29 June 2015

Antisocial media

A recent news story surprised me and yet, at the same time, chimed with me: a study had found that people could develop the symptoms of post-traumatic stress disorder (PTSD) as a result of viewing disturbing or violent images or videos online.

At first, this might sound ridiculous. How could seeing something on a screen compare with, say, experiencing war at first hand? Such a claim is surely an insult to anybody who has suffered real-life trauma?

As discussion opened up around this, however, it became clear that the study was reporting a similarity to PTSD symptoms, which include anxiety, insomnia and mood changes. It also indicated that only those who repeatedly exposed themselves to such images or videos were at risk of long-term problems that might lead to a diagnosis of actual PTSD. 

The study involved a group of just 189 people, so more research is needed, but this initial work has raised questions considered worthy of further investigation. 

It was carried out by Dr Pam Ramsden, Lecturer in Psychology at the University of Bradford, who warned that 'natural worriers' were amongst those most likely to be negatively influenced by online material - if there's one thing OCD sufferers are, it's natural worriers! 

She noted that a particular problem with social media was that images come up on screen without the kind of health warning that might be delivered by a continuity announcer or newsreader ahead of a violent film or distressing story. In fact, I've fallen victim to this myself twice, while on Facebook.

The first time, I was scanning the usual innocuous stories and photos posted by friends, when an image suddenly appeared of the aftermath of a car crash. I won't describe this, for obvious reasons, but the injuries to the four people who had died were extensive and graphically clear.

Image courtesy of basketman/
The person who had originally shared it had invited sympathetic comment and one of my friends - a compassionate woman - had responded, which led to the item being visible on my timeline. I scrolled away from it straightaway, but it was too late; the image was burned onto my mind and stayed at the forefront of my thoughts for days. 

The same thing happened when a different friend commented on a photo of a murdered hostage; once again, the image haunted me for a long time.

When I discussed this with the friend concerned, he expressed surprise at my response, and said 'People need to know about these things.' I explained that I didn't need to see atrocities to be aware of them, and found it distressing just hearing about these terrible acts, let alone viewing the aftermath.

Whether such images are of accidents or of man's inhumanity against man, they're a reminder of how little control any of us actually has. As well as being upsetting, they can be triggering for people with OCD, who are on a constant quest for certainty.

Social media allows me to stay in touch with friends and connect with people around the world, so I'm not prepared to give it up, just to avoid the occasional upset. I wish, though, that those of a more robust nature than mine would think twice about what they share - albeit sometimes inadvertently - with the rest of us!

22 June 2015

Mutual support

This week, I'm talking to Alison Islin, an OCD sufferer who has operated a support group in North London for more than 20 years.

Please tell us a little about your own experience of OCD. How badly affected were you, and how are you now?

I've had OCD since I was seven. If I heard anything bad on the news, or if something bad happened, then I would deliberately do nothing nice for the rest of the day: I wouldn't put on make-up and I wouldn't watch any programmes or read any books that I found interesting. I would literally 'will' the day away and wrote off whole days in that way.

If I broke a glass or a plate, I had to drive out of my area and throw it into a street bin before midnight, so that it didn't interfere with the next day. If I broke something close to midnight, I might have to leave home as late as 11.45pm to do this.

I'm also a skin-picker and pull out my eye-brows, although I finally gave in to the torment this caused me by having them tattooed.

I used to rip pages out of books to stop me from repeatedly re-reading them - as many as twenty or more times - then buy another copy of any damaged books to get the missing pages back! 

I now lead a full life and have just celebrated my 30th wedding anniversary. My husband and I have two adult sons and two lovely Westie dogs. I'm involved with Barnet Voice for Mental Health (BVMH) - the Barnet service user group - on the acute wards, attend acute clinical governance meetings, and sit on committees, as well as interview panels for consultants, nursing staff, social workers etc. Recently I joined the Board of Trustees for MIND in Barnet. 

I have co-written a book about my life with OCD, called Get Out of My Head, for which Dr David Veale (co-author of Overcoming Obsessive Compulsive Disorder) wrote the foreward, and was interviewed about this on ITV's This Morning programme. 

Above all, my OCD is now manageable and in no way interferes with my everyday life. If I'm feeling stressed, then I do ritualise, but I know how to recognise what's happening and prevent the situation becoming a downward spiral.

What prompted you to set up this support group?

After I'd spent six weeks at The Priory Hospital, in North London, some 23 years ago, Dr Veale suggested I start a group there. It's now the longest running OCD support group in the UK. This, in turn, led me to work as a volunteer for BVMH and, 18 years later, I'm still there.

What benefit(s) do users derive from attending a support group?

The fundamental benefit to service users is that they get the support and empathy that is perhaps lacking from family, friends and colleagues. They sometimes arrive frightened and confused, but a positive transformation slowly takes place, which is a privilege to see. 

I do a lot of sign-posting and we talk about evidence-based treatments, such as medication, Cognitive Behaviour Therapy (CBT) and Exposure and Response Prevention (ERP). It's also an opportunity for members to consult a large variety of reference books and I aim to start a library service for the group soon. 

I give out BVMH information to members who live in the London Borough of Barnet, so that they can come to my generic support group, which meets weekly, and to the drop-in service, Space 2B, which runs twice a week.

Some people might be nervous of talking about their problems in front of strangers - what would you say to reassure them?

Image courtesy of Idea go/FreeDigitalPhotos.net
I have ground rules which I outline at the start of each session. I then go around the group inviting everyone to introduce themselves and, if they want to, to say a few words about why they are there. We then move on to regular members talking about how their past month has been. 

I always stress that there is absolutely no pressure to talk and that by listening and watching others interact, people can learn a lot, too. I invite new members to talk a couple of times and let them know that I will also check in with them at the end. This enables them to take ownership of the decision as to whether or not they talk.

In what way(s) do you think it helps you, as a facilitator, to have had OCD yourself?

It's invaluable for a facilitator of any support group to have lived experience, as this helps to develop much more empathy and understanding. This applies to all kinds of groups, eg for cancer, diabetes etc. When you have the experience of travelling a similar path, then your understanding is far more than just theoretical.

Equally, does this ever cause you any difficulties in this role?

No. I am there as a facilitator, full stop. There have to be boundaries and I make sure that the only time I 'share' is if it could be of benefit to the member who happens to be talking at the time. At no time would I ever off-load. 

What has been your most rewarding experience as a facilitator?

Having so many of the same faces attend for several years, disappear, and then come and go again. Watching people grow in their confidence and self-belief. Also sign-posting clients to OCD Action, The Maudsley Hospital etc, and seeing them heal once they receive the correct treatment.

What changes - positive or negative - have you seen with regard to awareness of OCD since you were first diagnosed? Likewise, with regard to medical treatment for the condition?

Having been present at OCD Action's very first conference, I've watched the professionalism within the charity grow and grow, and I take great pride from seeing the benefit this provides to others.

I have welcomed the addition of Mindfulness to CBT and also the advances in ERP therapy. 

Personally, I have benefited from medication that has all but lifted the depression element of my OCD, which is wonderful, and my quarterly sessions with Rob Willson, a clinical psychologist, have been inspirational too.

* * *

Thank you to Alison for taking the time to share her experiences. Her book, which is co-authored with Judy Karbritz, of Poetry Press, is available from Judy at jmkarbritz@yahoo.com. 

Details of OCD support groups across the UK are available here.

15 June 2015

The A to Z of Normal

Once upon a time, on a midsummer's day half a century or so ago, a gypsy touting her wares knocked at the door of a modest, semi-detached house, in a small city right in the heart of England. 

The woman who answered the door was a new mother, though there was no sign of her weeks-old baby daughter from the doorstep, so she was doubly surprised by the gypsy's sudden pronouncement that 'The baby will be a writer'.

While I'm sceptical about fortune-telling, I do believe that particular prophecy, because the new mother was my mother, and the baby was me.

Perhaps if the gypsy had scrutinised her crystal ball a little longer, she would also have predicted that today I'd publish my first novel, The A to Z of Normal. Yes, today's the day my 'baby' takes its first steps into the big, wide world.

My mother didn't share this prediction with me until I began journalism training at the age of 24. I'd been directionless since leaving university, but my (then) boyfriend had become a journalist and it seemed an interesting career - certainly more interesting than any of those offered on the 'milk round' when I was a student.

However, I only really came to think of myself as a 'writer' eight years later, when I moved into fiction writing - by which time, due to an unexpected turn of events, I was working as a secretary.

In fact, it was the same year that I was diagnosed with OCD and, as my passion for writing grew, so did my interest in mental health issues.

Like many a writer, in the years that followed I dreamed of completing a novel. The final impetus to make that dream a reality was learning that one of my closest friends was terminally ill with cancer. In the midst of my sadness, I couldn't help but wonder 'If that were me, what would I regret not doing?'
Photo: Peter Gettins Photography

The common advice to writers is 'write what you know'. Not only did it seem natural to draw on my experiences of OCD, but also important, in light of the stigma associated with mental health conditions. However, whilst I wanted to address this, and to raise awareness, I didn't want my novel to be some bleak tale of woe - that would have been no fun to write or read - and so I decided to inject humour, too.

The journey to write - and publish - The A to Z of Normal has, nevertheless, often been challenging, but I don't regret a minute of it, and I hope you'll now join me on that journey as a reader.

You can view an extract here, and advance reviews here...or just go right ahead and order it - details below.

Happy reading! - and I'd love to receive your comments, or for you to post a review.

* * * 

The A to Z of Normal is available worldwide on Amazon, as an ebook and paperback. It can also be ordered from all good bookshops and directly from the publishers, SilverWood Books.

Paperback: ISBN 978-1-78132-381-6 (UK £10.00, with free delivery)
Ebook: ISBN 978-1-78132-382-3 (UK £3.99)

8 June 2015

What doesn't kill you

Last Wednesday, an opportunity came my way that was both amazing and incredibly stress-inducing: well-known consultant psychiatrist Dr Raj Persaud emailed to request an interview about my experiences of OCD and my debut novel, The A to Z of Normal.

Dr Persaud, who is also a broadcaster and author, explained that the interview would be made available on various sites, including the 'Discover Psychiatry' page of the Royal College of Psychiatrists.

So, a fabulous opportunity to raise both my profile and awareness of OCD? Indeed. Also, however, a fabulous way to ramp up my anxiety and exacerbate my compulsions!

Although I don't suffer from social anxiety, I hate speaking in public; in fact, a gathering of three strangers is sufficient to make me nervous. While this was to be a one-to-one interview, and not broadcast live, there was a potential worldwide audience, which is about as public as it gets.

I was fearful of drying up, of saying the wrong thing, in short, of coming across as an absolute lemon. As I re-read the email, though, a tiny rational voice kept whispering 'But you'll be talking about you and your book, and you know about those better than anyone. There won't be any right or wrong answers.' 

In spite of my fears, clearly I couldn't say no, and, after a short email exchange, I called Dr Persaud to agree details. 'When would you like to do it?' I asked. 'Could you make 8pm on Friday?' he said.

Now, spontaneity is not my strong suit - I don't readily agree to short notice events or last-minute changes of plan. It's all part and parcel of my OCD: I need sufficient time to weigh everything up and be certain that I'm taking the right course of action.

However, I didn't have the luxury of time, so hastily agreed, while mentally rearranging all my other plans for Friday, so that I could prepare for the questions he planned to ask.

Image courtesy of sippakorn/FreeDigitalPhotos.net

Our initial interaction triggered a combination of excitement and stress that made me feel as if I had completely lost control. As soon as I got off the phone, I knowingly caved in to my ordering compulsions, in a bid to reduce my anxiety - and then couldn't stop, in spite of the fact that my dinner was burning to a crisp in the oven.

The stress escalated over the next two days. The interview was to be conducted via Google Hangouts, but my ancient PC has no volume - nor did I have a headset or microphone - so I had to go to my boyfriend's...who lives a 45-minute drive away. What if there were traffic problems? And what if, even then, the IT didn't work?

The following day, the interview was pushed back to 9pm. On the day itself, however, Dr Persaud had an emergency, which meant delaying it to 10pm. I'm not good at waiting, either - again, it's all about loss of control - and by the time it got to 9.55pm, I was in a state of semi-collapse.

Somehow, though, everything came together and not only did I get through the interview, I even enjoyed it. Afterwards, Dr Persaud said 'I knew my email would stress you, but it's good that you've done it.'

And he's right: it was a great experience. It has given me such confidence, in fact, that I'm now actively seeking other speaking opportunities, and that's something I never thought I'd say!

* * * 

This interview will be available on the Royal College of Psychiatrists' website in the next few weeks. In the meantime, you can listen to it on YouTube or download it here via the free iTunes and GooglePlay app 'Raj Persaud in Conversation' - links to both apps are at the bottom of that page.

1 June 2015

Clean, cleaner, cleanest

Walk into any large supermarket these days and you'll be faced with a vast array of cleaning products, for both personal and household use. In fact, these products seem to have proliferated in recent years - a trend that feeds the fears of those with contamination issues and potentially generates worry in others.

According to the National Health Service, the idea that we're becoming 'too clean' is a myth. There is a tendency, however, for those of us of a certain age - who grew up in the 1960s and 1970s - to subscribe to this notion. We bemoan the fact that children are apparently overprotected nowadays and talk as if we ate nothing but soil, stoically declaring 'A bit of dirt never did us any harm'.

While these tales of our childhood may be exaggerated, it's true to say that - in most first-world countries, at least - we achieved acceptable hygiene standards decades ago, and many innovations since then seem largely surplus to requirements.

When I was a child, our family used one very cheap, plain product to wash hands, face and body: Fairy mild green toilet soap. It has now, sadly, been discontinued, though you can buy 4 'very rare' bars on ebay for £35.95!

Occasionally we availed ourselves of wet wipes, on picnics, but they were little more than damp, citrus-scented tissues. And my mum used white dishcloths to wipe down surfaces - without the help of any kind of spray - which she kept clean by boiling in a pan of water.

Now everything's antibacterial: from the hand gels and liquid soaps of every fragrance and hue, to the surface sprays that kill 99.9% of all known germs, and the wet wipes with exfoliating bumps to scrape every atom of dirt off your skin.

Image courtesy of dusky/FreeDigitalPhotos.net
The product I find the most mystifying is the 'no touch' soap dispenser, which supposedly reduces the spread of germs. I'm unclear exactly how this helps, when you have to touch the taps both before and after using the soap? It's just an Emperor's New Clothes' marketing ploy.

And while the television advertisements designed to counter problems such as food poisoning are well intentioned, and no doubt helpful to some, they can also cause more concern than necessary.

One warned about salmonella by showing a darkened kitchen decorated with neon splashes that represented the spread of contamination from not washing hands and utensils properly after processing raw chicken. The image was so striking - and frightening - that it prompted me to devise a ridiculously stringent handling system of my own, which includes wearing rubber gloves to stop meat getting under my nails.

Normal hygiene precautions are sensible, especially for the young, the elderly or those in fragile health, but we should think twice before buying into the sales' pitch for the latest must-have cleaning product - and avoid wasting our hard-earned cash!