As a teenager, Jeffrey Kotas aimed for perfection with his schoolwork, but it was coming at cost.
“I started having issues constantly rewriting my assignments over and over again,” says Jeffrey. “I didn’t really have any life outside of school. It was all about doing my compulsions and getting my work done in a specific way. I didn’t have time to watch TV or socialize, so every day was exhausting.”
In high school, he was diagnosed with obsessive-compulsive disorder (OCD), and as time went on, it became more pronounced.
“When I was buying textbooks for university, if there was a crease on the page or if it had touched something, I felt that it was bad and I had to get a new one,” Jeffrey says. “I had saved some money over the years, but in a short time, I blew it all on buying stuff over and over again, when I felt anything had been tainted.”
Living with OCD
OCD is a debilitating psychiatric illness that impacts one in 40 people over the course of their lifetime. Individuals with OCD experience obsessions, which are unwanted, intrusive and repetitive thoughts, urges or images that cause anxiety. Obsessions are typically accompanied by compulsions or rituals which are repetitive behaviours the individual may feel compelled to perform in efforts to ease the anxiety, and can take up many hours of the day.
For Jeffrey, handing in assignments became so distressing he eventually had to leave university. His illness progressed and he obsessed over contamination. “I’d take extremely long showers, like, four-hour showers. Cleaning the bathroom could take hours. Sometimes, I’d even go on a marathon clean of nearly 30 hours.”
After years of trying medication and therapy, Jeffrey realized he needed further treatment. He was the first person in North America to participate in a trial investigating the safety of using focused ultrasound for OCD, which harnesses the power of sound waves to precisely target specific pathways of the brain, without using scalpels.
Several months later, he felt the intensity of his anxiety was “significantly reduced” which he explains helped him immensely when he began the intensive residential treatment program for severe OCD at the Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook Health Sciences Centre.
The Thompson Centre is unique. It is the only facility and treatment program of its kind in the country, where patients with severe OCD can receive intensive residential and individualized care. Before the launch of the OCD residential treatment program in 2017, Canadians who needed this specialized treatment had to go to the United States.
“This residential setting supports clients by tailoring treatment to their individuals needs,” says Dr. Peggy Richter, head of the Thompson Centre.
“Therapy and treatments are not only delivered one-on-one, but also in group settings where clients experience the support of peers while learning how to combat their symptoms,” she adds.
A new beginning
For Jeffrey, arriving at the Thompson Centre, was the start of treatment that he hoped would be life-changing and life-saving.
“Since it is a residential program, I felt it would be best-suited for me,” says Jeffrey. “It allowed me to focus and not have to worry about anything else.”
“It is an extremely welcoming and supportive environment,” Jeffrey adds.
“OCD by its very nature can present differently in different individuals and any OCD treatment program must be able to meet these needs,” explains Dr. Marlene Taube-Schiff, team lead for the OCD residential treatment program at the Thompson Centre.
The program’s holistic and team-based approach includes psychiatrists, psychologists, occupational therapist, social work and a mental health clinician.
“Our team works together and collaborates each day,” says Dr. Richter. “Given the range of our collective expertise, we all play a unique role in treatment which ultimately provides the best care for our clients’ needs.”
In addition to his treatment team, Jeffrey also felt supported by the other patients, “There was a clear understanding that we were all in it together and we wanted each other to succeed.”
A typical day at the Thompson Centre
Throughout the day residents are immersed in various sessions: cognitive-behavioural therapy and other psychotherapies, occupational therapy and social work groups.
One major challenge for Jeffrey was exposure and response prevention (ERP) therapy, where an individual is exposed to anxiety-inducing triggers but refrains from completing their usual rituals. “We challenge our obsessions and compulsions. We do things that cause us anxiety, and sit with the feeling of it being ‘wrong’ and not doing what our OCD wants us to do,” explains Jeffrey.
While ERP was extremely difficult he began noticing a difference and reached a pivotal moment in his treatment. “Over time, the level of anxiety eventually started to decrease. I remember thinking, ‘I have to keep doing this. I want to succeed.’ And one day, I felt a certain degree of strength and thought, ‘It’s actually working, I can feel something now that I didn’t feel before. I feel certain things are getting easier,” he smiles.
When clients are immersed in an intensive residential setting, and complete the individualized treatment program, people with severe OCD often see a 50% decrease in symptoms or better.
“It is amazing to be able to support our clients in this change and in effect, help someone get their life back,” says Dr. Taube-Schiff. “I always tell our clients it is a privilege to work with them and I truly feel that way, every day.”
Life-changing residential treatment
In addition to providing residential care to 26 clients each year, the Thompson Centre also offers day treatment, which can serve an additional 18 clients. Over time, the wait list has grown for both programs. There are more than 30 people currently on the waitlist to be admitted into the intensive residential program. Over 70 people have applied to the program since opening one and a half years ago.
“Our hope is to one day expand programming to continue to provide individualized treatment to all those who are struggling with severe OCD, and better support them afterwards in recovery,” says Dr. Richter.
Jeffrey was in the intensive residential program for nearly nine weeks. “Before I was here — my life was just suffering,” the 31-year-old explains. “At this point, I don’t feel like I’m suffering at all. Even if I have anxiety — it doesn’t rule my life.”
This new-found strength is helping Jeffrey do things beyond his expectations. Once afraid of traveling, he recently went on a weekend road trip and is now planning for a possible international trip in the future.
“I’ve been going out with my friends lately. I’ve been taking my courses. I’ve been going to the food bank and volunteering. I’ve started going back to the gym. All of this would have caused me unbearable anxiety before,” says Jeffrey.
“My life feels like a completely different life.”