Are you interested in LGTBQ issues? Do you like talking about mental health? Enjoy watching videos of weird bespectacled people online? WELL WHAT A TREAT I HAVE FOR YOU TODAY…
When most people imagine someone with OCD carrying out a ritual, they probably picture them visually carrying the ritual out in the “real world”. Maybe some will picture a person repeatedly tapping a light switch, arranging books or washing their hands, but it is unlikely that the person pictured will simply be standing there with no obvious signs of ritualistic activity.
However, many people with OCD actually have rituals that can be carried out invisibly, and this is a side to OCD that I feel needs more discussion/awareness raised, partly to help others understand the condition better, but partly to help sufferers who do not realise that what they are experiencing is actually a form of OCD that can be treated.
Now I have started to write this blog post I have realised just how hard trying to explain a mental ritual is to people who may not have had them themselves (damn it past Katie why did you have this as an idea for a blog).
If trying to give a rough idea in terms of my OCD though, my personal thought rituals generally involve things like compulsively picturing certain events or people, thinking the same words a certain number of times, having to remember something in exact detail or ritualistic blinking (which I suppose isn’t really a thought ritual as if you know what I am doing you can physically see it, but in most circumstances people don’t notice and thus I count it as one of the lesser known invisible sides to the illness. Even when people do notice I am fairly good at covering it up anyway. You would not believe the number of times people have asked if I am ok because I am flapping my eyelids like the wings of a hummingbird and I have had to pretend I had an eyelash. I used to feel very bad saying this as I don’t like lying, but recently the guilt has gone as I realised that it isn’t actually a lie. It is indeed a true fact that I have eyelashes…just not in the specific eye location implied by my blinking…God this is a long set of brackets…sorry about that…I will close them now…actually wait…no it is ok that was all I had to say about blinking…today at least).
Some of these thought rituals mentioned above are fairly straightforward, as in the “repeating a certain thought over and over”. Okay it can take a long time but it is easy to understand and explain to professionals as a symptom. This is not however the case with all thought rituals, and in order to give some impression of just how complex they can become, I thought I would explain a specifically long and complicated one of mine (if you are able to follow this next bit and gain any sense from it then congratulations, you are a genius, please apply to Mensa immediately).
So, probably the most complex of my rituals is one that I carry out every night before I go to sleep in order to “keep my friends and family safe” (though I am of course aware that rationally there is no way that my thoughts prior to the land of nod are capable of such safeguarding. Nevertheless I still carry them out every evening without fail…GAH!)
The start of the ritual involves picturing a long mantlepiece (it is made of high quality mahogany in case you are interested), and it is lined with photo frames, each one containing the face of a loved one that I wish to protect. Over the years the photos of the people in these frames have changed as people have come and gone from my life, but it is rare that a picture is removed and more common for an extra one to randomly appear when someone becomes particularly special to me (bear in mind this is a very long mantlepiece that can hold an infinite number of frames. It is a nightmare to dust.)
Once all the pictures are imagined in their neat little line, the next step is to imagine a paintbrush with green paint on the end drawing a tick over the face of each person to confirm them as safe, much like an attendance sheet register thing that you have in school. What must not happen is that I picture a red cross being painted over each face. It sounds easy enough, after all they are my thoughts so surely I can think what I want (ha!), but it is very much like that trick when people ask you to imagine a scenario and not to imagine a white elephant, a statement after which you can think of little other than a trunked creature looming in the forefront of your mind. Once the green tick is imagined on the person’s face I then have to move on to the next picture and so on until all of the faces are adorned with a flourish of bright jade acrylic. However, if during this process one of the pictures goes wrong (aka they get a red cross), then I have to start the entire thing again from photo one. Even if I finally manage a line of perfect ticks though, the ritual is not over, as then I have to imagine staring at all these approved photographs for 100 counts without imagining a gust of wind blowing any of the pictures over which is incredibly stressful as if such a wind occurs I have to whip out the paint brush and start all over again. That little explanation from the painting of the green ticks is step ONE of this thought ritual.
There are ten steps overall. TEN.
Rest assured, I will not elaborate on the next nine steps as I fear I would be here all day. No matter what step I get to however, if there are any mistakes I am sent back to step one and hopefully this explains somewhat the difficulty, complexity and time consuming nature of rituals that may not be visible like those in which I wash my hands multiple times. I realise it probably sounds a bit weird to say that I get stressed and upset over imaginary breezes blowing imaginary photo frames off an imaginary mantlepiece, but if those breezes come and if those pictures fall then I fear I will put everyone I have ever loved in danger due to my negligence, an understandably scary thought for anyone.
You are probably wondering how on earth I concocted such ridiculously long mental routines, yet if you were to ask me how they appeared I honestly couldn’t tell you. They didn’t exactly appear overnight, rather they developed over time in a gradual process I cannot remember the beginning of. That said, if I had to pin the origin of my mental rituals it would probably be my first hospital admission to a psychiatric unit over ten years ago. With most people, OCD tends to evolve and morph over time as the person’s life and situation changes and it is often a dramatic change in environment or situation (like suddenly being inpatient in hospital), that can cause rituals to flick on stealth mode and turn invisible. Before my first hospital admission, all of my rituals were visible and involved things like showering for hours on end or repeatedly washing my hands. In hospital however, none of these rituals were possible as I was physically locked out of my bathroom and had to ask for permission each time I needed to use it, at which point I would be supervised and stopped from engaging in any behaviours. Now, on the surface, you would think this cured the problem. True, I was no longer showering for hours every day, but that wasn’t because I didn’t have OCD anymore, it was because I was physically incapable of getting to the shower despite best efforts (turns out I am rubbish at picking locks/kicking down doors of psychiatric unit shower rooms. I would make a poor criminal.)
By being physically locked away from the equipment needed to do my usual rituals then, my rituals changed and adapted. The OCD was too strong to just disappear at the first hurdle in the road and instead my compulsive behaviours became located in areas nobody could lock me out of, areas nobody could bar my access too, those areas being found in my own head (just left of imagination next to the frontal lobe to be specific).
The reason this invisible kind of thought ritual OCD is less talked about than its more apparent variants is probably because of how difficult it is to explain (let alone understand…seriously if you are following this get on that Mensa thing). Nevertheless, difficult or not I think it is a really important topic to raise awareness of as like I said near the start, some people may be suffering from OCD in this way and not really aware of it. I have been in treatment for years so when aspects of my OCD became internal I knew immediately what it was, yet I am sure there will be people out there struggling who never knew that this was a thing. Perhaps there are people out there silently suffering, in distress as they find themselves having to paint ticks and avoid imaginary gales without having any idea of why or how to stop it. Had I no knowledge of OCD and were I experiencing such things there is a good chance I wouldn’t tell anyone because even I can admit that thought rituals sound a bit “crazy” and are not something you would want to bring up voluntarily or admit to, especially if you didn’t know anyone else felt the same. Maybe people with thought rituals don’t even realise it is OCD because they think OCD is washing, and it is for those people (as well as any other lovely people reading this of course) that I have written this post.
If you are struggling with compulsively carrying out intricate thought patterns that cause distress if not performed correctly, you certainly are not alone and it doesn’t mean you are crazy. Obviously I cannot diagnose anyone online, but if you relate to this post there is a good chance that what you are struggling with is an invisible form of OCD. That probably sounds scary if you haven’t ever considered yourself as a person with mental illness in need of therapy, but hopefully it will provide some comfort knowing that your struggles are part of an illness that can be treated. It is not something to be suffered in silence even if your routines are performed in such a manner and I would urge anyone out there relating to this to go to the GP and ask for help. If they have any awareness of mental health issues they will NOT think you are “weird”, they will understand that this is a common issue for OCD sufferers and hopefully by speaking out you will be able to get the help you need. Also if there are any GPs out there or students training in medicine, maybe this post could help you identify these symptoms and help someone in the future. Either way I really think invisible thought OCD rituals need more discussion. The more we are aware of OCD, the more we can understand and most importantly of all, defeat it.
Take care everyone x
In two days time, on the 5th of October 2016, I am having an assessment with a new OCD service that I have been referred to (just clarifying the exact date incase you have invented a time machine and are reading this somewhere in1912 which would make “two days time” a lie. I don’t want to ever lie to any of you. Also if you are in 1912 maybe warn the Titanic to look out for icebergs). I have been waiting for an assessment date for several months now so it should be a relief that the day is finally near and more intense support on the horizon, but my God I am terrified.
Funnily enough, none of that terror comes from the fact it is an assessment where I will be meeting two strangers and having to talk to them openly about my mental health. Over the years I have had hundreds of assessments, I have even had assessments to see if I am suitable for other assessments (seriously, mental health services LOVE assessments. They even sprinkle them on their cereal in the morning), but there is something slightly different about the assessment that is only a few days away. Normally an assessment involves going to a new building, getting lost for several hours down some poorly labeled corridors, and then turning up in a stark room with chairs, a psychologist and a table topped with a box of tissues which I think is supposed to look friendly and welcoming but to me it is intimidating, more a threat of “I WILL MAKE YOU CRY”.
With Wednesday’s assessment however, I don’t have to go anywhere, the two assessors are coming to my house, and THAT is the reason for my currently heightened levels of anxiety.
Like many people who suffer from OCD, I really struggle with people coming to “my” house. I am sure for each individual, the reasons for this vary, but for me it is because my house is my “safe” place. Leaving the house is difficult because I am entering an environment that I have no control over. I do not know who has touched the door handle to whatever building I am in, or when the chair I may be required to sit in was last occupied. Maybe the floor was mopped with antibacterial industrial cleaner minutes before my arrival, maybe it has never seen the bristles of a broom, either way I don’t know, hence why for me, touching things out of the house is more difficult than in my own home. I can’t actually remember the last time I opened a pull door in a public place and I have lost count of the hours I must have spent standing on the side of a road, waiting to cross yet unable to press the little button to alert the traffic light of my presence and inspire an appearance from the little green man. We need more Zebra crossings in this country!
In my house then, it is easier, because I know when everything was last cleaned, who has last used it and I also know that cleaning products are mere moments away should I challenge myself too far and need to whip out the bleach. When other people come into my house however, an element of that control slips from my grasp. For the duration of their visit I cannot control what is touched, moved or anything else people may do with items in my home.
These OCD people (I am sure they have names but for now that is what I shall call them) have said that they want to do the assessment in my house because they need to see me in “my natural habitat”. To be fair that makes sense (although it does make me sound a bit like a tortoise on a nature program being visited in its personal hovel), and as a lot of my rituals take place in my household it will help for them to see the “scene of the crime”, yet in anticipation of their arrival all I can think about is what they will touch during their stay and where they will sit. I have honestly been having nightmares that one of them will have been drinking a lot of tea that morning and need to use the bathroom, aka the holiest of holies, “my tap” (please God let the OCD people be dehydrated just for October 5th).
Of all the people I should be able to be honest with about these kind of difficulties, people from an OCD service would logically be high on the list. If anyone is going to understand my fears it is them, and they are the least likely to come back at me with a dagger of stigma that leaves me feeling like a total freak. Nevertheless I feel I can’t say anything out of the fear that it will be inhospitable.
If it was up to me, whenever anyone comes to my house I would like to put them in one of those little carts you get on a roller coaster, where the bar comes down and you hear that voice asking you to “please keep all arms and legs inside the vehicle at all times”!…I wonder if you can get those installed within less than 48 hours…or maybe I could just tie their arms to their sides with tape…is that legal?…I feel like that would be illegal…or at least frowned upon…
Even if it wasn’t frowned upon though I couldn’t do it because like I said it seems too rude. I want to greet these people with the gratitude they deserve for coming all the way to see me for the afternoon, but how can you do that or appear hospitable when you are terrified of the people you are supposed to be greeting? What am I supposed to say? “Hello lovely OCD people, welcome to my humble abode, please make yourself at home but for the love of all that is holy in this world please don’t touch anything because I don’t know where you have been”. Oh dear God what if they want to shake hands. AHHH.
I find it stressful even when friends come over to the house too, but at least my friends know “the rules” prior to their visit. I really hate having to issue guests with a list of requirements alongside their cup of tea, yet I know that if I were not to do so I would be crying hysterically within five minutes which would be even more embarrassing.
Thankfully I am incredibly lucky to have friends who accept my difficulties and respect my level of anxiety. It is a tough balance, as obviously people can’t give into everything when it comes to my OCD. That would be inconvenient for them and would arguably perpetuate my beliefs that their germs are a genuine risk. Nevertheless, there is a distinct difference between following the dictations of my illness, and challenging me whilst not pushing me past my breaking point. My friends know not to take their socks off in the house, not to sit in “my” safe chair, and they know that I will probably take a ridiculously long time if I go to the bathroom due to the necessary washing routines that entails (picture a surgeon preparing to remove someones kidney, soap up to the elbows etc.)
They know that none of my requests are personal, that I don’t think they are dirty people who are infected with a contagious disease, because they know me. Some friends have been in my life since the day of my diagnosis so they grew up with a knowledge and acceptance of my conditions that few would comprehend. One friend was even on holiday in Greece last week and she literally texted me from across the Atlantic (is that right…is Greece across the Atlantic…screw it lets keep it this way, it sounds dramatic), to tell me at 10pm to stop fiddling with my hair as she knew that I was home alone and probably stuck in a hair routine that often takes place during that time (which I was). With friends then, it is ok to tell them not to touch anything, but with strangers no matter how kindly you say it there will always be (in my eyes at least), a little resentment on their part. I know if I went to somebody’s house and they told me to keep out of the lounge for fear of contamination I would probably feel a little offended myself.
It really is a tricky balance trying to be a friendly host whilst trying to manage my anxiety and for this reason I know many people with OCD refuse to allow people into their houses at all, just one reason as to how this illness can be incredibly isolating. If my friends weren’t aware of my mental health I know wouldn’t be able to manage them in the house either.
I guess what I am trying to say is that when it comes to OCD, it isn’t always the behaviour of the sufferer that causes the anxiety, but also the behaviour and actions of those around them. It isn’t just my hands I worry about when it comes to germs, it is everyone nearby. Most importantly though, in feeling this way about others, it is in no way a suggestion that a certain individual is dirty and no personal judgement on a bystander’s levels of hygiene.
Equally then, if you struggle having people in the house, you are not a bad person or rude, just as I am trying to convince myself now that I am not a horrible person for wondering if it is socially acceptable to tie my assessors up with tape in order to restrict movement. Obviously I am not going to do that, I am as always just going to deal with it and hopefully get the courage to speak out so that they are aware of my anxieties rather than suffering in silence, which would consequently make them worse.
If for some reason my assessors are actually reading this prior to our appointment, please know that if I appear inhospitable at any point in your visit I truly am sorry and trying my best. I really do appreciate you making the effort to come to my house and hope you feel welcome and relaxed in my home…JUST PLEASE DON’T TOUCH ANYTHING OR I WILL HAVE TO TIE YOUR ARMS TOGETHER AND WRITE THE NOTES ON MY MENTAL STATE FOR YOU.
Cheers… See you Wednesday!
In the past few months, an unusually high number of well known celebrities (well known in the UK at least), have died. It feels like every other day that I go onto Facebook and find new pictures of the recently deceased posted by friends in mourning. I understand that people die all the time, people who go unreported, people nobody mourns on Facebook because they weren’t “well known”, were just a nameless number in some horrendous incident in a different country that people care far less about because they don’t relate to it as much. I understand that all these celebrity deaths are not in fact a rise in the number of people dying overall, but still I can’t help but feel something has changed, something to cause it, and that that something is me.
When people have OCD there are various things that drive them in their rituals. Some simply carry them out until they “feel right”, whatever that “right” feeling is, but many, myself included, carry them out because they are fearful of what will happen if they don’t, that not carrying the tasks out is not just distressing but dangerous to either themselves or the people around them. Whenever I talk to professionals about this (professional people in the world of psychiatry I mean, not general professionals like professional penguin keepers who I feel would be less interested in my mental health problems), they call it having “an inflated sense of responsibility” a common symptom of OCD.
This symptom is pretty self explanatory from the name of it, but basically it makes sufferers feel as if their simple actions, like opening a door, are far more significant than they are, can control the world in irrational ways, that individually they have some great power which can cause events and impact the world. It can feel like tiny daily tasks have a ripple effect out onto the universe, like sitting down in a chair incorrectly will cause a totally unrelated event to happen elsewhere, such as an earthquake or tsunami. Of course when something “bad” happens that the sufferer wrongly blames themselves for, they are just connecting two totally separate things that coincidentally happened around the same time, but still it can be and is really frightening.
This sense of inflated responsibility is one of the reasons why OCD tends to get a lot worse for people when they are in stressful situations, things with a debatable outcome that they desperately want to have some control over or impact in favour of a positive result. In a way it is a comforting thought to think that you can influence things as if by “magical thinking”, even “sane” people without OCD do it all the time, like when musicians might wear their “lucky pants” with the aim of ensuring a good performance. The problem is that with OCD, this responsibility never seems to correspond to good events or making positive things happen, you can’t tap a door knob and “cause” yourself to win the lottery or anything, even to the irrational OCD, that idea is just silly. Instead, this power people feel they have can only do evil and not good, which when you think about it is quite possibly the worst superpower to feel you have of all time. I think I would rather feel I had powers like spiderman with the ability to spout webs all over the place, and I don’t even like spiders. Or close fitting lycra suits.
I remember sitting in the exam hall at school during my maths GCSE 8 years ago and being in a massive dilemma, a dilemma caused by this inflated sense of responsibility and not just a dilemma everyone faces when they are sitting before a maths paper.
In my world of OCD I had, and continue to have, both lucky and unlucky numbers, and for one of the questions early on, the answer was one of the unluckiest numbers to exist in my eyes. I can’t even write it here because it scares me, so I am just going to pretend the answer was “X” for the purpose of this post because that is what you are supposed to do in maths when you can’t write the number (cheers for that algebra). I knew 100% that the answer was X, I had checked it and rechecked it multiple times but still I could not write it down. I feared that if I wrote “X”, that my parents would die. I knew that in terms of maths, to write anything else would be wrong and I wouldn’t get the mark, but that seemed like a far preferable outcome to losing my loved ones. You might be wondering why I had this sense of a dilemma when obviously if the choice was ever “lose a mark or kill your parents” everyone would lose the mark, but whilst fearing this, I knew it was “just” my OCD freaking me out. My psychologist at the time was always telling me to challenge the OCD, to go against it because only then could you prove that all it spouted was lies. I wanted to do as she said, ignore the OCD and write “X” anyway because writing numbers doesn’t really have the ability to kill your parents, but I was too terrified, so in the end I had to write the wrong answer on purpose. This dilemma came up several times during the course of the exam (a surprising amount of my “unlucky numbers” came up in the 2008 GCSE maths paper), and every time I purposefully wrote the wrong answer. It was infuriating and I wanted to scream, but annoyingly that is something you are not allowed to do in a GCSE exam, as “no screaming” is in fact the rule just after “no mobile phones”, so I just sat there being controlled by this inflated sense of responsibility and importance I felt my maths answers had.
This influx of celebrity deaths has triggered me so much that I genuinely feel the need to apologise to everyone reading this for murdering these famous people of whom so many people are fans and are upset about. Nevertheless, I wanted to try and find some kind of positive or useful outcome from this trigger which is why I am writing about it to hopefully explain a bit more about this aspect of OCD. Now I guess the task is to just try and not let this impact my rituals more than it already has…I am just scared as to who my actions could hurt next.
(Just incase you don’t get it, the picture above is literally an inflated “sense of responsibility”…this probably doesn’t need any explaining and is nowhere near as clever as I think it is but just wanted to point it out because I was pretty proud of that little pun…It’s hilarious…no?…Ok never mind I will leave now so you can get back on with your day)
Standing on lego is annoying. Missing a bus by 30 seconds and seeing it drive around a corner without you on it is annoying. Oranges are annoying (don’t even get me started on oranges…little segmented bastards), but if there is one thing that annoys me more than any of those things, it is hearing the phrase “I’m a little bit OCD”. Seriously I would rather fight an army of oranges than hear that phrase in daily conversation and I REALLY hate oranges.
More times than I can count I have heard people use that immortal phrase that strikes rage into my very core to describe a quirk or preference someone has, from
“I like organising paper work, I am so OCD” to “The colour of my shirt always matches my socks, God I am so OCD!”. I realise that just because I am someone with OCD, I do not have the right to control and police the use of the word describing my condition, but still, hearing it used in such ways is not simply one of the many things that annoys me, but is actually a dangerous offhand turn of phrase that often contributes to the misinformed ideas and belief’s people have about OCD, a condition that is hard enough for people to understand in the first place.
Due to my OCD, a lot of things, if not everything in my life, is a certain way. The structure of every day is exactly the same and my routines and rituals could not be more rigid if they tried. Everything I do each day is exactly the same as I did it the day before but that is not in any sense because that is the way in which I like them. I do not wash for hours on end because I like to be clean, I do not take ages changing how I sit in a chair because I like to be comfy and I do not count things all day every day because I love numbers or have a passion for mathematics. The reason I do all of these things as well as the infinite other number of things I do in terms of OCD, is because I HAVE to do them in the way that I do. Ok I may be physically capable of being strapped to a chair away from soap or water so the feeling of “having to” do so many things is arguably “what my illness tells me” rather than fixed reality, but in terms of how I feel, everything I do is compulsory and I do not choose any of it or get any pleasure from the way things are whatsoever. THAT is the key difference between having OCD make you have things a certain way, or someone preferring to have things in a way that is most pleasing to them, despite the fact that to some it may seem odd or illogical. My Dad likes to fold towels over the bathroom rail in a way my mum and I think is ridiculous (seriously they don’t dry the way he hangs them, it is like he is on a mission to keep us in a prison of soggy towels. I guess in terms of what real prisons are like, soggy towel prison isn’t all that bad, still it isn’t ideal), but that isn’t because he has OCD and cannot handle the towels in any other way. It doesn’t bother him when my mum and I change the way the towels are folded back to the sensible way they dry more easily, he just sees that as our weird preference, just as weird as we see his.
Allow me to give a better example using fictional characters Sam (who is allergic to peanuts) and Pam (who is not allergic to peanuts. Pam is however a passionate ice skater and she has a degree in marine biology, but these details are not relevant to this particular story.)
Imagine Sam and Pam go into a bakery to peruse the selection of cakes on offer that day. They then ask the baker (a jolly fellow with a moustache – again, irrelevant detail but it sets the scene quite nicely) for recommendations and both say “nothing with peanuts”. Both Sam and Pam are physically capable of eating peanuts but Sam chooses not to because his illness would cause him extreme distress to do so (his heart races all over the place and his head puffs up like a balloon), and Pam chooses not to because she prefers things without peanuts and has a particular fondness for gingerbread men. This example obviously isn’t fool proof as I realise I am not physically allergic to breaking the rules set by my OCD, but the distress it would cause because of anxiety and panic (like Sam with the puffy head because of his illness), is a similar comparison when then viewed alongside Pam who also avoids certain situations/has rigid/peculiar fixed ideas for different reasons (not that gingerbread men are peculiar. I am actually like Pam in that respect and have a fondness for those smiley spiced little chaps).
Maybe I have gone too off topic here as to be honest now all I can think about is gingerbread men and peanuts, but I guess the point I am trying to make is that saying you have OCD or “are so OCD” because you like things to be in particular quirky ways is not actually anything to do with OCD at all and it misrepresents/creates confusion around an already misunderstood condition. Having OCD force you to have things a certain way, is not about choice or preference or about liking things to be “just so”, OCD is being compelled to live a certain way and perform tasks whether you like them or not, and often they create a lot more distress than they alleviate.
That said I am off to chat to Pam about Marine biology. And maybe get a gingerbread man.