There’s nothing like a posh cup of vanilla flavoured coffee with friends, and last Tuesday I met up with my friend, Sarah Bodell. We had a catch up and I generally moaned on about my experiences with obsessive compulsive disorder, but before she escaped back to her fortress of occupational solitude…well her office…she informed me of something that the directorate of occupational therapy at the University of Salford were delivering…online master classes in advanced occupational therapy! I decided to sign up and am so I pleased I did! The best £30 I’ve spent since my last art supplies binge!
Tonight though, I attended the first class delivered online by Dr Jackie Taylor, focussing on occupational science. Even though she was very unsympathetic towards my bad dose of ‘man flu’, I thoroughly enjoyed listening to her! I was so inspired by this lecture that I have decided to go away and delve into research of something exceedingly interesting for my blog. What is that I hear you grumble? Well we discussed the core meaning of occupation, yes we all know what that is…meaningful and purposeful activity and all that jazz…but think of this…are there times when occupations actually become detrimental to our health and wellbeing? Of course! Anyone who knows me and has read my personal account of obsessive compulsive disorder will be very much aware of how compulsions act as what I will refer to as “negative occupations” (how about that huh for a term :-p).
So with that said my plan now is to go away and research this area and relate it to obsessive compulsive disorder. Are there ‘positive occupations’ and ‘negative occupations’? What an interesting concept for my mind to wrestle with….
On a final note…The only criticisms I can possibly conjure up from this master class is that the most interesting bit (well I think so anyway) was right at the end of the class… and, of course, I want to attend much more of these classes!!! So Jackie, Sarah, Debbie…I will be officially picking your brains soon and pestering for more master classes!!!!
Over and out for now…
Before you read this story, please bare in mind that this is a true story, it is my personal experience of OCD and I believe that as a “therapist” I have a duty to be honest about this and to work towards tackling the social stigma that mental health problems make you weak, weird, inadequate and less of a human being than most. I am of the opinion that EVERYBODY at some point in their lives will experience some degree of mental distress, and it is our duty as a population of caring individuals to be honest, supportive and compassionate towards each other and do all we can to assist in the recovery of others. Let’s break that barrier, that stigma, stand tall and be proud of who we are, and work towards a shift in attitude towards mental health.
Some may laugh at some of the things I am going to write, and that’s ok, I laugh at them too sometimes, but although I am tolerant of others laughing at my OCD, I ask you to be compassionate to my experience, and importantly to others who you may or may not know who may be experiencing something similar. OCD is truly awful, it isn’t a secondary illness or disorder in any way, shape or form….it is torturous and frightening and it needs exposing for what it really is, not what people ignorantly consider it to be. Thank you.
What is OCD?
Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterised by persistent reoccurring distressing intrusive thoughts or images (obsessions) and repetitive behaviours, impulses, urges or rituals often used to reduce anxiety, counteract or cancel such obsessive thoughts or images (compulsions) (Smith et al, 2012).
There are numerous obsessions and compulsions that people with OCD experience, and here they are defined:
- Contamination (fear of dirt, germs, viruses, chemicals etc…)
- Fear of harm (doors not being locked, cooker left on)
- Extreme concern for symmetry and order
- Obsessions with the physical body and symptoms
- Religious, sacrilegious or blasphemous thoughts
- Sexual obsessions (e.g. homosexuality or paedophilia)
- Thoughts of violence and aggression (e.g. stabbing you own child)
- Checking (taps, gas, cooker etc…)
- Cleaning, washing, showering
- Repetitive acts
- Mental compulsions (saying special words to cancel out thoughts, saying prayers, repeated in set manners)
- Ordering, symmetry, exactness
OCD has no socio-cultural boundaries. It can affect anyone, no matter what age, gender, religious belief or economic status. The World Health Organisation (WHO) has ranked OCD as in the top ten most debilitating conditions, in relation to quality of life and loss of earnings over an individuals’ lifespan. To me, this marks OCD as a much bigger problem than what I believe most people, professionals and the media give it credit for. I also wonder what impact OCD has had on the economy as a whole, I wonder how many others, like me, have had to stop working due to their illness, and I wonder how much ignorance truly costs the government. I also fear for those unfortunate enough to depend on their Disability Living Allowance, and who are now worried about the prospective Personal Independence Payments, as I fear the lack of clarity on how disabling, destructive and limiting OCD can be is very misunderstood by parliament and policy makers.
Luckily though, OCD is being exposed more these days, it is a little more understood, and with the help of such charities as OCD-UK, more and more people who have suffered years of torment are now learning and gaining more insight into their condition and receiving support both from professionals and the wider OCD community (me included). I still believe though that more needs to be done to make the public aware of just how serious OCD can be, and this is partly why I am writing this piece. Another reason is purely and simply as a therapeutic intervention.
There is a common misconception that those who live with OCD are “clean freaks” and enjoy undertaking their compulsions, such as cleaning or tidying, which is often heralded as the epitome of OCD. However the truth couldn’t be more different, as for the individual presenting with obsessive compulsive symptomatology, their personal experience is one of torture, torment, doubt and terror. I for one can confirm this.
Can OCD affect Health Care Professionals too? YES! Here’s My Story…
One of my best friends is a manager of a Community Mental Health Team, and I am so lucky to have him in my life. I love him dearly for the support he has given me. He describes me as having “an inflated sense of responsibility”…I believe that this is very common in those suffering from OCD…
I graduated with a first class honours degree in occupational therapy in June 2009 after being given the opportunity to study on the occupational therapy programme at the University of Salford. I had no qualifications as such, but my experience as a support worker with adults with learning disabilities and commitment to the programme secured me a place. I was so grateful and so happy. I made “OT” my life! Ask any of my friends or any student in my cohort…it really became what I refer to as a “positive obsession”. Whether any obsession is healthy I am unsure about…the jury is out on that one, but I can positively say that my time at University was possibly the happiest moments of my life, and I personally put that down to said “positive obsession”.
My graduation day was probably the happiest moment in my life. I never imagined I would have achieved what I had, coming from a relatively poor background with a long string of failed academic experiences from school to college. I had hopes to find a job in inpatient mental health (my dream job; and there were also OCD reasons for this to which I will explain later), complete a Masters in Advanced Occupational Therapy and yearned for the opportunity to study for a PhD. My dream was to one day be an inspirational lecturer in occupational therapy, as I had been inspired by so many passionate lecturers/therapists at my University. I even managed to worm my way into presenting at a student conference at Sheffield Hallam…to me this was such a fabulous experience to hopefully make my name known in wider occupational therapy circles.
I had always suspected that I was “a bit OCD” (the ignorant person’s frequently used term) but I had no diagnosis, nor had I really sought professional help for my often distressing attacks of anxiety and, now what I know for sure is OCD.
In November 2010, I started to experience severe anxiety attacks and my doctor signed me off work due to what he referred to as “intrusive thoughts and depression”. I refused all medication, as I couldn’t accept that as a therapist I needed help. I threatened suicide and my doctor advised that I be better hospitalised, but I managed to convince my doctor that these thoughts were passive suicidal ideations. I was just dumbfounded by the whole thing, and medication would have just been the confirmation that I feared most: That I wouldn’t ever be able to practice in the profession I treasured and spent years of my time and heart in. Unfortunately I became very bitter, as I was in a very different frame of mind than I had experienced before! My love, excitement, and passion for the one thing I wanted the most (to be an occupational therapist) turned into a downward spiralling hatred and frequently the bile I carried inside would come gushing out in frustration of my experience. I guess this was some kind of warped coping mechanism looking back, as I felt cheated out of what I had invested so much in.
After a few weeks of seeing my GP, he suggested I seek “professional help” (oh those words pained me) for my “intrusive thoughts” and in the spring of 2011, I was awarded the very unsatisfying title of “Obsessive Compulsive”, after an assessment prior to commencing a failed series of Cognitive Behavioural Therapy (CBT). I say unsatisfying because I had always believed that I was meant to be the therapist, not the client, and my dream was to work as an occupational therapist with people with severe and enduring mental health problems. The mere thought of having some other therapist tell me how I should manage my mental health angered me and made me feel inadequate as a therapist. Still refusing to take any advice on medication from my GP, I began questioning myself on what am I going to do now? Who would want to employ a therapist who clearly is as “mad” as me? How could I possibly help others if I can’t help myself? I was utterly lost and did not know what to do or who to turn to.
After years of delaying learning to drive, I passed my test. I say delay because driving had also been an obsession of mine, and I avoided driving for as long as humanly possible. Alas, without a licence I would never find a “proper job” as a therapist as 99% of jobs demanded a license to even apply for the job. Maybe it won’t surprise you, but since I passed my test I have never sat behind the wheel of a car again…and do you know why? Because of OCD! I have intrusive thoughts that I could accidentally run somebody over and not know, and being OCD, I would have to return to the same route over and over and over again or check the car for signs of damage time and time again to convince myself that I had not harmed anyone! I’m quite sure you all think that that is ridiculous. It is, but this is OCD we are talking about. The realms of ridiculousness have no boundaries.
I still won’t drive, but unlike before I now want to build up the confidence again to drive independently (when I can afford to run a car that is)!
In September 2011 I began teaching health and social care at a local college. I had decided to try to take hold of my life again and so enrolled on a Postgraduate Certificate in Education. The stress of this ultimately made me even more ill than I had ever been, and I had to exit the programme in February 2012.
How did it affect me?
ALL areas of functionality to put it bluntly! I couldn’t go out alone as I believed that I would forget what I had done or convince myself of doing something truly awful or saying something equally appalling to another person.
I couldn’t pick up items in supermarkets as I held the belief that if I did, then the food would become “contaminated” and turn poisonous and I would cause harm to another person. If I touched anything, it had to be bought, I couldn’t risk somebody else touching the item of food, a book, you name it, as in my warped mind, I had to protect others from my “dirtiness”. Yes, I thought that I was “dirty”, “contaminated” some how and even had my own cutlery at home and yes I would taken these out on meals out too (had I been well enough to go out for a meal)! I couldn’t visit friends’ houses either, because I was frightened that I would accidentally contaminate them and ultimately make them ill. So because I cared so much about my friends, I refused to visit their homes, occasionally friends came to see me, but I struggled being near them, touching them, I couldn’t make them a drink even or touch anything that they could or would touch. Imagine what kind of operation that would be!
Communication with both friends and family had completely broken down, I couldn’t communicate over the phone or even online, I had to constantly be reassured of everything I said, did, thought and imagined. When the phone rang, it would be ignored, unless of course somebody was around to verify what I had said, or written in a text message. The obsessions just were relentless and I’d reached a point where I couldn’t do anything alone, even the basic things such as talking to others.
This is slightly embarrassing, even now, but still, I feel compelled to be honest, but for 3 months, I couldn’t even sleep in my own bed as I could not be alone, (and yes I was 29 man at the time, now 30) so I slept on the floor beside my dad where he frequently comforted me in the dead of night when I’d wake up almost screaming, or crying or tearing my hair out! Sometimes I would jump out of bed, at 2am or 3am, 6am, it made no difference, to check and check and check that my worst nightmares were not going to unfold. Check things I had written in the past…you name it, I checked it…even bits of rubbish! Cereal packets or empty boxes, I had to check them all because I had intrusive thoughts that I had written awful things without my knowledge. This became such a time consuming activity that completing this compulsion left me worn out physically and mentally. Everything had to be shredded…and then even the shredded paper was difficult to let go of and I had to go back again and check the shreds. I even remember one time, I was out with my parents (as I couldn’t be left in at home alone) and unfortunately I needed the loo whilst out….could I go alone? No! My dad had to come with me, luckily not into the cubicle, but after I had come out, my dad to had go inside of the cubicle and inspect it for anything I could have touched or written disgusting words on. Even the toilet paper! Yes! Mad! I know! Nevertheless, if he hadn’t have done this, I’d have been frantic and probably wouldn’t have left the public toilet for love, nor money!
MAD I know and I hear you say it…but OCD has a very clever way of convincing you of the unbelievable, the worst possible outcomes coming true and your worst fears and nightmares become reality. I had many other obsessional thoughts, most of which I cannot discuss because they’re truly and deeply distressing and I do wish to maintain some element of privacy, but also because I have experienced so many different kinds of intrusive thoughts, I fear I could be writing this blog for a long, long time!
But for the record, all obsessions are equally evil and to reassure you, they prey on your inner most fears, your disgusts and make you believe that you’re something or someone you are not. So don’t fear, you’re not the homosexual that your thoughts tell you that you are, you’re not a paedophile, you’re not a murderer, and you’re not going to lose control, harm anyone or blaspheme and be condemned to Hell. I PROMISE YOU! What you ARE however, is unfortunate enough to be affected by OCD, and not just any OCD, but a tpye referred to as ‘PURE O’! One thing I feel important to add to reassure those who have OCD and obsessional disturbing thoughts, there have been no cases of anyone with OCD carrying out any obsession…mental health professionals KNOW this…and they have heard YOUR story a hundred times before! Believe it or not, you’re not a freak!
So how do I cope now? Well…I finally gave in to taking medication and I now take 40mg of fluoxitine daily (that is Prozac)! Yes it is an antidepressant, but it is also well known for reducing OCD symptoms…and thankfully it has with me! My advice to anyone would be, take the medication, and don’t resist. You wouldn’t want to go through what I did! What I experienced, I wouldn’t put my arch nemesis through…not that I have one, but you get the gist of how distressing it all was…
I am working towards going back to CBT. This is a highly frightening prospect, but I know that it is necessary for my own health and wellbeing.
I now use art as a therapeutic activity to channel my thoughts, to take my mind off the OCD and to feel a sense of achievement again. I love art, and only through my experience have I truly understood what a positive tool it can be for recovery.
My goal is work on my recovery and work towards reclaiming the career that I wanted and worked for. My dream was to be an occupational therapist, but I believe that my experiences will make me an even better, more empathic therapist than I could have ever imagined. I have now started to immerse myself back in the world of occupational therapy and am ready to get back in the saddle.
Recovery is a slow and long process, this is know, but I feel that writing this exposé has triggered a strong sense of determination for recovery.
Watch this space because this occupational therapist is well and truly back in town 😉
One final note, I came across this quote when trying to cheer a friend up, but it is so apt for this blog for anyone experiencing OCD…
“Don’t confuse your path with your destination, Just because it’s stormy now doesn’t mean you aren’t headed for sunshine”
Smith, A. H., Wetterneck, C.T., Hart, J. M., Short, M.B., Björgvinsson, T. (2012) “Differences in Obsessional Beliefs and Emotion Appraisal in Obsessive Compulsive Symptom Presentation” Journal of Obsessive-Compulsive and Related Disorders.(1) pp. 54-61.