OCD and Christmas

Medical Reviewer

I start with a confession, this Sharepost only loosely associates OCD with Christmas. More accurately, it's about a memory I have, which faithfully, you might say obsessively, presents itself every year about this time. This is about Jack (not his real name) my introduction to OCD and a few things I've learned along the way

I first spoke to Jack through a closed door. Our negotiations took quite a time but eventually he let me in. Once inside his home he insisted I turn around three times one way, then the other. I complied. I walked passed a neat row of chairs and got as far as the kitchen where a column of dishes, arranged according to size, were in the middle of the table. Then he found it all too much and told me to leave. Jack was later admitted to the hospital, which is where we got to know one other. Given our age differences at the time I think it's safe to say Jack will be long gone.

I remember being fascinated by Jack's obsessions and rituals. Jack had previously worked in accounting and the level of detail and attention required in his job seemed to feed its way into his obsessions. Jack first came to our attention following a series of driving accidents. He began to fixate on number combinations that, when added, came to 13. Any vehicle owner unfortunate enough to have that licence plate combination, was quite likely to be bumped. The reason for this was Jack's associated compulsion, which was to close his eyes and count to 13 in order, he said, to counteract the effect.

During his time at the hospital the full extent of Jack's OCD became more apparent. Without going into too much detail it involved umbrella's, the underside of footwear, groups of three people, pouring liquids with the bottle label down rather than up, and a host of others including those commonly associated with OCD such as washing, organizing, listing and grouping. I was quite pleasantly surprised at the tolerance shown to Jack during the first few days after his admission. He would frequently require patients to turn in circles, change hands when drinking from cups or get them to stand in a line. He would also frequently bump into people and knock things over because he was walking around with his eyes closed.

After a couple of weeks Jack seemed more settled. During lunch we were chatting amiably when a visitor walked in and sat down. It was then I realized how sensitized I had become to the things that preoccupied Jack's thoughts. The visitor sat beneath the large wall clock and was leaning on an umbrella. For a moment I saw things through Jack's eyes: it was a perfect storm. It was 1 p.m., so the clock hands pointed to 12+1, there was the umbrella and the legs outstretched showing the soles of his shoes. Jack made a noise and rushed towards his unfortunate victim. My intervention was about as useful as a chocolate teapot. The poor visitor repeatedly stood, sat, and turned in circles, all the time Jack pleading for him to do more. Finally, with a little help from a colleague, we were able to calm the situation.

It's nice to think that our learning should be a happy and fulfilling process but the reality is that we learn in many different ways. This was my introductory lesson to OCD and so much more vivid and emotional than any book could convey. Since then I've come to understand that Jack had some fairly extreme symptoms that didn't seem to respond to intervention. However, this was also during the 1970s when the prognosis for OCD was fairly poor and treatments limited.

I last saw Jack on a Christmas Eve. He was deemed well enough to go home and I remember walking with him along the hospital drive. We said our goodbyes and Jack headed off, touching the latch of every gate he passed and stamping his foot after every thirteenth step. Thankfully, in treatment terms, a lot has changed since then. I only hope that Jack was still around to benefit from the newer treatments and that he eventually found some peace and relief from his symptoms.