Why Familiar Surroundings Are Important When You Suffer With OCD

The original title of the blog I was planning to write today was “Tips on staying away from home when you have mental health problems”. You see, my parents were jetting off to Malaysia and seeing as I am not well enough to manage by myself at the moment, the plan was for me to go and stay with their friends in this lovely little house out in the countryside.
We have been planning it for months, I had visited the house and felt OK about it seeing how nice my bedroom, personal office AND personal bathroom were going to be. There was even a cat called Pingu. A cat. Named after my favourite childhood penguin. Ideal right?

Well I thought so, but was still worried about managing my mental health with new carers who do not know me as well as my parents, so I came up with a list of coping strategies and ways to manage it. Consequently I decided to write a blog sharing my oh so helpful tips incase anyone else out there was in a similar situation, but then…well…I went to the house where I was due to stay for two weeks, lasted approximately four hours and then was driven home in hysterics at midnight with my parents due to fly the next day despite having still not packed so much as a flip flop, because we have been spending weeks packing for me to go away (if you want to imagine how many things and bags it was, think of the average stuffed car that people often drive off to uni in, double it and chuck a penguin on top for good measure. Oh and a Christmas elf. One must never travel without one’s cuddly Christmas elf. Oh there we go! I did give a travel tip! YAY ME.)

Clearly then, I am in no place to be giving tips about staying away from home right now BUT over the course of this traumatic experience, I have been reminded of a valuable lesson about mental health problems, so I thought I would share that with you today instead.

Having been mentally ill and having been in therapy for over a decade, I would say I understand my conditions and myself rather well, which is why I felt that I could make a plan about an approaching situation in advance without running into any unforeseen issues.
Trying to do my same rituals in a different place however, really reminded me of something a lot of people might not realise: that being that sometimes with OCD, it is not just about carrying out a specific behaviour like a shower routine, it is about carrying out a very specific shower routine in a very specific shower.

I always knew that because of OCD and anorexia, I have a LOT of routines, rituals and specific ways of doing things. I eat out of certain bowls with a certain spoon, I drink tea out of a certain mug at certain times of the day and I wash my hands, shower and get dressed in very specific ways. As rigid as these and a number of different actions in my day are, logically you could assume that I could carry them out in a different place so long as I had the correct equipment. There was a shower where I was going to stay so of course I could do my shower routine, there was a sink so of course I could wash my hands and I was taking all of my cutlery/crockery so obviously I would be able to eat all in my usual ways.

Even I can admit that years ago, though still having OCD, I was able to do these fixed ritual things in other places with other sinks and showers. I have been on holiday since my diagnoses, have stayed in a hospital and went to university (kind of…), always carrying out the same actions just in different locations. Therefore I tried to do that this time going to a strange house but, with things how they are at the moment, as hard as I tried and as good as my intentions were at the time I attempted it, it isn’t possible (at least to a manageable realistic degree that doesn’t involve hysterics 24/7 for a fortnight which is less “a good challenge” and more cruel torture. I am all for accepting challenges and trying things out of my comfort zone but sometimes you need to eat a few mini muffins before you are up to demolishing an entire five tier wedding cake by yourself).

I was truly shocked as I sort of hadn’t realised how bad things have got again.
The descent has been a gradual process, little slips that in the end add up to a sky diver height of a fall. It is like what they say about if you put a frog in boiling hot water it will hop out but if you put it in warm water and gradually turn the heat up it will boil to death before it realises (that is what they say isn’t it? Who are these people? Please dear readers, do not go putting frogs in boiling water. If you really want to see some green bubbling in a pan just whack in a bag of frozen peas, far more humane AND one of your five a day).

When we pulled up at the house I fully intended on staying for the next two weeks (obviously I did, I had my penguin and my cuddly Christmas elf, I was committed to this trip). Even though I was anxious, by using multiple packets of anti bacterial wipes and with support from my parents, I got through the unpacking and after two hours my room, bathroom and office all looked really nice, filled with familiar things, a comfortable home from home.

It was when I tried to shower that things went so horribly wrong. First there was the issue that the shower was a stand in shower cubicle with a door. At my house our shower head is hanging above the bath, so when I am getting all lathered I can stand out of the flow of water to reach the required bubbliness (I know that this is not the most environmentally friendly way to live my life and that I could just turn the shower off but just know that I am unable to do that at the moment and to be honest when you are focusing on just keeping yourself alive your carbon footprint is not a top priority. At least I am not flying across the globe in an aeroplane to Malaysia like SOME people…).
With this stand in shower however, I was unable to reach the desired bubbliness needed to get through all of my thought routines because before I had time to count to the required numbers the suds had all been washed away.
Then there was a problem that I had to put my soaps in a basket so my lemon shower gel for feet was too close to my banana shower gel for body and far too close to a wall that I couldn’t touch, and the way you turned on the shower made my usual vitally important life saving way impossible.

I took so long to shower that all the hot water ran out and after a while of forcing myself to stand under the cold ice like hail pelting me in the face, I got out though I still didn’t feel clean. I was in a bit of a state but I didn’t want to give up so I persevered and tried to get on regardless but it was one thing after another. I couldn’t wash my hands in the sink because the tap distance to the back of the sink meant holding my arm at 135 degrees rather than 90, I couldn’t step off the towel I had laid on the floor because my bare feet couldn’t touch the tiles and I couldn’t put on the socks that I had brought into the bathroom with me without direct access to trousers and slippers. “You should have taken slippers in and trousers too” I hear you cry but I had thought of that already and couldn’t because there was nowhere safe in the bathroom to put those things at an acceptable distance away from each other. I found myself standing stranded on this towel shivering and blue with cold, so I naturally did what any other person would do in that situation. I cried uncontrollably and screamed in terror for my mother.

Luckily my parents were still there because the unpacking had taken such a long time that they had ended up staying for dinner whilst I showered.
Seafood rice was cooked and eaten and a homemade rhubarb crumble was just being served when the screaming happened and mum came running. She tried to help by offering solutions, one being the ideal “I can go and get the trousers and not let them touch anything”, but I didn’t want to do that. Yes it would have been safe, but I wanted to solve the problem by myself somehow with support.
Mum could have easily gotten my trousers and I could have left the bathroom but what the hell would I do the next day when she was on a beach somewhere in Malaysia? Around this point my “in a bit of a state” descended into full on “out of control don’t know what I am doing dangerous risky chaotic hysterics and panic” and from there things are a bit of a blur. All I know is that I cried for several hours (I tried to talk too but was at that hiccuping crying point so “I don’t know how to manage I want to disappear” came out more like “Hic gasp gulp hic scream”), and my parents and friends frantically tried to decide what to do.
When I was able to talk and sob at the same time I made it clear that I felt it was a challenge too many and that rather than tackling the “parents away and totally different location for all rituals for two weeks” I wanted to attempt the “parents aka usual carers away, in a familiar place” challenge. Losing both was like losing both of my homes, a tortoise rudely ripped from his semi detached terrace house and his shell in the same day leaving a cold naked slug unable to survive in its place.

There were then more hours of discussion before we realised that this really was not a feasible option and then after two hours of packing all of my things back into the bags we had unpacked them from (we didn’t have to pack my elf. He went and got himself back in the car the second he heard the first bout of screaming. He knows me well), we were back in the car driving home in the dark, leaving the abandoned now cold homemade crumble on the dining table. It is a big shame. My parents love rhubarb crumble.

So it was that I ended up back home after my much shorter than planned and somewhat failed “stay away from home with mental health problems”. On the plus side I did manage to get to the house and unpack…I just left two weeks too early.

Clearly then, I think I have proved my point and raised awareness to all the people who might not understand OCD, that when it comes to OCD and other mental health problems with ritualistic behaviours, it isn’t just the rituals that are important to a sufferer but the specific location and circumstances under which those rituals are carried out.

Take care everyone x

Bubbly

An Explanation Of Invisible OCD Rituals

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

mantlepiece