The ill-understood condition of an obsessive-compulsive disorder (OCD) is often the butt of jokes. It raises merciless laughter from a society who views the behaviour of those who suffer the disorder to be amusing, irrational and odd. What goes unrecognised however is the endless daily torment endured by the individuals living with this condition and their battle with its constant interference with their ability to function in normal daily life, especially in the work place. An extract from www.webmd.com reads as follows:
“Obsessive-compulsive disorder (OCD), formerly considered a type of anxiety disorder, is now regarded as a unique condition. It is a potentially disabling illness that traps people in endless cycles of repetitive thoughts and behaviors. People with OCD are plagued by recurring and distressing thoughts, fears, or images (obsessions) they cannot control. The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform certain rituals or routines (compulsions). The compulsive rituals are performed in an attempt to prevent the obsessive thoughts or make them go away.Although the ritual may temporarily alleviate anxiety, the person must perform the ritual again when the obsessive thoughts return. This OCD cycle can progress to the point of taking up hours of the person’s day and significantly interfering with normal activities. People with OCD may be aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop them.”
The painful and debilitating impact of the disorder was well illustrated in an incapacity matter in which I was engaged as an expert. In this matter an intelligent, professionally qualified woman of middle age was assessed to be unable to continue working owing to the complexities of the OCD and the concurrent bi-polar disorder with which she had been diagnosed. Understanding the enormity of the impact of the symptoms of OCD on her life via the written information provided by various medical specialists proved to be somewhat impossible in the absence of a functional assessment and professional observation. It was only through such assessment, combined with significant collateral obtained from the individual’s line manager, that those tasked with assessing the merits of her application for ill-health benefits were able to determine the crippling impact of her illness.
Some examples of her work-related difficulties whether in a depressed or hypomanic phase, and always suffering with OCD, included the following:
- Not being able to get to work on time owing to repetitive checking of windows and doors upon leaving home each morning, followed by returning home half way to work to re-check all;
- Following a specific morning ritual of making a drink after having locked her handbag in the desk locker upon arrival, which she then checked a number of times before getting in to the staff kitchen;
- Spending time writing up and posting Post-It notes around her desk listing all the routine tasks that had to be done for the day prior to commencing work;
- Not being able to tolerate office noise, any spontaneous engagement with others, meet deadlines and more.
What could so easily be mistaken for non-performance was in fact the result of the uncontrollable and immensely powerful demands of a psychiatric condition that had taken ownership of all aspects of this woman’s working life.
Irrespective of the work adjustments made; the job swapping introduced; the most compassionate leadership and much medical management, the person concerned simply could not function in the working world – and in fact, never had. She had merely managed to survive throughout her attempts at a career, having been constantly aware of her under-performance and always experiencing a sense of failure.
A strikingly sad moment during the assessment process was when she noted quite insightfully – and a little tearfully – that all she had ever wished for was to ‘be normal’.
The desire to work and the hunger to be a productive member of society was not absent in this instance and there was no secondary gain to be had by being medically boarded. Perhaps for the first time in her life, however, once her need to stop working had been recognised, this long-suffering and gentle soul could possibly start to live a life less exhausting, frustrating and demoralising than that through which she had battled for 30 plus years in trying to ‘fit in’, always knowing she did not.