Letter of support for Frederick W.Thompson Anxiety Disorders Centre
From Jennifer Bayne, a grateful client

Before commenting on my life-altering experience at the Frederick W. Thompson Anxiety Disorders Centre, first let me provide an analogy for what my life with Obsessive-Compulsive Disorder (OCD) was like. Picture living with a room-mate who sweet-talks you into sharing a place, telling you she has your back and vowing to protect you and make you safe in exchange for shared room and board. Once she moves in though and you get to know her better, you discover she is actually abusive, cunning, and mean-spirited, saying she’ll protect you only as long as you play along with her rules which, as time goes on, become more and more detailed and constricting. She makes it clear that if these rules are not followed, grave consequences will result, especially for the people or things you value the most. Like an abused partner, after a while you stop seeing the abuse as originating with her and start to make it part of your own psyche; at this point, the rules are your own and you follow them blindly, out of fear of reprisals and imagined catastrophic consequences.

This is the room-mate I’ve lived with for 55 years. My OCD began around the age of six and morphed over time from contaminations, to reassurance-seeking, to ordering, and to counting (to name a few), often in combination. I was able to have a successful career but all the while was fighting my OCD demons, which exploded with full-force when I retired last year. At that time, my OCD flared and turned into an out-of-control forest fire, being flamed daily by successively worsening triggers. By the time I reached out to the Thompson Centre, I was panicking. I was visualizing my life becoming narrower and narrower to the point of complete catatonia. I was only able to leave the house for short periods which were becoming increasingly stressful and anxiety-provoking. Just crossing the street or riding my bike were becoming hazardous, due to the need to avoid cracks and crosswalks or any small obstruction in the road. I was becoming a danger to myself and even to others, as my compulsions were becoming more and more frequent and erratic. I was also having suicidal thoughts again; they were not so much thoughts of taking my life as wishing I could die. My sister, who also had OCD, had taken her life when she was 29 years old and so I knew how much the agony of OCD could lead to the desire to end it.

After my referral to the Thompson Centre and a wait of about four months, I volunteered for 3 or 4 clinical trials. I was assured that I would still be on the one-year wait-list to see an individual therapist, but in the meantime participated in a Mindfulness-Based Cognitive Therapy (MBCT) group treatment program, one of the clinical trials designed to test the efficacy of that approach on OCD. I had no expectations, merely a desire to get respite at any cost. The 10-week program was, quite frankly, a life-saver. It involved doing daily meditations and keeping notes of observations or progress week by week and then meeting with a group of other OCD sufferers. It was quite possibly the hardest thing I have ever done. I was massively confronted by my OCD, which I was now being forced to look in the eye, I had panic attack after panic attack, I convulsed, and I cried. But in the end, I got through it and I saw my room-mate for what she truly was. As I said to my MBCT group, possibly the last straw was when she proverbially ‘made’ me stand on the edge of the CN Tower and jump; she laughed as I leapt, but I laughed back. After the MBCT experience (lead by Dr. Steven Selchen to whom I am deeply indebted), I saw Dr. Peggy Richter, who was invaluable, and I hope to participate in some further CBT group work.

I still do my daily meditations and record my thoughts in a diary. Yes, I still have OCD and yes, it still shows up every day, sometimes more, sometimes less, depending on my fatigue and stress. But without the Thompson Centre, I am fully convinced I would now be house-bound, unable to do activities of daily living, and increasingly alienated from my loved ones. As I reflect back on my experience, what pains me the most is how many people like me are suffering as badly if not more so, and who have to wait up to a year or longer to access services, assuming they are even well enough to find out about them. The Thompson Centre’s work is essential and a catalyst and change-agent for change across the country. Please ensure its continued viability.

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People often make casual remarks or jokes about mental illness. Referring to someone’s quirks as “OCD,” expressions of anger as “going mental,” or disappointment as “depression” is a harmful misuse of language. It often stems from a lack of knowledge about mental illness. Although it may seem harmless or indirect it can have damaging effects on those affected by mental illness. It reduces language that describes something intense and disabling into an exaggerated character flaw or insult. In this way, it strips sufferers of a legitimacy that’s already difficult to obtain.

The words used to identify mental illness are important for those affected by it. They act as a way to label what they’re going through, separating the person from the illness. This restores a sense of self that can be fragile during difficult times.

Would you ever poke fun at someone for having the measles or epilepsy? Probably not. Most people would find comments about physical illness inappropriate, because they trivialize real suffering. But somehow mental illness escapes this logic, perhaps because it isn’t seen as existing on the same plane as other illnesses.

This can stem from the belief that thoughts, behaviour and mood are always under the control of the individual and therefore could be changed if only that person tried a little harder. This isn’t true. Mental illness is a physical illness, one that affects the brain and manifests as disturbances in behaviour, feelings, perceptions and thoughts.

Stigma

Stigma is a negative stereotype. Discrimination is unfair treatment that occurs because of the stereotype.

Let’s take a look at some of the specific ways people with mental illness experience stigma:

• Feeling at Fault: Believing that they are the cause of their illness.
• Feelings of Failure: The impression that they could overcome their problems if they had stronger character; that negative outcomes are the result of personal failure.
• Feeling Devalued: Belief that one is abnormal or unworthy of help.
• Exclusion: People avoid what they don’t understand, putting those with mental illnesses at a disadvantage. This can lead to social rejection, lost job opportunities or access to a safe housing.

All of these attitudes increase the incentive to conceal. The burden this adds to illnesses that already affect mental well-being can be highly damaging. It intensifies shame. And shame prevents people from acknowledging their problems and seeking out the help they need. This goes further still. Not only does shame prevent access to help, it also hurts a person’s ability to be receptive to treatments that require cooperation (e.g. CBT, psychotherapy, mindfulness). In this sense stigma inhibits not just access to help, but also receiving help successfully.

Reinforcement from Language

Using casual language around mental health strengthens stigma.

Imagine you have severe Obsessive Compulsive Disorder. This might mean you have urges to check things in your home repeatedly, to the extent that you can barely leave the house or hold down a job. This is intensely distressing and you are aware that your behaviour is counterproductive and harmful. But no matter how hard you try you can’t stop. You know you need help but are too ashamed to discuss it with anyone.

While grocery shopping you see a couple in the cereal aisle. When the women changes her mind about a cereal and puts it back on the shelf, the man steps forward to reposition the box so that it lines up with the others. Rolling her eyes the woman says, “God, you’re so OCD, I can’t take you anywhere.” They both chuckle a little and walk away.

This remark deepens your feelings that you aren’t normal and that if anyone knew the true extent of your problems you would be ridiculed and rejected.

The suggestion here isn’t that we should all become militant language police. There’s a challenge not to overdo it with censorship, particularly because of the silencing effect of mental health stigma. We don’t want to be so frightened of using language around mental illness that it prevents healthy communication and expression. There’s still a need for discussion and understanding. Thoughtful reflection of the words you use and how you use them is a good start.

Language can also present an opportunity for understanding. It’s useful in helping us imagine what life’s like for those with mental illness. Healthy people also experience a wide range of emotions and mental states. Perhaps we can use our experiences of anxiety, intrusive thoughts, distress and sadness to imagine what it’s like for those who endure these on a vastly more intense and disabling scale.

In this way, language is a type of window, a way of seeing into the lives and challenges of someone else.

So what can we do to improve?

Think about what you’re saying. What do you really mean to say? Chances are, someone listening has been affected by the words you’re using. One in five Canadians will experience mental illness in their lifetime. Someone you know has likely been affected. The casual language you use to embellish a story is probably personal for someone hearing you.

If you catch yourself saying something you didn’t really intend, correct yourself or apologize. Talk about it. Everybody makes mistakes, but the way we respond to our mistakes can make all the difference.

Positive actions you can take to reduce stigma:

• Choose your words. Pay attention to the language you use. Challenge others when their words may be hurtful.
• Be compassionate. Treat those with mental illness with the same kindness you would for a person with any other illness.
• Talk about it. Discuss it. This means asking questions, listening to other points of view and opening yourself up to other opinions.
• Educate yourself. Learn more about the issues. Here are some good resources for information about mental health:
  • Canadian Mental Health Association
  • Frederick W. Thompson Anxiety Disorders Centre
  • Centre for Addiction and Mental Health
  • Anxiety Disorders Association Canada
  • Fact sheets about mood disorders

Citations:

http://ontario.cmha.ca/mental-health/mental-health-conditions/stigma-and-discrimination/

https://en.wikipedia.org/wiki/Mental_disorder

http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/stigma/Pages/stigma_brochure.aspx

http://www.cmha.ca/media/fast-facts-about-mental-illness/#.V0N_KNdTo4A

http://letstalk.bell.ca/en/end-the-stigma/

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Who should attend?

• Individuals of all ages with OCD and related disorders
• Family members, loved ones and advocates of those with OCD
• OCD researchers
• OCD therapists and clinicians

This unique conference brings together those researching and treating OCD with those experiencing it, bridging the gap to encourage education and understanding for all.

What’s on the agenda?

• Programs for kids, teens, adults, parents, families, therapists and researchers
• New presentations on OCD and substance use
• Research to Clinical Practice series: bringing together researchers and clinicians to share information
• Body Dysmorphic Disorder Series
• Hoarding meeting
• Evening activities: Improv for Anxiety from Second City Training Centre, OCD pub trivia, and support groups

More information related to the program and schedule can be found here.

Interested in attending the conference? Visit the conference website.

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Ready to learn more about Obsessive Compulsive Disorder (OCD) and Anxiety? The Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook holds a monthly information session, Getting Started: Learning About OCD and Related Disorders Information Group, on the third Wednesday of every month.

The Thompson Centre is working hard to meet the needs of its clientele. However, there may be lengthy wait times for consultation and treatment. The Getting Started Group is a great way to learn and ask questions about OCD in the meantime.

The sessions aim to communicate information about OCD and related disorders. Each session covers a different topic, such as causes of OCD, medication and other treatments, community and web-based resources and strategies for self-care.

We invite persons with OCD and related disorders and/or their loved ones to attend these sessions.

Please understand that this is not a consultation or treatment service but rather it is an informational session intended to provide attendees with knowledge about OCD and OCD Related Disorders that may be helpful while you wait for consultation at our clinic, or as you think about getting treatment.

Meetings are held on the third Wednesday of every month, from 3:30 to 5 pm, at Sunnybrook’s Bayview Campus located at 2075 Bayview Avenue in Room EG 21. Click for a schedule of upcoming meetings.

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Dr. Peggy Richter, head of the Thompson Centre, speaking at an event in 2012.

By Beth Hopwood, a member of the Thompson Centre Patient & Family Centred Care Committee

On March 18, the Fredrick W. Thompson Anxiety Disorders Centre proudly held its annual conference, entitled “The Future is Now: Evolving Best Practices for Obsessive-Compulsive Disorders & Anxiety.” The conference, in its fourth year, is the only educational event of its kind in Canada focusing on obsessive-compulsive and related disorders. Health care workers from a variety of backgrounds came to learn more about advances in treatment and new technologies.

The event kicked off with a warm welcome from Dr. Peggy Richter, head of the Thompson Centre.

Speaking first, on the impact of severe OCD on family, was Laura Armstrong, a member of the Thompson Centre’s Patient & Family Centred Care Committee. Armstrong delivered a deeply felt reminder of the pain the condition causes for patients and loved ones. She highlighted the need for specialty care, like that provided by the Thompson Centre, and the difference it can make in the lives of those affected by OCD.

Next to speak was Dr. Richard Swinson, professor emeritus and former chair of the Department of Psychiatry and Behavioural Neurosciences at McMaster University, reflecting on the evolution of treatment for anxiety and his forecast for future care. Dr. Swinson was also the recipient of the inaugural Thompson Award in honour of his work as a Canadian leader in anxiety disorders.

Throughout the day attendees participated in workshops of their choice, ranging in topics from psychopharmacology, CBT, mindfulness, peer support, neuromodulation and e-therapies, and sessions on adults, youth and families.

Dr. Z. Jeff Daskalakis, Temerty Chair in Therapeutic Brain Intervention, closed off the event with a talk on emerging biomarkers and mechanisms of response to brain stimulation and the future direction of mental health treatment.

Fully accredited by the University of Toronto, participants received certificates for attendance; having learned advanced treatment principles for OCD, anxiety and related disorders (trichotillomania, excoriation disorder, hoarding, and body dysmorphic disorder).

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