how it works. The condition can’t be cured, but it can be managed, dialing down the barrage of obsessive thoughts — and the compulsive behaviors or physical tics that briefly relieve them — so they aren’t so overwhelming.

And for reasons that also aren’t fully understood, some highly trained athletes and performers find that being onstage or on the field, in front of thousands of people — an environment most people find highly stressful — actually reduces their anxiety.

“Something happens and it’s like, ‘No, sorry, you can’t do this to me now.’ I don’t know why. It’s less in the front of my brain then,” said Loch, who has worked for years with therapists who have helped him manage his disorder. “When I step onto the stage and start dancing, my body says: ‘It’s performance time.’ Something deep inside of me flips the switch. I was always scared of going onstage because I was afraid of being tainted by intrusive thoughts.”

But somehow, that was one of the few places where they receded — even on that bad afternoon in March 2014.

Intrusive thoughts

In person, Loch is gregarious and effusive, with an unmistakable ballet-dancer posture. At rest, his spine is ramrod straight. If he gets enthusiastic about something (which is often), his body becomes fluid — his torso undulates and his hands dance in the air like butterflies.

Today, it’s hard to imagine him frozen with fear four years ago, hugging his knees on a bathroom floor, dreading the moment he’d have to go back into the world and dance.

But that afternoon, Loch was having “intrusive thoughts” related to which direction he faced at any given time.

“I felt like if I faced in one direction, I’d die or be tortured,” he said.

Before the matinee began, he’d been offstage, turning in different directions, trying to find the one that produced the least anxiety-ridden thought. “North, south, east, west,” he said. “All of them had something.”

Most of the thoughts were what he called “sexually intrusive.” They weren’t fantasies or flashbacks to past traumas, but of taboo sex acts with taboo partners: God, Jesus, family members, ballet instructors. Loch grew up in a devoutly Christian home in Denton, Texas, and still identifies as a Christian — the thoughts weren’t things he wanted to do, but things that horrified him. At times, he said, the thoughts were so vivid, he could feel the acts physically, like Jesus sitting in a menacing way on his shoulders.

“But you have to face a direction!” Loch said. “You can’t not-face a direction.” So he hid out in a backstage nook, turning and turning.

Once he got onstage for the first number, the OCD symptoms didn’t exactly disappear, but dramatically faded.

After he finished the final number, his parents — who’d flown in from Texas to watch him perform, and recognized that their son was having a breakdown — drove him to a nearby mental-health hospital, where he stayed for a week. That intervention was an important first step, but people at the facility didn’t seem to understand his condition. “When I was admitted, I told the doctors about my thing with directions,” Loch said with a wry smile. “They’d ask: ‘Oh, is that some kind of feng shui thing?’ ” Shortly after, he flew out to a facility in Wisconsin, where he endured exercises like picking up objects on the first try — without counting — and wearing a scarf to accept the feeling of something being on his shoulders.

After his first two weeks at Rogers Memorial Hospital, he was ready to start dancing again, and began choreographing a solo piece about OCD while wearing a chain around his neck. He hoped to perform it at an international ballet competition being held that year in the U.S. in June.

That was progress.

“Leaky filters”

Dr. Sam Zinner, a specialist in neurological development at the University of Washington and Seattle Children’s hospital, describes OCD as an inability of the brain to filter out “noise.”

“The brain is complicated,” he said. “One hundred billion cells, and none of those cells can think or do anything, but the way the brain works is networking with 100 trillion connections talking through neurotransmitters, chemicals, electrical connections.”

The human brain has a cluster of neurons called the basal ganglia. Put together, he explained, they’re the size of a walnut, and take in the deluge of cognitive, motor, memory, emotional and sensory information that floods through our brains when we, say, kick a soccer ball or watch out for poisonous snakes while walking through a swamp. The basal ganglia are supposed to filter out all the extraneous noise so we can focus on the task at hand. “In every picosecond of time,” Zinner said, “the basal ganglia have to decide what is relevant, what not to block out so you can survive.”

But the basal ganglia in brains with OCD — and related conditions, including Tourette syndrome and attention deficit hyperactivity disorder (ADHD) — are, in his words, “leaky filters.” Those leaks lead to information overload and behavior that, to the casual observer, might seem odd — like compulsively touching a magazine three times before picking it up, or hiding on a bathroom floor in costume during a ballet performance to avoid horrifying, intrusive thoughts.

“In those cases, the basal ganglia don’t block as well as they should,” Zinner said. “Anxiety is an appropriate, self-protective thing we have to respond to threats. But people with these leaky filters feel anxiety, threats, that aren’t actually present at the time.”

Whether those thoughts seem arbitrary (one number being “good” while another number is “bad”) or culturally conditioned (the intrusive thought of a taboo act with a taboo person), Zinner explained, they’re all “pesky messages” that the average person might have, but would barely register and quickly forget. For people with OCD, those “pesky messages” run up the neurological flagpole to red-alert status.

So why do some highly trained individuals — athletes, professional dancers — report their symptoms fading in stressful performance situations?

In his 2014 autobiography “The Keeper,” for instance, professional soccer goalkeeper Tim Howard, who has OCD and Tourette syndrome, wrote: “On the soccer field, my whole world changed … the closer that ball came, the more my symptoms receded. The tics, the crazy thoughts, the conflicting mental messages — poof! They were gone in an instant.”

The only thing left, he wrote, “remained in sharp focus, its every detail vivid: the ball, moving toward me.”

Why that happens is “not well understood,” Zinner said. “The brain is very efficient and it recognizes patterns. The basal ganglia sees patterns and sends messages back to the brain that it can understand — a type of neural ‘muscle memory’” formed by repetition and training.

According to the National Alliance on Mental Illness, about one person in 40 in the U.S. will be diagnosed with OCD.

“It’s a debilitating condition that affects more people than you think,” said Carol Lundemo, Loch’s therapist, who specializes in OCD. “And people are quite ignorant about it.”

Lundemo said that many people think of OCD as “those people who just wash their hands all the time” or Tourette syndrome as “those people who just curse a lot.” But the outward manifestations repeated as shorthand in film and on TV are just a tiny slice of what’s happening inside the brain.

Lundemo often asks new patients how often they feel like they’re living on a “split screen.”

“One part of my brain might be thinking: ‘Hey Brendan, it’s so great to talk to you.’ The other part is saying: ‘Did I lock my car? What if I didn’t lock my car? Someone is stealing my car and mowing down an entire playground of children right now and if I didn’t lock my car I’m responsible for that.’ Everyone with OCD has a monster in the basement that is ravenously hungry and trying to bust up through the door into where you live.”

The first recordings of probable OCD, Lundemo said, come from the journals of priests in the 1500s, who reported the same people coming back to confess the same sins over and over. “They called it ‘religious melancholia,’ ” she said.

With Loch and her other patients, Lundemo uses “exposure and response prevention” therapy. For instance, some patients are afraid to drive because they’re terrified they’d run over someone, so Lundemo makes them drive with her in the passenger seat, talking them through their fears. One patient, who was terrified she’d stab someone even though she didn’t actually want to, quit chopping vegetables at home and started taking circuitous routes through department stores to avoid the cutlery aisle. Lundemo instructed her to carry a knife in her purse at all times, just to prove to herself she wasn’t going to stab anyone.

“If my anxiety was not being able to pick up a magazine,” Loch said, “I’d have to do it after only one try, then sit with the anxiety until it dropped by half.”

The therapy worked.

“I felt so free”

Loch wants to talk about his OCD to help other people who might be suffering in silence. “There is hope,” he said. “Sometimes it feels like you’re walking down a path so long, there’s only one way to go, and trees everywhere else.” But, he added, it doesn’t have to be that way.

Jeff Loch, Steven Loch’s father, said he thinks his son is “a pretty tough young man.”

“He was always a little different,” Jeff Loch said. “Growing up, what he was interested in, most boys weren’t. He was in the dance studio while they were about playing ball.”

Jeff is “more of a sports guy,” he said, but he married a former dancer who had some Baryshnikov training tapes around the house. Steven would pop them in the VCR when he was just 2 years old — he’d watch them through the first time, without moving, then he’d stand up, rewind them and start to follow along.

“I’ve come to realize that for dancers, it’s not what they do,” he said. “It’s who they are.”

Jeff said he came to admire Steven’s determination to dance, and determination to talk about his struggles. “Steven,” he concluded, “is pretty dang strong.”

After six weeks at the psychiatric hospital in Wisconsin, Loch’s doctors and therapists decided he might be ready to leave the facility and dance in that year’s International Ballet Competition in Jackson, Mississippi. (The event — which is recognized by UNESCO and alternates among Sweden, the U.S., Bulgaria and China — is like the Olympics of ballet.)

Loch made it to the final round, where he performed his solo about OCD — the one with the chain around his neck.

“I started in the dark, at the back of the stage,” he said, “then I walked into a spotlight. As they announced my name, I thought: ‘All the hard work is done.’ I felt so free that I could honestly do whatever I wanted on that stage, could dance any way I wanted.”

Loch didn’t win first place, but he danced — after the suffering, the hospitalizations and, for the first time in a long time, without feeling haunted by what demons might be waiting for him offstage.

“That moment,” he said, “was one of the best things I’ve ever felt in my life.”

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Loch dances in “Emergence,” featuring works by Crystal Pite, Yuri Possokhov and Alejandro Cerrudo. April 13-22; Pacific Northwest Ballet at McCaw Hall, 321 Mercer St., Seattle; $37-$187; 206-441-2424, pnb.org.