I wake, and for the most fleeting of moments all appears well. Then the slumbering monster in my brain awakes and unleashes its fury. I am paralysed by fear, fear about the harm I might inflict on unsuspecting individuals. I am bathed in cold sweat, pinned to my bed with dread, as a relentless stream of unutterable, offensive, violent thoughts ricochet around in my brain. I recoil in horror, shame and guilt, convinced I am an evil, deviant person. And it’s not even 7.30am. The day has barely begun, but my OCD is in full flight, making each individual moment a living nightmare.
The most typical form of OCD involves obsessive thoughts, feelings or urges, combined with compulsive rituals such as hand-washing or checking. But I have a particular form of OCD, called Pure O, which involves intrusive, horrific thoughts and images of causing danger or harm to others. The shame and guilt that follow cannot be put to rest through physical rituals like hand-washing or counting. Instead, I am left obsessing, silently and almost continuously, incapable of finding conclusive proof that these hideous scenarios won’t occur. And they don’t. But, like other sufferers, I live in fear they might.
I try so hard to think positive thoughts, to act “normal”, but my OCD always wins out. The monster voice is always there – above me, behind me, inside me, always taunting, telling me what a disgusting person I am, planting repellent thoughts in my head. While caring for my dying mother, the thought of smothering her popped into my mind, images of me putting my hands over her chest, her face, her mouth. I was almost sick. What kind of person could have such a thought? What kind of a monster? And if my sister had not been right by my side, I would believe to this day that I had put my hands on my mother’s chest and pushed. Pushed hard, killing her. Even now my sister must keep telling me that I did nothing, keep reassuring me. Over and over. But the relief is only temporary. The doubts and the fears never go away. Never ever.
So I’d have to perform mental rituals to neutralise the fear. I saw evidence of my wrongdoing everywhere; an ink blot on a girl’s uniform, a bloody knee in the yard, a chipped tooth, all my fault, I believed. And though I could not possibly have done any of these things, the doubt lingered.
It’s hard to say when it all started. I was always a little worrier, always wanted to please. And yes I kept my room tidy but nothing out of the ordinary. I had very normal, loving parents, and bar the sudden death of a sibling when I was six months old, there was nothing there that might provoke such high levels of anxiety. Nothing to engender this OCD monster.
I was in my teens at school when it first surfaced. I noticed scratches on a desk and suddenly thought “My God, I did that”. The thought would become so loud, so insistent and I became so abnormally anxious that I’d have to go to the principal and apologise. She, of course, would reassure me that the scratches were probably there a long time, and not to worry. The relief that followed was like some sort of high – sweet but short-lived. The monster inside would tell me I was evil, that I’d hoodwinked everyone into thinking I was a nice person. They would eventually discover my true deviant nature. So I’d have to perform mental rituals to neutralise the fear. And the more I thought about it, the more I fed the monster. I saw evidence of my wrongdoing everywhere; an ink blot on a girl’s uniform, a bloody knee in the yard, a chipped tooth, all my fault, I believed. And though I could not possibly have done any of these things, the doubt lingered. There was no let-up, and every time someone assured me I had done nothing wrong, the stronger the compulsion became to go over that thought in my brain. But I didn’t understand this. I didn’t understand that I had the “doubting disease”, as OCD is known. I just felt different, isolated, always on the brink of a panic attack, but just wanting to be normal, to be a normal teenager.
Then it was time for me to leave school. As long as I can remember, all I wanted was to be a nurse, to be part of that caring profession. And to my delight I got a place. But almost straight away the “What-ifs” started. What if I harm someone? What if I make a mistake and someone dies? What if I leave something inside a patient? An instrument? A needle? A scalpel? My anxiety levels spiked. Thoughts that other people can bat away in the blink of an eye took on a life of their own, rendering me a nervous wreck, every moment in the hospital fraught with the possibility that I could harm someone, put someone’s life at risk. So I quit. Quit the one thing that I loved, and took a secretarial position instead. And the Voice sneered and sniggered in my head: “They would have found you out sooner or later. Just as well you ran.” And I’ve been running ever since. Running on this giant hamster wheel, trying to outrun my OCD, trying to outwit it.
I adore children, I always have. But my OCD turned it into a hell, my own private hell. I saw danger everywhere. Worse still, I was the danger. What if I drowned the children or dropped them? What if I had a sudden whim to suffocate?
Somehow I managed to find someone to love, who, incredibly, seemed to love me back. At first anyway. I tried every trick in the book to banish my inner demon. On the outside, I appeared normal, smiling, funny, a good friend, a good wife. But the monster didn’t leave me alone for long. It convinced me that any good or normal moments I had were just an act. Eventually the mask would slip away and people would see the true unlovable me. When my two children came along I was in heaven, nurturing, caring, mothering. I adore children, I always have. But my OCD turned it into a hell, my own private hell. I saw danger everywhere. Worse still, I was the danger. What if I drowned the children or dropped them? What if I had a sudden whim to suffocate? What if? What if? What if? The worries, thoughts, doubts multiplied. I tried to out-logic them, bludgeon the violent, intrusive thoughts into submission but here’s the rub, trying to fight your thoughts when you have Pure O only makes them stronger. My marriage ended and I was left alone with two small children. Well, not quite alone. My OCD and me. A lethal combination.
But we were like The Three Musketeers, my two kids and me, one for all and all for one. For them, I tried everything; every doctor, every therapy, every counsellor. The first doctor I saw tried to convince me I was a grand girl, “the salt of the earth” – not quite the therapy I needed. So I changed doctor, tried yoga, tried mindfulness, tried everything. But the day-to-day challenges still remained. Driving the children to and from school was particularly fraught with anxiety. I regularly thought I would knock someone down, that I’d deliberately swerve into a pedestrian and kill them. And that thought is so abhorrent that driving is one of the most stressful things I have to do. But also necessary. I have a job, a family, and needs must.
I remember once having a lovely day at the park with my children when they were young. I drove home, each of us singing songs, laughing and having fun. Then I saw a couple walking hand in hand ahead of us and suddenly a thought reared its ugly head in my brain – “Look at them, how dare they be so happy and carefree? I want to knock them down, kill them.” I recoiled in horror at the thought but it kept coming and coming, insistent, intrusive, unwanted. I drove past but heard a small sound, in all probability a stone bouncing off the car, but I became convinced that I had in fact killed them. Completely tormented by the thought and ravaged by guilt, I had to drive back along the route to check if I’d caused any harm. The children, although young and used to my hit-and-run obsession by now, were begging to go home, telling me over and over that I hadn’t harmed anyone, but the compulsion to check continued. And each return journey provided a fresh opportunity for me to think that I may have hurt someone again. And on and on it went. A vicious cycle of mental rituals to keep the fear at bay. So tiring, so debilitating, so pointless. And that evening, when I finally got the children to bed, I sat in my driveway in the dark, throwing pebbles at the car and listening, replicating the sound, trying desperately to ascertain if that was what I had heard. Next morning I awoke, totally exhausted, with a car pockmarked from my nocturnal stone-throwing. And still tormented with the thought, the doubt, the fear that I had injured those innocent people. Every day the thoughts come. Every moment of every day.
I cannot tell you how much of my life I have spent obsessing about these possible scenarios and then compulsively ringing every establishment I have visited, looking for reassurance that I didn’t in fact cause someone’s death. I’ve even phoned police stations, asking them to take me away for crimes I thought I may have committed. Sometimes these thoughts would be so ferocious that it all became too much.
I worry about washing my hands in the bathroom of a café, a friend’s house, a restaurant, wherever. What if I inadvertently let some water drip onto the floor and the next person slips and injures themselves? What if I mistakenly move some cement on a path and someone trips and loses a limb? What if I disturb the corner of some carpet or lino in a shop, a supermarket, a bank, and the next customer falls and breaks their neck? I cannot tell you how much of my life I have spent obsessing about these possible scenarios and then compulsively ringing every establishment I have visited, looking for reassurance that I didn’t in fact cause someone’s death. I’ve even phoned police stations, asking them to take me away for crimes I thought I may have committed. Sometimes these thoughts would be so ferocious that it all became too much. A spell in St John of Gods would follow, where I received counselling, therapy and rest. But even as the therapist explained the nature of my OCD, and even as I write this now, the monster is taunting me – “That’s a great get-out clause for you. Typical. You’re no good, you know that. It’s all an act, even this … ” and the voice goes on and on.
But for me it’s hard to go on. It means nothing when people say. “Cop on, that didn’t happen. You did nothing wrong.” It’s never a question of copping on. And it’s exhausting trying to bat away these horrible thoughts. And all this, while trying to get on with my life. Because I do have a life. I have children, though grown up now, and a mortgage to pay. I have to work, pay bills, keep up the appearance of being efficient and competent. And funnily enough, I know I’m good at what I do, but it takes such an enormous effort just to function at a normal level. I get through the day and all I want to do is crawl into bed, where sleep comes and sometimes a measure of relief.
Medication helps. It certainly keeps my anxiety levels down, although it’s not a cure-all. Cognitive Behavioural Therapy works for some. One of the tools of CBT that can be helpful is Exposure and Response Prevention (ERP) – forcing myself to perform an anxiety-provoking activity again and again until it no longer triggers the surge of anxiety I so greatly fear. Another variant of this therapy is articulating the gruesome scenarios into a dictaphone. I’m encouraged to verbalise my most horrific thoughts, be as graphic and gory as possible, then listen back over again and again until it becomes old news. The thought loses potency, and its ability to alarm and terrify. The repetition soothes and calms, reduces the intensity of the fear. But it’s all so time-consuming, so exhausting. It’s so hard to do all of this just to banish one thought, and then another pops up. For an OCD sufferer nothing is simple. Nothing is easy.
I’ll keep taking the pills. I’ll do my mindfulness. I’ll keep repeating the mantra – Fear is only False Evidence Appearing Real. I have obsessive thoughts. I am not my thoughts. I’ll do it, but I’m tired, and I’d love for one day not to have fight so hard for so little.
A common misconception about OCD sufferers is that we are ungrateful – we just don’t appreciate the blessings in our lives. Nothing could be further from the truth. I thank God every day for my children, who are still loving and supportive, though they have had to bear the brunt of my illness. I thank God for my two best friends who are my saviours, who can make me laugh at myself, who can tell me to put the bad thought away in a box in the attic and sit on it. I can hardly believe that I have had a second chance at love, that I have found a partner who wants to be with me, wants to share his life with me. The Voice is still there, telling me the truth will out. It will all fall apart. I am a hateful person. I cannot be happy. But I’ll keep trying. I’ll keep taking the pills. I’ll do my mindfulness. I’ll keep repeating the mantra – Fear is only False Evidence Appearing Real. I have obsessive thoughts. I am not my thoughts. I’ll do it, but I’m tired, and I’d love for one day not to have fight so hard for so little.