Obsessive Compulsive Disorder

Obsessive Compulsive SECOND Disorder EDITION Practical, tried-and-tested strategies to overcome OCD ‘A highly readable and most informative account’ Padmal de Silva Dr Frederick Toates and Dr Olga Coschug-Toates Obsessive Compulsive Disorder Reviews of Obsessive Compulsive Disorder ‘This is an excellent book – full of helpful hints, advice and inspiration for those who suffer from OCD. The authors resist the temptation to simplify, and succeed in providing an insightful guide to a complex problem.’ DR FRANK TALLIS, Clinical Psychologist and author of Understanding Obsessions and Compulsions ‘. helpful both to those who suffer from the condition and to those who wish to help but struggle to understand.’ JOAN BOND, Director, TOP UK Obsessive Compulsive Disorder Practical, tried-and-tested strategies to overcome OCD 2nd edition Dr Frederick Toates DPhil,DSc Reader in Psychobiology at the Open University Visiting Professor in France, Germany and Sweden and Dr Olga Coschug-Toates PhD Physicist Foreword by Padmal de Silva CLASS PUBLISHING • LONDON First published by Thorsons as Obsessional Thoughts and Behaviour 1990 Reissued by HarperCollins as Obsessive Compulsive Disorder in 1992 Text © Frederick Toates 1990, 1992 Text © Frederick Toates and Olga Coschug-Toates 2002 © Class Publishing 2002, 2005 The rights of Frederick Toates and Olga Coschug-Toates to be identified as the authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. Without limiting the rights under copyright reserved above, no part of this publication may be reproduced, stored in or introduced into a retrieval system, or transmitted, in any form or by any means (electronic, mechanical, photocopying, recording or otherwise), without the prior written permission of the above publisher of this book. The authors and publishers welcome feedback from the users of this book. Please contact the publishers. Class Publishing (London) Ltd, Barb House, Barb Mews, London W6 7PA, UK Telephone: 020 7371 2119 Fax: 020 7371 2878 [International +4420] Email: [email protected] Website: www.class.co.uk The information presented in this book is accurate and current to the best of the authors’ knowledge. The authors and publisher, however, make no guarantee as to, and assume no responsibility for, the correctness, sufficiency or completeness of such information or recommendation. The reader is advised to consult a doctor regarding all aspects of individual health care. A CIP catalogue record for this book is available from the British Library ISBN 1 85959 069 1 Edited by Gillian Clarke Designed and typeset by Martin Bristow Indexed by Val Elliston Printed and bound in Finland by WS Bookwell, Juva Contents Foreword by Padmal de Silva, MPhil, CPsychol, FBPsS vii Foreword to the first edition by Hans Eysenck, PhD, DSc ix Preface xi Preface to the first edition xiii Part 1: Autobiographical sketch 1 Home in Histon 3 2 Leaving school 14 3 Student life 17 4 Denmark – almost heaven 23 5 Signs of trouble ahead 28 6 Decline 34 7 Getting back to normal 43 8 Misplaced complacency 47 9 Never get complacent 52 10 Going public 66 Part 2:What is obsessional disorder and what can be done about it? 11 The nature of the problem 83 12 Overlap and confusion with other conditions 101 13 Who develops the disorder, and what is it like for them? 114 14 Professional help 129 15 Self-help – what to do and what not to do 142 16 Trying to solve the puzzle 155 17 Some famous thoughts 177 18 Conclusion 238 Glossary 243 Resources 247 Index 255 Foreword by Padmal de Silva Obsessive compulsive disorder (OCD), classified in psychiatric thinking as an anxiety disorder, remains a fascinating phenomenon. It is more complicated in its features and presentations than any of the other anxiety disorders – such as agoraphobia or post-traumatic stress disorder – and some aspects of it may seem truly bizarre to those who have no experience of it. Why would someone feel compelled to touch the four walls of a room in a clockwise fashion as soon as he enters it? Why would someone look at an object three times with the right eye, followed by three times with the left eye? Despite excellent scientific and clinical research in the last three decades, OCD continues to fascinate and puzzle. Much has been written about this disorder, dealing with its nature, its various dimensions and its correlates in recent years. Frederick Toates’ book, which was first published in 1990, was one of several books on this subject intended for the general reader. It was, however, different from the others. Here was an author writing about his own experience of suffering from OCD, and also summarising – and commenting on – the scientific literature on the subject. Toates, as a well established and highly accomplished experimental psychologist, wrote on OCD from two vantage points: that of the sufferer, the insider; and that of the scientist who could assess and evaluate the literature. This made his book unique, and it was received with much acclaim. It is pleasing that a second edition of the book has been prepared. In this edition, written in collaboration with his wife Olga, Toates gives an updated version of his personal story. This is a highly readable and most informative account, a human story told with a frankness that all readers will find touching. In the second part of the book, what is known about OCD and how it is treated is lucidly explained. Even in this part, the personal perspective is not entirely absent; his first-hand experience is there to illuminate, and to illustrate, various points. There is also a wealth of information about many famous people who have had OCD, which further adds to the human interest of the book. vii viii OBSESSIVE COMPULSIVE DISORDER For all these reasons, this excellent new edition deserves to be widely read and widely discussed. I am sure it will be received as a valuable and significant contribution. Padmal de Silva Senior Lecturer in Psychology, Institute of Psychiatry, King’s College, University of London; Consultant Clinical Psychologist, South London and Maudsley NHS Trust Foreword to the first edition by Professor Hans J Eysenck A few years ago, Stuart Sutherland wrote a book entitled Breakdown about the psychiatric troubles which all but put an end to his acade- mic career as an experimental psychologist. In this book, Frederick Toates, another well-known experimental psychologist, describes graphically his own troubles with obsessive-compulsive thoughts and ruminations, and gives the reader an opportunity to discover just how debilitating such thoughts can be, and just what they mean in the life of a busy professional man. Both authors clearly needed a lot of courage to disclose their troubles in public, and we owe a debt of grat- itude to both for making it much easier for other sufferers to realise that they are not alone with their troubles, and to gain access to professional advice as to what can be done, and what cannot be done, in order to lessen their burden. One might have thought that psychologists should know enough about the mind not to fall prey to such disorders, but this is not a real- istic way of approaching the topic. Just as physicians often fall ill, or have physical diseases, so psychologists and psychiatrists quite frequently fall prey to psychiatric ones – indeed, unkind critics have often suggested that psychiatrists and psychologists frequently take up the study of their subject because they hope to find therein some help for their neuroses! As the ancients used to say: ‘Physician – heal thyself!’, and the attempts of these two authors to run the gamut of therapies offered on all sides is one of the most interesting aspects of their work. It will certainly be of considerable interest to all those who are suffering from obsessive-compulsive thought disorders, because usually the advice given to them is one-sided, and often based on ignorance rather than on thorough knowledge of what is available. What indeed can psychology do for the sufferer? It would be idle to pretend that we have foolproof methods of treatment which guarantee success, but equally it would be wrong to imagine that nothing can be done. This book dis- cusses in considerable detail the methods used, and what is known about their success, as well as the author’s own experiences with them. Anyone suffering from obsessive-compulsive thought disorders, and the attending anxieties and depressions, would be hard put to find a ix x OBSESSIVE COMPULSIVE DISORDER better survey to guide him in this labyrinth. It seems likely that Stuart Sutherland and Frederick Toates are shaping the beginnings of a new tradition in psychological writings, for the benefit of their colleagues as well as of fellow sufferers. Let us hope that this tradition will establish itself quickly, and that other sufferers from psychiatric disorders will come forward to write equally courageous accounts of their sufferings! H J Eysenck, PhD, DSc Emeritus Professor of Psychology, University of London Preface In 2001, F.T. was approached by Richard Warner of Class Publishing with a view to issuing a new edition of the book that had first appeared in his name in 1990. F.T. suggested that he should collaborate with his wife on this project. Therefore, Part 2 is a collaborative effort and uses the personal pronoun ‘we’, whereas Part 1 is the autobiographical account of F.T. and uses ‘I’. Compared with the earlier versions, the emphasis here is more on how you can try to help yourself to cure the disorder. More is now known about treatment, and that is reflected in this edition.

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