Instructions not included
September 2010

Q. I’m 23 and recently started to experience difficulties at work. Friends would describe me as being very conscientious. Recently it was implied that I’d made a mistake at work. In the 4 months since then, I’ve found myself having to check my work 2 or 3 times. More worryingly, in the last 2 months, I’ve noticed it has extended to checking the office before I leave, and also having to check the door anything up to 6 times before I leave the house in the morning. Can you offer any help or advice?

THE PANEL

MIKE: Reader
Poetry-zine editor, college lecturer and soother of troubled souls.

PHIL: Exposed Owner
Believes a positive mental attitude makes anything possible.

JOHN DAVIES:
Consultant Adult Psychotherapist & Clinical lead for Cognitive Behavioural Therapy

MIKE: The key thing here is your perception of yourself, and your place in the world. The way you word this, it seems you’re exclusively seeing yourself through the eyes of others: friends describe you as conscientious, and it was implied (by someone else) that you made a mistake. But what do you think? Whether you actually made a mistake or not is irrelevant. It is the fact that you allow your self image to be defined by the views of others that’s causing your present angst. Try to forget what others see and attempt an honest appraisal of yourself. What do you perceive your personal qualities to be? Who are you, at your core? If you answer those questions, unless the distress I detect in your question is false, I’d wager you’ll find someone that isn’t obsessive but simply cares about doing the right thing when they can. After this, it’s a short step to realising that you don’t need to repeatedly check what you’re doing: you’ll trust yourself enough to know that you’ve done all that could be reasonably expected of you, and your anxiety will vanish like the illusion it is.

PHIL: You are obviously a very meticulous person who takes their role at work very seriously. And while that’s an admirable quality, you need to realise that none of us are perfect and mistakes are inevitable. I don’t know how serious your error was - but it seems to have led to Obsessive-Compulsive Disorder type behavioural patterns which are having a negative effect on your life. There are a number of ways to try to treat these - from medication to behavioural therapy techniques - so it’s worth seeing your GP who can assess your symptoms and decide which approach is best to take for you. I’d also suggest you try some relaxation techniques; meditation, yoga and other stress relieving techniques may help reduce the anxiety you’re feeling. It’s also a good idea to understand the nature of the condition, so head to helpguide.org and search for OCD. It should help.

JOHN: As your friends have commented you are an overly conscientious person. Given this personality trait the incident you describe has taken on greater significance and caused you more stress than it may have done to your friends. It appears from what you have described that this is the earlier stages of an obsessive compulsive problem, which is characterised by a need to check to reduce your fears of making another mistake. It’s good that you’ve recognised this problem early, and the evidence shows that you can overcome this. You may be best advised to seek professional help, as early recognition and treatment using a Cognitive Behavioural Therapy approach has proved generally to have a positive outcome. I would advise that you speak to your GP who should be able to advise or refer you. You may also want to look at information on the NHS website: nhs.uk/Conditions/Obsessive-compulsive-disorder/ which shows best evidenced approaches for the management of this problem, from a cognitive and behavioural approach. There is also some helpful information on the OCD action website: ocdaction.org.uk.