Clock-watching

In common with students the world over, I spent a great deal of my exam preparation time drawing up revision schedules. A key element of any study session for me, though, was that it should start at the 'right' time, ie anything with a five or a zero at the end of it. 

I might be settled at my desk with all my materials, but I still couldn't start work until I'd checked the time: if it didn't end with the right number, I'd have to wait for the display to change.

As a result, I spent a lot of time looking out of the window and twiddling my thumbs; being at school and university in the 70s and 80s, I couldn't text my friends, check emails or surf the Internet to occupy myself. 

Countless hours must have vanished in this (in)activity, just because I felt uncomfortable starting my revision at, say, 09:29. And, of course, if I didn't look at the clock at the right moment, I'd miss my slot and have to wait for the next one.

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I still do this. On a Monday - my writing day - I begin each piece of work at a time ending with a five or a zero. Now, though, I do fill those waiting minutes by reading emails and surfing, which means I often miss my moment and have to kill yet more time. No wonder I sometimes feel these days are unproductive.

It wasn't until we went on holiday last July that I discovered I could not only schedule blog posts to publish on a given day, but also at a specific time. Now, even when I'm actually sitting at my desk, I schedule my weekly post for the next 'good' time coming up, rather than click on Publish the second it's ready. 

I prefer the numbers ending in zero and, for the first few weeks after this discovery, was also fixated on publishing at 12:30. One day, however, circumstances conspired to delay me - the clock-watching may have contributed - and I had to settle for 13:00. At which point, I realised that I liked the double zeros even better. I've managed to resist getting stuck on those, and to settle for the next available five-minute mark, which avoids ridiculous delays in publication; such as a piece being ready at 12.02, but not publishing it for 58 minutes. 

Somehow, before this revelation, I accidentally published at a good time by chance on three occasions. How I wish I could amend the other nine, along with my post from
9 December 2013, which, for some reason, appeared at 17:48; both strangely late in the day (possibly due to IT problems) and at a horrible time. 

Those random publication times feel untidy to me, but since they're as set as fossils in rocks, I'm just going to have to live with them!

Perfect day

If you have ever experienced a run of misfortune, you'll know that it can leave you feeling as if nothing will ever go right again. For anxiety sufferers, it might take no more than a couple of incidents to start this spiral into negativity. 

Once in that frame of mind, even minor knocks assume significance. You mentally catalogue every last little thing that has gone wrong, your thoughts racing in a dismal litany of 'and then that happened...and then this...and then that...'. They are all fuel for your conviction that life has gone irretrievably bad, and contrive to make you fear what will come next.

This year has been much like that for me. It's as if I've been playing a game of snakes and ladders, with a couple of three-runged ladders in a jungle's worth of snakes.

Image courtesy of Serge Bertasius Photography/
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Now and again, though, the fates seem to turn back in your favour. And so it was on my birthday, earlier this month. 

It was a 'big' one this year and I felt I should make something of it, but was short of ideas: all I knew was that I wanted to celebrate it somewhere with a view. So, at fairly short notice, my boyfriend and I booked an evening at the Paramount restaurant at the top of the Centre Point building, in central London - drinks in their 360° viewing gallery, on the 33rd floor, followed by dinner in the restaurant, one floor down. 

The venue was something of an unknown quantity: the TripAdvisor reviews were mostly good, but with some brickbats. To add to the uncertainty, as the day drew near, storms were forecast. Would we end up eating measly portions of over-priced food, peering through rain-lashed windows at a possibly invisible London?

Against the odds, the sun came out, affording us spectacular views from the gallery, to accompany our champagne. On to dinner, where the waitress steered us to a table beside the window, just as we'd hoped. As darkness fell, and the lights came on, the city skyline became even more beautiful.

At the end of the evening, we found ourselves reeling off everything that had made it so special. From the friendly couple next to us in the bar and the professional, yet approachable waiter, to the iridescent cloud brightening the sky and the mouth-watering chocolate fondant dessert. An altogether different list of 'and thens', adding up to magic rather than misery.

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Not only did we have a truly memorable evening, but it seemed as if it might mark a turning point in the year. Although I have had other enjoyable days, amidst the traumas, this one felt different, and I have been a lot more relaxed since then.

Perhaps simply choosing to see this as a turning point has actually made it one. My mind so often tricks me into finding cause for worry; maybe I have tricked it back.

Whether they're the result of truth or trickery, positive thinking and peace of mind certainly make a refreshing change.

Parental guidance

This week's post is the first in a series of interviews with people who are able to offer a different perspective on obsessive-compulsive disorder. Today's guest is Janet Singer*, who lives in the USA and whose son, Dan*, now 24, suffers from the condition.

At what age, and how, did you first realise that Dan had a problem, and how soon after this was he formally diagnosed as having OCD?

I didn't realise Dan had a problem until he told me he had OCD, at the age of 17. He had diagnosed himself with help from the Internet and, shortly after that, his longtime paediatrician confirmed this. I had noticed Dan had been having trouble sleeping, and seemed anxious, but I attributed it to the fact that he was waiting to hear back about college acceptances. His compulsions were mostly mental, so were easy to hide. Of course, in hindsight, there were signs.

OCD takes many forms - what were the Dan's key obsessions and compulsions?

Dan's OCD centred on harming obsessions, as far as I know (he was never comfortable sharing the details with me or my husband): fears that he would somehow hurt, or be responsible for harm being caused to, those closest to him. I believe he also feared hurting just about anyone he came into contact with.

His mental compulsions included reviewing the day's events in his mind and counting. Overt compulsions included tapping and touching. Ultimately, what nearly destroyed him was avoidance: avoiding people, places, situations etc. At his worst, he was unable to eat, and would get 'stuck' in one place, physically, for hours on end.

How easy was it to access treatment, and what hurdles did you and your son encounter on his journey to recovery?

Like so many others who seek treatment for OCD, we were originally steered in the wrong direction. Access was easy (the 'local' clinical psychologist); unfortunately it was the wrong treatment! This therapist told us Dan's OCD was 'no big deal' - this was before it got really bad - and used traditional talk therapy with him. Dan had about 10 sessions of the wrong treatment before he went off to college, 1,500 miles from home. When his OCD became severe there, he saw a psychiatrist who prescribed his first medication.

In total, Dan took 10 different meds on his journey to recovery, but, for him, the best medication turned out to be no medication at all. We only learned about exposure and response prevention (ERP) therapy when he was accepted into a residential treatment programme for OCD. They knew how to treat the condition, but this programme presented other hurdles, such as lack of communication with me and my husband, as well as Dan beginning to become institutionalised, ie too dependent on the programme. We ended up forcing him to leave, which, in retrospect, was the right decision.

As a parent, what were the hardest elements of Dan's condition to deal with?

Before I understood what OCD was all about, I would inadvertently enable Dan. Once I realised that this only made his OCD stronger, I stopped, and at first that only added to his torment. That's hard for a mum; I was supposed to make everything 'all better', not worse. For me, the hardest part of Dan's ordeal was just seeing him suffer, and not being able to do much about it except tell him that I loved him and was there for him.

His relationship with me also became strained when he was on the residential treatment programme. He was there for nine weeks and I felt very isolated from him.

Image courtesy of David Castillo Dominici/FreeDigital Photos.net

Does anybody else in Dan's immediate family suffer from OCD, or any other anxiety disorder?

There have been no official diagnoses, but we 'have anxiety' on both sides of our family. I was an anxious child and even had a few 'OCD tendencies', but I never developed the disorder. The more my husband and I think about it, the more we believe it's quite possible we both have immediate relatives who might have OCD, though certainly not as severe as Dan's was.

Were there any major turning points or breakthrough moments for Dan in tackling his OCD?

We were extremely fortunate that Dan never had recovery avoidance and always accepted help readily. For me, there were two turning points in his journey. The first was his entrance into the residential treatment programme. Even though I had some complaints about this, the bottom line is that they knew ERP therapy and I believe this therapy literally saved my son's life. The other was Dan getting off all his meds, which harmed him, both physically and mentally, and in some cases, made his OCD worse.

What key advice would you give to parents who suspect their child might have OCD?

They should consult with a competent specialist as soon as possible, as the condition rarely goes away on its own. In most cases, the earlier it's addressed, the less ingrained it will become, and the easier the journey to recovery will be. Even if you think things are 'not that bad', there is no reason not to meet with a specialist. If your child doesn't have OCD, the therapist can still address whatever your concerns are.

And your advice to parents whose child has already been diagnosed with the condition?

The most important thing is to connect with a therapist who specialises in treating OCD through the use of ERP therapy. The International OCD Foundation (IOCDF)** has a list of questions that you can ask potential therapists in order to find the right fit for you.

Remember, also, that while the experts know about OCD, you are the expert on your child. Your thoughts, concerns, and opinions are important and should be heard.

Lastly, the journey through OCD can be hard on the whole family. It's okay to be angry, frustrated and upset, as long as you make it clear to your child that whatever you're feeling is directed at the OCD and not them. Our children need to know that they always have our love and support.

How is Dan now?

I'm incredibly thankful that Dan continues to do well. He graduated college and moved across the country. He's working in his chosen field, supporting himself and living life to the fullest. His OCD is classified as mild.

I would like to thank Janet* for taking the time to share her experiences. You can read more about them on her excellent blog.

* * *

*Pseudonyms Janet uses to protect her son's privacy.
**The IOCDF is based in the USA. For details of UK-based organisations, and online resources, see the sidebar.

Playing chicken

My contamination fears mean that I won't eat food that falls onto a cafe or restaurant table, unless its surface is covered by a pristine cloth. However, I also need 'wholeness' in what I eat, which means I can't bear to lose any item from a meal. 

Whenever possible, to avoid this dilemma, I spread a paper napkin under my plate, to create a safe spillage zone. This is particularly important when the plate is full, or has a cargo that is prone to escape, like peas. I'll happily do this in company, and even tell my dining companions why, rather than risk having to consume something incomplete. Even eating a sandwich at work necessitates a trail of protective napkins from my food to the table edge.

For many years, I bought a pot of fruit salad from the canteen to have after lunch. Usually, I would eat it at my desk, and, usually, at least one piece would end up on the floor. Rather than ruin my pudding by throwing that piece away, I would surreptitiously take it to the kitchen - some 30-40 feet away - wash it thoroughly and wolf it down at the sink. Many a time, a colleague would walk in on me while I was washing the fruit and I'd have to hide it in my fist.

Most people would recoil from doing this, whether they had OCD or not, but the compulsion to achieve wholeness was far stronger than any contamination fear and made this perfectly acceptable to me.

Photo: Helen Barbour

Dry products, which can't be washed, are another matter; I won't eat any that make contact with the table surface, let alone the floor. 

There has, however, been one recent exception to this rule.

I'd bought my lunch sandwich early and asked for it to be wrapped in clingfilm, rather than greaseproof paper, to stop it drying out. There were layers and layers to unroll and my sandwich ended up atop a slippery slope of the stuff. No sooner had I started eating than I noticed one quarter had slid off the film, and the entire length of one crust, and a piece of chicken, were touching the table.

Now, I couldn't tear off the 'contaminated' bits, as that would have left two-thirds of the quarter - and a total consumption of an unsatisfactory 11/12ths of a sandwich. I toyed with the idea of abandoning the whole piece, but that would have made for an insubstantial lunch and, frankly, three-quarters of a sandwich is no better than 11/12ths when your goal is wholeness.

Instead, I picked it up and ate it, trying not to think whose dirty fingers might have touched the table, or whether the cloth that had last cleaned it was, well, clean. I felt as if I were gambling with my stomach and expected to be vomiting within 24 hours - needless to say, I wasn't.

Unfortunately, I don't think this victory will help me to win future contamination battles. My OCD brain tells it was just luck that I didn't get ill and that the more chances I take, the worse the odds.

Could it be magic?

Imagine you're engaged in some DIY work at home; let's say, putting up a set of shelves. You've learned, from past experience, that these projects can sometimes take a disastrous turn. On this occasion, however, things are going well. 

'This is easier than I expected,' you say to your spouse/children/dog and, then, in the next, slightly anxious, breath, 'I've probably jinxed it now.' Sure enough, five minutes later, as you put a screw in the wall, the plaster around it crumbles and falls out. You can't help thinking you somehow made it happen.

Such is the illogicality of 'magical thinking'. Of course, it isn't actually possible for a comment to weaken plaster. Nor is the plaster a living entity that heard what you said and flung itself off the wall to spite you. It's just a coincidence. 

Likewise, if your boss is trying your patience beyond reason, provoking you to say 'I wish he/she would drop dead', it's not your fault if they expire the next day as the result of a ruptured aneurysm. The fact that you made the comment is still likely to trouble you, though.

This kind of thinking is quite common, but doesn't cause excessive, or enduring, concern to most of us. We know that we're not really to blame for chance incidents and don't dwell on them.

Image courtesy of luigi diamanti/FreeDigitalPhotos.net

However, some people with OCD take magical thinking to an extreme and genuinely feel that they have the power to influence situations. As a result, they may be driven to carry out compulsions to cancel 'bad' thoughts, to prevent these from coming to pass.

Now, you might find it ridiculous that anyone would think in this way, so here's an experiment that, hopefully, demonstrates the point.

First, think of someone you love - husband, wife, child, best friend (=Name). Now think of a horrible circumstance leading to death, such as developing a terminal illness, being in a plane crash, or drowning (=Means of death).  

Then say out loud 'I wish Name would die of/in/by Means of death.' Better still, find a pen and paper and write it down.

Did you manage to say it, or write it? If not, why not? If you did, how did it make you feel? I suspect many of you were uncomfortable just thinking the words, let alone voicing them or committing them to paper.

When I saw that experiment being conducted at an OCD Action conference - specifically with delegates who didn't have the condition - many were literally squirming in their seats and couldn't write anything.

The fact of the matter is, most of us would have difficulty wishing ill on our loved ones, even as an experiment, and even when we know that we can't cause such ill to happen.

It's easy to see that living with such a feeling - such a fear - day in, day out, is terribly distressing.

Whether you're prone to magical thinking or not, perhaps it helps to think of it from another perspective: that of generating fortune, rather than misfortune. How many times have you said you wished you could win the lottery? And have you...?