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Friday, 27 July 2012

Jon Richardson and OCD

Just some thoughts on Jon Richardson's excellent Channel Four programme on Obsessive Compulsive Disorder this week. Jon did a great job investigating the problem of OCD; coming at it from the perspective of someone living with mild obsessions and compulsions himself. Diagnostic tests towards the end of the documentary suggested his difficulties were not sufficiently severe or distressing to attract a clinical diagnosis of OCD. But his experience of what he called 'quirks' gave him a great deal of empathy for those who did live with the disorder in its severe and debiliating forms.

Jon interviewed three individuals living with the disorder and it was distressing to see the torment these individuals were experiencing. First of all Jon met a young man, aged fifteen, whose life was becoming increasingly populated with obsessions and compulsions, expressing themselves as rituals about where and how he placed his feet and how many times he touched things. He perfectly expressed the bind at the heart of his OCD: 'If I don't perform the rituals then I experience distress that leads to more rituals and more OCD'.

Another person living with OCD was unable to let Jon into her home. Her OCD showed itself as a fear of contamination and to ward off the fear of inhaling dust and being 'permanently contaminated' she cleaned and cleaned. One of her rooms was sealed and dust free. Her partner was on the point of leaving, unable to cope with her relentless pursuit of safety through cleanliness.

A third visit was to a women who lived with OCD, ordering her life to prevent dirt and dust entering her home. When she or her husband entered the house they each showered and changed their clothes. This preserved the inside of the house from contaminants and allowed her some peace of mind. Further tragedy was revealed when she began to tell the story of her son. A truly gifted engineering student so tormented by obsessions and compulsions that he poisoned himself to death by blending twigs and leaves from a Yew tree and drinking the result. It was a sobering thing to see obsessive compulsive disorder on the death certificate. Sad to see the grief as she carefully removed her son's suicide note and other documents from its dust free folder. She regarded OCD as a blight on the family.

There is evidence of OCD being inherited, with early onset at age seven and late onset in the early twenties. Jon talked about his perfectionism, and his mother commented on the delight Jon experienced when book shelves were orderly. Perfectionism certainly seems a character trait associated with OCD. But Jon and the people he visited sometimes linked OCD with stressful, even traumatic experiences.

So it seems some individuals are susceptible to OCD. Risk factors including genetics, personality traits, and environmental factors, such as whether or not other family members have OCD. Then there are triggers - stress and distress. OCD's positive intention is to manage the resulting anxiety, setting in train a self-maintaining system of obsessions and compulsions with the potential to take over an individual's whole life and being.

Jon Richardson's programme left one feeling a bit hopeless. Each visit ended with Jon more aware of how debilitating the disorder can be. The hospital he visited used medication and exposure and response prevention to treat very severe cases with an 80% recovery rate. That was more hopeful; another programme showing how people recover from OCD would be most welcome.

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