Dragging myself back

My previous post discussed the sudden relapse (“relapse” in the sense of going from bad to worse, not from well to ill) that I encountered at the beginning of September. I thought I’d write a post to update you on how it’s been going since then.

I haven’t been myself during the past month. I’ve had to cancel plans because I’m too ill, something that I haven’t really had to do in years. I’ve cried most days – at times crying on and off throughout the day. Partly that was because being very sad was easier to handle than being terrified – to an extent crying provided a bit of relief from the fear. But I also cried at things the usual me would find faintly ridiculous – I visited a zoo nearby and kept crying because I’d been there with my partner when we were first dating. I watched a programme about guide dogs and cried at everything that happened – happy or sad. Today I’ve been crying because pushing on through OCD is so hard and I just wish I could be well.

One of the things I discussed with my therapist soon after I got suddenly very ill was that the last time I had a period of intrusive thoughts on this kind of theme (doubt and existential fear), it lasted for a year or two. It happened when I was about 15 and I remember it as a very bleak time. I was determined not to go through another year of it. The past few weeks have been so intensely hard to manage that I feel there is nothing I can do but very actively seek out strategies to get me through it. I’ve been devouring information and books that might help.

A few things have stood out in my attempts to get back to my normal state of being (I’m trying to get back to where I was in August – nowhere near well but not suffering like I have been lately). The first thing is my mum’s wisdom. She came to stay with me a couple of weeks ago and we enjoyed being together even though I kept crying and felt very frightened most of the time. I talked to her about the content of my constant intrusive thoughts and fear (focused on death and religion), and she listened and provided her thoughts. But after a while, she realised I was doing what I spent so many years doing in the past – asking the same questions repeatedly. She’d give an answer, I’d take it in, and then an hour later I’d ask a similar thing again. This is classic OCD, and my mum realised that.

Genuine questions respond to genuine answers. OCD doesn’t. It’s a constant cycle of “OK, but what if…”. My mum and I worked out that whilst I’m in this severe patch of OCD, my brain simply can’t take answers on board (as seen in recent neuroscience research on ‘safety signals’). Even if I were to come up with a true revelation on the meaning of life, so long as my brain was in OCD-mode, I wouldn’t be able to believe it! Therefore the only way to answer these constant doubts is to get well. If I have genuine questions/doubts when I’m well, I can use my well brain to respond to them. The way I got well last time was by not engaging with the questions. Therefore, if I genuinely want to get to the answer, I have to ignore the question.

The second thing that has really helped me in this period is what I’ve learned with the help of this website: http://www.accounseling.org/coping-statements-for-christians-with-ocd-scrupulosity/ My brain is desperately seeking certainty – OCD tells me if I can just find that one answer that sticks, I’ll be ok. But the nature of OCD means my brain can’t feel certainty at the moment. So instead of reaching for that certainty, I have been trying to redirect myself to doing the most loving thing I can do in the moment. Sometimes that’s doing my work, sometimes it’s walking my dog – it doesn’t have to be major. This is a way to live my beliefs even though I can’t feel my beliefs. I have to move forward through the uncertainty, not try to solve it.

I realise that talking about love in this way may sound dramatic or excessively grand. But the reason I am doing so is that love is the only concept bigger and stronger than the depths of this relapse. I think this will make sense to other people suffering with serious mental illness. Talinda Bennington, who lost her husband Chester to suicide, talks about moving forward in love – moving through the grief instead of becoming stuck in the despair. I’m using love in a broad sense – having compassion for others, choosing to be kind when it’s easier not to be, spending time with friends and loved ones.

The intrusive fears were almost constant when this relapse began – I wrote down a tally of each instance and it was more than one per minute. Now they are less frequent – I had about 10 when listening to an hour-long lecture the other day. I have got better at holding them off and redirecting my attention. I have periods of feeling ok, and these periods are getting longer. I’m still working at it very hard, but people close to me tell me I have improved a lot from where I was. I suspect this post may be more ramble-y than usual, but I hope it gives a good idea of what this is like. I’m quietly hopeful that I will be able to read this again in months or years to come and feel grateful that I got through it.

Walking the dog with OCD

Proceed with caution if you have religious OCD, especially if it’s based on Christianity – here I talk about some of my religious thoughts without going into detail on why they’re wrong (though be assured they are wrong, as is every OCD thought).

Just got back from a dog walk. I fought hard with OCD on this walk – specifically, by allowing my feet to face white marks when I was walking, even if there was a beat at the same moment in the song I was listening to. This post is about the point at which I struggled most during the walk, due to a specific thought which took hold more than the others did.

The thought

There was a word in a song I was listening to that sounded a bit like “fool” (I don’t think it was “fool”, it might have even been a French word). My foot was pointing at something white, and in OCD parlance that means using that word to describe the Holy Spirit (white = Holy Spirit). OCD tells me that this in turn means I will go to hell, due to insulting the Holy Spirit. This is bolstered by a Bible verse in which Jesus says if you call your brother a fool you’re in danger of the fires of hell – so I’m quite nervous about the word “fool” in general, even though I’ve heard other Christians use it without concern, and even though I don’t really believe in hell. Interestingly it takes a whole paragraph (with additional links) to explain this thought, but in my head it’s pretty much instantaneous – all those connections are just something I “know” less than a second after it’s happened.

Whether to neutralise the thought

OCD said I had to neutralise what I’d done by winding the music back and walking back to the spot in order to “take it back” or “take it back into myself” by making some kind of mental movement towards myself whilst my foot was pointing at the white mark and the word came up in the song. Alternatively I could neutralise it by thinking or saying “no” or “not” whilst pointing at the white spot with my foot at the moment the word came up in the song. This would, according to OCD, “undo” what I’d done wrong. (Incidentally, beware of OCD claiming that your compulsion can make something ok – OCD will never be satisfied that you’ve done it correctly enough for it to be truly safe).

Choosing not to neutralise it

I didn’t want to neutralise it as I’m trying to do exposure when I walk. So I spent about 3 to 5 minutes stood still trying to work out what I should do (my dog meanwhile had a lovely run in and out of the woods). Then (and now) I don’t have a great deal of access to the reality that this is preposterous and makes no sense – it feels quite real. Nevertheless I used the arguments that a) God knows it’s OCD and doesn’t want me to obey it, b) my brain can’t use safety signals properly, so it won’t be possible for me to feel that it’s ok; I have to choose to believe it is safe even though it feels threatening. I didn’t go back in the end, though I’m still feeling anxious about that decision about half an hour later. My Fitbit reckons I was doing cardio exercise during this walk (a leisurely walk in the sun + OCD = 143 beats per min – I’m not especially fit but I’m young and physically healthy, so it shouldn’t be this high).

We walked through a meadow a bit like this

Yesterday, when I walked the dog with my mum and sister through a meadow, my sister commented on how nice it was and that we were living our best lives. I brought the tone down a bit by adding that I was in the process of trying to prevent my eternal suffering. It reminded me of a joke John Robins made, that when he goes on holiday he can’t relax because he (i.e. the problem) is still there. OCD is there 24/7, whether I’m in a relaxing situation like having a massage, whether I’m concentrating on something or doing my favourite activity. It did stop for 20 minutes when I gave an important talk recently as all my mental resources were focused on the talk. OCD also shut up for the majority of episode 5 of Game of Thrones season 8, as it’s my favourite programme and a lot was happening. OCD was there as usual in episodes 4 and 6 though.

Anatomy of an OCD thought: Part 3 – fighting back

Click here to read Part 1.

Click here to read Part 2.

CONTENT NOTE: As with parts 1 and 2 please take care if you have religious OCD or OCD which focuses on magical thinking (i.e. if I do x then y will happen). However, I hope this post will be helpful for people who have similar OCD thoughts as in this part I will attempt to show why OCD is wrong.

The OCD situation I discuss here is described in detail in Part 2, and the OCD rationale behind it is described in detail in Part 1. In this part I am aiming to show myself (and others with similar thoughts) why OCD is wrong using cognitive reappraisal techniques.

What does OCD say?

  • I “know” (because OCD has told me) that what I did meant I was insulting the Holy Spirit and the devil.
  • They can hear my thoughts and know this too. Therefore they will be insulted unless I make it safe.
  • I used my middle finger because I was intending to insult the Holy Spirit and the devil.

What are the arguments against what OCD says?

  1. OCD is a mental illness. The thought is the symptom of an illness. If I didn’t have OCD I would not have had this thought. OCD is a mental illness which focuses on the things that matter most to the individual with OCD, and the things that cause the most fear to them. However it is a symptom of an illness, in the same way that someone with psychosis may believe they are Jesus, or someone with meningitis may get a rash. The exemplar person with psychosis believes they are Jesus, this doesn’t meant that they are. The person with OCD believes that their actions are insulting to the Holy Spirit or the devil, this doesn’t mean that they are.
  2. Christian arguments against the thought (re. the Holy Spirit). The Bible says repeatedly that God knows everything, He is omniscient. That means He knows that the thought I had was a symptom of OCD, and that I had that symptom specifically because it is the worst thing my OCD could come up with. The Bible also says that God is just – He could not be just and also knowingly condemn someone for the symptom of their illness. Furthermore, the Bible says to test the spirits and see if they are from God, and says that the Holy Spirit is not a spirit of fear. Jesus says “do not be afraid,” and “do not let your hearts be troubled” and that Christians should trust Him, not their fear. This clearly sets OCD up against Jesus and God, OCD is not on God’s side. I believe that God’s only concern with this OCD thought is that it is harming me – He doesn’t see it as offensive to Himself.
  3. Christian arguments against the thought (re. the devil). There is evidence from Biblical scholars that the devil is not meant to be read as a literal individual. Even if we did accept that he was a literal individual who could hear our thoughts, he would know that my thoughts were OCD. Furthermore, supposing we accept that hell is a place where the devil resides – in this case he is still under God’s rule, according to the Bible. He is not “in charge” of hell, according to the Bible. In this manner the power of the devil to harm me would be the same in hell as it is on earth. I am not afraid of him causing me additional harm on earth. This gets to the heart of the fear really – uncertainty and fear of the unknown (in this case death).
  4. Arguments against the notion that I intended to “give the finger” to the Holy Spirit or the devil. This argument won’t work for everyone(!) but I have never “given the finger” to anyone in my life. I never use direct insults at people, even when I’m angry. I rarely use insults when I’m talking about someone I am angry with, even if they are not there. I may have been angry with OCD when I had this OCD thought, but I was not angry with the Holy Spirit or the devil. Even if I had been I wouldn’t have sworn at them. (As an example from UK politics – I was one of the students inspired by Nick Clegg to vote for the Lib Dems, then I watched him triple tuition fees after promising to scrap them. When I met him I told him this but I stayed civil! Like many of those students I haven’t voted for the Lib Dems again, but I digress.)

So after writing all three posts in this series I have done a bit of birthday planning. This kind of OCD thought won’t diminish much until I go against it, so I’ve tried to be brave.

Anatomy of an OCD thought: Part 2 – the practice

Click here to read Part 1.

Click here to read Part 3.

CONTENT WARNING: In this post I discuss the content of my religious OCD. If you have religious OCD, or other forms of OCD which involve magical thinking (e.g. “if I do x then y will happen”) please take care if reading on. OCD has been known to “take on” new symptoms when hearing about other people’s symptoms. (The post starts below the picture).

I’m now going to write about a specific OCD thought that is based on the OCD lies I described in Part 1. I hope that by writing it out I can help myself to see it for what it is, and show other people what OCD looks like in detail.

A couple of weeks ago I was on my way into town and I itched my eye with my middle finger. OCD told me that this meant I was giving the middle finger to the Holy Spirit or the devil. [It is frightening for me to write that.] OCD told me that I had to “correct” it. In order to correct it, what I needed to do was itch my eye with a different finger whilst in the same position on the road and whilst listening to the same part of the song that I was listening to when I originally itched my eye. OCD says that if I can do this successfully then I will ensure that I am not insulting the Holy Spirit or the devil.

I have tried to “correct” it, but haven’t managed to do so in a way that makes me feel it’s been properly corrected and “made safe”. I can’t keep trying to make it safe at the moment, a) because I am many miles away from the place I had the thought, b) because when it comes to “correcting” something OCD is never satisfied – anyone with OCD will know that however hard you try to do as OCD wants it will keep changing the goalposts. For example it will say I wasn’t quite in the right position, or the wrong part of the song was playing (I can’t actually remember the exact position or the exact part of the song that was playing, so OCD is bound to capitalise on that).

The way it is bothering me now is that I want to plan an event for my birthday. OCD is telling me that I can’t, because the eye-itching situation has not been adequately corrected. If I were to go ahead and plan the event I would need to re-do the planning once the eye-itching thing had been made safe. This is a good example of one of OCD’s tricks – in order to stop you moving on from a situation like this it will attach itself to a situation in the future, ensuring it stays in your mind.

Another trick OCD is using at the moment is making me doubt my intentions – it’s telling me that by itching my eye with my middle finger I was intending to insult the Holy Spirit and the devil. This gives OCD more power as it’s harder to dismiss as an intrusive thought if it tells me that it was actually me who was behind the thought. I will try to tackle this in Part 3.

Anatomy of an OCD thought: Part 1 – the theory

Click here to read Part 2.

Click here to read Part 3.

CONTENT WARNING: In this post I discuss the content of my religious OCD. If you have religious OCD, or other forms of OCD which involve magical thinking (e.g. “if I do x then y will happen”) please take care if reading on. OCD has been known to “take on” new symptoms when hearing about other people’s symptoms.

OCD’s “theory”

The idea that I have insulted the Holy Spirit or the devil are the most powerful thoughts that my OCD uses. They underpin almost every OCD thought I have and every compulsion I do. I’m planning on doing a later blog post about strategies I have found useful in combating these lies that OCD tells. For now I’m mostly going to describe what they mean to me in the context of my mental illness.

There are 2 verses in the Bible in which Jesus says all sins can be forgiven, but insulting the Holy Spirit cannot be forgiven. Scholars of the Bible suggest that these verses mean that if you reject God (i.e. reject God’s gift of His Spirit) then you can’t be forgiven because you are choosing not to accept His forgiveness. The verses are not referring to a specific event or to insulting language etc. I know this, but OCD still uses the verse to terrify me. The ultimate fear behind this, for me, is the idea that if I insult the Holy Spirit I will not be saved and will not go to heaven. I no longer believe that hell is a real place, but my OCD still keeps me afraid of going there. I’ve discussed in other blog posts how having OCD means you can know that something is incorrect yet still fear it.

The second thought that OCD uses, that I could insult the devil, is also ultimately linked to a fear of hell. The OCD rationale says that if I insult the devil and one day end up in hell then the devil will single me out for specifically harsh treatment. This rationale depends on cultural notions of the devil as being in charge of hell, an idea that came into fruition long after the Bible was written. This concept of the devil as a god of hell is not actually Biblical. Even if you take the view that hell is a place, there is nothing in the Bible to suggest that the devil is in control there. In fact many Christians believe that the devil is not a specific being, but a metaphorical concept which was used at the time the Bible was written to describe the conflicting nature of the human mind – sometimes we want to (and do) do things that are wrong because it feels good, for example. The irony here is not lost on me – it’s plausible that when the Bible refers to the devil and demons afflicting people this is a pre-scientific description of what we now understand as mental illness.

One of the reasons my OCD has settled on these thoughts is that they can’t be disproved in the way that my earlier OCD thoughts could. If OCD tells me that my mum will die if I don’t stand in a certain spot, I can ignore OCD, then check if my mum is still alive. There’s no way to check whether I have insulted the Holy Spirit or the devil, and there’s no way to check whether I have stopped myself from going to heaven when I die.

Another reason why these thoughts are so powerful is that as a Christian I believe that God knows my thoughts. OCD is a condition which is based on intrusive automatic thoughts. Recovering from OCD involves accepting that you can’t control your thoughts – “but what if,” my OCD says, “by letting these thoughts go by, I am insulting the Holy Spirit and ruining not just my life but my eternity?” This is terrifying, and gives you an idea of why religious OCD is so difficult to treat.

I also fear that the devil knows my thoughts, or listens to the things I say out loud in attempt to prevent me from getting totally stuck, such as “I am not insulting the Holy Spirit or the devil if I use my left foot”. Again these fears are not based on a thoughtful reading of the Bible, but are more based on myths created by writers such as Dante.

This post has outlined some of what lies behind my OCD thoughts. Read Part 2 to see a concrete example of what this looks like in practice.

How can I tell what is OCD and what isn’t?

Sometimes people with OCD have trouble identifying which thoughts are OCD and which aren’t (see the bottom of this post for some tips on how to do this). I have had many years of therapy, and as a result I am relatively good at identifying when a thought comes from OCD. However, there are still times when I’m unsure. For this post I’ve divided OCD thoughts into ‘obvious’ ones and ‘subtle’ ones.

‘Obvious’ OCD

Obvious OCD thoughts are things like “my mum will die unless I touch the table 4 times”, “I knocked over the cyclist that I drove past”, “I can get cancer by breathing in when I look at the word ‘cancer'”.
You can usually spot the obvious OCD thoughts by imagining how someone else would react to the thought – they would know that it wasn’t true. The strange thing about these OCD thoughts is that even without asking anyone else, we know that others would see the thoughts for what they are – the output of a mental illness. (The reason why we still ‘obey’ them despite knowing this is discussed in other blog posts).

‘Subtle’ OCD

Subtle OCD thoughts are sometimes more extreme versions of everyday thoughts. For example “did I leave the cooker on?” People without OCD will wonder this from time to time, but they will usually forget about it quickly. In contrast, people with this form of OCD may check repeatedly that they turned the cooker off, and may worry about it constantly once they have left the house. In cases like this, if the thought interferes with your daily activities, and happens on a regular basis, it’s likely to be OCD.

OCD has been called the ‘doubting disease’ because it makes us doubt ourselves and the things that matter to us. For example, after a number of years of living with obvious OCD thoughts (e.g. “my mum will die if I touch the table”), I entered a period where I didn’t have many of these obvious OCD thoughts. What I did have, however, was constant doubts about my faith. It’s normal to have some doubts about faith and religion, but for me it was 2 years of doubts/fears which happened every hour of every day, irrespective of what I was doing at the time. It wasn’t immediately clear to me that this was another part of my OCD, because the content itself was something that many people think about at times, rather than a strange, obvious thought that doesn’t make sense to the average person. In this way it was an example of subtle OCD, it hid itself as something else (normal doubts).

OCD’s tactics

OCD is a crafty condition (though remember, you are always more intelligent than OCD is). Sometimes if you begin to resist it, it will try to recruit your emotions to make itself more powerful. For example, one of my OCD thoughts is that I will send loved ones to hell. I am usually relatively good at ignoring this thought, for reasons I’ll discuss in another post. However, this thought becomes much more powerful if I am feeling angry with someone. In this case, OCD will ‘tell’ me that not only can I send this person to hell [i.e. the basic OCD thought], but that I actually want to send them to hell because I’m angry. I have never wished for anyone to go to hell, never mind those that I love and care about. But OCD uses emotion to make me doubt that fact (there’s the ‘doubting disease’ again). This makes the thought more powerful – “what if I do ‘mean’ the OCD thought after all?” At this stage it becomes even more difficult to ignore, because it is recruiting additional feelings of inflated responsibility, guilt and fear.

Is it OCD? A few tips

The following list is intended to help people with OCD to work out whether the thought they are dealing with is a part of their OCD. It’s not designed to help people decide whether they have OCD or not. If you answer ‘yes’ to a few of these statements, it’s likely that OCD is driving the specific thought/fear. Note that you don’t need to answer ‘yes’ to all statements to label your thought as coming from OCD.

  • it focuses on something you care about in some way (e.g. loved ones, religion, work, things you enjoy doing)
  • it causes you distress
  • it interferes with your daily activities
  • it bothers you a lot of the time (not just occasionally)
  • it involves ‘magical thinking’ – the idea that thoughts or actions can cause real life events
  • it is the direct opposite of what you want to think
  • it involves symbolism, such as connecting unusual (typically frightening) meanings to left/right, colours or numbers e.g. yellow = cancer
  • it keeps coming back, even if you come up with a good ‘answer’ or reply to it
  • it gets stronger the more you think about it (even if the reason you are thinking about it is to contradict it); it gets weaker if you ignore it