Mind Games

October 2016

The shrill of her 8 a.m. alarm is startling. The ring that’s been making her anxious lately doesn’t usually manage to wake her in time for work, but for the past few weeks, She hasn’t been sleeping at all. She goes to bed at around 1 a.m., and lays there, restless, oppressed by pervasive thoughts, until she hears the dreadful hail of the clock blaring through the room. She makes her way to the bathroom through the scattered boxes and bags left to unpack from her move five months ago, prompted by a poor relationship with her landlord. Anytime she has a major transition that involves change, her OCD comes on full force, and now is a horrible time of anxiety for her. She barely eats, lost a solid ten pounds, cut herself off from friends, and only leaves her apartment to go to work.

She starts her morning ritual: pet the cat, jump in the shower, wash twice in scorching water and scrub until skin is left chapped and sore, apply eczema cream vigorously, remove clean clothes from the dryer, put on several layers of clothes and carefully pack away remaining garments in double-layered plastic bags, start a third rinse cycle of clothes in the washer, and repeatedly check stove, fridge, kitchen and bathroom faucets, light switches, and backdoor lock.

The 15-minute walk to work is daunting. She has a fast and mechanical step, always on the same side of the sidewalk on the same street, instinctively making sure her feet don’t stay on the ground too long. Paranoid, she hides beneath an oversized black nylon winter jacket zipped up to her nose, and a dollar store beanie from which blond streaks of messed up, scarecrow-like hair come out. Her hands are buried deep down her pockets, fists clenched to avoid contact with germs; she never looks up, her gaze hooked to her calcium-covered boots. Any bystander would notice she has some sort of social phobia.

At 9:42 a.m., Liz walks into work, her mascara dripping from the cold. She looks troubled, exhausted. Her deep and sunken eyes and eczema-reddened face unable to conceal the heavy burden of acute anxiety she’s been bearing. “Sorry I’m late, I had door problems this morning,” she says. An excuse often heard.

Obsessive-compulsive disorder is a common, chronic anxiety condition with a waxing and waning course, marked by urges that interrupt everyday thinking, and repetitive behaviours aimed at easing the anxiety and distress the invasive thoughts cause. Dr. Alain Lévesque believes there are over 750 K registered OCD cases in Canada. Well in his fifties, the grey-haired child psychiatrist from Rivière-des-Prairies Hospital says OCD can occur at any time of life, and can develop from the interaction of several biological, environmental and social agents.

OCD is often treated with sertraline, an antidepressant that affects serotonin levels in the brain that may become unbalanced and cause the disorder, but Liz hasn’t renewed her Zoloft prescription since her health insurance card expired two months ago. Since being off her meds, she’s had a sense something terrible will occur if she doesn’t perform her rituals, leading to a constant feeling of uneasiness. She also put an end to her Skype therapy sessions because her therapist, an OCD specialist, made her feel “uncomfortable.” The past two months have been excruciating.

Dr. Lévesque who has never treated Liz but has seen many similar cases, says control is a debilitating defence mechanism of people with OCD. “In order to alienate anxiety, they try controlling all elements of their environment by performing repetitive actions.” Liz falls into two OCD areas: checking and contamination. Her obsessive fear of danger causes her to examine things compulsively, while her obsessive fear of death by means of contagion triggers the need to clean and wash, over and over again.

Four years ago, 28 year-old Liz flew to Montreal in search of better work opportunities, leaving her native Bordeaux behind. She grew up on a vineyard in a quiet area in Southwestern France, where morning fog would give way to burning midday hues, and she and her parents drank the wine they crafted along some sautéed foie gras on the ceramic terrace overlooking the vineyard. Second child of a family of three, Liz says she was like any other happy teenage girl, until mild obsessive thoughts she kept to herself appeared when she was 14. “I would constantly check my watch and flicker light switches, but the anxiety remained low.” Dr. Lévesque has seen many OCDs develop among teenagers and young adults, possibly because of the many changes the adolescent brain goes through. But for Liz, it’s her “journey to Canada that caused the OCD to skyrocket.”

Upon arrival, she quickly got an account coordinator position at a wine-importing company in the heart of the lively Mile End area, where I also worked. The second she walked in on her first day, I knew she was tormented.

At 9:50 a.m., another ritual begins before she settles down. She locks herself up in the office bathroom, washes her hands several times, brutally rubbing up to her elbows, tap stream fully on, spraying walls, floor and counter with hot water and soap as she does so. She’ll sometimes leave a clod of brown paper in the toilet or on the floor, for fear it might contaminate her. She squirts on some hand sanitizer just in case she missed a spot and then, she’s finally ready to get to work.

For four years, I have experienced Liz’s OCD firsthand: her rituals, her ups and downs, and even the onset of new phobias and ensuing compulsions, trying each time to understand what went on in her head. She opened up to me a few times here and there, but never let me in completely, always avoiding the extent to which the disorder affected her everyday life.

A few weeks ago, I tried interviewing her for what I originally intended to be a profile story. Although she had given me her consent prior to our conversation, she would not open up; I believe this was due to her need to control the situation. She was OCDing. When she uses rituals as a strategy to control the obsessions, she is in fact producing the opposite effect, thinking about the obsessions even more. Being subjected to this constant need for control motivated me to focus on my personal observations and experience of Liz’s overpowering need to always be in the driver’s seat.

Another reason why she shared so little information about her condition is because “people with OCD are terrified of other people’s judgment,” according to Dr. Lévesque. But as she refused to answer when asked how she perceived herself, I realized that not only was she afraid of other people’s judgment; she was especially terrified of her own. Her incapability of letting me in “did not reflect a lack of will, but rather a great fear of losing control over the situation, as well as a fear of looking deep within herself,” thinks Dr. Lévesque.

At 7:15 p.m., Liz’s the only one left at work. She starts drafting emails, typing with what’s likely a false assurance, tidies up her desk a little, stretching the last few moments before heading back home, where her demons await, behind a front door she will unlock and lock again several times. The walk back home is even more daunting, her fast and mechanical step on the same sidewalk of the same street even more noticeable. She stops by the same convenience store every night to buy a 25-pack of Benson & Hedges Silver she will smoke entirely. She will skip dinner, just like she will skip breakfast in the morning, the fear of food poisoning outweighing her need to eat. She will call off her plans for the weekend, pretending she’s busy when in fact she’s just smoking cigarettes, doing laundry and checking things, over and over again.