So where was I? I ended my last post by describing where I had got to at the beginning of this year. I had just been discharged from CBT for the second time and had a fabulous new toolkit at my disposal. I felt better than ever about my OCD. All the work I had done made me feel like I had most areas covered. If thoughts of harming others ever came up I was not bothered. If health fears arose I could challenge them with ERP techniques. If existential trauma broke out I knew I had to intensely leave it alone. These could all be termed as ‘classic’ OCD themes. I legitimately felt like I had an answer for all of them. Yet the aforementioned (in previous post) psychological banana skin was not far away.
I am in my first year of mental health nurse training so January was significant because I had my first practical placement. I was naturally looking forward to this next chapter in my career. Within a couple of weeks I unfortunately started to struggle. The placement was in a hospital on a surgical ward, a setting I had no experience in. The whole thing brought stress levels back up to a place they had not been in years. Within one month of being discharged from CBT, my anxiety was shooting back up. I started to question my career choices as a whole. This questioning, especially prolific late at night, then led to questioning about other topics. Old ones with a familiar tone. The odd health fear, a worry that I had contaminated patients on the ward, “Why do I do anything?”. Shit it’s happening again…
Something my therapist had mentioned in our last session was playing on my mind. Along with the congratulations and best wishes she had given me a gentle warning. That this was a cruel disorder and can come back. Especially at times when you are feeling your most vulnerable. A lot of the support forums and online information offered a similar grim message. The word “chronic” is so often used in association with OCD. I suppose it was natural therefore that in February this year a new theme became “Will OCD always ruin my life?”. I reasonably feared that this monkey would never be off my back. Life would always have times of stress. Would OCD always be around to compound my heartache?
I called my GP and they concurred that it is at times like this when sufferers must do their best to “manage” their symptoms. They said to do my CBT work or take up their offer for more medication. I was gutted. I had just done the best treatment of my life and things were falling apart again. University signed me off placement for a week because I couldn’t sleep. I felt low.
One morning I woke up with a strong sense that I was missing something. I could not just accept that things would always be like this. A part of me still believed it did not have to be this way. I went on Youtube and typed in OCD. I came across a guy called Mark Freeman. Within 10 minutes, or about two of his videos, something clicked. Mark’s message had a strong impact on me for many reasons. For one, he has a clear and infectious belief that recovery from OCD is possible. This conviction is vital to hear for any doubtful sufferer. His positive and jovial nature is also the perfect foil to OCD’s weary cynicism. Despite this positivity the videos do speak realistically about what is necessary to get better. It is not easy. All areas of your life most likely need to be addressed. And you need to keep practising good habits to stay well, just as you do with your physical health if you want to stay fit. This made complete sense to me. I was ready to “build great mental health”.
Possibly the biggest lesson Mark has taught me is to closely re-address my relationship with uncertainty. His view is that OCD is really about a poor relationship with uncertainty in all areas of the sufferer’s life. As soon as I looked at my own examples it dawned on me quickly that I have always interacted with the big U quite dreadfully! “Themes” had simply arisen when I could not digest the uncertainty in a part of my life that was important to me. I could not 100% prove that I was not capable of hurting people. I could not be certain that I would not die in the next 24 hours. I could never provide a formula that could make myself certain that things mattered to me. This all was beginning to make sense…
Towards the end of the first video I have provided below you will see Mark urging the viewer to “give bug hugs” to all uncertainty that week. This is what I did. The exercise showed me how often I had been trying to avoid, control and deny uncertainty. Day by day, hour by hour, I would come across uncertainty and try to do nothing with it. This was really tough but I relished the challenge knowing how healthy it was for me. Like how a runner enjoys the burn of that uphill struggle, it was exciting for me to see how much my mind wanted me to fix an uncertain feeling, but then to deny that. In that first week or two I interestingly experienced what some people call “recovery headaches”. These are common if you are incessantly denying your brain the actions it has ordered you to do for so long. It feels as though your brain is literally changing, for the better. They were the best headaches I have ever had!
Of course these exercises were most striking when it came to my main themes. This came as no surprise and the embracing of uncertainty in these areas was so useful. What struck me most was the all the other little bits. Mark hits home the point that overall uncertainty intolerance is the problem and you need to “practice” challenging it again and again. A common example would be in social situations. If a friend said something that sounded a little “off” I realised that for years I would have had to think of many situations when they had spoken kindly towards me or given me praise, to convince myself they still liked me. In these recovery weeks I therefore had to say myself “Maybe they don’t like you anymore” and be okay with that. In the past if I went to work and felt like I had acted too rushed when speaking to a work colleague maybe that would tip them over the edge and lead them to commit suicide. So I would say “Yes maybe what I have just done could be the catalyst for individual disaster” and then sit with that feeling. In years gone by if I was having a good day, pleased with my accomplishments, I would have a thought of “Maybe I am only nice to people to convince myself that I am not bad”. And so now I agree with that and any resulting horrible dread!
What I have learnt from these beautiful simple exercises is that life is uncertain in so many ways. But I can live with that and I am actually okay with it. I now know that I can have a day when my worst possible fears are screaming at me that the world is about to end and it is all my fault, but accept these terrors and do things that make me happy anyway. In fact because I am okay with that happening it actually means that those days do not occur very often anymore. The Buddhist monk Thich Naht Hanh states “Those who learn to suffer, suffer much less”. For me hugging uncertainty is all about learning to suffer healthily and hence being able to just get on with life. We spend so much time trying to eliminate what could happen that we end up not just doing what we want do. I now accept fully that it is possible I could hurt someone. I also know there is a chance I could die at any moment. And maybe everything I do believe in is bullshit? But because I do not try to change those fears anymore, I am free from their traps. This is why this blog is called OCD Choice. Because now I can choose how I interact with uncertainty. I can deny it and perform loads of compulsions. Or I can embrace it and live my life. Essentially I can choose whether to practice OCD or to practice being healthy and happy. Two people who do well to articulate these points are featured in the videos below. Thanks for reading everyone. Go on, give it a hug!