30 March 2015

Anxieties past

When a new worry grips me, it not only wipes out any happy thoughts and positive feelings, but all other current concerns, which suddenly seem to pale into insignificance. How could I have been so bothered about those things, when now I have this to deal with?

The reality is that this is frequently no more than speculation or dread about something that might happen. So it was when I became obsessed with the idea that my kitchen radiator would spring a leak. 

It began when I was on my hands and knees, mopping up a wine spillage, and spotted a dot of rust on the bottom edge of the radiator. Peering underneath, I saw that this ran along a whole section of the rim.

My heart started pounding. It was as if the rust had just appeared before my eyes and was spreading like wildfire. I tried to tell myself it was nothing: it had probably been there for ages and was just on the surface. I rubbed a finger over it and while the skin did, indeed, turn orange, there was still rust visible on the metal. How deep did it go?

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Pictures formed in my mind of it creeping between the two welded edges of the radiator. Creeping up and up until it split them apart and water poured out. Every time I entered the room, I looked for puddles on the floor. Even when I found none, I felt compelled to touch the bottom of the radiator, to be sure it wasn't dripping. 

And so a new anxiety had mutated into a new obsession that had led to a new checking compulsion.

Fortunately, my plumber was due to visit to carry out a non-urgent maintenance job, so I took the opportunity to ask him if I should be concerned. Reassurance seeking is common in OCD sufferers, but ill-advised; the reassuring effect is usually temporary and fails to satisfy the disorder's demands for absolute certainty. However, there was a chance that an expert assessment - if positive - might calm me down.

He glanced at the radiator. 'It looks brand new.' He was clearly bemused as to why I should be worried.

'It's under here,' I explained, crouching down and touching the lower edge...and then I felt it - water! 'Oh no, why is it wet?' I looked up at him, panic-stricken.

'It'll just be condensation,' he said. 'Have you had the window open in here today?'

'Er no...and I did two lots of washing, which made the room quite warm...and I haven't had the heating on.'

He shrugged. Warm air plus cold metal could only have one outcome. 

I felt foolish for even asking the question, but his response did enable me to bring my checking to an end, albeit gradually over a number of days. 

Months on, I can walk into the kitchen without thinking about leaks at all and wonder how that ever became such a huge concern. Of course, a succession of other, equally pointless worries have been and gone in the meantime. If I could only fast forward to a position of hindsight every time a new one surfaces, life would be a lot easier.

23 March 2015

In the beginning

Many children adopt habits that mimic OCD behaviours, but are unrelated to the condition. For example, several parents, on hearing about my ordering compulsions, have worriedly told me that their child insists on lining up toys in a specific way. 

This type of ordering is, in fact, very common, part of normal child development, and one of a number of recognised 'schemas' - patterns of repeated behaviour. It's understandable, though, that parents might become concerned about this kind of activity.

It's equally understandable that they might miss signs that could actually be a precursor to OCD, or other mental health disorders.

During my childhood and adolescence, I engaged in a number of behaviours that showed a tendency towards OCD, perfectionism and generalised anxiety, including health worries.

For example, I had designated positions for the ornaments in my bedroom, which I'd established according to what 'felt right'. When my mum dusted, she'd knock them out of place, which left me feeling extremely uncomfortable. Before I could do anything else, I'd have to restore order, by angling all my knick-knacks correctly again.

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An early indication of my perfectionism was that I wasted hours over the presentation of my schoolwork, which had to be immaculate. Rather than cross out errors in my homework, I'd rip out the offending page and rewrite the whole thing - providing this was in the first half of the exercise book, so that I only sacrificed a blank page on the other side of the staple. Needless to say, I had a lot of very thin books.

However, if I'd gone past the halfway point, I'd have to use correction fluid instead. This was a satisfactory solution, so long as, a) it hadn't gone lumpy, and b) I let it dry properly before writing on it. Otherwise, I had to resort to Plan C: glueing a clean piece of paper over the whole mess. By the time I handed in my work, it often looked like an arts and crafts project.

As for my anxiety, one incident stands out amongst many. After watching a film in which a woman found a lump in her neck that turned out to be terminal cancer, I spent a sleepless - and tearful - night convinced that I had a lump in mine. Actually, I did, and I still do: it's a muscle that pops up if I turn my head a certain way!

In fact, my OCD didn't fully manifest until my late 20s and it would have been impossible for anybody to join the sparse - and mostly hidden - dots when I was younger and realise the direction my mental health might take. All that these clues showed was a possible genetic predisposition, which is just one of a number of factors that can contribute to the development of the condition.

And, in those days - the 1970s - there was limited awareness of any kind of mental illness. At least now there is more knowledge, more openness, and a better chance of parents, teachers and health care professionals identifying youngsters with a potential problem. The situation isn't perfect, but it's better than it was, and work continues to make it even better.

* * *

Help for under 25s with OCD, and their families and friends, is available from the OCD Youth network, which is a branch of the charity OCD Action.

16 March 2015

Normal life

'The only normal people are the ones you don't know very well.' 

I love this quote from Joe Ancis *, and the idea underlying it, ie that nobody is 'normal', is a theme in my novel.

Those of us with diagnosed mental health conditions are frequently viewed as 'abnormal' and have to endure the stigma that goes along with the medical labels we've acquired. Yet how many people behave in ways that are every bit as strange as, say, an OCD sufferer's compulsions, without being subject to the same prejudice or ridicule?

Everything we experience in life can potentially affect how we act in future, and sometimes those experiences contribute to the development of a recognised mental health condition. Often, though, they damage people in a less clearly defined way.

Let's say, for example, that you find out your partner has been cheating on you and you never get over that breach of trust. As a result, you develop a fear of commitment and sabotage every prospective new relationship.

Or perhaps your parents were so frivolous with money that they couldn't meet their mortgage repayments and lost their home. You respond by hoarding money, depriving yourself of life's pleasures and driving others away with your meanness.

We don't view trust issues or being tight-fisted as mental illnesses, with all the associated negative connotations, but this kind of problem can lead to odd behaviour that is just as detrimental to the pursuit of a happy life. 

Of course, we're all on a spectrum - hence my novel's title, The A to Z of Normal - but it's surely impossible to say definitively where the 'normal' end lies? 

Some behaviours may seem so beyond the pale that there can be no doubting their abnormality, but even then, cultural differences may come into play. What is normal in one society may be shocking in another. Who's to decide what's right?

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And if 1,000 people do something, is it normal? 10,000? 100,000? Recent history is proof that even if a given attitude is widely held, or a particular behaviour is common practice, that is no guarantee of their wider acceptability.

The absence of a recognised mental health condition is no proof of a person's so-called normality either. Labels may bring stigma, but they're both inevitable and useful, as an accurate diagnosis will help to determine the best course of treatment. Not having a label, though, is no guarantee you're 'normal'!

* * *

*Joe Ancis was a comedian who was apparently too shy to perform stand-up himself, but a major influence on Lenny Bruce and others.

9 March 2015

Mirror mirror

Most of us are probably unhappy with some aspect of our appearance - for me, it's the bump in my nose and the ridiculously narrow shoulders that mean clothes don't sit properly and I'm forever hitching up handbag and bra straps. The majority only think about such 'flaws' occasionally, though; any discontent is transient and has no significant impact on day-to-day life.

For those with Body Dysmorphic Disorder (BDD), however, concern about their looks may be so great that it prevents any kind of normal functioning. 

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BDD is an OCD related condition in which sufferers are preoccupied with one or more elements of their appearance. This preoccupation is usually with a non-existent 'issue' that others wouldn't notice - though it can also be with something normal, like male pattern baldness - but which makes the sufferer feel ugly or unattractive.

As a result, they engage in rituals, such as repeatedly checking themselves in the mirror, or take measures to conceal the perceived defect - wearing shapeless or heavy clothes, or applying thick make-up. Some even resort to unnecessary cosmetic or dermatological procedures. They may also restrict their activities, to avoid being seen, possibly to the point of becoming housebound.

For a diagnosis of BDD, this preoccupation needs to occupy at least an hour a day and to cause significant distress and/or interfere with ordinary living. It's not a question of vanity; sufferers genuinely believe they are ugly or somehow defective. The problem can be so serious that some are driven to suicide.

About 10% of people diagnosed with OCD also have BDD, but research is still needed to identify its causes. It's unclear, therefore, how much cultural influences may contribute to its development.

Recent editions of the Channel 4 documentary series Bodyshockers have made me wonder, though, whether as a society we aren't steering whole generations onto a path that might lead to this condition.

The programme follows people who have had their bodies modified by tattoos, piercings or cosmetic surgery. Those who regret these modifications, and want to reverse them, are introduced to others who are contemplating similar work.

One show involved a girl in her early 20s who was obsessed with the size of her breasts. The fact that they were - in her eyes - too small was all she could think about and she was determined to have augmentation surgery. Her mother was devastated at the prospect - and uncomprehending, as she had tried to bring her daughter up to understand that there were more important things in life than looks. Unfortunately, all of the girl's closest friends had undergone the same procedure, making it the norm and her the odd one out.

In another show, an 18-year-old girl obsessed with taking selfies had filler in her face to make her eyes less baggy. Yes, at 18. I would have laughed, if I hadn't felt so much like crying.

Our increasing obsession with looks is leading more and more people to have unnecessary procedures and surgeries, and it's hard to imagine how we might ever turn the clock back on this disturbing trend, which has already caused so much mental and physical damage.

* * *

You can find out more about BDD from the Body Dysmorphic Disorder Foundation.

2 March 2015

100 not out

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Today's post is a landmark one, as it's the 100th weekly piece I've published since launching The Reluctant Perfectionist early in April 2013. And, ironically, it's actually my obsessive nature - and my associated love of rules - that I have to thank for this consistency of output.

Emily Benet's blogging workshop got me started and one of her tips was to decide on a sustainable frequency of posting and stick to it. I was working four days a week, so settled for weekly, on my day off, ie Monday. 

As the weeks and months passed, and I published post after post, that decision became a rule set in stone. Never mind not missing a week, I could not, whatever happened, publish on a different day.

My blogging platform's scheduling facility allows me to plan around events that might divert me, by setting up posts to publish in my absence. Last year, I was able to blog through holidays, celebrating my boyfriend's birthday and even an operation. I do sometimes wonder, though, whether this facility might, one day, result in a piece appearing posthumously... 

Those of you who receive posts by email might, by now, be thinking 'Hold on, I sometimes get mine on a Tuesday'. This is because the mailing software looks for new content around lunchtime every day. If I post later than that, I miss that day's 'collection'.

When I realised my 100th post was coming up, this became a new goal that I absolutely must not miss. As it got nearer, I grew more and more nervous that something insurmountable would intervene to stop me - like a runner who has trained for months for the London Marathon, only to sprain an ankle two days before the race.

The way I administer my blog reflects other aspects of my personality, such as my need for control and certainty. 

I keep meticulous records, including a spreadsheet where I log my weekly word count, with formulas to calculate the annual and grand totals and also average post length, both annually and overall. This may seem pointless, but it's somehow reassuring to have these facts to hand - perhaps any crumb of knowledge is a comfort to those of us who crave certainty. Incidentally, I've written 50,722 words worth of posts...the equivalent of half a novel!

My filing system includes electronic copies of all posts and accompanying images, screen grabs of every blog page, and a back-up of the design template. This all, supposedly, provides a fail-safe system in the event of my website suddenly disappearing off the face of the internet. In reality, I could never recreate the entire content, even with all of these tools at my disposal; it would take far too long. Nevertheless, having an emergency plan in place makes me feel better. Control, control, control - it's all about control. 

Still, whatever happens in the future - whether my blog disappears or I do - nothing can take away the fact that I made it to 100 posts. Now, where has that celebratory card from the Queen got to...?