28 October 2013

Rules of engagement

Towards the end of last month, I embarked on a fresh attempt to reduce my compulsions and promised to report back on how this went.

I started by setting some ground rules, ie I would:

1. Restrict this exposure and response prevention (ERP) exercise to the bathroom.

2. Put things down with no attempt to position them.

3. Only be allowed to check that the window was locked once before I went out and once before I went to bed.

4. Only be allowed to verify by sight that the taps weren't dripping (rather than by tightening them so hard that I could hardly turn them on again).

These guidelines led to a number of unexpected challenges over the next few days.

Firstly, in restricting my efforts to one room, I effectively had to turn my OCD off and on. This proved difficult, but I couldn't risk extending the 'messing up' to other areas, for fear I'd be overwhelmed - as has happened before.

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Then I began to wonder whether it was avoidance to put something down and walk away without looking at it. Most people probably do that, but ERP means actively facing your discomfort and anxiety, so I forced myself to linger and look at the wonky shampoo bottle, liquid soap dispenser, etc.

Their displacement didn't initially trouble me. The mind is a tricksy beast, though. Later, I realised I was unconsciously trying to straighten the dispenser while using it; watching my fingers adjusting the container was like an out-of-body experience.

I resolved to pay more attention to what I was doing. It became apparent, however, that I would have to re-learn how to just put things down, rather than position them. I'd lost sight of what normal behaviour was and had nothing to judge mine against.

Until my boyfriend came over for the weekend. Going into the bathroom after him, and seeing the towel ruffled up and the soap dispenser and toothbrush holder askew, I was reminded: this is what normal looks like.

The question was, did I really want that?

A colleague had asked me why I was trying to change my behaviour. I'd been thinking about this and had realised that only certain habits troubled me: the ones I got stuck on, or which had no grounding in practicality or logic, such as leaving the door open a certain amount.

And so, I revised my rules. I identified the compulsions I wanted to drop completely and, for the rest, adopted a 'one touch' only approach. Returning to items again and again was, by far, the most time-wasting feature of my habits. Now I would permit myself to position objects as I put them down, but there would be no going back once I'd let them go.

Although I've heard it said that even quick OCD is still OCD, key elements distinguishing the condition are the distress it causes and the time it takes up. It seemed reasonable to me, therefore, to refocus my efforts on the compulsions that bothered me most.

Week 2 started with my new rules of engagement. Watch this space to find out where they took me.

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Please note that the above is a personal strategy for dealing with my OCD, which may not be suitable for other sufferers. If you think you have OCD, please consult your GP for professional advice.

21 October 2013

Trigger unhappy

With OCD, you never know what might unexpectedly exacerbate it, or even trigger new compulsive behaviours.

In the years since my diagnosis, I've watched many a documentary about the condition, without any adverse effect. Lately, though, a couple of programmes have put ideas into my head as to potential new 'risks' and associated compulsions.

On one, a woman was shown wiping down every item of shopping before putting it away. I'd never thought to do this, and I don't propose to start, however, it did make me think about my approach to food preparation. I always wash my hands beforehand - as, I imagine, does everyone - but then, inevitably, have to touch the packaging of various products. While watching this woman, it suddenly occurred to me that this contact must, surely, undermine that initial hand-washing?

Even just making a cheese sandwich necessitates handling a bread bag, cheese wrapper and margarine tub, yet I don't wash my hands again before touching the actual food. In spite of doing this all my life - without suffering repeated stomach upsets - I now felt the need to wash my hands more frequently. So far, I've resisted doing this, but the seed of the idea has been sown.
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More recently, a participant in BBC3's excellent Extreme OCD Camp had to face his fear of drinking from a glass in a café. Seeing the difficulty he was having, I found myself thinking, 'That really is revolting. Why would anyone drink from a glass someone else's lips have been on? What if it hasn't been cleaned properly?' You'll know from last week's post that I don't usually have issues with using crockery in public venues. Again, I haven't changed my behaviour, but the thought could resurface at a later date and lead to a new compulsion.

It's not just programmes about mental health that are a hazard. On a recently broadcast edition of QI, a question came up as to what was the most effective element of hand-washing in terms of killing bacteria: the answer was the vigour with which you rub your hands. For weeks afterwards, I rubbed mine harder, once more ignoring the fact that I generally have good digestive health. Fortunately, I've since been able to go back to my usual level of hand-washing.

While broadcasters use content warnings to protect viewers from unwittingly coming across subject matter that might provoke upsetting or damaging memories or reactions, they could hardly be expected to predict that a comedy quiz show might be a risk.

I certainly didn't anticipate that these programmes would mentally ambush me in this way. It just goes to show how little it can take to push someone further along the OCD spectrum.

14 October 2013

Cruel to be kind

The friends and family of OCD sufferers can often end up pandering to their compulsions, in a bid to relieve their distress. Sometimes, this even leads to the non-sufferer enacting these themselves.

One television documentary about the condition featured a woman who engaged in constant checking to avoid losing things. Her husband spent hours going through the contents of bins with her, to reassure her that she hadn't thrown away anything important. He was completely embroiled in her OCD behaviours, which occupied so much of their time that neither of them was able to work.

Providing reassurance, at a lower level, may seem the kindest, most expedient, course of action: how could it possibly do any harm, for example, to reassure someone that a door is locked? In fact, it's the worst thing to do, as OCD feeds off reassurance. The condition makes its victims constantly doubt what they see, believe or are told, and drives them to seek an absolute certainty that can never be provided. Reassurance only leads to the need for more reassurance.

As I live alone, there is rarely anyone available to provide this, even if I were to request it. In fact, I have to trust my own eye as to whether things are symmetrical or ordered correctly, as only I know my 'rules'. 

I do, however, also suffer with some contamination issues, and my boyfriend, Pete, complies with a related compulsion that I engage in to deal with one of them.
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We take a lot of self-catering holidays in the UK, always staying in good quality rental properties. Yet, no matter how clean our holiday home is, I can't bring myself to use the crockery, cutlery, pans etc until I've washed them. Otherwise, I'm plagued by the worry 'What if that knife/glass/plate is dirty? What if it makes me ill?' 

Before we can even have our first cup of tea after our journey, I'm up to my elbows in hot water and washing-up liquid. Pete will then also wash subsequent items we use, knowing how I feel about this. I'm still likely to ask 'Have you washed that?', if I see him cooking, or laying the table, with something new.

As with many OCD compulsions, this is quite illogical, as I happily use crockery and cutlery in restaurants, where I have no way of guaranteeing their cleanliness.

It wasn't until our last trip, in June, that I realised there was an obvious solution to this problem. As most of our cottages have a dishwasher, why not simply load it up as soon as we arrive? 

So, that's what we did, filling it with a large selection of items we were likely to need. We left the machine to do its work, while we enjoyed our first dinner in the local pub...with me happily using their plates and cutlery.

As I opened the dishwasher at the end of its cycle, the steam billowing out was all the reassurance I needed.

This time-saving tactic will make it hard - if not impossible - to give up this compulsion in future, but it will, at least, reduce its impact on my nearest and dearest.

By the time you read this, we'll be on our next holiday, in Dorset. And, yes, the cottage is equipped with a dishwasher.

7 October 2013

Decisions, decisions

One consequence of being a perfectionist is that you can be hopelessly indecisive about the most trivial things. 

I have trouble, for example, choosing from a set menu of three starters, three mains and three desserts, for fear I won't like what I end up with, and will ruin my evening out. Of course, that kind of menu only offers 27 possible permutations for my meal. Give me a multi-page one and my dining partner is likely to have expired from starvation by the time I've made up my mind.

I didn't think creating this blog would entail too many decisions. Blogger is a free service, so I assumed I'd have a very limited range of designs to choose from.

Not a bit of it; I was presented, at every step of the way, with a wide array of formatting options. First, there were dozens of choices for the basic background and layout. Then a multitude of font types, sizes and colours - in fact, the entire colour chart was at my disposal. I had to select a font not just for the blog heading, but also the post headings, post text, link text, tab text... The font features alone must have generated a billion permutations.

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And I was determined to explore every level of every formatting and design menu, to ensure I didn't miss anything crucial to creating the perfect look. Every one of those avenues generated thousands more permutations.

For guidance, I went back to the blogs I'd previously researched, but that only confused me more, revealing new elements I hadn't yet considered. That earlier research really should have given me an appreciation of the vast range of designs that would, in fact, be available to me.

All this was before I'd even started installing Blogger's 'Gadgets' - special features - on my site. The initial list offered 27, from which I began with the basics, such as 'Subscribe by Email', 'My Blog List' and 'Links'. 

'There must be more,' I moaned to my boyfriend - though why I wanted more choices to complicate matters, I don't know. He spotted the 'More gadgets' link...which then gave me a mere 871 to peruse. I resolved to review them all: if I didn't, who knew what gems I might overlook? By the second page, I'd given up: 'The Daily Puppy', 'Body Mass Index Calculator' and 'Darth Vader Quotes' weren't quite what my blog needed.

Eventually, sense prevailed and I resolved that, providing I liked what I'd produced, I should stop tinkering. If I hadn't, I'd still be designing the site now, half a year on. 

I'm happy with its final, uncluttered look, in spite of realising, too late, that I'd inadvertently emulated my work's corporate colour scheme.

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My blog is six months old this week. I'd love to hear what you think of it and whether you, too, like the look of it.