A temporary vegetarian 

My wife is a dietitian. Starting yesterday, she and the team of dietitians she leads are trying out some of the clinical and controlled diets that their patients experience. So, for a week, my wife has chosen to be a temporary vegetarian. 

Two of my daughters are already vegetarian; the other is a devout carnivore. But, for this week, the whole family is having a go at the vegetarian thing, in solidarity with my wife. 

We’re into our second day and it’s going OK so far. We bought a lot of vegetables and vegetarian food at the supermarket yesterday. We didn’t buy any fish or shellfish – we’re not doing the ‘pescetarian’ cop out, but we’re also not trying the full vegan thing either. I will struggle enough with just a vegetarian diet. 

One thing I insisted upon was trying some of the facsimile products, like Quorn ‘chicken’ nuggets. We will make some meals from scratch, but I wanted to try some of the foods which are considered as ‘cheating’ by some proper, permanent vegetarians. If one likes meat, but for whatever reason chooses to be vegetarian, then why not have some things which are meatlike in taste and texture?

We have been trying to have one or two meatfree evening meals a week, so we’ve already tried some products. I find the Quorn Mince an unconvincing texture, so we just use it to bulk out a smaller amount than normal of proper beef mince. This week, we’ll have only Quorn mince, so I’ve decided that chilli sin carne would be the best way to disguise it, with kidney beans, peppers & onions adding some bite and texture. 

As well as trying the food, I will also be attempting to cook some of the meals. Normally, I struggle with contamination OCD intrusive thoughts so much that it renders me incapable of handling raw meat products. The decontamination rituals make preparing a meal distressing, prolonged and impractical. So I’m seeing how I deal with veggie cookery. I will still have to face handling things like eggs, so there are some pretty big triggers remaining. It’s still going to be a challenge. I will do my best. 

I’m keen to try a couple of Indian and North African recipes. I’d like the experiment to be a balance between cooking from scratch and lazy convenience foods. 

My wife will be taking professional nutritional, qualitative, cost and environmental impact notes throughout the week, in order to present her findings & experiences to her team. I think that the added data of the whole family participating will make the experiment much more useful. Since it’s only day two, I haven’t yet started to crave bacon sandwiches, but I expect to. From past experience, vegetarian ‘bacon’ is both weird and disappointing. I do intend to try doing a veggie fry-up though, with veggie sausages, which are OK. 

Do I expect to go permanently vegetarian by the end of the experiment? Not a chance. I will always be carnivorous, but it would be good to broaden the repertoire of vegetarian food which could be interspersed among the usual non-stop meat frenzy. 

The experiment ends

It was an interesting week. We set out with a few objectives and achieved some, but not all of them. We had some of our preconceptions challenged and confirmed other things we expected to be true. 

  • We all stuck with the experiment without lapse for the full week
  • We ate more processed products than we intended to, cooking fewer things than planned completely from scratch
  • My vegetarian daughter who still lives at home ate a more varied diet with fewer processed products than usual during the experiment 
  • The range, quality & texture of processed products has improved greatly since I last paid attention to them
  • The texture issue is still variable. Fake chicken nuggets and chicken burgers were convincingly like cheap chicken products, but without the gristle. We’d get them again. Fake meat pies were sub-football-ground quality. We wouldn’t get these again
  • The quality of food based upon price wasn’t consistently equivalent to the meat based version. Processed vegetarian foods aren’t always great value for money
  • Both me and my youngest daughter regularly felt hungry and unfulfilled throughout the week. I tried increasing carbohydrate intake to compensate, but this didn’t help
  • The nicest meal of the week was a chunky veg chilli prepared from scratch
  • The other really enjoyable meal was a barbecue, the highlight being satay kebabs made of peppers, onion, courgette and haloumi. These will be a part of all future barbecues
  • The issue of farting wasn’t as bad as anticipated. I expected a remake of the Blazing Saddles campfire scene
  • I did however find that the instant I woke up in the morning, I had to dash to the bathroom for a “long sit”. The sudden increase in vegetable and fibre intake had a noticeable effect in this respect
  • The flavour of the processed products was often quite strong. It felt over the top at times. Was this to disguise a bland base product? Maybe. 

So, will we repeat the experiment? No, I don’t reckon we will. Will we eat fewer meat based dishes, more vegetarian dishes and more vegetables? Definitely. We will also be trying a more varied diet, with more seafood and less red meat, which is a positive outcome. I’m glad that we joined in with my wife’s experiment. It was educational. 

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    What is contamination?

    Such a simple, direct question. Somebody asked it recently during an OCD support group meeting. I was slightly taken aback. I didn’t know how to answer succinctly. This was someone else with OCD who had never experienced a contamination obsession. It just goes to prove that even we sufferers aren’t immune to being influenced by the misconception that OCD is “that handwashing thing”. 

    What is contamination? It’s a reasonable question. For different OCD sufferers it can mean different things. For some that meaning can alter over time. 

    For me contamination primarily means “contaminated by humans”. What does that mean? That somebody sneezed on something? Well, it can mean that, but it can also mean lots of other things. 

    It can be the mere fact that another human has touched something or breathed near it. Or the possibility that someone may have done so. To me the mere presence of other humans means the presence of contamination. The fewer humans, the better. The further away, the better. Humans are dangerous. 

    For me it’s not even just the risk of contracting a communicable disease or a parasite from other people. It is also their “difference”. I don’t want to catch “being like them”. In the past, this has had some unpleasant undertones. My father was an extreme racist. He had drilled into me fear, distrust and loathing of anyone culturally different from us. My OCD latched onto this fear and turned it into a fear of “becoming like them”, as if, for example, being ethnically Chinese was contagious. Or Orthodox Judaism. Or Presbyterianism. I had fought hard to be me. I didn’t want to become somebody else against my will. If I had been Ethnically Chinese, I would have been just as fearful of contracting Northern European whiteness. 

    My father also despised the “untermensch”. The physically weak. The physically disabled. The mentally disabled. My contamination fears expanded to include these forms of “contamination”. I used to hold my breath as I went past disabled people, for fear of contracting “untermensch”. As if you could catch having an amputated leg by brushing past a one legged person. Or become mentally disabled. 

    Yes, contamination for me is mostly the fear of communicable disease, but I’m ashamed to admit that it has been these other things too. 

    I’m not racist. I’m not prejudiced against disabled people. I don’t care about anyone’s sexual orientation or gender identity. I was just taught to fear these things literally like the plague. Being “different” was as bad as being diseased. My dad had some very weird views about the world. OCD will happily piggyback the most illogical concepts. Logic doesn’t often have much to do with OCD obsessional focuses. 

    Most people understand the contamination focus to be “fear of contracting illness from others”. What few realise is that the converse applies just as much. If I have a cold, I will go to great lengths to ensure that I don’t contaminate others. If I’m not totally certain that I can prevent me being a source of contamination, I don’t leave the house. I couldn’t forgive myself if I gave a bad cold to someone with asthma or COPD and they died as a result. 

    When depression has had its firmest grip on me, my personal hygiene has been poor – not showering, shaving or brushing my teeth. This has played right into the hands of the OCD contamination fears. Someone unclean is surely a source of contamination to others, therefore I must isolate myself further from the world, in order to keep people safe. The depression feeds the OCD and the OCD returns the favour. A nasty cycle of self destruction and social isolation. 

    For others, contamination fears can have a focus on blood, bodily fluids, animal faeces, unidentified substances, stains or smears, chemical contamination, pollution, radiation, genetically modified organisms, contamination by dangerous foreign objects like glass shards or rat hairs in food.

    It’s not by any means just about avoiding catching the latest headline grabbing exotic death virus. So, can you see now why I struggled to answer a question as simple and direct as “what is contamination”?

    Obsessive Compulsive Cleaners – an OCD sufferer’s opinion

    I deliberately wasn’t going to write a blog post about Obsessive Compulsive Cleaners – a television series on Channel 4 in the UK, because I don’t believe in feeding the troll – giving the oxygen of publicity to something or someone causing harm. 

    After discussing the show with fellow OCD sufferers and some of the viewers of the show, I have reluctantly changed my mind. I wish it wasn’t necessary to write this blog post.  

    The basic premise of the show is getting people who are obsessed with cleaning or very motivated to clean, to do cleaning challenges. Mostly the challenge is to tidy, then clean the revoltingly dirty house of someone with severe hoarding problems. They do other, smaller, highly orchestrated challenges too. 

    The implication of the name of the show is that the cleaners all suffer from contamination focussed Obsessive Compulsive Disorder. Some of the cleaning participants have indeed been clinically diagnosed with OCD.

      

    Some of the participants are just highly motivated people who love to clean. Some are people who run cleaning or cleaning-product businesses. I’ve derived this information by both enduring watching the show sometimes (with great difficulty and anxiety) and also seeing participants interacting on Twitter. They are generally nice, genuine people, but most are on the show for some form of material self advancement. I have no objection to people earning a living, but not if it’s stigmatising and harming others in the process. 

        
       

      

    The implied mental health diagnoses of the hoarding problem participants isn’t so clear, but unlike possibly some of the cleaning participants, some of the hoarders may be suffering from OCD – hoarding can be an OCD driven compulsion. I myself hoard, but not to the same extreme extent as the programme’s participants. But whatever the cause, nobody with a healthy mind hoards and builds up filth in the way that the show’s participants do. 

        
       

     

    The show’s creators and supporters rightly argue that everyone who takes part in the show has done so voluntarily. Yes, some of the participants are clearly severely mentally ill, but even we, mentally ill people are capable of rational thought and making decisions about what we do or don’t do. I accept that.

    So that’s OK then? No different to X-Factor or Britain’s Got Talent? 

    No. X-Factor audition-shows do sometimes cruelly feature excruciating footage of people who are not 100% mentally healthy, are devoid of talent, yet are still giving it their all. But neither of those two talent shows sets out to recruit mentally ill participants specifically because of their particular mental illness. That is the crucial distinction. 

    People aren’t recruited to appear on Obsessive Compulsive Cleaners on the basis that they have an amazing talent for competitive cleaning. The show would have been called The Great British Cleanoff if it was a cleaning talent competition. 

    Because of the show’s name, the implication is that participants are compelled to clean up other people’s filth because OCD makes them do it. This is a complete fallacy. None of those people are there because OCD is making them rid the world of contamination, one filthy house at a time, like some anxiety riddled superhero. They are there for the 15 minutes of fame that Andy Warhol promised them. 

      

    Or they are there to promote their cleaning business. Or in the case of the hoarders, they are there to get some other fool to shovel dogshit off their living room carpet. 

       

     

    I sincerely pray to God, yes really, that none of the participants are on the show believing that taking part will benefit their mental health more than seeking specialist professional medical treatment. The mere possibility of that appalls and horrifies me. I have heard anecdotally that one participant claims that the show has benefitted them, but I have no evidence either way about this claim, so cannot comment upon it. 

    I am someone who has suffered from severe OCD all my life. In adulthood this has been primarily, but not exclusively, contamination focussed OCD. I can say hand on heart that the immediate reaction by anyone who has contamination focussed OCD to setting foot in a filthy shit-laden house would be to run screaming from it, burn their clothes and shoes and then bleach and scrub their entire body. I have done exactly this on numerous occasions when accidentally exposed to a serious contamination source. 

    So the people on the show are bravely facing their fears?

    Up to a point, perhaps yes, but then they throw bucketloads of bleach at the problem to make the threat of contamination go away, thus negating the initial exposure experience. This is known as carrying out a compulsion. The “C” bit of OCD.

    Disordered obsessive-compulsive thinking about contamination happens like this:

    “Arghhh! That object or place has become contaminated. I can see dirt, I can smell a bad smell or I can feel something on the surface which doesn’t feel right. IT IS CONTAMINATED! ITISCONTAMINATED… ITISCONTAMINATED… ITISCONTAMINATED… I’m certain it now contains bacteria or diseases which will kill me, my family or other people if I don’t destroy the contamination. It will be my fault and my responsibility if someone dies. I must destroy this contamination now!”

    This may sound far fetched or exaggerated, but this is absolutely textbook, typical OCD contamination thinking. I thought like this for decades. These thoughts won’t go away. If the person sits and does nothing for three days, at the end of three days their mind is still overwhelmingly screaming at them that they must destroy the contamination to avoid catastrophe. 

    OCD tells them that the only way to quell the thoughts and the resultant huge surge of anxiety is to destroy the contamination. No contamination, no thoughts. So they carry out the compulsion. They clean, scrub, bleach, burn. Whatever it takes to destroy the contamination. 

    Phew! What a relief! Hey presto! Problem solved. Let’s stand back proudly, admire the pristine cleanliness, then enjoy a well earned cuppa. 

      

    Emmmmm, no. The relief gained by carrying out the compulsion is all too brief. The OCD is already whispering toxicly into the person’s mind that maybe they missed a bit, maybe the bleach didn’t spread everywhere, maybe the contaminated cleaning cloth touched something else, which is now contaminated too, maybe the person is kidding themselves that they did the job properly, maybe they cut corners lazily, maybe, maybe, maybe… What if… what if… WHAT IF???!!!!!

    So the person cleans, scrubs, bleaches, burns again. Job done this time. Isn’t it great? Let’s have a cuppa. 

    Nope. The OCD is whispering again. 

    And so the exhausting, destructive, maddening cycle of obsession-anxiety-compulsion-relief-doubt-obsession-anxiety-compulsion-relief-doubt… goes round and round forever. Imagine this, every waking second of every single day. That is the constant reality of an OCD sufferer. 

    So cleaning something is a compulsion? A bad thing? How can cleaning up some utter shithole be a bad thing?

    Firstly, it is reinforcing dysfunctional core beliefs that 100% deadly contamination exists everywhere, that it must be destroyed and it is the person’s responsibility if somebody dies because they haven’t done it properly. 

      

    Secondly it is the compulsion stage in the toxic cycle. What inevitably follows the compulsion is doubt. There is never surety of a job well done, no matter how well it was done. There is no satisfaction. No self praise. Only doubt, anxiety, guilt and fear. Carrying out the compulsion makes the OCD stronger, worse, more powerful, more credible. OCD is the bully who pretends to be your friend and protector.  

    Thirdly, cleaning up a hoarder’s house doesn’t miraculously cure them of the mental health problems which are causing them to hoard. Without appropriate professional medical treatment, within weeks their house will be stacked high once more with detritus, filth and dogshit. 

      

    For a person with contamination focussed OCD to benefit from being in the filthy house, they would need to sit on the infested sofa, shoes resting amongst the dogshit on the carpet, for a prolonged period of time, whilst not cleaning. Yes. Not cleaning. They would need to observe their anxiety level spike off the scale, then watch the anxiety curve very slowly subside. They’d next need to get up calmly and leave, then not wash or bleach their hands, not shower, not wash or burn their clothes and shoes. They’d then need to wait, maybe up to a week, to see if the OCD was telling the truth, that the contamination would definitely kill them and all those around them. They’d finally have to consciously acknowledge that the OCD had lied to them because they were still alive and well, despite having carried out no compulsions. 

    This is a well established therapeutic technique called Exposure and Response Prevention (ERP), which forms part of Cognitive Behavioural Therapy (CBT), the standard, largely successful therapy technique for overcoming OCD. The show doesn’t do this, it instead encourages harmful compulsions. But hey, we can’t have a cleaning show without cleaning. 

    So cleaning makes contamination focussed OCD worse and doesn’t help the hoarders either? What’s the point of the TV show then?

    Entertainment. Pure and simple. Like a modern Molière play. It is the latest in the Minorities As Entertainment genre which Channel 4 and Channel 5 have sadly made their own in recent years. My Big Fat Gypsy Wedding, Benefits Street, Immigration Street, Obsessive Compulsive Cleaners. “Let’s deride Pikeys, Dolescum, Foreigns and Handwashing Nutters.” Cynical, shot-to-a-script, ignorant prejudice reinforcing, exploitation television.

       

      

     

    There is no empathy in the scripting, visual treatment, filming, editing, storytelling, background music or narration. Just sneery, formulaic, predictable, everyone’s in on the joke but the participants, cynicism. 

         

      

     

    Channel 4 is consistently shameless in its flippant, mocking approach to promoting the programme. 

       

     

    It’s ghoulish voyeurism, nothing more. Like stopping at a car crash to watch people bleed. If P.T. Barnum was alive today, he wouldn’t be running a circus freakshow, he’d have a TV production company making cheap, generic, voyeuristic exploitation documentaries for Channels 4 and 5. 

      

    But no real harm done though, eh? Apart from maybe to some of the participants? Just a bit of a giggle at the participants’ expense. 

    Again, no. 

    The show both trivialises and misrepresents the reality of suffering from OCD. It’s not something which can be made happy ever after at the end of a one hour TV show. It’s also mostly not about cleaning. 

      

    Not about cleaning?! But OCD’s that handwashing cleanfreak thing. Everybody knows that!

    No, it’s mostly not. OCD obsessions can have many focusses: fear of harming others, fear of being harmed by others, religious obsessions, moral obsessions, fear of causing offence to others, fear of accidental fire, flooding, electrocution, fear of causing road accidents, fear of public humiliation, fear of failure, fear of chemical contamination, fears of sexually unacceptable thoughts & behaviour, rumination, hoarding. All equally life-destroying, all equally OCD. So mostly not “that handwashing cleanfreak thing”.

    Imagine having obsessive fears that you are going to stab your entire family and thinking that OCD was just about people who love to clean. What sort of monster would you imagine yourself to be? A latent psychopath? When really it is an irrational fear, created by OCD because you love your family and would never actually hurt them in any way. OCD takes the best of us and turns it against us, making us doubt our very identity. 

    But surely I’m just some random online nutter with a bee in my bonnet, ranting about a TV programme I simply don’t like?

    Nutter. A bee in my bonnet. Very funny. OCD is a whole bloody beehive. Hell, I’m thinking of going into business selling honey. It is an important issue to me, yes – suffering from a life destroying anxiety disorder which people think is entertaining, quirky or funny isn’t a barrel of laughs, putting it very mildly. 

    I am passionate, though surprisingly not obsessed, about reducing the stigma suffered by all of us with OCD. I want to help more people seek appropriate medical help sooner, not suffer in isolated shame for decades as I and many others have done. 

    And I’m not a lone, random oddball in my objections to the programme. 

    OCD-UK and OCD Action, the two national charities for OCD sufferers, have raised written objections to the programme and refuse to co-operate with its production. Professor Paul Salkovskis, a world renowned expert in OCD and its treatment, has raised his own objections to the stigmatising, trivialising and misrepresentative nature of the programme.  

     

    Increasingly, more and more diagnosed OCD sufferers are making their objections online to the show. A look at the #occleaners hashtag on Twitter shows this clearly. Even viewers of the programme are beginning to question the cruel basic premise of the programme. The days of Obsessive Compulsive Cleaners as a series are numbered. It has overstayed its welcome. It’s an obscenity which should never have been commissioned in the first place.

      

      

      
      

      

      

      

     

      

      

    So what can the TV production company Betty, who make OCC, create for Channel 4 as a replacement?

    Morbidly obese people being fed doughnuts until they cry in despair?

    Injecting type one diabetics with massive amounts of insulin and watching them become dangerously hypoglycaemic?

    Tipping people out of their wheelchairs to watch them struggle to get back in the chair?

    Katie Hopkins on a jetski toppling refugee boats into the Mediterranean?

    The crass, tasteless possibilities are endless. And OFCOM don’t seem too worried about cruelty or stigma as entertainment. Thank goodness there are none of those tiresome ethics that Channel 4 used to have to get in the way of a good laugh. If you can’t mock the afflicted, who can you mock?

    EDIT: 13/09/15. I have sent a link to this blog post to OCC’s production company and Channel 4. I honestly expect no response from them. 

    If in the unlikely event that they do respond, I’m fully expecting the usual flannel about it being a brave, boundary pushing, carefully supervised, social experiment to raise awareness of mental health issues, with expert mental health consultants on location at all times, assuring the wellbeing of all participants. 

    Nobody’s buying that spurious waffle. The finished product unambiguously shows the cynical intent of the show. It’s car crash TV, poking fun at serious mental illnesses. Nothing more. END EDIT.  

    If you are in the UK and believe you are suffering from OCD, the best thing you can do is see your GP or refer yourself directly to specialist NHS mental health services, if available. Below is a link to advice on what to say to your doctor:

    Click here

    Good luck. You are not alone. We are not freaks. We are ordinary people. There is hope. 

    Lost in the supermarket

    I’m all lost in the supermarket,

    I can no longer shop happily, 

    I came in here for that special offer,

    A guaranteed personality 

    – Lost In The Supermarket, The Clash

    Hands up who likes going to the supermarket. Anybody? No. I thought not. 

    Going to the supermarket is a chore at best. Going to the supermarket with OCD is an absolute minefield. I used to have to psych myself up before going in. I almost certainly made myself more anxious by doing that. I am however, stupidly bloody-minded. I have never avoided OCD triggers. I always did things anyway and just suffered the anxiety. A bit like ERP, but with just the Exposure and never any Response Prevention. Mucho stupido. 

    What happens in a supermarket that can cause anxiety? For me, the main thing, but certainly not the only thing, is human contamination. All the grubby, dirty people, with their coughs, corralled into shopping-aisle-canyons with me.

    I shall write this as if it’s a typical visit by the pre-therapy me to the supermarket. 

    Park the car. Deep breath. Let’s do this. The first obstacle is the trolley (shopping cart). The handle of the trolley has been touched by hundreds of people, maybe thousands and almost certainly never cleaned. I anti-bac gel my hands, then put gel onto a tissue and anti-bac the trolley handle thoroughly. Contamination not removed, but contained. 

    Now, into the shop. 

    I start to threat assess the people around me. How busy is the shop? How difficult will I find it to navigate through the other trollies? What will my escape route be if there is a major incident?

    OK. Initial threat assessment done, but I will continue threat assessing as I go. I start to move through the first aisle. I have to go up and down every single aisle, even if I’m just in for a loaf of bread. I can’t ever recall having a specific obsessional focus with this compulsion; I just HAVE to go up and down every aisle. No choice. No option. I suffer a huge anxiety spike if I try to deviate from this. 

    Then the product selection starts. This is a serious business. No messing about. I don’t have a paper list. I have recorded everything we need in my mind, in the order of the shop layout. I always select products from the back of the shelf in order to get the freshest product possible. Fuck you supermarkets, I’m wise to your “putting the oldest stuff at the front” trick. The other advantage of selecting from the back is that no other customer has pawed what you put in your trolley, so less risk of contamination. 

    I check all fresh food for imperfections, blemishes, bruising, visible contamination or needle marks where a toxin has been injected. I check all packaging for tears, dents, damage. Nothing imperfect or contaminated gets into my trolley. 

    The trolley itself is compartmentalised in my mind, so cans & bottles go together, at the far end of the main section. Fruit & veg go in the small separate basket section at the very end. Cold and freezer products are stacked neatly together at the near end, to keep them cold. Non food items go near the cans and bottles. Soft, dry goods go on top of everything else, but stacked so that I can take the heavy cans, bottles & non food out first. I see this being referred to by some people, mostly men, on social media as being OCD behaviour. I don’t believe it is, because there is no obsessional focus or anxiety associated with it. It’s just logical and organised. Many experienced, mostly women, grocery shoppers do it without a conscious thought. 

    Because I have the route planned, I can move through the supermarket quickly. I used to shop at 2am, so nobody got in my way. If somebody in the same aisle as me coughs or sneezes, I hold my breath until I’m into the next aisle. 

    When I get to the cleaning product aisles, I start to stock up. Bleach, anti-bac gel, anti-bac hand wash, anti-bac surface cleaner spray, bleach, shower gel, medicated shampoo, limescale remover, floor cleaner, scouring pads and bleach. Plus all the usual stuff, like washing up liquid, clothes washing liquid and bleach. Maybe an extra bottle of bleach. And some extra hand gel. It is damned expensive. There is no pleasure or satisfaction in this. There is no time for complacency or joy when fighting contamination. 

    Finally, with everything on the shopping list in my mind now in the trolley, I go to the checkouts. Stress over? Unfortunately not. This has always been one of the most stressful parts of grocery shopping for me. Queueing up. People in front of me. People behind me. Unable to move from the queue. Trapped. So close to escaping the shop, but not close enough. 

    I always choose a checkout with a middle aged female member of staff. They know how to do the job properly, professionally. They scan the goods at a reasonable pace for packing and keep the products in their groups. Occasionally, they will engage in basic smalltalk. At this point I’m really struggling and also shy, but I put the normal face on, smile and exchange smalltalk, trying to keep the panic out of my voice. 

    At long last, reaching the conveyor, touching the (contaminated) divider, to separate my pristine shopping from the person’s in front. Loading each preplanned group of products onto the conveyor in sequence. All done. Quickly. Efficiently. Impatiently. C’MON C’MON! Oh bastarding bollocks! The people in front have coupons and they’re counting out cash. ARGHHHH! C’mon! Done! Finished! C’mon c’mon! Lift your fucking stuff and fucking get the fuck out of my fucking way! I’m sweating. Getting too hot. Face beginning to flush. Panic rising from the pit of my stomach. I just want out into the fresh air, but I have to pack my groceries and pay for them. Quick QUICK! 

    Then, once everything is scanned and packed into the trolley, I face one of my nemeses. The chip and PIN machine. I must key in my PIN on the keypad. The dirty, filthy, contaminated, never ever washed keypad which everybody touches. CONTAMINATION THOUGHTS. Panic thoughts. What if I forget my PIN? One two three four. One two three four. My PIN is one two three four. I key in 1234. (It’s not really 1234). A pause. Oh God! The machine’s going to reject the card! I put my PIN in wrong! The card has expired! I have no money left in my bank account! I shall be publicly humiliated when I’m at my most vulnerable and unable to escape. Could I run, leaving my card in the machine and my trolley full of groceries?

    Card accepted. Transaction complete. Please remove your card. 

    Aaaaaaaaaaaand breathe. Card into wallet. Check that card isn’t still in machine. Check card is in correct compartment in wallet. Check card isn’t in machine. Check card is in wallet. Touch card to ensure eyes aren’t lying. Wallet into pocket. Zip up pocket. Check wallet is in zipped pocket. Check for keys. Check for mobile phone. Check for inhaler. Repeat. Repeat. Now I can leave.

    MY HAND IS CONTAMINATED! MYHANDISCONTAMINATEDMYHANDISCONTAMINATED… Apply anti-bac gel. Contamination sealed in temporarily. 

    Out into the open. Out to the fresh air. Another ordeal at an end. Anti-bac hands. Put groceries in the car, return the trolley, anti-bac hands. Scrub hands clean when I get home, then bring the groceries in. Put groceries away, labels facing outward, checking for any damage incurred in transit. Wash hands. 

    I have done that at least once a week since I was eleven years old. 

    One of the first things I did as an exposure exercise when I started Cognitive Behavioural Therapy was to go to the supermarket. I literally drove from the CBT session to the supermarket. I retched, wept, sweated and hyperventilated my way round. I missed out a couple of aisles. I didn’t use anti-bac at all. The second time I did it, I deliberately bought two things with damaged packaging. This was EXTREME, but I did it and survived. Nobody became ill. Nobody died. I persisted with it and saw that the OCD had lied to me. 

    I now go to the supermarket without anxiety. I still shop meticulously – old habits die hard, but the obsessions, fear and anxiety are almost totally gone. I sometimes get stressed & anxious at the checkouts, but I recognise it starting to happen and use mindfulness & CBT to challenge and overcome it. This was the first bit of OCD nonsense I properly trounced and, now that I stop and think about it, I am inordinately proud of that. I called OCD’s bluff, then kicked its arse. About one thing. But it was a start. 

    I’m no longer lost in the supermarket,

    I can now just shop happily. 

    #HandWasher

    There is a visual cliché when representing mental health in print or on the news. It even has its own hashtag now. #Headclutcher. You know what it is without me having to say. The distraught looking person clutching their head with both hands as if it’ll fall off if they don’t. It’s inaccurate and the work of lazy picture editors. Time To Change have created an excellent campaign to replace #HeadClutcher with more representative images. 

    OCD has its very own version of headclutcher. I can see you’re already ahead of me on this one too. Yes, it’s #HandWasher. A lovely posed professional shot of a hand model (yes there really is such a thing) washing their lovely hands with lovely soap in a lovely sink. Isn’t that lovely altogether? Lovely soap solves the nasty problem instantly. So easy. So lovely. 

    Except… OCD isn’t like that. OK, one of the best known forms of OCD, contamination focussed OCD, is thought of like that by the general population, partly because #HandWasher is the picture editor’s current goto image for OCD. But most of OCD isn’t like that. There’s lots of other things like unwanted intrusive thoughts, anxiety, fear, obsessions, urges, other compulsions, hyper-responsibility, guilt, exhaustion, rumination, insomnia, self loathing. None of these sound very visual …or lovely. …Let’s stick with the lovely hand model photos. We don’t want to make picture editors actually work now, do we? Oh no no no. That would be awful. 

    There is also the other problem. What’s that? The lovely hand washing. It’s not so lovely in real life. 

    What do I mean, “not so lovely”?

    Well, first of all, the real hands tend to look a bit mangled from all the hand washing. Calloused. Cut. Red-raw. Skin splitting. Like Lady Macbeth washing her hands, but the blood is real. 

    Oooooookay. 

    And then there’s the washing itself. Well, it’s often more like scrubbing. A lot of scrubbing. With a bit of scratching. And scouring. And sometimes bleaching. I even once considered using a potato peeler to “decontaminate” my skin, but changed my mind. So definitely not so lovely. But the sink can be lovely. …unless the hands have started to bleed. …Then that’s not so lovely either. Here’s one of my hands, looking medium bad for me:

    So, apart from the wrong hands, the wrong handwashing technique and the wrong sink, the #HandWasher images are accurate?

    Yes. Well, about handwashing, yes. Though they don’t represent all of the other compulsions that people with contamination obsessions do. …And of course they don’t represent all the people with checking obsessions, religious obsessions, scrupulosity obsessions, harm based obsessions, sexually based obsessions, external harm obsessions, relationship obsessions, rumination or hoarding. 

    But apart from all that, 100% representative and accurate?

    Oh yes. Absolutely. 

    What are the lazy-picture-editor lazy alternatives to Handwasher, when they think they’re being creative, but are still being lazy? I’ll list a few recent and regularly occurring ones:

    Patrick Bateman: Who he?

    The title character, played by Christian Bale, of the Film American Psycho. Psychopath. To be absolutely accurate, wannabe psychopath Walter Mitty type character. Not OCD sufferer. Nowhere close. But hey, a sexy photo of Christian Bale is good clickbait. 

    Cutting grass with nail scissors:

    Ah, OCD. They’re all anally retentive weirdo perfectionists, aren’t they? Actually no. We’re not. We can have an obsessional focus on things being the way they need to be to prevent very bad things from happening, but I personally know of nobody who cuts their grass with nail scissors. My lawn is currently about 8″ long. I must cut it one of these days. With a lawnmower. The notion of the harmlessly eccentric obsessional nutcase belongs in a dated 1970s sit-com. 

    A neat row of identical pencils, with one out of place:

    This used to be almost as common as HandWasher, but thanks to Channel 4’s televisual garbage Obsessive Compulsive Cleaners, it has been usurped. Again, unless a single individual with OCD ascribed a particular significance to pencils, this image too is totally irrelevant. See also: misplaced floor tile and blue jellybean in a jar-full of orange jellybeans. 

    A group of cleaning product bottles:

    This is a little less specific and can visually represent contamination obsessions, but if the story is about religious obsessions or harm obsessions, it may as well be a photo of a poodle dyed pink with purple spots. 

    Colour separated M&Ms:

    Even picture editors rarely use this one these days. Except maybe extra lazy, hungover ones who really want to be llama farmers in the Cotswolds. It’s such a hoary old myth that it has passed into urban legend. 

    What would I suggest as an alternative course of action?

    Read the copy. It’s not rocket science. The text will give you all the information you need. If it’s a piece about OCD, discover what it’s ACTUALLY about and then source or shoot a photo which represents the actual story and the condition. Use your imagination. How do you visualise “lots of thoughts going round and round”? How do you visualise an obsessional focus? Think and visualise like the OCD sufferer in the text. What does invisible contamination look like in the mind of a sufferer? How do you make a kitchen knife look inert, but potentially dangerous? You’re a creative. Be creative. Use your imagination. Be relevant. Hmmmmm, sounds like hard work. 

    So, picture editors. Over to you. Perhaps the next time there’s a story or feature about OCD, maybe you’ll remember a little professional pride and use a feature image as relevant and impactful as the text. We’ll see. It’s time to say goodbye to #HandWasher