RITUAL WASH: OCD Patients are paranoid about cleanliness

Joe Wells, 17, is a fairly typical teenager. One big preoccupation is finding space for his vast and growing collection of CDs. He plans to study philosophy or journalism. Life is good, especially since his first book, Touch and Go Joe, was published last month.

But things haven’t always been like this. Until recently, terrifying thoughts ruled Joe’s life because he had a form of obsessive-compulsive disorder (OCD) that meant disasters, death and even the loss of his soul seemed near. He was forced into elaborate rituals to keep them at bay, including intricate tapping sequences and the repetition of phrases, head and body movements. “It was hell. I’d never want a child of mine to go through that,” he says.

It started when he was 9. While his younger sister, Emma, 6, was playing in the garden, Joe would be at the bathroom sink, struggling to turn the tap off with his wrist. “I felt I had to avoid touching the tap in case somebody with dirty hands had touched it,” he says. “It might be the tenth time I’d washed my hands that day but I knew it wouldn’t be the last, even though my hands were red and sore. I’d become obsessed with fears of poisoning.”

More dangers loomed: from car exhaust fumes to bacteria and even wallpaper solvents. “I was paranoid about touching door handles because of germs. Any of them could be the end of me. My home had become a terrifying place.” The more Joe tried to push a worrying thought out of his mind, the more it would force its way in. “I felt I was a freak. Or going mad.”

At 11, Joe’s family moved house and losing familiar surroundings increased his worries. “I developed a huge fear that if I sinned, I’d die. A lot of stuff we were taught in Sunday school was very heavy. I had to keep repeating: ‘I do believe in God and I do accept him in my life’. I was like an anxious monk.”

By 12, Joe was terrified that his soul would be stolen. To guard against that he performed complicated tapping sequences. “I needed to tap an object a certain number of times or my soul would be taken away. If I lost count, I’d have to start again. I was tapping thousands of times a day.”

That summer Joe and his family holidayed in Corfu. “Because it was a strange place, my stress levels rocketed. The rituals became completely unmanageable.” He remembers tussling with his parents in a restaurant. “I was in the middle of tapping a plate. They were trying to take it away, I was pulling it back. They couldn’t understand why I was so upset and angry.”

By then he had developed stepping routines to prevent his soul being stolen. “But because I had to step on all the different road surfaces, it made me sway as I walked.”

“I began to meander as if drunk. If I linked arms with one of my parents, I could walk straight, but I’d still be stamping my feet or taking exaggerated strides. Unsurprisingly, my parents didn’t want to walk with me”.

The problem couldn’t stay hidden. “Luckily, Mum had been lent a book by a friend, which described OCD. Mum said that it sounded like what I had.” Joe’s GP referred him to the Hampshire NHS family-therapy team who diagnosed OCD. “Having a label helped,” he says. “I wasn’t a freak. This was a proper illness”.

He was referred to a clinical psychologist, Alison Wallis, for cognitive behavioural therapy to challenge the OCD beliefs. “She’d ask me to give evidence for and against the ideas behind the compulsions, and for the specific fear of losing my soul”. The therapy seemed to be helping, then adolescence kicked in. “I was like Harry Enfield’s teen character Kevin, Joe Wells and OCD moulded into one. I had constant arguments with my parents. Depression and OCD was a terrible combination”. At that point he was prescribed selective serotonin re-uptake inhibitors (SSRIs), a medication to treat depression and anxiety. “I began to feel more confident. I started arranging to go out with friends. I found the courage to tell people about my disorder. With Mum’s encouragement, it developed into a book”.