Self-Fulfilling Prophecy: The OCD Tyrant!

Here’s a helpful cautionary tale from the modern folklore that is Star Wars.  It doesn’t matter if you’re not a fan of Star Wars, you’ll pick up the idea.  (Although it does matter if you’re not a fan of Star Wars – what on Earth is the matter with you!?!)

Anakin Skywalker is an heroic Jedi Knight who, for all his powers with the Force, harbours two personal struggles: one is a self-perceived guilt over the abandonment, and later death, of his mother; the other is that he is plagued by nightmares that the love of his life, centre of his universe, Natalie Portman (or Padme, as he likes to call her) is going to die in childbirth.  Influenced by the guilt he feels over his mother, and the fact that his marriage to Padme is secret (so he is even afflicted by guilt over his own feelings of love) he does not only fear that these nightmares shall come true, but that this, too, shall be his fault.

Right, now you’re probably thinking ‘wow, that’s a great story Baz, but (either) a) I already know it, I’ve seen the films, b) I couldn’t give a toss, (plus) c) what the hell has this got to do with a blog allegedly about the mental health condition Obsessive Compulsive Disorder, which was all very helpful and informative until you stopped bothering your arse even writing it at least a year ago?

Well, please – allow me to continue and to clarify.  Back to the story, and enter Chancellor Palpatine, a.k.a. the evil Sith Lord in disguise who is soon to become the tyrannical Emperor, oppressor of all liberty and hope.  A.k.a. the intrusive thoughts at the heart of OCD.  ‘Ahh,’ you all say, ‘he’s using it as a metaphor!’

Yeah, yeah, thanks for keeping up – let me get on with it.

The Chancellor / Emperor has befriended young Anakin for some time now, and has been subtly manipulating him to believe that he understands the troubled hero whereas no one else does, making him the only one that can truly be trusted.  So of course Anakin confides his fears to the Emperor, who then makes clear to him that not only are his irrational fears definitely going to come true! (cleverly reinforcing Anakin’s guilty feelings that what might go wrong is all his own fault), but that the only way he can stop this happening is to side with the Emperor and embark on an increasingly destructive set of actions which then actually result not only in the very things he has been fearing taking place, but also in the loss of everything else he loves, and the loss, effectively, of his own identity (replaced by something dark, corrupted, and destructive – Darth Vader).

Now, I’m not just telling you all this as an example of literary criticism, and presenting Star Wars: Revenge of the Sith as cinematic metaphorical depiction of how OCD can work (though it seems to work that way quite well, now that I’ve written it).  Rather my intention was to use it as an example of something that is key to the perpetuation of intrusive thoughts and their impact in OCD, or indeed other experiences of anxiety and worry: the self-fulfilling prophecy.

The only reason, ultimately, that everything goes so very badly wrong for Anakin, was because he was persuaded that he had to do something about his worry: and those very things that he did were the actual cause of his fears coming true.  I’ve spoken in blog articles before that the issue, when it comes to OCD, is not the thought (the ‘O’ – Obsession – component of OCD), but the response or reaction to this thought that we feel compelled (the ‘C’ component) to do about it.  The thought becomes the central problem in your conscious existence when you follow it, believe that it will be this problem, and so you try to stop it.  Things only go so badly wrong for you due to the measures that you carry out to prevent, change or nullify it: checking again and again that the door is locked; washing your hands if you touch a certain thing; avoiding seeing a certain food product in the shop; finding reassurance that the strange thing you just thought about is not the case, constructing arguments in your head about why it must not be the case.  It’s not the problem to have the nightmare: the problem is to listen to what the Emperor says you must do about.

This Star Wars example, this metaphor, cropped up in a therapy session of mine a year ago.  I had made certain progress at the time, but a small something occurred while I was watching a film (an activity that I enjoy a lot, but had been unable to consistently do for a couple of years at that point due to my OCD) and something I saw made me think of something, that linked to intrusive thoughts that I had been suffering.  I actually did pretty well – I was discomforted for a few days, but recognised that I could accept that and that there was no need to follow the thought and demonstrate why it was not a problem; no need to avoid watching another film until I had managed to demonstrate this to myself – because it was only going to become more than a temporary discomfort and become a mentally crippling problem if I tried to demonstrate this to myself, to challenge the thought through internal arguments which would escalate, and get out of control, if I believed that any of this was necessary.  My therapist was pleased with my response, with the insight, and laid bare the role of self-fulfilling prophecy in OCD, of recognising that is what it would become.

So, why am I writing about all this today, a year after that conversation, and about the same length of time since I last contributed to this blog?

In terms of recovery from OCD, I have been doing very well.  A month after that session last year I had a bad, bad downturn and was in what cognitive scientists call a ‘right fucking state’ for a few months.  But then in November / December I made a massive break-through, and a couple of brief slip-ups aside that I have sailed through well, this year I am pleased to say that I am doing much, much better – the best I have felt in four or five years.

In recent weeks however, I have noticed some warning signs.  Not so much of OCD – but of becoming overwhelmed by my own feelings, of ruminating on this, worrying about it.  I have experienced depression in the past as well as OCD and I have noticed that I am projecting the way things may pan out based upon those experiences: I have started applying certain negative interpretations to things happening around me, applying self-judgement as a result, ruminating over how I need to adjust my behaviour in order to avoid the path of depressive episodes before; to make sure that the faint whispers of OCD symptoms I’ve been hearing for a couple of weeks at the edges of my mind don’t grow into a problem…  Then, it struck me, as I opened the laptop today, to work on the book that I’m writing (hence, so little blog activity), and weave in the Anakin Skywalker self-fulfilling prophecy metaphor into the self-realisation of one of my characters, that the very way I am approaching my feelings is same thing.  It’s the Emperor, wearing a different outfit, and warning me what to do about a different nightmare.  I am feeling a bit down at the moment, but the way it shall become the disaster I fear, is by my trying to work out what to do about it.  There is only one thing I need to do: recognise the thought-distortions involved in my current thinking, take a step back, don’t judge and to be aware.

Very much advice Yoda would give, rather than the Emperor.

So I wrote this, to remind myself.  But also, because I hope that it is useful and helpful.  As I have said before, OCD is a disordered version of normal human cognitive processes: understanding what goes wrong, how it escalates and what can be done about it is useful for all of us.  Recognising the role of self-fulfilling prophecies, of thought distortions in our thinking when feeling anxious or down, is helpful, because they can be countered.

That’s great, you all say.  What are these thought-distortion thingys again?  Are they like Jedi mind tricks?

Ah, no.  They are something else.  And because this is getting long, and I’ve got a book to write, I shall leave it there, on that cliff-hanger.  But I shall be back very soon to explain their part in my current worries, and the part they play in all of our worries.  Best still, I’ll suggest what you can do about them.

Who tells you how you feel? You.

I don’t know where I’m going with this article as I start it, so hold on tight – it could end up anywhere.

It has been sometime since my last post, which means that the ongoing narrative about what OCD is, and the importance of it being understood (along with mental health issues as a whole) has somewhat drifted.  I feel that I should at least say something about where I have been the past four or five months, then work out where to pick up the thread.

I have been distracted from writing articles for this blog recently by taking a career-break from my job and working on a longer-form writing project (a novel, in fact.  Ooh – fancy!)  I have also been working very hard in therapy, making progress in my own personal mental health battle, and perhaps, ironically, that progress has taken some of the immediate urgency out of the blog writing – I don’t know.

During the last six weeks or so, there have been a number of things that have been gently prompting me with a reminder that I need to get a blog post done.  Among them: a grossly irresponsible documentary by BBC Panorama concerning hypothesised side-effects of SSRI medications (Selective Serotonin Reuptake Inhibitors – drugs used as part of the treatment for anxiety, depression, OCD, eating disorders and Body Dysmorphic Disorder); becoming riled and upset by a thoroughly ignorant arse berating me in the most twattish manner on social media, following my challenge of a ‘jokey’ OCD quiz on Facebook; someone else on twitter expressing their fear concerning her OCD diagnosis due to things that she had read in the media; and a post-it note attached to my laptop saying ‘Baz – You Need To Get A Blog Post Done!’

Where on earth do I start..?

Well, unfortunately, what has probably prompted me most is a motorway pile up of shitty experiences in the past month, which has seen a (temporary) halt in the writing of my novel, and a crash in both my mental and physical health.  Last month I commenced the long overdue process of trying to track down my estranged father, whom I had not seen since I was a teenager.  One of my first discoveries, four weeks ago, was that I had indeed waited too long: he died at the end of January this year, and neither I nor any of my siblings had been informed.

Understandably, this has been something of a shock; the waves of which are carrying a great many feelings stirred up from the deep and sending them crashing upon my waking shore.  These are feelings arising from complicated familial situations based in my childhood (mainly teenage) years that have had significant impact upon my emotional development, and are an integral part to one aspect of my work in therapy.  So it was of little surprise to my mental health key worker that OCD symptoms (some that I’d very much gotten past) reared up again.  These have subsequently interfered with the grieving process over my dad.  Luckily, to make it all easier, I was then admitted into London’s Royal Free Hospital for the fifth time since 2012 with an infection exacerbated by the serious autoimmune disease from which I suffer (and have referred to in an earlier article).  I’m home now, recovering.

I believe that there is a phrase for these kind of situations.  I can’t remember if it is ‘perfect storm’ or ‘taking the fucking piss.’  Either one shall do for now.

I considered making this blog post about those feelings stirred up in the wake of the news about my dad; about the unhappy situation when I was growing up and its relevance to some of my therapeutic work.  My hesitance around this is that the aim of the blog is to inform/educate about OCD and provide help for those experiencing or encountering it either personally or second hand, and I was unsure how helpful for others it would be.  I spoke to a good friend about this, just before I went into hospital a couple of weeks ago actually, as I was first sketching out this post, and she felt that it was perfectly valid to base the article on such a cathartic discharge – as it can still be helpful for people to see the importance of doing something with feelings that may be contributing to their mental health difficulties and, of course, helpful for me.

Ultimately, I have decided not to make a discussion of those particular feelings the central focus of this post (it may still come out in another post, or as part of a number of posts), but what my friend said has been influential on what I do want to say today.  Because she is right: what I am feeling and experiencing is what is relevant to my blog, not what I think I should have to be doing, saying or discussing.  And I realise that this ties up rather neatly to those earlier prompts to get a blog post done that I listed in the third main paragraph above.

Both the BBC Panorama show and the ignorant twat (who I don’t even know by the way) that berated me on social media are material enough for a blog post in themselves – one about the representation of mental health, and how important it is.  This is already a running theme throughout the articles in this blog however: I have discussed before the importance of responsible representation of mental health issues, and the harmful nature of misinformation, perpetuation of myths etc.  The Panorama programme was called – I shit you not – ‘Prescription For Murder’, and with a sensationalist disregard for facts and evidence, it presented the hypothesis that SSRI drugs may have such harmful effects upon a minority that take them, that perhaps even lead to killing, with a quality of analysis that would see me sacked from my job as a Research Analyst if I had handed it in to my boss.  The social media twat launched his attack on me after I challenged a Facebook quiz (entitled the ‘OCD Radar’) due to how harmful this misrepresentation of the illness can be.  But rather than thinking about how badly mental health issues were represented in each of these instances, I want to focus on the judgemental ownership of mental health issues that occurred in each case, and the prescriptive attitude towards the people actually experiencing mental illness.

In the Panorama case there was a great deal of irresponsibility in the implications made about how mental illness should or should not be treated.  Within the community of those affected by mental illness, the use of medication can be a touchy subject.  This is generally because (and am simplifying a bit here) on the whole, psychiatric practitioners tend to feel that what can make a greater long-term influence on recovery for anxiety, OCD, depression, are other therapies (e.g. appropriate talking therapies, CBT etc.) plus peer support, lifestyle and wellbeing choices, rather than just medication alone.  And, of course, there are side effects to the medications prescribed (SSRI’s or other types).  But before anyone panics, keep this in mind: there are side-effects to all medications.  The medications that I have to take for my physical illness have some genuinely horrible and rather serious side effects (in fact there are a couple of medications I have to take because of the side effects of others that I take!)  As a result (remember – I am simplifying) there is a phenomenon among those who suffer mental illness, sometimes known as pill-shaming, whereby using SSRIs, anti-depressants etc. is frowned upon and criticised.  So when that Panorama programme occurred, there was something of an outcry through social media among the large population for whom these medications make an essential positive difference (literally being life-saving in many cases).  Unfortunately, in turn, there was also something of a backlash against this, amongst those who have struggled with some of the side effects (not by massacring people, as Panorama carelessly implied) of SSRIs enough to not want them as part of their treatment.  They felt that the medication-defenders were criticising them.  The medication-defenders pointed out that they are often pill-shamed.  The makers of the Panorama show, not even interested in this side of the issue slunk off without a care.

The point is, whether you take medication or not is between you and your medical professional (be it GP, psychiatrist, therapist – whichever combination).  The most important person in recovering from mental illness is the person experiencing the mental illness.  You.  If a particular therapeutic combination is working for you (or indeed, if it really isn’t) then you are the person to know that, and should not be made to feel worried that you are in the wrong.  There is someone I know who during a medical where they work was told by the contracted doctor there that they it was wrong for them to have been taking anti-depressants for as long as they had!  Causing them distress and anxiety during the medical.  That particular doctor was being nothing short of unprofessional, and badly ill-informed, not being my friends own doctor or knowing their full case.

Take this parallel.  Think of how annoying it is if someone asks you who your favourite band is.  “Little Mix” you might say.  Or, “Slayer”, “Coldplay” – whoever – and their face twists in disgust or laughter.  They shake their heads.  “No,” they say, “that’s stupid, they’re childish/cheesy/crap!”  It could be your favourite film instead, or celebrity crush, I don’t know, anything.  Who are these people to tell you what your experience is!?  What you like or not?  That’s annoying right?  Now imagine someone telling you what your experience of mental illness is or should be, and what does or does not help you feel better!  That’s not annoying.  That’s insensitive, that’s distressing, that is dangerous.

Of course, there are parameters involved.  If you are being treated for anxiety by someone who tells you to sleep in a tree and eat nothing but Percy Pigs (they’re a British gelatine-based sweet for non UK readers – and you should try them), then actually, that probably isn’t going to help a great deal in the long term, even if you initially think it might.  You want informed approaches advised by qualified professionals.  But here’s a thing to consider.  There is not one approach, and there is varying evidence that qualified professionals can draw upon.  Mental illness is also a complex subject that these qualified professionals are still learning a lot about.  So within the parameters of legitimate help and treatment, there is variation, and there will be variation about what works or what combination works for one person to the next.  This is down to you, together with your doctor/psychiatrist/therapist to establish.  If CBT is working for you, and you don’t feel medication helps – great.  If CBT is not enough and there are other talking therapies that sort out the mess that feeds your anxiety/OCD/depression: good.  If you find that adding medication to the mix makes you better still, awesome.  There is no fixed rule.

So beyond the irresponsibility of the poor representation of certain issues, that Panorama show contributed to this dictating to and judgement of what people going through mental illness experience and how they can be helped – which frankly pissed me off.  The social media twat that berated me, well, yeah the argument was triggered by the poor representation of a mental health issue, and his views were most likely informed by other successive poor representations, but what really got me was the way the guy was telling me, someone that suffers OCD, what my attitude about it should be (that I should take it all a lot less seriously), and how that would help me be some kind of better person.

But the most important person that I want to reach out to in this post, is the person who posted on twitter, saying that she had been given a diagnosis of OCD, and that she was scared.  She had read about OCD online, she feared just how bad it could get, feared that she would never recover.  Oh I know that fear.  Each time there is an episode, the symptoms rear up again, that fear drives their resurgence.  This is it.  I’ve lost, I’ll never get better.

What I want to tell her, much that I am in a funk at the moment, is that it will get better.  I have seen in another (very good) blog post listing OCD myths that one of them is that sufferers can have good OCD days and bad OCD days.  Rather she says, it is always there but the key is learning to manage it.  That is her experience, and it is not wrong, and I am pleased that she has that management tool in her armoury – but from my own experience, I disagree.  It can, and does, go away.  Which one of us is right, which one is wrong?  Neither, both, whichever way you want to put it.  That’s not how it works.  Both of our experiences are real, and should be respected.  Just as there may be two people with the same physical illness, one may be treated in such a way that the condition can’t be gotten rid of but can be managed, whereas the other may recover completely.  For the twitter girl my advice is learn from the experiences of others, but remember that these are not fixed rules, so do not allow them to become fears or pressures.  Some people deal with recovery and management of OCD without feeling a pressure to get completely ‘better’, accepting that managing it well when it occurs is the aim.  Others, like me, are boosted in the fight by a therapist that insists full recovery is possible, and reading accounts that support that.  Remember, neither is right or wrong – there’s a lot of people in the world, with a lot of different experiences.

Yes OCD is scary and miserable, as I don’t need to tell her. But it is treatable, it is manageable, it does get better – whether that means being so well managed that you can carry on ok regardless, be it that it goes away for periods of time, even after it recurs, or be it that you can recover altogether.

And now this post has gotten very long, and I’m just going to stop.  It’s been more rambling than usual, but I hope that it is helpful in some way to someone out there, and yes – I hope that it is helpful to me.  I’m not feeling good right now, but I shall remember that this has been the case before, and strive for the recovery that is ever improving.

And I shall be back sooner, rather than later, as there is an important theme here which I want to pick up: Fixed Rules, and the part they play in our mental health.  I don’t just mean people diagnosed with OCD, anxiety, depression etc.  I mean in the mental health for all of us.  As I have said in the past, just as every person that has a body has physical health that can be anywhere on a good-bad spectrum at any given time, every person that has a mind has mental health, which moves and rests on an equivalent spectrum.  Understanding the part that Fixed Rules, and the other five Thought Distortions (which I shall introduce next time) is important to understanding, managing and dealing with that mental health – be you diagnosed with a mental illness or not.

Finally.  I wish I had seen my dad.

Cheers.

OCD – The Opportunistic Troll

So, it’s been a while since the last entry in this OCD story of mine, and for those who have been following the blog, it feels like I need to open up with an American drama series style ‘last-time on Sketches by Baz’ sequence of key points from the last few episodes.  Basically those key points were:

  • In OCD, despite all appearances, the intrusive thoughts are not the problem – it is the process of attributing an alarming significance to these thoughts, and the subsequent defensive reaction
  • By disengaging from that defensive reaction – be it washing hands, checking things, making lists, generating counter-thoughts and seeking validating arguments – and letting the thoughts be, they lose their power
  • This is all good news – but unfortunately the reaction is compulsive, deeply unpleasant and doing all this is, while achievable, bloody difficult

I’ve actually just looked back through the last few articles from late December and early January.  Largely because I need to tell myself all this – because in the last few weeks I’ve had a bit of a crash in my recovery and am currently feeling really bloody awful.

What I want to explain is that this could be a crucial period in my battle, and it could actually be a positive thing, no matter how difficult that is to believe this very minute.  Recently I have made a lot of achievements in overcoming my illness.  Part of my current problem may have come about by giving the OCD a window of opportunity by the very act of reviewing my achievements and checking that they are stable.  While the OCD has indeed taken this opportunity, it has made clear a characteristic about itself that my therapists say I can use to my own advantage.

Ok, first let me give you an example of a gain I have achieved over the OCD.

I had discussed in CBT this helpful analogy.   When I first fell in love with a couple of my favourite Pink Floyd albums, my copies were tapes (kids – use Wikipedia to look up audio tapes), copied from fairly old LP’s (vinyl records kids – you’re not bloody cool if you don’t know what they are!)  So as well as the music, there were a lot of crackles, pops, a couple of places where the needle on the record jumped a little.  Does this mean that it ruined the experience of listening to the albums?  No.  Because I focused on the music.  I could still process the beauty of the music in and of itself.  I was long at the stage where by I did not process the crackles and pops at all.

The crackles and pops, are not part of the music.  Just as my horrible intrusive thoughts are not part of the things in life that I have been struggling to enjoy.  Whatever the thoughts tell me, what I enjoy, what I am, life – it is still beautiful and enjoyable if I focus on it, and not on the interference.  And if I don’t focus on that inference, I’ll stop being aware of it.

Understanding the truth of this analogy makes me feel really good.  Then, a day after talking about this in CBT recently, I had a wobble.  I thought, does this analogy work in my particular case?  Is it different because…?  Does that mean what I thought I had achieved is wrong?  If so then…?  What if…?  But… but… but…  Before you knew it the intrusive thoughts were using my gain against me.

So what had happened?  It’s not actually that complicated.  You could say that because I had achieved something, the OCD threw a noisy strop.  I stopped responding to it, so it shouted louder.  You can demonstrate this basic kind of mechanism in behaviourist psychology.  If you have a mouse (Gerald) who lives in a cage where there is a lever and he presses the lever, only to have a pellet of food delivered, he’s going to press the lever again.  By delivering the food each time Gerald presses the lever, you have conditioned a behaviour in him.  My intrusive thoughts, while not as cute as Gerald, have been behaving the same way.  They pop into my head, I react to them.  In reacting to them I have reinforced their occurrence, so like Gerald with his lever they keep coming back into my head demanding attention.  Now, if you stop delivering the pellet of food to Gerald, what does he do?  Does he think ‘oh, stuff it then’, and wander off, taking no further interest in the lever.  Does he buggery!  He presses it, presses it again – sooner than he normally would, and goes briefly berserk, pressing it with heightened regular intensity.  Where is the food he’s conditioned to expect!?  Where, where!?  Press, press press!  Eventually, of course, he gives up.  And that’s what the OCD does.  Shouts, jumps up and down, causes a ruckus: ‘where is my reaction!?’

Having achieved something over the OCD, unfortunately, I gave it an opportunity, an opening, by kind of safety-checking my thoughts and feelings.  ‘I’ve made an achievement, is it ok now?  Is my achievement stable?’  Doing that was just enough of an opportunity for the OCD to get its foot in the door, and shout desperately ‘no Baz, your achievement is shite!  You’re shite!  And you’ve got stupid hair!’

What is important to recognise however, is not just that the OCD is opportunistic, not just that it is reacting against achievements I’ve made.  It is the manner in which it is reacting.  It is a wind-up.  It is acting just like an internet troll: its message (the content of the thoughts) don’t matter, it has no actual argument of its own, all that matters is its intention: to upset met.  Trying to provoke a reaction from me.  It just wants its pellet of food.

So if you say something good, something that you have achieved, something you deserve to be happy about on twitter, and a troll starts sending through messages that amount to saying your achievement is crap, that you are crap, what do you do?  Argue with them?  Does that make them go away?  No.  Just because they say you should worry about the validity of your achievement, should you worry?  Should you try to explain to them?  No.

Understanding this character of the OCD will help me win.  I’ve had a bad few weeks, and have received excellent help in some pretty intensive therapy sessions, where it already has helped me, just I’ve then slipped a bit again.  These troll like thoughts… pouncing on my own safety checking like unscrupulous salesmen, con men, tricksters employing suggestion and implication to get to me to doubt myself, tempt me back in to engaging with them…  It’s difficult.  But knowing that that’s all they are, trolls – that I can’t win by engaging with them and justifying myself, that there is no onus on me do so, it will help me win.  They have no argument to present, and my achievements are real.

Be back soon with an article about how valuable the friends in my corner supporting me through my illness are.

 

And by pouncing on my own safety checking like an unscrupulous salesman, a con-man or a trickster, to use suggestion and implication, getting me to doubt myself, it is currently getting that reaction.

OCD – is it a bit weird or are we all ‘a bit OCD’?

In the article ‘Finding the D in the OCD’, I spoke of how the disordered component in OCD is the compulsive interpretation and reaction to intrusive thoughts.  This is what keeps the illness going, and although if feels as if the intrusive thought is what is wrong and what is hurting, it is actually this reaction.  It is this reaction that CBT targets, but it’s not an easy thing to challenge.  Do not underestimate how strong the disordered compulsion is.  Just think about the word: compulsion.  Something that you are compelled to do, that you have to do.  In her book ‘Am I Normal Yet?’ Holly Bourne equates it to the physical urge to urinate.  It is a deep and irresistible urge, which takes over and can’t just be ignored.  It is not something that you choose to do, mistakenly, for the best.  It is not a habitual peculiarity that becomes irritating and difficult to break.  It was no irritating peculiarity which influenced a couple of (admittedly half-arsed, but nonetheless despairingly intentioned) suicide attempts in my early twenties.

It is not easy to explain how much these disordered interpretations and reactions feel a part of you; how undeniable the unsettled, distorted state of mind and self-perception feels, as most people have probably never experienced anything like it.  Hmm, apart from… most people probably have experienced something like it.

As I also mentioned before, everybody has thousands of thoughts passing through their minds a day, and some of those thoughts will be weird or unpleasant, incongruent and unwanted.  Let’s just pluck a few examples out the air:

You’re waiting for a train and among myriad thoughts passing through the background scenery of your mind, this one pops up: ‘what if I jump in front of the train?’

You’re eating your tea/dinner/supper (all regional interpretations catered for here) and for no good reason as you stab your fork into some carrots you have the mental image of a rabbit, doing a poo, on your plate.  Eurgh!

You are walking past a playground when you find a dropped hat.  You pick it up, thinking maybe to hand it in somewhere, then out of nowhere think – ‘what if the child who dropped this has been kidnapped and murdered?!  What if everyone thinks I’ve done that?   I’ve got the hat!!’

Think, just for a moment.  These are just a few examples I’ve made up, out of near infinite possibilities of potential thoughts.  Just think – you’ll find your own examples that all of you will have at some time experienced.  Many of which, you shall have forgotten.

Likewise, everybody experiences unpleasant emotional reactions to thoughts or external events.  Everybody gets trapped in worry-loops about something in particular, sometimes rational, but unaided by the worry, sometimes thoroughly irrational.  In relation to thee examples of unwanted thoughts above, consider these reactions:

While you may think a surprised ‘blimey’ on the train station platform, and take a step back, you may also inspect the thought – ‘why did I think that?  Can I control urges to jump?  I’m not suicidal – am I?’

Where one person may well laugh at the idea of a rabbit doing a poo (each to their own), another may feel sickened, disgusted.  Put off their tea, or even for a while put off carrots.

You may shrug at the thought of being accused of kidnap and murder (unlikely), and carry on; or you may drop the hat, then worry for the next twenty minutes that your DNA is on it.  Or that if you told someone about the thought, they’d wonder why you were hanging around playgrounds.

Also everybody sometimes employs some personal set of rules to manage how comfortable they feel about something.  You knock one had as you walking through the shop, you feel like knocking the other one, to balance it out.  You have in your kitchen a hand towel (for drying hands only), a tea-towel (for drying dishes only) and a dish cloth (for wiping down the work surface only).  And you do not mix them up!!  You get fidgety and irritated when someone visits and uses the wrong one for the wrong thing.

Again, look through your own life, and you’ll find some of your own examples, at some point, somewhere.

So… does this mean that OCD actually affects everybody?  Aha, thanks for asking: No!  Absolutely not.  The often casually banded phrases of ‘I’m a little bit OCD’, and ‘everybody’s a bit OCD aren’t they?’ are part of the harmful myths to which I’ve referred before, which perpetuate a misunderstanding and belittling of a very serious illness, that affects between 1%-2% of the population of the UK and USA (OCDUK.org figures).

You may be thinking ‘OK Baz, fair enough mate, but, um, you do appear to have just slightly contradicted yourself by saying everyone experiences these thoughts and reactions, but it’s wrong to say everyone is a bit OCD…’  Yeah, don’t worry, there’s no contradiction.

What I’ve intended to demonstrate here is that these odd, unwanted thoughts, these anxious interpretations of things, weirdly disproportionate emotional reactions, ways of maintaining our own mental comfort or order are totally normal.  It is all part of normal human cognition, emotion and behaviour, and very valuable it is too, even when sometimes confusing or worrying.  But just as everybody sneezes and coughs, it doesn’t mean that they have a cold.  Just as when people have colds, it doesn’t mean they have pneumonia; or it doesn’t mean they have a serious, chronic and potentially terminal health condition.

What I am getting at here is that OCD, however it may appear, is not weird.  There is a disordered severity to what otherwise could be a normal reaction, to a thought, resulting in attention assigning wrongly significant interpretations to thoughts and behaviours.  In themselves, the processes involved are normal.  Not everyone has it, but as with all mental illness, OCD is normal human thoughts and behaviours becoming unhealthily detrimental.

Realising this is very important to understanding, accepting, and dealing with mental health.  And it is important for everyone.  Because, just as with physical health, while not everyone has a mental illness, everyone has mental health.  This health is on a spectrum, not fixed in one place.  Mental health can move up and down this spectrum, changing to more or less well, for everybody.  So understanding it, is important for us all.

Thanks for reading.  The next article shall be about an important feminist issue in film and culture – and a social campaign that I am going to attempt to start!  I shall return to the continuing narrative regarding OCD and mental health in the article after that.

 

 

 

 

 

 

Finding the ‘D’ in the ‘OCD’

It’s not about the content, it’s about the process.

This is something my CBT therapist discusses with me a lot.  He’s pleased that recently I’ve been attending OCD support groups and Bryony Gordon’s excellent Mental Health Mates meet-ups; things I’d have previously shied away from.  We’ve discussed the therapeutic benefits, amongst which is finding the similarities with others who overtly, at least, seem to experience something very different to me.  Realising that the similarities lie in the process of how the illness works, not the content of thoughts and scenarios experienced, is a very valuable thing indeed.   For the more that you realise that the content of intrusive thoughts does not matter, the closer to recovery you come.

Let’s strip OCD down to the basics.  Meet the stars of today’s two made up examples: Buffy and Davros (what?!  That’s their names, ok?).  Buffy loves going jogging, but has been terrorised by this intrusive thought: that when she runs along the street and encounters a little girl playing on her scooter, she’s going to violently shove that little girl out of the way, into the road, under the path of a speeding van.  She is horrified by this image, appalled that she has thought it, and terrified about why she has thought it.  Is there something bad in her?  Is she actually going to do that?  She can’t get rid of the image, and  she stops going running, or even walking in the street.

Davros doesn’t understand Buffy’s problem at all, and wishes that was all he had to worry about.  His anxiety has gotten out of control since he nearly left the house with the kitchen tap running.  He turned it off, but then turned it on and off again to be sure.  He finished getting ready to go out, but then checked the tap again, turning it on and off again twice more.  Getting to the front door, he thought, what if he left the bathroom tap on as well?  So he went back, turned that on and off again three times to be sure of that too.  Feeling better he finally left, but now he keeps thinking about the incident.  Before he knows it, he is struggling to ever leave the house or any room without turning taps, light switches, all sorts, on and off three times; and his anxiety about it and how weird it is, is making him feel sick.  Buffy hears about this and thinks it’s stupid.  Why worry about that?  It’s not like he’s being terrorised by images of pushing little girls in the road all day long, which might mean she has evil impulses!

The scenarios differ in content, but the process of Buffy and Davros’ problems are the same.  There is a thought that invades their minds (‘push girl in front of van’, and ‘left tap running’).  This thought glares the spotlight of each ones attention, gets trapped in their minds, like a song you can’t stop replaying in your head.

To try to neutralise this obsessive thought, both carry out a reactive behaviour.  Even though she loves running, Buffy stops going.  When this doesn’t work she even stops walking in busy streets.  Davros checks all the taps.  He checks excessively by turning them on and off three times each.  When this doesn’t work, he starts checking all manner of things, turning them off multiple more times.  This is a compulsive behaviour.

Ok, but last time I talked about mental images that upset me, and about abstract misery regarding the concept of humour.  They were obsessive thoughts, sure, but where was the compulsive element?  These type of OCD experiences are sometimes referred to under the umbrella term ‘pure O’, meaning pure obsession.  It is a term that I dislike for a couple of reasons.  Firstly it sounds to me like the title of a porn video!  Secondly, it is misleading, as there is a very strong compulsive element in terms of my reactions to the obsessive thoughts.  For a start, I do carry out overt behaviours, such as avoidance.  Also, the behaviours don’t have to be overt – they can be internal, mental.  In my case I try to transform the images to make them more acceptable or manageable.  Or I try to justify reassuring arguments that I construct to deal with the obsessive abstract terrors; try to ‘solve’ or ‘clean’ the thoughts.  Inn Buffy’s case she tries to stop the image, or questions the reason for it.

However, the real compulsive element in all cases, is not just found in the action carried out to manage the situation, but also the initial reaction to the thought.  This is a very important point in understanding and fighting the illness.  Because this negative reaction involves an interpretation of the original thought.  Buffy thinks ‘that’s horrible – but why did I think it; what if I actually do it;I must not do that; does it mean there is something bad in me; what if I can never walk in a street again?’.  Davros thinks ’how do I know I turned off the tap if I forgot before; why am I still worried about it; I must not let this happen; why did it feel better after three times; what if I can never just do things first time again’.  These are thoughts-about-thoughts – meta-cognitions.  They tell you that you need to do something about the thought.  Now.  NOW!!  They tell you the thought is dangerous, frightening, disgusting – do something about it, neutralise it, NOW, and don’t stop until it is gone.

And how do you make the thought gone?  Do you try to ignore it?  No, no, no.  Ok, you need to keep acting out sets of behaviours or counter thoughts until you find the right one to stop it, right?  Do you arse! (if you are reading outside the UK, this translates as ‘most certainly not’).  Look at Buffy and Davros’ examples.  The more they do, the worse it gets.  Oh, ok, shit.  So what do you do to stop them?

Well – you don’t.

What?!  But… surely…. What?!

What I mean, is that you don’t try to stop them.  And also, you can’t stop them.  But don’t worry, you don’t need to stop them.

You see, the thoughts themselves are not the problem.  They are just thoughts.  No matter how weird or unpleasant.  Everyone has thousands of thoughts passing through their minds every minute, and some of them are, well, weird and unpleasant.  Having the thoughts is not the disordered component in OCD.  How could it be, when the thoughts themselves can be about anything at all?  What is disordered is the reaction to the thoughts.  The severity of that compulsive reaction, that alarmed interpretation, keeps the thought in the spotlight of attention.  The meta-cognition which demands corrective behaviour, a mental solving of a problem, that doesn’t actually exist, maintains the obsessive problem in a vicious cycle.

This is the reason that, in cognitive-neuropsychology terminology, OCD is such a total, utter, bastard.  But while it is a long, long way from easy, once you fully get to grips with where the disorder truly lies – in the process, not the content – then you can start working towards dealing with it effectively.

How OCD first invaded my mind, and other stories

As I explained last time, the experience of OCD is massively varied.  Not only does it vary from person to person, but within one person’s experience it changes too.  This is an important point to emphasise – as next time I’ll discuss how it is not the content of the thoughts that is important, but the process.  Today, to provide that discussion with some context and to demonstrate OCDs variable nature, I’m going to take you on a tour of the earliest years of my illness.  Believe me – this is deeply uncomfortable.

14 -16 years old: Contamination

It began with a problem at school.  Bullying?  Girls?  Long division?  No.  Acid.

I don’t mean acid as in LSD or late 80s dance music (‘this is aciiieed!’).  I mean hydrochloric, sulfuric… whatever acid as used in chemistry class.  Although I believe that acid tends to announce is presence on skin quite proudly, I felt deeply uncomfortable after science class.  What if the chemicals were on my hands?  On my clothes?  On my school bag?  Within no time at all, just going to school resulted in a feeling of entering a contaminated environment.  And I mean feeling: I experienced a highly sensitive physical discomfort, like walking in to lukewarm, dirty, water.  My home life and school life were wrenched apart – I had to keep them separate.  Anything associated with school took on this irradiated quality, humming with a stale warm glow, like the halo around people who had eaten porridge in the old Ready Break adverts (showing your age Baz – tell them to look it up on YouTube).  When I got home I would remove my uniform, store it, my school bag and books in an isolated location which could not be touched, then go straight into the bathroom to thoroughly wash.  While my school work went to shit (I didn’t do any homework) and social life was affected, I managed the situation up quite well, I thought.  When I went into the sixth form, which was safely separate to the rest of the school, the problem faded away.  It was not until years later, that I told anyone about all this, or associated it at all with what was to come.

16-22 years old: mental imagery

Gradually over these years OCD properly took hold, and took the form of bizarre mental images that intruded upon my minds eye like a waking nightmare.  Polluting and infecting all other mental imagery, they’d twist and distort my imagination.  This is still the most common form of the illness I experience to this day, when I have relapses.

The problem would come and go, be more manageable sometimes or worse others, and last varying lengths of time.  The frequency, duration and severity gradually increased over a few years, until by the age of 21 it was near constant and having a severely distressing impact.  I responded to the images with compulsive feelings of disgust, repulsion and severe upset.  Their presence was feared and delivered an extreme sense of discomfort and wrongness, accompanied by apparent physical sensations: similar to the irradiated contamination I described above, and a warm sickly sensation in my head like a lumpy ooze bubbling under my skull, or rock jammed in my brain.

I was also stricken by a guilt – a responsibility, a need to seek reassurance from myself that I could fix this this.  Try to restructure the mental images, arrange them all as if solving a puzzle to get back to normal.  To have a ‘clear’ or ‘clean’ head again.  I tried to avoid physical or topical stimuli that may trigger the images.  My reaction to encountering such stimuli was as if to an electric shock, or an alarming, explosive sound.  They commanded my attention, demanded reassurance and resolution.

The form that the images themselves took changed every couple of years after they started.  First it was cigarette butts.  I’d be reading a book, picturing a scene – and there was a mound of cigarette butts.  Thinking of nothing in particular – there was a rotting cigarette butt floating in my head.  That changed as the problem intensified, both in frequency and severity.  The first change came when I’d poked my hand down the side of the armchair to retrieve a dropped pen, and recoiled in disgust at feeling food crumbs that had escaped and gathered there over time.  Now thoughts and images invaded my head with a force I’d not experienced before – ‘imagine that mess mixed with cigarette butts; imagine all little things in the world dropped and mixing with that mess; imagine that mess is the rubbish everywhere, all around us choking the world; imagine all chairs, all homes, all safe places you snuggle into… you are snuggling into that disgusting mess!’  Comfort, safety – they felt stripped away.  I felt exposed to a terrifying mass, surrounding me, closing in.

In turn this too changed.  For a long time the images were of a specific food stuff – a gooey, horrible dessert, which, I’m sorry, I’d rather not describe.  But really it doesn’t matter.  As each image changed, what used to upset me no longer did.  I could often deliberately think of previous images and they didn’t bother me, or if they did, the thought passed out of my head.  But the distress remained, and worsened.

 

22 years old: Conceptual crisis

In 1993 I was in an utter mess.  To this day I have a difficult, anxious, OCD relationship with the number 93.  Some weeks I couldn’t operate at all, and was bedridden, wishing I could just not think at all.  The images had gone after one day the foodstuff image took the place of something else as a punchline in a joke.  My response was devastatingly strange.  My compulsive, defensive instinct was to try to stop the image being associated with the joke, so as not to ‘contaminate’ it.  But then this other thought smashed everything away.  What was funny about the joke anyway?  How does it work?  How does any joke work?  What is humour?  Why is humour?  How is humour?  I scrabbled mentally to explain, and with every explanation opened up a trap door – what did I mean by this?  What did I mean by that?  What is enjoyment?  What is beauty?  Why do you like things?  Explain and justify these things!!

Within a week, all the unpleasant, upsetting mental images had gone.  But they were replaced by this non stop, howling, abstract storm in my head, which carried with it all the feelings of physical discomfort and exposed wrongness that used to accompany the images, and which I knew could not go until I lived up to my responsibility, and solved these unsolvable abstract riddles.  Consciousness was exhausting.  All I wanted was this crap out of head, or just to be dead.

And then help at last

The diagnosis of Obsessive Compulsive Disorder and subsequent psychiatric help late that year saved me (see earlier posts),  and until a little over a year ago, management of my illness has been pretty successful.

But see how varied it can be: an irrational fear of the contamination by chemicals.  Upsetting, stubborn mental imagery.  A compelling need to justify my own thoughts at the cost of despair.  All parts of the same illness, and none of them as funny as arranging my pens by colour.  What is it about these thoughts that makes them so disordered?

Well, the answer is – nothing.  They are, no matter how weird, just thoughts.  It isn’t the content of these thoughts that is the problem in OCD.  It is the mental interpretation of them.  It is in this, and the response, that we find the disorder.  As I shall discuss next time.

Beyond the OCD Myth

There is a myth about OCD, and it is a harmful myth.  This myth forms a common public perception: cleanliness, organisation, order, symmetry, doing things in threes, having quirky rules about how you set out life.  Being the love-child of Monica in Friends and Sheldon in Big Bang Theory basically.  What about this is a myth?  And what is harmful about it?

Well, for a start if it really was all a highly sensitive concern about or distaste of germs, dirt and disorder, involved habitual, unnecessary hand-washing, then I, of anyone, should be a textbook example.  I have very good reason why such things should worry me.

Let me digress for a moment, with a short story about me.

Almost five years ago my life changed, to a certain degree, when I was admitted into London’s Royal Free Hospital with a mystery illness.  I had hepatitis, my spleen was distended, and I was – to paraphrase some of the best medical minds at one of the worlds’ top research hospitals – properly buggered.  To cut a very long story (which is still ongoing) short, I have a very rare autoimmune disease, which at first attacked my joints and liver, but given the opportunity would adopt a scorched earth policy throughout my entire body.  At this stage all I can say about my immune system is: ungrateful little bastard.

I was off work for the whole of 2012.  I take a pretty large amount of medication, most of which is, quite frankly, not very good for me.  I take two sets of medication that suppresses my immune system.  This comes with the obvious risk that I am highly susceptible to infection, and when infection occurs I cannot fight it.  As an extra exciting bonus, my liver is no longer very capable of dealing with infection when it does occur – so I’m left on a bit of a knife edge.  I have been readmitted to hospital a number of times since with infection problems.  My illness is still under investigation, as it is so complex, but what has been made clear to me is that it will not go away – and there are a number of ways in which it is likely to go south at any given moment.  Upon my most recent hospitalisation, this past summer, I enjoyed a bone marrow biopsy, and am currently under the care of three sets of consultants, two at the Royal Free, one at the Macmillan Cancer Centre, University College Hospital.

Now, I’ not looking for sympathy or awards for dealing with this (I will accept amazon vouchers – or just cold hard cash – if you really insist).  While I am pretty annoyed at some of the impact on my social life (no beer, for heaven sake!) I do deal with it pretty well.  It’s serious, but you’ve got to laugh, eh!  I tell this story though so that you know I have good rational cause to be fearful of germs.  The very serious consequences of infection are drummed into me, so I should take measures to avoid it which could very easily become excessive… and yet… I’m really not that bothered.  I don’t worry about it and have to admit sailing pretty close to the wind sometimes regarding precautionary measures.  I don’t wallow in filth or anything, I shower each day, my room is (relatively…mostly) tidy enough… but sometimes it’s a chaotic mess, and I spare it very little thought.  None of it really worries me at all.

So how can that be Baz?  You’ve got OCD man!  You’re supposed to be fussy about germs and cleanliness at the best of times…  Oh, yes, right – that’s the myth!  So where does this myth come from then?

Well, for some people OCD commonly can express as an irrational fear of infection, or an extreme discomfort about certain physical features of their environment.  This overwhelming upset is in response to an invasive, obsessive, thought, trapped in the sufferers mind.  The resultant washing or carrying out of specific behaviours to alleviate this fear or discomfort, and remove the obsessive thought, is a compulsive behavioural response.  Such responses become excessive, as they never can alleviate the fear or discomfort, and actually reinforce it (more about this another time), so have to be done more and more.  And to take washing as an example there is nothing ‘fussy’ about this behaviour.  There is a very real need, a seemingly irresistible urge.  Think of that word: compulsion.  You are compelled, you have to do it.  I recently met someone who prior to hospitalisation was trapped in her shower for 9 hours a day, and suffered a great deal of damage to her skin.  OCD victims becoming housebound prisoners, using bleach on their bodies… these really happen.

But my OCD involves nothing to do with germs, washing etc.  The illness expresses in many, many different forms – impossible to list here.   The invasive, intrusive thoughts can be anything, and the compulsive responses demanded as protective measures, can be anything – either external behaviours, or internal patterns of thought.

A number of things make the myth harmful.  If people believe only the myth, then they are misunderstanding and underestimating a serious mental illness that this year was added to the list of ten most debilitating illnesses by the World Health Organisation.  It is demeaning to, and dismissive of, the anguish and despair that those suffering the illness experience.  Would it be acceptable to be so dismissive and demeaning towards the symptoms of cancer?  No.  Given the seriousness of my physical health condition (while I’ve been flippant about it and am doing ok at the moment, the consultants make very clear how serious it is), I feel that I am qualified in making the comparison.  No matter how serious it is, I feel far more affected by my mental health situation.  If I could be free of one of the two, there’s no hesitation: I would get clear of OCD and take my chances with the physical disease.  Being dismissive about it makes sufferers ashamed and not seek help.  It also means that for all those suffering OCD which in no way resembles or has reference to cleanliness/washing etc., they either don’t know what is wrong with them, or people they turn to for help do not know what is wrong, and they suffer on without help.

Great, now we know what OCD isn’t, what it doesn’t involve.  So, if that is the OCD myth, what is the OCD fact?  What is it all about?  How does it work, and what makes is so bad? Even if I can’t list all the possible ways it expresses, I can at least tell you what has happened to me, right?  First hand insight?  Ah, yes… I’d rather worried it was going to have to come to that.  I guess I has better make a start on relating some of my experiences, next time.

Why I never wanted to write a blog about my mental health… and Why I think it’s important to write a blog about my mental health!

1 -Why I never wanted to write a blog about my mental health

So during the normal baseline, ‘clean’, periods between major OCD episodes, you know what?  I want nothing to do with OCD.  Rather, I want no acknowledged relationship between it and me.

I’m an empathetic person, and as having a psychology degree suggests, I’m interested in the functioning of the mind.  I care about the welfare of people and mental health – but I like all this at a distance.  It’s a bit like I’ve been deeply involved with the activities of this fiend – yeah, I’m Holmes and it is Moriarty – but when our battles are not actively taking place my interest changes to: ‘yes, everyone should learn about Moriarty, learn how deal with the bounder – it’s a very important matter!  Me?  Oh no, I’ not cut out for that kind of thing… There are better deerstalker-wearing mavericks out there for that task.  I support them!  Jolly good on them!  But me, no.  I’m off to play snooker’.

So, when my current OCD episode – the worst and longest lasting I’ve endured since the year leading up to first being diagnosed – and it was suggested to me that I write a blog… I kind of nodded vaguely, while thinking to myself ‘no bloody way!’

The suggestion had been made by my friend (all names here are changed to protect the innocent, so let’s call her…) Zsa Zsa.  The conversation was taking place, because I had changed my typical behaviour.  Usually when experiencing such an episode, I would tell people that I was unwell, that I sometimes suffered a strange neurological complaint that made my head feel gooey and sticky, made me feel a bit down in the dumps.  This time, I knew it was a really tricky one.  I felt isolated, alone, scared – and I suddenly opened up, told people.  Friends, work colleagues, my boss.  I am lucky in some ways – there was overwhelming support.

So, I was talking to Zsa Zsa about it, about going to CBT (Cognitive Behavioural Therapy), about being afraid that I’ll never go back to normal (I think this every time), but that I was fighting hard.  Zsa Zsa was giving me a good supportive pep talk, saying I would come through this, and when I did I’d be different this time – I could share my experiences, champion awareness and hope, helping myself and others in the process.

I nodded along, while thinking: ‘Hmm, or , screw that.  When I get better I don’t want to touch this experience again with a shitty stick!  I want to embrace my normality and dismiss this whole episode as a sticky nastiness that happened, matters not to me now, and is best left well alone!

And there’s a thing about OCD – avoidance.  I want to avoid thinking about it, engaging with it when I’m feeling ok, so that it doesn’t contaminate me, trigger associative thoughts, get my head all yucky and infected with it.  I want t get better asap.  I do not want to start my writing career with a blog about having OCD.

2 – Why I think it’s important to write a blog about my mental health

And what do they tell you in CBT about avoiding anxiety-tagged objects or situations?  Do they tell you to leave them well alone?  Do you go into CBT, explain that every time, oh I don’t know, you see or think of a bottle of pepsi max (other anxiety-inducing stimulants are available) it triggers a series of obsessive, disgusting mental images of your teeth and tongue melting, and the only way to neutralise these thoughts is to scrub your tongue until you are sick… does the therapist recommend that you never enter any shops selling pepsi max, and force yourself to ignore any mental images of pepsi max?

For those who have never done CBT, I’ll give you a clue:  No.

Doing that maintains the problem.  It makes the problem worse.  It doesn’t mean that you have to drink pepsi max for the rest of your life, but do get used to discomfort when entering shops where it lines the shelves, and if you don’t try to hide from it, over time it will become less important and harmful to you.

So hiding from having OCD when I am feeling more well… it sounds almost like developing OCD about OCD!  And while the problem with OCD really is the thoughts about thoughts, that situation is in danger of becoming so meta only Charlie Kaufman could make a film about it!

But that is not why I’ve now decided that writing a blog about having OCD is a good thing to do.  While I don’t want to spend my life running away from the monster, as I start feeling better there is also no need to go chasing after it all the time either.  I don’t want to hide from OCD, but I don’t want to make my life all about it either.

Zsa Zsa made an important point about helping myself and helping others.  Over the course of this year I have made progress.  Bumpy, stop-stat progress and I’m not there yet.  But progress there has been, and at least a part of it is down to new approaches and openness.  Engaging with wider and different types of help.  Addressing wider emotional issues as well as the OCD symptoms.  Reading accounts of the condition (e.g. Lily Bailey’s ‘Because We Are Bad – OCD and a Girl Lost in Thought’).  Joining Bryony Gordon’s Mental Health Mates Facebook and meet-up group.  ‘Coming out’ – telling everyone.  Not only has this made dealing with the situation less lonely, the support I’ve received has improved as my friends learn what support does help and what doesn’t.

There’s the big thing there – learning.  A huge issue with mental health illness is a lack of awareness and knowledge.  This is particularly pronounced with OCD.  ‘I’m a bit OCD’ says someone lining up the blinds just so, aping the merits of a quirky American sit-com character.  The public ‘know’ what OCD is – it’s people being really fussy about being clean or organised, right?  And when they’re too fussy, it’s a bit silly, right?  That dirt isn’t really going to hurt them…

No.  If they have OCD, their thoughts are harming them.  If they have OCD they probably won’t be telling you – they’ll be hiding it.  Worse still, if they have OCD they may not know it – be suffering alone in silence, while that relief of knowing what is happening in their heads ‘is a thing’, when real treatment is out there to help them.

You see, it’s not just the trivialisation, making a joke, of OCD that is harmful.  A public perpetuation of the myth that OCD is about cleanliness, neatness, symmetry, organisation means that a huge amount of sufferers where it is expressed in it’s many, weird, different forms (such as mine – come to that another time) may not realise what’s happening to them.  Not know it is ‘a thing’.  Not get help.  Suffer.  Die.

Sounds dramatic.  Well, that’s because it is.  And real.

So while I’ve been opening up, sharing, and realising that getting some of this crap out through talking and writing can help me, I have encountered a wonderful community of people who want to help.  And a wonderful community of people who need the help.  I’ve realised that I want to be part of these communities.  I want to share in the process of helping me and helping others.  Add my voice to those who can educate and support through experience.  I’m going to get involved beat this beast, destroy OCD and save the world…  Oh incidentally, my therapist is working with me on how I set my expectation levels at the moment.

So here we go: I never wanted to write a blog about my mental health.  Welcome to my blog about my mental health!

An introduction: Who’s this Baz bloke then? What’s his problem?

Baz?  Yep that’s me – a happy go-lucky bloke (on the inside), lives in London, has lived in Scotland, holds a degree in Psychology, works in social research, and dreams of being a writer.

Problem?  Well, I’ve had Obsessive Compulsive Disorder (OCD) since about the age of 15.  Known that’s what it is since I was 22 years old, after it had gotten so bad over the prior two years that I thought either I was going mad entirely, or that it was all real – this mess and horror in my head were right, real, that the thoughts intruding into my ‘normal’ mind were exactly who and what I was, and that was the way it would always be until, well, I killed myself.  This situation had led me to successive doctors appointments (I was actually hoping that they were going to find a blood clot or tumor or something in my brain and have to cut it out) and eventually to a psychiatrist.  I explained, with a sense of exhausted hopelessness, the weird, abstract thoughts reducing my conscious existence into a devastated war zone, believing that he’d never get what I’m going on about… Then was taken aback with a stunned relief I cannot nearly explain when he told me ‘oh yes – we know what this is.  We can get this sorted out’!

To hear that a professional doctor finally understood what I was experiencing, that it was an actual thing; that something could be done, I could be helped, treated, made to feel better, have my normal thoughts back and be ME again – just that revelation in itself made such a difference before even getting started.

Through frequent psychiatrist appointments and medication, my initial recovery was rapid.  In the 20 or so years since then I’ve had a see-saw relationship with this screaming OCD bastard (I’ve heard some fellow sufferers call it the devil; my current CBT therapist and I recently christened it ‘Donald Trump’!)  On the whole, I’ve managed it well.  Most of the time I’ve felt ok – clean in my mind – able to manage this thing when it lurks in the background.  But it has returned, it does return.  Usually in what I myself describe as ‘discrete episodes’ that last anything from a couple of weeks to three or four months at a time.  These periods are the worst in my life.  My mind is no longer clean, but an irradiated, contaminated mess, the screaming thoughts dominating my existence. Through various changes in medication, consultation, counselling, one brief stay in a psychiatric facility, and learned management, these periods pass.  Then I feel ecstatic, and can happily return to the normal stresses of everyday life!  In the past decade major ‘episodes’ have become fewer, with bigger gaps between – 2, 3 years even.

Well, that’s a great story Baz, thanks for sharing, but… oh, wait, sorry – not finished yet?  Going to start a whole blog about all this?  Why’s that then?  Well, stay tuned for the next thrilling installment to find out – why, in fact I never wanted to write a blog about my mental health, and why, I feel, writing a blog about my mental health is actually quite important.