Many of us have habits that make us feel better in some way. Athletes and sports fans, for example, might have special routines that seem to bring good luck before the big game. Others might find satisfaction in a clean kitchen and a shiny sink. But for people who have obsessive-compulsive disorder (OCD), some routines become obsessions that disrupt their lives in a significant way. These obsessions are often accompanied by compulsive behaviours, which are an attempt to reduce the anxiety from those intrusive images or thoughts.
There are different categories of compulsions. Checking compulsions, for example, might involve people checking clocks, outlets, and ovens multiple times. Some people have ordering, rearranging, or repeating compulsions, such as knocking on the door a certain amount of times, or twirling around to undo thoughts or images.
Washing and cleaning compulsions are among the most recognized when it comes to OCD. Individuals who go to great lengths to avoid contamination, such as excessive and repeated washing and cleaning to remove dirt or germs, are often portrayed in TV shows and films.
People with OCD believe that if they don’t do these things, their biggest fears might come true. For example, if their books aren’t arranged in a specific way, their family might die.
So given that we find ourselves in the midst of a global pandemic, are people with OCD facing greater challenges this year?
Yes, and in more ways than one might think.
Gabrielle Eyahpaise was 14 when she was diagnosed with OCD.
“By the time I had become a teenager, OCD had taken over most of my life,” she describes. “I had two safe spots in my house but even then I had to have a blanket around me… it was one chair and a corner of my bed.” She was showering for hours at a time. She remembers lying awake at night because she was so worried about accidently drinking bleach. She’d check her hands to make sure they weren’t wet, monitor her mouth for weird tastes, and sit on her hands. This took up hours of her day.
Dr. Floyd Wood, a psychiatrist at The Royal who also worked in The Royal’s temporary C-PROMPT clinic during the peak of the pandemic, treated a number of people with OCD. Contamination issues, however, weren’t their only concern.
“There are a lot more existential issues coming along right now: existing and being,” says Wood. “With everything going on with social distancing, and with all the restrictions, now there is this impending sense of doom.”
“The people who do have fears of contamination, this is definitely not a helpful situation because leaving the house would result in – what I suspect would be – a lot more precaution than the average person.”
Today, Eyahpaise is a mental health advocate and frequently speaks about her experience publicly. She’s studying psychology at university. She credits Exposure Response Prevention (ERP) therapy with helping her take control of her OCD.
ERP involves exposing yourself to a fear and gradually increasing the “intensity” of it. At one point, Eyahpaise felt tremendous stress about touching her shoes and her compulsion was always to wash her hands afterwards. Her ERP had her touch the shoes and “sit with the anxiety” without washing her hands. Eyahpaise was eventually able to put her shoes on her lap, then on her head. “I think it’s one of the hardest things I’ve ever had to do,” she says.
She wasn’t too worried when news about a novel coronavirus started circulating earlier this year, but then the situation escalated with shutdowns, physical distancing, and instructions from public health to be vigilant about handwashing and the danger of touching our faces. Suddenly there was a lot more to think about as she was leaving the house.
“Part of my rational brain was like ‘ok, you have to wash your hands following the guidelines of washing your hands for 20 seconds’ but there was also my OCD brain that was saying it didn’t feel right and wanting to wash them over again. And then I caught myself.”
It was the same with using hand sanitizer. Eyahpaise found herself questioning whether she was using enough and applying it properly, but at the same time she was conscious about falling back into old habits. “It took awhile to understand what was going on in my brain. Is this OCD talking, or is this Gaby talking?”
“Part of ERP is being okay with the uncertainty,” explains Eyahpaise. She decided that she was simply going to follow public health guidelines and not do more or less than what was being asked.
It’s something she has to be mindful of, every day. Thanks to the ERP, the anxiety doesn’t last very long anymore. “It’s a lot easier to manage,” she says.
Wood recommends that people with contamination compulsions not be afraid to reach out for support, especially given the pandemic. He says it’s also helpful to review and practice skills learned in therapy.
“This is definitely a time to start bringing out the books and starting to learn those chapters and modules over again,” says Wood. “This is a whole different phenomenon, so they may need to start going back to basics. Start practicing, engaging, and trying to not avoid things that can bring on the obsessions and compulsions while also not giving in to the compulsions. Avoidance is one of the biggest issues. Once you start avoiding, that could lead to a slippery slope of further engaging in compulsions and limiting your lifestyle.”
Eyahpaise says that one of the most positive things that has happened to her over these past few months is how many people have reached out to her. She also appreciates what she sees as a greater understanding that everyone is struggling in different ways.
In the meantime, she’s trying hard to remember what she’s learned, and to share those lessons with others.
“I’ve been through it, and I’ll go through it again, but I’m able to manage it in the end.”