“I do two hours of cleaning each time one person comes home,” says Kirti*, a former barrister. “My son comes home at three o’clock and I do two hours cleaning. Then my husband comes home at six o'clock – two hours cleaning. Then my daughter comes home at nine o’clock – another two hours cleaning.”
Kirti has had Obsessive Compulsive Disorder for most of her life. For her, the condition manifests as an aversion to any person, place or object that has come into contact with death – something she believes may have been triggered by watching relatives follow the Hindu tradition of bathing and washing their clothes after attending funerals.
What began as a need to avoid graveyards and hospitals has evolved into an inability to spend time with anyone who has been to a funeral or a hospital without them first showering and changing their clothes. Kirti also couldn’t touch pathologist’s reports in court.
“Now that I’m older, most of my friends’ parents are starting to die and then I can’t meet them anymore,” she says, explaining that even being near a mobile phone that has been present at a funeral can trigger her fear of contamination.
Kirti’s husband is a doctor and, unfortunately, his daily proximity to death exacerbates her urges to perform cleaning rituals.
“He was absolutely insistent that we could work around it,” she explains. "I have rituals that I have to do, things like when he comes back from work I have to clean and he has to come in through the garage door.”
Kirti’s husband has supported her in seeking counselling, therapy and medication but, for now, her fears of contamination remain a prominent feature in both of their lives.
According to Dr Claire Lomax, Programme Director for the Doctorate of Clinical Psychology at Newcastle University, it is common for partners to be involved in behaviours known as ‘rituals’ that help ‘protect’ the sufferer from the object of their obsessional fears.
“It may be that the partner or family member is asked to participate in rituals, such as helping with cleaning,” Dr Lomax explains. “The sufferer might ask the partner for reassurance that they are clean or not spreading infection or germs.”
Faced with a loved one who is distressed and fearful, it is hard for partners of OCD sufferers to know how to offer comfort, while also avoiding reinforcing their fears.
“It is really difficult for partners to know what is the ‘right’ thing to do in this situation,” says Dr Lomax. “Obviously they want to help [the sufferer] to feel better so will offer comfort through reassurance. They often know that this isn’t really helping though, in part because the benefits don’t seem to endure.”
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What happens when a partner is the central focus of contamination fears?
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“It may seem like you’re helping but in the long run you’re just encouraging them to believe that their thoughts are real,” agrees Becca, a 28-year-old personal assistant whose OCD symptoms are triggered by a fear of contamination from dog faeces. “By not engaging they may get angry but it will help build a picture that if you don’t do the safety behaviours the worst doesn’t happen.”
Sometimes, however, Becca explains that it is necessary to strike a pragmatic balance.
“There are times when a little participation is necessary, such as my recent house move,” she says. “My partner had to help with a few of my safety behaviours to allow me to function daily at that time.”
One strategy Dr Lomax suggests is to enlist the help of a therapist to create an “agreed plan of what to do when the individual with OCD seeks reassurance”. Couples work together to identify a long-term strategy to combat the sufferer’s unwanted fears, often referred to as ‘intrusive thoughts’.
But what happens when a partner is the central focus of contamination fears?
Sarah*, 26, became terrified that the sexually transmitted infection she caught in her first year of university might return and felt compelled to repeatedly check herself for symptoms.
“I would often go to the STI clinic or the GP and ask them to check too and I would read up as much as I could on the internet about the chances of the STI returning,” she recalls.
Sarah sometimes abstained from sex to be certain that she could not be passing anything to her partner, often pretending to be too tired. It was only when a Cognitive Behavioural Therapist encouraged her to stop checking for symptoms that she finally shared her fears with her boyfriend, who she had been afraid would break up with her if he knew she had had an STI.
Becca’s contamination fears aren’t related to sex but a condition she suffers from called vaginismus, which causes involuntary tightening of the muscles around the vagina when you want to have sex, and is sometimes triggered by her OCD.
“I can find myself becoming distracted and caught up in my OCD thoughts,” she explains. “On a few occasions I have become so lost in thought and panic I have tensed up and found myself having to stop.”
Sufferers’ thoughts and compulsions can seem nonsensical to outsiders but the picture these three women give of their OCD resembles a relentless bully which, at times, they feel totally incapable of resisting.
“Most people with OCD know that their thoughts and behaviour are irrational and senseless, but feel completely incapable of stopping them, often from fear that not completing a particular behaviour will cause harm to a loved one,” says Dr Lomax. “No matter how small the risk, the person with OCD will always feel responsible for preventing that bad event from happening, and will do whatever it takes to avoid it.”
This heightened sense of responsibility can leave the sufferer completely exhausted, especially if the people around them aren’t aware of their condition.
“Sometimes I wish I could just hand out leaflets about OCD to everybody I meet,” says Kirti.
“I’ve tried saying things to friends like ‘I’ve got OCD’ and immediately they go 'Oh yeah I’ve got OCD too!’” she recalls. “People say ‘I’m really OCD!’ and I always think 'gosh you have no idea'.”
A partner, friend or family member who is educated about OCD can be an invaluable aid to recovery.
“Just listen and appreciate how hard it is for your partner to be telling you their most upsetting and consuming, unwanted thoughts,” advises Becca. “Laughing through tragedy and making jokes inappropriately can really lighten the mood even in the darkest of moments and my partner is great at that.”
For further information on OCD and to seek support for yourself, a partner or someone you know, contact the organisations below:
OCD-UK Advice Line: 0845 120 3778
OCD Action Help line: 0845 390 6232
OCD Action Help line: 0845 390 6232
*Name has been changed