Understanding OCD, in the workplace and beyond
Chief Executive of OCD-UK
Obsessive-Compulsive Disorder (routinely referred to as OCD) is an anxiety-related condition where a person experiences frequent intrusive and unwelcome obsessional thoughts. This can lead to the person feeling compelled to carry out compulsive behaviours.
We asked Ashley Fulwood, the Chief Executive of OCD-UK, to talk about OCD, and how it might affect your employees and colleagues.
What is OCD, and how does it affect someone's life?
There are two significant aspects to OCD: obsessions, and compulsions (as the name suggests). The process of how our thoughts (obsessions) and our behaviours (compulsions) are entwined is quite complex.
No two people that suffer from OCD are alike. The thoughts and behaviours associated with OCD can vary in both theme and severity for each individual, both fluctuating over time. OCD is a very distressing condition which significantly interferes with a person’s life. This is why it’s important we highlight that the D in OCD stands for disorder.
OCD goes far beyond the stereotypical view that somebody with OCD likes things to be neat and tidy, and in fact can have significant, sometimes catastrophic impact on a person’s ability to function. The debilitating nature of OCD is often overlooked and for those that have OCD, the suffering can lead to an impact on a person’s education, relationships and their career.
How does it affect their working life?
The way OCD impacts on a person will vary from person to person, and is why every employer and therapist will need to communicate effectively with the person to understand the impact the condition will have on their life.
For some people, the OCD will be observable behaviours, and for others the impact will be non-observable with internal mental checking (called ‘compulsions’) taking place. They may lead a relatively normal working life, despite suffering with OCD, because the manifestation of OCD may be primarily in their private life. In my case, on a day-to-day basis you might not know I have OCD, as it would perhaps impact on my working ability less frequently. For others, the impact of OCD will be more significant and impact on them at work most days. So the way OCD manifests itself is different, and so is the way it impacts on the persons life.
But rest assured – in order for it to be OCD, it will be impacting on some aspect of their life.
A person may feel they have to avoid certain work tasks because that will trigger the OCD fears and worries
However, when OCD does impact on a person’s working life it can affect their concentration, and even in the middle of a meeting conversations can be missed because they are replaying a previous conversation or engaged in some mental checking compulsion. For others, observable behaviours they ‘feel’ a need to do must be completed before they can move on, and this behaviour might take hours to complete and leave them mentally and physically drained. Sometimes these behaviours take place before they leave the house forwork, or even on the journey to work, and sometimes that can lead to poor time-keeping, even if that person got up many hours earlier to try and be at work on time.
In other cases, a person may feel they have to avoid certain work tasks because that will trigger the OCD fears and worries that will lead to lots of compulsive behaviours. Similarly, a person with OCD may sometimes seek reassurance that a work task they have carried out is accurate and OK, especially if this task involves a level of safety or responsibility.
But the important thing to remember is OCD is different for every individual, not just in the compulsive behaviour, but the reason they ‘feel’ the need to carry those out. The reason will often be a fear or worry of something bad happening that will lead to terrible consequences. This is what we call the obsession and is in fact what drives the behaviours (compulsions).
What can employers do to support a member of staff who might be experiencing OCD?
Be patient and understanding, even if you don’t fully understand! Because every person with OCD will have a different form of the condition, which can change sometimes too, pro-active and ongoing communication is vital.
But also be patient. Not everybody is comfortable talking about OCD, especially if they have not yet received any kind of formal diagnosis or treatment.
Ask the employee what you can you do to help. This may sometimes requireto be made. Sometimes these may be short term, as the employee may be fortunate enough to receive effective treatment. Other times they may be slightly more long-term because NHS waiting times can sometimes take 12+ months, and then treatment may take many more months.
Some people need several courses of therapy to recover
And of course, be flexible with hours if the work role allows for that with regard to OCD related lateness, and offer the employee time off to attend therapy sessions. This is usually CBT (cognitive behavioural therapy) which is available through the NHS and is often offered for one hour a week for 10-20 weeks. Some people need several courses of therapy to recover.
When we access treatment through the NHS we don’t get to choose our appointment time sometimes, so where possible be supportive of this. If a time slot is in a morning, when the employee returns to the workplace later that morning or afternoon, be patient and supportive of their emotional needs, because therapy is. So where some people might welcome a chat about it to offload, others may prefer to be allowed to get on with their tasks without talking about their therapy.
What should employers and colleagues be careful NOT to do?
It should not need saying, but it does, ensure all staff know that(and any mental health problems) are not helpful and are offensive to some people. We don’t tolerate jokes about race or sexuality and we should not tolerate jokes about mental health problems.
We have all seen and heard those jokes, or seen the Christmas jumpers that say ‘I have OCD, Obsessive Christmas Disorder’ – you can change Christmas for any one of cake/coffee/cat, we have seen them all. None are particularly that funny, but all are incredibly unhelpful! Whilst seemingly inoffensive, they trivialise the suffering someone with OCD goes through and they arebecause it leaves people reluctant to talk about their OCD and will almost certainly leave employees suffering with OCD or those who have family members with OCD feeling unsupported and possibly resentful and less productive because of that.
Try not to judge somebody with OCD
The same goes for the comment ‘we all have a little bit of OCD’ – no we don’t! If it does not impact on your quality of life, then it’s not a disorder, and so it’s not OCD.
Most importantly, try not to judge somebody with OCD, no matter how unrealistic what they worry about is likely to be. Sometimes OCD convinces people that something which realistically is 0.1% likelihood of happing to feeling like a 99.9% chance of happening.
Remember, a supported employee is more likely to be a productive employee.
Is there any advice you’d offer someone who is, or thinks they might be, experiencing OCD?
Reach out for help. I am now almost fifty and have had OCD since I was around 17, but like many people of my generation I was too embarrassed to reach out and talk about it and waited years to seek help. If you feel you might have OCD, reach out to charities like Mind or OCD-UK for information and of course speak to your GP and tell them you think you might have OCD.
The most important information I would offer is this, people can and do recover from OCD.
If you’re not sure how to approach a GP (or therapist) to discuss OCD, we have created a ‘GP Ice Breaker‘ which you can download or print and take with you.
We have created an overview of the NHS recommended treatment, and patient rights for the treatment of OCD which can be found here. We run also a series of online OCD support groups which are free to access. Finally, our website contains lots more invaluable self-help book recommendations and conference presentation records all available here.
Ashley Fulwood is the co-author of the book ‘FAQ’S on OCD’, due to be published on 24th October 2022.