In Focus
Nov 30, 2015

OCD is a Paranoia, a Lack of Control Over Your Mind – But it’s Treatable

Aoife O'Donoghue explores the experience with living with Obsessive Compulsive Disorder when the condition is largely misunderstood by the public.

Aoife O'DonoghueContributing Writer
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Thibaut Loiez for The University Times

Signs in cafes that say Obsessive Coffee Disorder. Pinterest boards with captions that say I have OCD: Obsessive Clothes Disorder! These 30 images will satisfy the OCD in you! I’m so OCD about my room being clean. I must have OCD because I hate when things are dirty. That’s OCD, right? Right?

Obsessive Compulsive Disorder, or OCD, by definition is a disorder resulting in excessive thoughts, or obsessions that lead to repetitive behaviours or what you would call compulsions. It isn’t a quirky fad or a quote beside a picture of a minion that your middle-aged aunt shares on Facebook. OCD is when you sit up in bed ten times before you can sleep. It’s rewriting this sentence over and over again until I can write the next one “safely”. It’s not eating for two years in case something “bad” happens. Washing your hands until they bleed and having to cover your hands in plasters so that you can hold a pen in school. It’s not listening to your favourite songs because of its track number. It’s paranoia, it’s anxiety, it’s a lack of control over your mind. It’s the background gag of Michael J Fox walking in and out, and in and out of the hospital in Scrubs. This is possibly the most accurate portrayal of chronic severe OCD in mainstream media.

It’s crippling and lifelong. So why do we mock it? Why do we not take it seriously as a disorder? There are a million clickbait articles about what to do to help friends with depression or with anxiety, but not one telling you how to help someone stop turning off the light switch before the bulb explodes. Who’s helping the people who can’t control their minds?

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One organisation aiming to do this is OCD Ireland, who recently held a support group meeting for sufferers of OCD, body dysphoria and trichotillomania in the Student Counselling office on South Leinster St, which is a difficult building for first timers to find, organised externally by OCD Ireland. OCD Ireland offers free and confidential support groups to anyone who suffers from these disorders and to loved ones who want to understand and help. Speaking to The University Times by phone, Simon Tierney, PR Manager of OCD Ireland, explained: “Hundreds of people travel from all over the country for these support groups because they’re a real lifeline to people, not everyone has health insurance and it’s their one opportunity to share problems in a safe environment”.

It’s the background gag of Michael J Fox walking in and out, and in and out of the hospital in Scrubs. This is possibly the most accurate portrayal of chronic severe OCD in mainstream media.

The groups are small, with only six people in attendance, but for an hour and a half, words flow. Everyone coming from different backgrounds but all feeling the same. “It helps people realise they’re not unique in their problems,” Tierney explained. Every person in that room nodded in agreement when someone else told their own story. It then became clear what the purpose of support groups was: something life-saving rather than a mere plot point of Fight Club.

Speaking to The University Times by email, Yvonne Tone from the Student Counselling Service reaffirmed the importance of running these support groups: “We are all a little obsessive and ritualistic, but OCD clients overestimate dangers and catastrophise, underestimating their ability to cope or make a decision which is very distressing and functionally impairing”. She went on to confirm that the counselling service will continue to offer these groups, with the next meeting being December 14th, and that any student who wishes to get a text reminder of the OCD Ireland group can give the service their email or phone number to be added to a reminder list.

Tone stated that not only does student counselling offer these support groups every month, but they also offer extensive professional counselling. “Using a cognitive behavioural approach and other therapeutic approaches, anyone with OCD is encouraged to understand what is happening and how the significance attached to their thinking leads to distress and ritualistic behaviours. Through a process of education and using graded exposure they’re encouraged to resist carrying out the rituals in a step-by-step way which does lead to relief of symptoms”.

Trinity offering these services is a promising move as it shows sufferers and those struggling that services are there and that they must just reach out. Yvonne explained that there is every effort made to let people know what is offered to them. “Our website has detailed information on how to make an appointment and includes a calendar of groups and supports available. In addition we email students about all groups and our Wellbeing Wednesday talks”. Sufferers of OCD can reach out for help, and this is especially reassuring for those who can’t afford private care. There are services readily available, but we must let people know that they can speak out about these problems, and that they don’t need to be embarrassed or ashamed.

The numbers of people who suffer with OCD in Ireland are currently vague with no official figures available and only rough estimations: maybe 1 in 33, maybe 1 in 50. This fact was most clearly shown in the small group of six attending the support group meeting. According to Dr Padraic Gibson, founder of the international organisation The OCD Clinic, who has lectured in postgraduate psychotherapy at Trinity, the question of figures is not an easy one to answer. “Many people with OCD live silently with their disorder. However, international research says that between 5-8% of the population suffer with OCD. From our work, we can safely say that this number is more like 20-25% of the population”.

It is certainly an alarming number, but Gibson, speaking to The University Times by email, goes on to further explain: “Many people’s compulsions do not hinder them in life, even if they do cause them distress”. Connected to this, people have become open about speaking about their emotions. Across the world there are campaigns upon campaigns encouraging people to talk to someone, and celebrities coming out and being honest about their difficulties with depression. This shift in attitudes is admirable and significant to watch.

But sufferers with OCD remain silent, crippled by something so invisible to all, yet visible and violent toward themselves. “There’s a stigma attached”, Tierney explains. “It’s misrepresented and misunderstood, and compulsions can be too embarrassing and personal to speak out about”.

OCD can appear in numerous ways, and according to Dr Charlotte Emma Wilson, an assistant professor in clinical psychology in Trinity, the easiest way for someone to distinguish them is by “purely behavioural terms”. Speaking to The University Times by email, she goes on to explain that, “if you can’t see any rituals, and yet the obsessions are there and are not going away, then the individual is probably doing something to keep themselves safe and this is probably thought based rituals”.

For some people, they’ll never have to count things or touch things repetitively, like the common assumption. Pure Obsessive OCD, a type of OCD that is rarely talked about, involves intrusive thoughts. These are thoughts that you fear, and thoughts you know aren’t yours. It can range from suicidal thoughts, images of loved ones dead and fears that you’re gay. It is most common that pure obsessive intrusive thoughts involve thoughts that are “stigmatised” or “wrong”. This type of obsession is considered an “autogenous” obsession which are subtle to the naked eye obsessions, involuntary and random guilt-provoking thoughts that keep you up at night. The more common “stereotype” of OCD involves reactive obsessions, turning off light switches over and over again and putting your pens in a certain order to prevent something happening, or out of fears, be they irrational or rational.

One way to think of them is as “magic thoughts”. Many OCD sufferers’ compulsions centre around this thought that, if I do it like this or if I do this multiple times, it will stop this thing happening. This isn’t rational in any way at all which is something sufferers of OCD are acutely aware of. It’s superstition at a suffocating level. It’s taking bad luck to the extreme and obsessing over it to a level that’s harmful and unhealthy. Wilson recounted some cases she had seen that had fallen on this extreme end of the spectrum. An example of this is those who had to rebuild their bathrooms and kitchens because they had cleaned them so much they had started to fall apart.

“There is obviously a spectrum of obsessional thoughts and associated rituals. At the minor end everyone has preferred ways of doings things and has thoughts they would rather not have. In the middle are people, who, when very stressed out, will have to repeat actions again and again and who might have to do certain activities that feel very risky to them, such as touching door handles or eating from plates or cutlery that haven’t been washed immediately beforehand. At the other extreme are people who cannot leave the house, who cannot access work or school and whose lives are ruined by OCD”. Wilson went on to reaffirm that, “it is fair to say OCD is one of the more misunderstood conditions”.

Then what is there to help those who suffer from OCD? “We tend to stay away from the word cure”, Tierney points out, “it’s not helpful. OCD is a very treatable condition, a condition that can be managed to have a healthy controlled life”. Some methods of treatment include: medication such as Fluoxetine (commonly known as Prozac), or CBT which is also known as Cognitive Behavioural Therapy. Wilson considers CBT to be the “best-evaluated therapy for OCD”. The key ingredient in CBT is “allowing yourself to experience the thing you are scared of, whether that is your obsessional thought, or a particular experience, without letting yourself do the ritual associated with it”.

“We are all a little obsessive and ritualistic, but OCD clients overestimate dangers and catastrophise, underestimating their ability to cope or make a decision which is very distressing and functionally impairing”.

This can be a difficult thing for people to do, especially people who have begun to use their OCD almost like a safety blanket. While it is destructive, it’s what they know. However, Gibson is confident that OCD can be cured, as he, alongside others are about to publish a three-year outcome study done in Ireland, which shows an 85 per cent success rate in outcome for complete resolution of OCD. “When we speak about maintenance, my heart sinks for sufferers with OCD. There is a solution available”.

The ocean of OCD research is a murky and unclear one. Research is being done. Wilson speaks of the research projects she is involved in on people’s experiences of living with OCD, either within themselves or growing up with a parent who has OCD. She also mentioned a new set of behavioural therapies that focus more on “letting thoughts and feelings come and go, without focusing on what they mean”.

However, to the general public, OCD is still primarily thought to be a quirk or someone just being overly anal in their everyday lives. Society has moved past the idea of being depressed as just being sad. There is a small but perceptible push for people to accept OCD as not just a tendency to clean a lot, but a disorder deeply rooted in control and anxiety, that can destroy so many people’s lives. In this regard it can be compared to the early stages of awareness for suicide prevention. When only a number of years ago the majority of the public was too timid to speak on the matter, there are currently more and more initiatives started to save more lives.

Dr Gibson summed up his opinion on OCD treatment in Ireland by sharing a story that illustrates the illogical rationale of an OCD sufferer: “One day, a psychiatrist is in a hospital, and comes upon a patient clapping his hands every ten seconds. When asked about the reason for this strange behaviour, he explains: ‘I do it in order to scare away the elephants.’ When he was told there were no elephants in the hospital, the man responded by saying: ‘Well, there you go. It works’”.

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