I often see newspaper headlines as images in my mind about the terrible consequences of my OCD fears.
How it started
Currently lying in bed, it’s still light outside, but all I feel within is darkness.
Back in February I was extremely worn down and when I went to a shared toilet I noticed inbetween wipes a reddish mark on a piece of unused toilet paper. Where did it come from? Was it from me, or someone else? How long had it been there? I threw the bit of stained paper away, and I don’t remember seeing anything before and after. But the OCD brain is completely irrational. My memory is hazy and my thinking distorted.
Since then I have had 3 to 4 lapses about this; I am currently in another at the time of writing.
On Monday I pulled a bogey out of my 2 year old son’s nose (I know I know), there was a bit of red in it. Where did this blood come from? Was it his, was it mine? What If there was traces of blood on my thumb and I contaminated him.
I struggle with dermatillomania (skin picking) at times, usually only minor, but I feel the urge to remove any blemish on my skin. My arms can sometimes be covered in red marks where I have picked and at times I draw blood. I am also a Dad, which means I prepare food, change nappies, bathe my children and yes, disgustingly remove a bogey once in a while.
Of course I try to maintain good hygiene, but what if I picked my skin inbetween washing my hands and some blood remained on my fingers and thumb, perhaps underneath the nail. Often this process feels unconscious, automatic even. If I got HIV from the magic biology defying toilet paper what if I transferred this to my little boy via his nose, or when I applied nappy cream, or when I prepared his food. Vivid pictures of him suffering swarm in my mind and it breaks my heart. It would be all my fault. I must be an evil person.
I try to fight it
Over the last couple of days I did some ERP by touching inside his nose a few times and didn’t avoid nappy changes. Like a pick axe smashing into an ice block (or bogey?) it once again became stuck. Brain lock here we are again. Deflated, utterly deflated. I was so happy and thriving last week as well.
The OCD whispers: “Why did you do the ERP Richard, you have just increased the probability of your child becoming the first recorded case of someone getting HIV from nose picking or from applying nappy cream. No one will believe you, and will assume you are a terrible human being. What sort of selfish bastard uses his own family as an ERP, what an awful father you are.”
I frantically try to reassure myself. Hello Google, I’m back. Most of the links going up to the 10th page of results are almost all purple rather than blue – I have clicked on them before.
Believe it or not there isn’t a huge amount of information online about the transmission of HIV via toilet paper and then subsequent nose picking. Perhaps that could be my niche for writing a book?
The crucial point I always start with is survivability of HIV in blood in the environment. The vast majority of experts state that HIV doesn’t survive very long once exposed to the elements. There isn’t an exact time given, and this varies amongst websites (seconds to minutes). I then focus on possible environmental transmission despite there being no documented cases in the history of the virus that have been contracted from an environmental surface. I then dig deeper with regards to the specific concerns, namely transmission via toilet paper and then subsequently nose picking. If OCD gives me something to find, I am the expert at finding it.
Examples of reassurance from the web
I used to have an HIV reassurance essay on my phone, but I deleted some time back. I could have made a fortune from that bad boy on the OCD reassurance black market.
Anyway, I’m ashamed to say, that I have some reassurance screenshots on my phone that I have gathered since February. Here are a few of them:
Its never enough
So there you have it, an insight into my secret treasure trove of reassurances collected in desperation during times of struggle. To be honest most of the time I don’t even look at them, but as a safety behaviour I keep them there “just in case”. I know full well it is compulsive. I am still recovering. I try not to beat myself up too much, but more often than not I do. One day I know I will have to remove even the smallest of safety behaviours when I feel a lapse coming on.
It’s absolutely ridiculous really: world leading experts and a qualified peer educator on the subject of HIV stating either directly or indirectly that my potential toilet paper exposure is not possible. Yet my OCD won’t accept this; Dr OCD knows more than these people.
I feel like a complete fraud, I am ashamed; especially when I know better. I know the futility of what I do and yet I still allow my disordered brain to trick me and fall into the same traps. Like a recovering alcoholic who has a couple of sips. Surely it won’t hurt right? Wrong.
The worst part of OCD is that there is literally no way out. It’s like being buried alive for days. If I engage with compulsions such as research, I only prolong my stay in the coffin. Yet OCD tells me it’s the only way out. You have to sit in the discomfort of being buried alive for a good few days until Mr Clarity comes and opens up the tomb and allows you to be free. Would I prefer to have OCD or be buried alive temporarily? That’s a difficult question, which tells you all you need to know.
Inevitably my mind will tell me to maybe ask a doctor, or worse get a test. But I cannot do this. Testing will only programme my brain even further to keep this disorder embedded making a possible future relapse even worse. I haven’t had a test in 8 years, I am not going to do it now. No way.
I have actually calculated the probability of contracting the virus in lots of different weird and wild situations over the last decade or more. For example, in the UK I have calculated that 99.9779% of people either don’t have HIV or if they do (0.23%) they are virally suppressed. In other words, there is a 1 in 5000 chance that a person has transmittable HIV. That is even before any possible exposure! Fresh blood in the nose is estimated to be a 1 in 10,000 chance of transmission according to the CDC. I’m not sure what wiping with toilet paper would be, but most experts would argue the question to be irrelevant due to the virus’ fragility. OCD doesn’t like that answer.
Of course the more you research the more fringe opinions you will see online. There are a few people who argue HIV can survive for hours and even days. Whilst this is true in artificially high concentrations of the virus in laboratory conditions, in real life there is no evidence of this. And besides survivability does not mean infectability. Yet OCD brushes aside the experts in favour of random people taking research out of context.
Well, once again I have to drag myself up from the floor and push forward. Surrender the compulsions and wait in the coffin of uncertainty. It is painful, tiring and scary. But I’ve been here 100s of times before.
75% of the time I manage this disorder really well, so I should be proud really. It’s hard to feel that way in the midst of a lapse.
Sometimes I wonder why the hell I bare my soul in these pieces, but knowing the suffering I experience and have experienced with OCD I feel morally obligated to do so. In ACT we are encouraged to focus on our values. Well, this is one of my values (helping others with OCD), and this is my small part in actioning this goal. I can feel vulnerable, nervous and embarrassed at times (probably the OCD and decades of stigma talking), but please know you are not alone. I am here with you all, even when I’m struggling myself.