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Effective Treatment and Support Available in Christchurch for Obsessive Compulsive Disorder
(This article appeared in 'The Press' on Sat 6 October 2001, by Susannah Hawtin)
Robyn Corner was twenty-eight years old. It was a week before her wedding. The alarm went off at 7.00am as usual. She turned to switch it off, and was immediately overwhelmed by the feeling of dread that had been her constant companion for the past six months.
She went to the bathroom and washed her hands. She stepped inside the shower and started to wash herself, washing her hands repeatedly between washing different parts of her body. Three quarters of an hour later she emerged, gathered up her nightwear and towel and dumped them in the washing machine. Her hands felt dirty again so she returned to the bathroom to clean them. By now her hands were washed red raw so she rubbed in some moisturizer. They didn’t feel as clean and Robyn felt a strong urge to wash them once more. She looked at her reflection in the mirror and told herself not to be so stupid, that she would be late for work again if she didn’t get a move on. But she couldn’t resist the urge. She quickly washed her hands and hurried into the kitchen, kicking the door open to avoid contact with the germ-ridden doorknob.
After breakfast - and several more hand washes - Robyn systematically went from room to room locking and checking all the doors and windows. Finally she stepped outside the house. By now she was already late for work but thought she’d better go back inside and check everything one more time, just to be sure. When this was done, she got into her car and drove down the street. Before she reached the end of the road she wondered if she had locked the front door properly. Back she went and checked the handle five more times.
Robyn had almost reached her workplace when she was suddenly plagued by the idea that she might have accidentally hit a cyclist. She mentally retraced her steps. She remembered driving past a few cyclists but certainly didn’t notice that she had hit any of them at the time. However, just to be on the safe side, she decided to drive round the block again. It came as no surprise when she didn’t see any injured cyclists lying on the road and she cursed herself for giving into such an irrational idea.
When Robyn finally pulled up outside her place of work she looked at her watch and saw that, yet again, she was unacceptably late. Work started at 8.30am not 10.30am.
Robyn was diagnosed as having Obsessive Compulsive Disorder in 1994. Her diagnosis came as a relief. At least now she knew she wasn’t going crazy and that the behaviour that had inexplicably taken over her life had a name and was treatable. While her family was generally supportive she said the majority of people didn’t understand. “A lot of people around me were shocked but felt I should just get over it, they couldn’t see any logical reason for the behaviour or the distress.”
Obsessive Compulsive Disorder is a common illness. Between two and three percent of the population have OCD. It is characterised by recurrent, unwanted and unpleasant thoughts (obsessions), and/or repetitive, ritualistic behaviours, which the person feels driven to perform (compulsions). People with OCD know their obsessions and compulsions are irrational or excessive, yet find they have little or no control over them.
Typical obsessions include incessant worries about germs, contamination, infection, recurrent thoughts that something has not been done properly, fears of losing something of importance, feelings that certain things must be always in a certain place, position or order. Obsessions are often repugnant to the sufferer, and may involve themes of harm, for example fear of having run over someone with a car or harming a loved one.
Compulsions are strong urges to do something to reduce anxiety or other discomfort from obsessions. Typical compulsions include washing (particularly hand washing), cleaning, checking, touching, repetitive actions, counting, arranging and hoarding.
The exact causes of OCD are still unknown. However, researchers strongly suspect that a biochemical imbalance is involved. Recent genetic studies, coupled with work on neuro-chemical abnormalities in people with OCD, have suggested that there are inherited abnormalities in neurotransmitter functions. While most of the abnormalities point to the neurochemical, serotonin, other neurotransmitters may be involved. Additional research has implicated specific regions of the brain in the causation of OCD symptoms. Psychological factors and stress may heighten symptoms.
Effective treatment for OCD is available in Christchurch. In the Public system the Anxiety Disorders Unit is the main treatment provider for adults aged between 18–65. Children and adolescents with OCD symptoms are referred to Youth Specialty Services and the Child and Family Service. These teams are part of Canterbury District Health Boards. To access this treatment a person must first get a referral from a health professional such as a GP or counselor. Treatment is also available by some private practitioners.
Ron Chambers, Senior Clinical Psychologist from the Anxiety Disorders Unit, says, “Treatment for OCD involves Cognitive Behavioural Therapy (CBT) and sometimes medication.” CBT involves getting the patient to identify their obsessions and rituals and educating the person about the nature of OCD. Ron says that “people become so distressed by their obsessional thoughts that they typically feel that the only way they can respond to them, to reduce their distress, is to do a ritual such as washing, hoarding etc. Performing rituals inadvertently strengthens the hold that obsessions have on people and the likelihood that they will continue to perform rituals.”
The next step in the treatment process is called Exposure and Response Prevention. This is aimed at getting people to reduce and then stop their rituals. It involves building up a systematic picture of what triggers off their rituals and getting them to confront these triggers or situations, while resisting the urge to do the rituals. Ron says, “If people can learn to resist their urges long enough, while they tolerate their anxiety, then over time their anxiety and distress will diminish. Consequently the urge to perform rituals will decrease and the ability to resist performing them will increase.”
Studies demonstrate that these Cognitive Behavioural interventions significantly reduce OCD symptoms. OCD sufferers can now feel there is hope where there was once only despair. Treatment however is not easy, Ron points out, because, “it involves confronting obsessional thoughts and resisting the urge to do rituals. If people persevere they generally achieve good results.”
Medications, which can be effective in the treatment of OCD, include the following antidepressants: Clomipramine, Fluoxetine, Paroxetine and Citalopram. These drugs have anti-depressant benefits as well as being helpful in the treatment of OCD. There are also a number of other drugs, which may be used if OCD symptoms are persistent.
Robyn has suffered occasional relapses of OCD but feels that these relapses have become less intensive because she can recognise the symptoms early and put into place the strategies learnt in therapy and through personal experience. She firmly believes in a holistic approach to treatment, which includes CBT, medication, relaxation techniques, meditation, personal development, exercise and a healthy diet. Robyn also finds art and writing therapeutic tools. Robyn is convinced her life would have been “pretty miserable” if she had not sought treatment for her OCD. Robyn acknowledges that the OCD contributed to her relationship problems and eventual separation from her husband, as well as necessitating her resignation from several jobs over the years. While feeling a sense of sadness for the toll the OCD has taken on her life, she says she generally feels positive about the future now. She hopes that through her art and poetry she can give hope to others.
Ron recommends that clients attend the OCD Support Group after treatment. The group meets once a month and provides a safe place for people with OCD and their families to share common ground, information and support. A Coping With OCD Forum is held before the main meeting. This is a chance to discuss OCD and its treatment with a specialist from the Anxiety Disorders Unit.
Robyn, who is now the Co-Chairperson of the Obsessive Compulsive Disorder Support Group in Christchurch, says, “One of the first things that hit me when I came to the group was how comfortable I felt in the room. I didn’t feel anyone would judge me and tell me to get over it or look at me because I was doing something unusual. I felt relaxed very quickly.” She says she was excited about the potential to develop a support network for herself without relying on mental health services.
Robyn says the most important thing a person can do to help people with OCD is to give them unconditional love and encourage them to seek the help they need. Without support and treatment people with OCD may be disabled for life.
Education Liaison Officer
OCD Support Group |
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Aug/Sept 2008 OCD Newsletter