Writer and illustrator Helena Tarrant on growing up with Obsessive Compulsive Disorder and anxiety, the steps she took to deal with them and how she’s now feeling better than ever
‘I was seven years old and lying in bed, worried that I hadn’t trodden on a piece of grass embedded in the pavement. I got really distressed because I couldn’t go back and tread on it,” UK-based illustrator and cartoonist Helena Tarrant recalls. This was the first time she knew something wasn’t right, but it would take years, until Helena was in her late 20s, for her to get a diagnosis of OCD.
“I realised other people found things much easier than I did, and didn’t worry so much. OCD wasn’t in the language as it is now, people were still not so aware.”
Now 58, when she was a small child, Helena’s family knew about her worries but were occupied with her brother, who is autistic. Also, she points out, the invisibility of OCD and the lengths to which sufferers will go to hide their symptoms, meant they didn’t realise the extent of the issue.
She adds: “I told my mother and she was very sympathetic, but they didn’t know what OCD was, and kids that age always have funny little obsessions and rituals of their own so it wouldn’t have been distinguishable.”
Her best friend knew about her compulsions. “She actually gave me really effective treatment, although neither of us knew it. She would either laugh at it, not in a nasty way, or she wouldn’t pay attention to it, again in a nice way. She would say, ‘Oh you can stay locking the door, I’m going to walk to the bus’.”
Helena’s book, Beating OCD and Anxiety: 75 Tried and Tested Strategies for Sufferers and their Supporters, with illustrations by the author, documents her story, as well as offering multiple tips for dealing with OCD. She now considers herself in recovery. “It’s been hell, until I started to recover.”
For years, she was plagued by obsessive thoughts, often around contamination. “Once, in the office, I was washing up cups and I had to keep washing and rewashing because I was afraid I would leave contamination on them. Even if one particle of contamination was left on them, someone might drink out of it and get cancer. Now, I know you can’t get cancer in that way, but OCD skews logic in an extraordinary way.”
Her OCD impacted every aspect of her life, socially and professionally. “It makes you very intolerant of uncertainty, so you’d be very risk averse, or have a very magnified sense of danger.
“When it came to career choices, it tended to make me very careful, to the point where I would turn down very good jobs and opportunities.”
An assumption of possible negative outcomes, and catastrophising, were her default modes of thinking.
She says: “I didn’t take opportunities and it really messed up relationships and friendships. I tended not to seek them. If you’re indulging in OCD behaviours, like checking the door 15 times before you go out, why would a partner or even a friend put up with that?
“If I got a job offer, I’d be thinking, ‘Well if I take this job, this office has a lot of windows and I’ll be 45 minutes every time I leave the office on my own closing the windows and checking they’re shut’.”
Eventually, when Helena was 27, she talked to a co-worker who worked in the mental health area. “I just burst into tears because I couldn’t cope with whatever it was, and she said, ‘Look you need to get help with this’. I realised I had a condition that could be treated.”
She went to her GP, who referred her to a mental health unit for talk therapy. “I realised after the first session that I didn’t think this would help,” she says.
She returned to her doctor, who referred her to an institute of psychology in London for cognitive behavioural therapy and exposure therapy. It was so effective that some results started to show within two weeks — although others would take a year.
“I had a ritual about washing my hands after going to the toilet, which is very common. So he said, ‘Right you need to go to the toilet now, and wash your hands, but I don’t want you to wash them 15 times, I want you to wash them 12 times’. My homework for that week was to wash my hands only 12 times, then try to reduce it gradually.
“It’s a bit like learning a language. You get better and better at it. If you’re under stress or a big life event, it can go a bit off, even good life events like having my son or starting new relationships.” Because of this, she has returned to therapy several times.
“OCD gives you a hugely exaggerated view of your own responsibility,” Helena explains. “So you think, if I don’t wash my hands, I’ll contaminate someone.
“When it comes to rechecking, you’ve done it multiple times, but it’s as if your brain doesn’t clock that. It’s really like you’re starting again, and the more it happens the harder it is to get away from it.”
Exposure therapy forces you to gradually, rather than cold turkey, sit with the discomfort of not repeating a behaviour. “It felt awful,” Helena smiles wryly. “But then the feeling gradually subsides, and you get over this hump of anxiety.”
Helena had also suffered from general anxiety disorder (GAD). She says: “GAD is when you can’t feel relaxed ever; you’re always worried about something.”
Where OCD fears might be detached entirely from reality — Helena gives the example of worrying you might have run over somebody, based on nothing — GAD fears seem more normal.
“As soon as you got rid of one fear, another will crop up. In a way you’re looking for anxiety.” She recalls someone in her therapy group describing anxiety as her “default position”.
“Although it’s terribly distressing and horrible, it’s what you know, so it’s your comfort zone. You have to force yourself out of it. When the therapist first suggested to me, ‘Perhaps you’re looking for anxieties’, I said, ‘What, how dare you?’” Helena realises now that her therapist was correct, and now calls it anxiety fishing.
“One of the things I felt I was doing was, I thought I didn’t deserve as good as a life as everyone else, and so that led to me having to be distressed.”
Helena knows this is a condition she will be dealing with for the rest of her life. “You can manage your OCD or anxiety through therapy and management techniques. You have to listen out for alarm bells and keep on top of it.”
Her son is now 22. She also recalls worrying excessively about germs when he was a baby. She says: “OCD seems to exaggerate any worries you have anyway. It will hugely exaggerate when it comes to your loved ones, particularly your children.” However, she is quick to point out that her OCD did not impact her experience of motherhood with a young child as much as she had thought it might.
“If you’ve got OCD, you can’t anticipate what worries you’ll have, you just have to go ahead and do it. I mean, there were things that didn’t bother me at all,” she adds.
Helena explains if someone suffering from OCD comes to you seeking reassurance, then it is actually unhelpful to give it to them. “It reinforces the cycle and the behaviour,” she says. “It’s a temporary relief, it doesn’t actually get to the underlying problem.”
Instead, they can encourage you to do a distraction technique. Helena told her partner about her OCD when she knew the relationship was getting serious, even though by that staged she had recovered. “You can’t really keep OCD separate. When you’re stressed, it’s suddenly going to come out. You might start having what seem to your partner to be irrational worries.”
The difference between how she felt in her 20s, and how she feels now, is something she would not have thought possible, she says.
“When you’re in the throes of OCD it’s difficult because you can’t get away from it. It’s like a bumble bee in your head. When you’ve recovered, it’s still there, but instead of a huge bumble bee, there’s a tiny little fruit fly in your head. You can’t always see or hear it; it’s not affecting everything you do. You’re in a state of constant distress if you are in the throes of OCD. When you’ve recovered, you’re not.
“I feel fabulous now. I feel a lot better than I ever though it was possible to feel when I was younger. My life was turned around completely.”
Jackie O’Kelly, psychiatric nurse and cognitive behavioural therapist, cbt-ireland.ie, gives the following advice on OCD:
⬤ Recognising childhood OCD is complicated by the fact that it can resemble normal, temporary fears and compulsive behaviours/habits. Most children will experience short phases of this. The difference with OCD is the duration and degree of distress but the similarities can lead to the problem being overlooked.
⬤ Children can experience the same obsessions and compulsions as adults but a common childhood obsession is something “not being/feeling quite right”, for example with clothes, the feel of a seam in socks or the rub of a label.
⬤ There are a range of categories of obsessions. Obsessions are recurrent, unwanted thoughts that cause high levels of fear and distress. With aggressive obsessions there may be the fear of losing control and unintentionally harming oneself or others. Contamination obsessions may involve the fear of becoming ill or being responsible for making others ill. Sexual obsessions may involve unwanted thoughts about being a paedophile or having sexual feelings that don’t sit with the person’s own sexuality. Superstitious obsessions include lucky/unlucky or good/bad numbers or colours. Religious or moral compulsions may involve high levels of scrupulosity or conscientiousness. The last of the main categories would be about order, wanting things in exactly the right place or symmetrical.
⬤ Compulsions are actions or behaviours that seek to gain relief from the discomfort caused by the obsessional thoughts. The problem is that the relief is only temporary. The thoughts happen again, the feelings return and therefore the person with OCD will feel that the behaviours have to be repeated, creating a vicious circle.
⬤ Reassurance seeking, checking or repeating things until they feel right, excessive washing/cleaning and avoidance are common examples of compulsions.
⬤ The treatment of OCD initially requires appropriate psycho-education from somebody who really understands the disorder. In the case of children, family members may need to be involved in this. CBT, more specifically exposure with response prevention is the recommended/evidence-based approach and can be combined with medication if necessary.
Beating OCD and Anxiety: 75 Tried and Tested Strategies for Sufferers and their Supporters, by Helena Tarrant, published by Cherish Editions, €10.99, amazon.co.uk