Imagine being a child and taking a photo of your father and kissing it. Sounds normal enough. Then imagine doing so 100 times, every time you pass it. Every night. Every morning. Tack on picking up glass, lint, and dirt from the street, collecting it and fondling it as if it held the key to the universe, and you’ve got the world of Abby Sher, 9-year-old obsessive-compulsive. After her aunt dies, Sher quickly formulates a reason: Her aunt must have done something bad to deserve death, so Sher will be good. Ultra good. Pious. Perfect.

According to the National Institute of Mental Health, Sher is one of 22 million American adults affected by OCD, one-third of whom develop symptoms as children. In Sher’s case, “good” evolved into checking appliances and blessing each one, tracing her wallpaper, praying at the passing of every ambulance, washing her hands until they bled, and eventually starving herself, all of which she documents in Amen, Amen, Amen: Memoir of a Girl Who Couldn’t Stop Praying (Among Other Things), which grew out of an essay she wrote for Self about “how I killed a woman with a grocery cart” (more on that in the book).

“If I could talk to the Divine and make sure that the world is being taken care of then I could think of no greater source of control.”

Sher isn’t sure exactly when the pivotal moment occurred. When did she go from being a regular little girl to one who picked up garbage in an attempt to save people from car accidents? (They might drive over bits of broken glass.) But she knows when it became an official problem.

“After my dad died and I continued to not be able to cry—that really drove me bonkers,” she explains. “I was searching for a reason why I didn’t feel the pain that everybody around me did. I started formulating this idea that I must not feel pain because I’d wanted him to die, because I’d thought in my head, Next time you see me, it will be at my dad’s funeral.” Losing him was a blow that further upended her world.

She couldn’t hide her dirt collections or bleeding hands from her mother, but even with therapy and a concerned family, Sher wasn’t able to stop her obsessions. Her mother tried to reach out, with minimal results. “I had one person read an earlier version [of the book] and ask, ‘Why didn’t your mom take you to the doctor right away?’” Sher says. “Part of that was my mom figuring [it] out. I was very defensive; she worked so hard to make it easier for me and at the same time was not being told the truth. My mom would say, ‘What if you just took a break or just didn’t do it today?’ It was like, she so totally doesn’t get it. I often lied to her and to my doctors, so she was up against a lot of obstacles.”

In one of the memoir’s most poignant moments, while Sher and her siblings sort through their deceased mother’s belongings, they find a faded handwritten note asking, “What can I do to help Abby?” The simple questions that follow (“What therapy is she using? How to control cutting?”) speak volumes.

In college, Sher discovered improv and became immersed in the theater, eventually working with Chicago’s famed Second City. Yet humor, save for a kind of gallows humor (from her What I Believe Now That I’m 10 Years Old List: “Anne Frank is a really good role model because she’s skinny and Jewish and dead and she didn’t complain a lot.”), isn’t something you’ll find in Amen, Amen, Amen. Nor is there much about her experience performing, because that time period coincided with her increasingly severe eating disorder.

I asked Sher about the connection between performing and OCD. “I originally wrote this book all in the present tense because I love inhabiting a different age, a different persona,” she says. “I love being someone else. I would wear wigs every day of the week if I could! [Performing] was so freeing and exhilarating and yet not eating and going on stage will creep up on you; people feel like they’re getting away with it, but it will find you. That’s why I had to leave because I was onstage thinking about eating or cutting, not inhabiting this other skin. My outlet was no longer an outlet.

“But I love every moment that I get to be onstage. It’s this amazing freedom of just not inhabiting my own thoughts. If I’m truly in the scene, I don’t have my past, present, or future, I don’t have my skin or my repetition or anything, I just have what the scene offers.”

Prayer became a central form of Sher’s OCD behavior; she’d stop and pray 100 times to the mezuzah, or prayer scroll, outside her door, in addition to praying throughout the day, pausing whatever else she was doing to tend to this most essential of acts. “Prayers weren’t an illness; they were actually a cure,” she writes, and most anything could trigger the need to pray, especially the idea that someone was ill or in danger. “Like a lot of, if not all, addictions, it was about trying to control the uncontrollable. If I could talk to the Divine and make sure that the world is being taken care of, then I could think of no greater source of control.”

For Sher, the prayers were largely outwardly focused, about her being “good” in order to save others. “I try to make it more of a conversation with a higher power, and with the book coming out, I feel like I’ve got to talk to Him about the book and our relationship,” she says. “It’s got to be more honest by sheer necessity. I’m also open to listening to other [religions]. My husband is really not a religious person at all, which scared me for so long, but if I don’t hear him out or listen to any other views, then I don’t think that’s a very honest form of faith, either; that just feels like OCD.”

Toward the end of Amen, Amen, Amen, Sher incorporates yoga, which she teaches occasionally, and Buddhist chanting into her repertoire. “It’s a little tricky; I sometimes feel like I’m cheating on a test,” she says. “The bulk of my prayers are just me in plain English speaking, but I do think that some of the sentiment of these chants is really reflecting what I want to put out there. Including them is important because I never necessarily knew what the Hebrew prayers I was saying meant; it was more ritual than spirituality. If I include something now, I hope I‘m learning more about why I’m doing it.”

Through the help of an eating-disorder treatment center and the encouragement of her boyfriend (now husband), Sher slowly learned how to step back and stop trying to control everything around her, though she considers it a lifelong journey. “I work with a doctor to make sure that I’m eating. That’s still a struggle,” she acknowledges. “It progresses with being a mom now. My daughter is 1, a very impressionable age, and I need to exhibit for her, ‘Now we’re eating a peanut butter sandwich together.’ She’s seen me kissing the mezuzah, and she’ll make a kissing sound at the door. I’m teaching these behaviors to her before she even speaks, so I have to be aware of them. It’s an amazing reflection, seeing someone who’s completely new to this world. If I want to teach her about faith, or about being a good person, I have to be honest. Kissing something doesn’t make you a better person, and starving doesn’t make you a good person. I don’t want her to get values that I think I’ve outgrown.”

At one point, her therapist says to her, “Monsters never die, they just change.” This could be taken to mean someone who’s experienced OCD will never be rid of it. Sher prefers the more hopeful interpretation: “I love that quote. I’ll decide this week that my monster is that my daughter thinks I’m a jerk. Or this week my monster is I’ll never find my next book to write. I can make up whatever my next obsession is going to be.”

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Rachel Kramer Bussel is the editor of Peep Show: Erotic Tales of Voyeurs and Exhibitionists, Bottoms Up and over 25 other erotica anthologies, and hosts and curates In The Flesh Reading Series.