0:00:02 > 0:00:05As a psychologist, I am fascinated by how the brain develops
0:00:05 > 0:00:08when children grow from babies into adults
0:00:08 > 0:00:11and why sometimes things don't follow the typical pattern -
0:00:11 > 0:00:15when they lack the usual social skills,
0:00:15 > 0:00:17when they struggle with learning,
0:00:17 > 0:00:19and when their anxieties mean
0:00:19 > 0:00:23they can't deal with the daily pressures of the world around them.
0:00:25 > 0:00:29Over the last 50 years, neuroscience has begun to unlock a new understanding
0:00:29 > 0:00:31of how the brain works
0:00:31 > 0:00:34and what happens when it develops differently.
0:00:34 > 0:00:36So it's like, constantly, a voice in my head saying, like,
0:00:36 > 0:00:39"You have to do it or you'll get ill."
0:00:39 > 0:00:42It's like there's someone standing there telling me to do it.
0:00:42 > 0:00:47In this film, I want to look at one of the most common teenage anxiety disorders -
0:00:47 > 0:00:50Obsessive Compulsive Disorder, OCD,
0:00:50 > 0:00:54through the eyes of the families affected by it.
0:00:54 > 0:00:58It's one of the very characteristic aspects of OCD,
0:00:58 > 0:01:01that some people call it the secret problem or the hidden illness.
0:01:01 > 0:01:04To investigate what causes it, how it affects the brain
0:01:04 > 0:01:07and see how it can be treated.
0:01:07 > 0:01:10I think it did go through a depressive period cos you used to
0:01:10 > 0:01:12get suicidal thoughts, as well, with that.
0:01:12 > 0:01:15I mean, thinking, you know, it's best just to end it now, almost.
0:01:15 > 0:01:18I was so scared that he was going to do something.
0:01:18 > 0:01:22I just knew then...we, we've got to get some help.
0:01:33 > 0:01:36The world can be a dangerous place.
0:01:36 > 0:01:39There are lots of things that can cause us harm.
0:01:39 > 0:01:42Children are born with a defence mechanism
0:01:42 > 0:01:45which they use to help them learn what is safe.
0:01:45 > 0:01:47Fear is actually good for us -
0:01:47 > 0:01:49without it, we'd have no sense of danger.
0:01:49 > 0:01:53But we have to learn how to control our fears and anxieties.
0:01:53 > 0:01:58If we don't, they can take over and ruin our lives.
0:02:02 > 0:02:08Anna is 16 and she suffers from OCD, Obsessive Compulsive Disorder,
0:02:08 > 0:02:11an extreme form of anxiety.
0:02:13 > 0:02:16She is terrified that anything she touches will contaminate her
0:02:16 > 0:02:18and cause her harm.
0:02:19 > 0:02:21I went to London yesterday
0:02:21 > 0:02:24and one of my friends was ill as well, which didn't help,
0:02:24 > 0:02:27because I was sort of trying to avoid, like, being with him
0:02:27 > 0:02:29to catch what he had.
0:02:29 > 0:02:31Even if it was catchy, I don't even know.
0:02:33 > 0:02:38I had to go out for lunch, to, like, a sandwich place,
0:02:38 > 0:02:39which I don't usually do,
0:02:39 > 0:02:45because sandwiches involve someone touching bread or food or whatever it is, but I did that.
0:02:45 > 0:02:48Even though I couldn't eat it, like, out of the bag,
0:02:48 > 0:02:52I had to hold it in the bag to eat it and it was quite awkward.
0:02:53 > 0:02:57'As a child psychologist, I see families affected by OCD.
0:02:57 > 0:03:00'It's a common childhood anxiety disorder.'
0:03:01 > 0:03:05Sufferers have constant intrusive, obsessive thoughts
0:03:05 > 0:03:09that compel them to commit repetitive compulsive behaviours
0:03:09 > 0:03:11that they believe will reduce their anxiety.
0:03:13 > 0:03:17And a lot of my friends getting jobs, as well,
0:03:17 > 0:03:20which made me realise that, like, it's kind of annoying
0:03:20 > 0:03:22that they can get jobs but I can't,
0:03:22 > 0:03:26cos who is going to want to employ someone that can't touch anything?
0:03:28 > 0:03:31And also, at school, I had to get my friend to do up my shoelaces
0:03:31 > 0:03:32because I couldn't touch them.
0:03:32 > 0:03:35Then my other friends started having a go at me
0:03:35 > 0:03:38and saying I was being lazy and stuff.
0:03:41 > 0:03:43'This is Anna stroking Gabbie.'
0:03:50 > 0:03:52I have just slept for the past two hours
0:03:52 > 0:03:54because it's just so exhausting,
0:03:54 > 0:03:58trying to fight, like, the compulsions all the time.
0:04:02 > 0:04:04And if you think about Anna as a young girl,
0:04:04 > 0:04:08is there a time when you thought that something was developing in her differently?
0:04:08 > 0:04:12The only time the anxiety showed was probably a couple of years ago
0:04:12 > 0:04:16where she suddenly sort of panicked when we arrived at school
0:04:16 > 0:04:20and she didn't want to get out of the car and...so that's how it started.
0:04:20 > 0:04:22You know, she wasn't having masses amount of time off
0:04:22 > 0:04:27because I knew that actually being at home didn't really help anyway, even if I had let her stay at home.
0:04:27 > 0:04:31Well, no, cos in a way that doesn't...doesn't help you sort of confront what is the actual fear.
0:04:31 > 0:04:33No, no.
0:04:39 > 0:04:42Everyone has anxieties and phobias.
0:04:42 > 0:04:45One of mine happens to be spiders.
0:04:46 > 0:04:48I know it's irrational
0:04:48 > 0:04:52and I know that I shouldn't be afraid, but I am.
0:04:52 > 0:04:54And every time I even think of a spider,
0:04:54 > 0:04:57let alone see one, I can feel my heart rate go up.
0:04:57 > 0:05:02I start to sweat and my mouth goes dry.
0:05:02 > 0:05:05It's what we psychologists call the fight or flight response.
0:05:05 > 0:05:09So, once and for all, I want to conquer this fear.
0:05:11 > 0:05:14She might move, mightn't she, because she's alive?
0:05:14 > 0:05:16She could move, she could move at any moment, yeah?
0:05:16 > 0:05:19I am going to make her move now. I am going to make her move onto this hand.
0:05:19 > 0:05:23She'll stay there. Here she comes. If she walks up my arm, don't worry.
0:05:23 > 0:05:27Is there anybody who would like to have a try? Yeah?
0:05:27 > 0:05:29- You'll have a try. - But make it quick.- I will.
0:05:29 > 0:05:31'Fear and anxiety are actually good for you.'
0:05:31 > 0:05:33Are you sure she's not agitated?
0:05:33 > 0:05:36No, no way at all. She's very relaxed in my hand.
0:05:36 > 0:05:39'They are powerful and primitive human emotions
0:05:39 > 0:05:42'that have evolved to alert and protect us from danger.
0:05:42 > 0:05:45'As long as we learn how to control them.'
0:05:46 > 0:05:48That's enough, that's enough.
0:05:48 > 0:05:51'Because I now know the spider won't hurt me,
0:05:51 > 0:05:53'I should be able to curb my fear.'
0:05:53 > 0:05:55Brilliant, well done.
0:05:55 > 0:05:58Time out. Really, really good. Really good.
0:05:59 > 0:06:01We can do this.
0:06:01 > 0:06:03..people throw them at me.
0:06:03 > 0:06:07'Some people have such an extreme response to anxiety
0:06:07 > 0:06:11'that is so overwhelming that it completely takes over their minds,
0:06:11 > 0:06:14'to the extent that it can ruin their lives
0:06:14 > 0:06:16and those of the people around them.'
0:06:16 > 0:06:18I'll tell you when that happens...
0:06:18 > 0:06:21'It is as if they have a fear of fear itself.'
0:06:21 > 0:06:24You've got her. Look, well done.
0:06:24 > 0:06:26You've got her on your hand.
0:06:26 > 0:06:27Now, I am going to take her off.
0:06:27 > 0:06:30Here she comes, straight back on to me.
0:06:30 > 0:06:34I want you all to give yourselves a round of applause. It's brilliant!
0:06:34 > 0:06:38APPLAUSE
0:06:38 > 0:06:39Fantastic.
0:06:43 > 0:06:48OCD is one of the most common anxiety disorders in growing children.
0:06:48 > 0:06:52It affects just over 1% of people in the UK every year
0:06:52 > 0:06:55from any race, creed, class or gender.
0:06:57 > 0:07:00Sufferers have intrusive obsessive thoughts
0:07:00 > 0:07:02that can cause extreme anxiety
0:07:02 > 0:07:06that then compel them to repeatedly perform compulsive behaviours
0:07:06 > 0:07:09aimed at reducing that anxiety.
0:07:09 > 0:07:12These compulsions can include excessive cleaning,
0:07:12 > 0:07:15repeated checking or extreme hoarding.
0:07:17 > 0:07:21In Anna's case, she washes her hands, often dozens of times a day.
0:07:25 > 0:07:27Anna, can you, um, explain your OCD to me?
0:07:27 > 0:07:32Um... It's mainly about, like, a fear of getting ill,
0:07:32 > 0:07:34so a fear of germs and stuff, mainly.
0:07:34 > 0:07:37So I wash my hands a lot, I don't touch things.
0:07:37 > 0:07:41And do you know why you developed that fear?
0:07:41 > 0:07:43Not sure.
0:07:43 > 0:07:45- But you, you...- It sort of happened.
0:07:45 > 0:07:48- But you worry that you might get ill?- Yeah.
0:07:48 > 0:07:49Do you know what sort of illness?
0:07:49 > 0:07:52Just any kind of... Well, illnesses you can catch,
0:07:52 > 0:07:56but just any kind of illness.
0:07:56 > 0:07:59When it's at its worst, what's it like?
0:07:59 > 0:08:02Um... Well, I just can't touch anything,
0:08:02 > 0:08:04I just wash my hands all the time.
0:08:04 > 0:08:07My hands get quite cracked and dry...
0:08:07 > 0:08:09And...yeah.
0:08:09 > 0:08:12How's it for you, do you really understand it?
0:08:12 > 0:08:17Uh... Sort of, but there're some things I don't really understand,
0:08:17 > 0:08:20like why I'll do one thing but not something else.
0:08:20 > 0:08:24While we all worry about getting ill and avoid germs where we can,
0:08:24 > 0:08:29Anna's obsessive thoughts are irrational in the extreme.
0:08:29 > 0:08:31Have you been ill recently at all?
0:08:31 > 0:08:33- No.- Oh.
0:08:33 > 0:08:35I'm not really sure why I'm scared of getting ill.
0:08:35 > 0:08:39Hm, but it's the, it's the thing that you fear the most.
0:08:39 > 0:08:40Yeah.
0:08:40 > 0:08:43So it's just like constantly a voice in my head saying, like,
0:08:43 > 0:08:45"You have to do it or you'll get ill."
0:08:45 > 0:08:48It's like there's someone standing there telling me to do it.
0:08:49 > 0:08:51- Come in, Laverne.- OK.
0:08:51 > 0:08:55If you just take a seat on that stall there, that's great.
0:08:55 > 0:08:58'Dr Adam Perkins of King's College, London,
0:08:58 > 0:09:01'is an expert on the psychology of fear.
0:09:01 > 0:09:05'He has a test that can measure how well we respond to threats.'
0:09:05 > 0:09:08Cos the hypothesis is that the more intense you defend yourself,
0:09:08 > 0:09:10the more anxious you are.
0:09:10 > 0:09:12So you're the green dot and you are chased by the red dot.
0:09:12 > 0:09:14The harder you push the joystick,
0:09:14 > 0:09:16the faster the green dot goes.
0:09:16 > 0:09:20OK? So if pop your headphones on, we'll get underway.
0:09:22 > 0:09:26'The joystick runway test is designed to simulate the anxiety
0:09:26 > 0:09:29'anyone might feel by being chased.
0:09:29 > 0:09:31'The player's anxiety level should rise
0:09:31 > 0:09:34'as the dots come closer together
0:09:34 > 0:09:37'and peak if the green dot is not driven away fast enough.'
0:09:49 > 0:09:54'Anxiety has evolved as a defensive response.
0:09:54 > 0:09:56'As long as you survive to have kids,
0:09:56 > 0:09:59'that's how natural selection works.'
0:09:59 > 0:10:02To make your survival count, you have to produce kids
0:10:02 > 0:10:06and so, the...if being anxious means that when there's a blood bubble
0:10:06 > 0:10:08coming out of your baby's nose you think,
0:10:08 > 0:10:10"Oh, something's going on here,
0:10:10 > 0:10:13"I'm...I'm worried, I think I'll go to the doctor",
0:10:13 > 0:10:15then, your baby will have more of a chance of surviving.
0:10:19 > 0:10:21'Most animal species of all kinds
0:10:21 > 0:10:25'have some kind of threat withdrawal mechanism,
0:10:25 > 0:10:29'so if you tap a snail on its shell, it'll curl up into the shell.'
0:10:29 > 0:10:31So there's been a long evolutionary pressure,
0:10:31 > 0:10:36a selection pressure on animals to get away from a threat.
0:10:41 > 0:10:46The more complicated the animal, the more abstract it seems to become,
0:10:46 > 0:10:51so a snail doesn't really get anxious about the meaning of life.
0:10:51 > 0:10:55Once you get up to primates, great apes, humans,
0:10:55 > 0:10:58that's really when you start getting proper angst.
0:10:58 > 0:11:02- And you've got my results there. Can you tell me how I did?- Yep.
0:11:02 > 0:11:06You're significantly lower in your threat responsivity than average.
0:11:06 > 0:11:11You are just not as bothered as our average female participants
0:11:11 > 0:11:16by the threat that was chasing you in the task.
0:11:16 > 0:11:20'Like most people I am able to control my anxiety.
0:11:20 > 0:11:25'But, for Anna, her obsessive fear of getting ill has taken over her life.
0:11:28 > 0:11:29'Over the last few months,
0:11:29 > 0:11:33'Anna has been keeping a detailed diary about her OCD -
0:11:33 > 0:11:37'how many times a day she washed her hands to alleviate her anxiety.'
0:11:40 > 0:11:44So if we look at one of the days, just, just take... Well, just take the first one, we come to...
0:11:44 > 0:11:48Between seven o'clock and ten o'clock and it's a week day, so probably you were at school...
0:11:48 > 0:11:50- Yeah, yeah.- You tell me.
0:11:50 > 0:11:53Um...between 10am and 1pm,
0:11:53 > 0:11:57I washed them once, but I used hand gel twice.
0:11:57 > 0:12:02Then, between one and four I washed them once, but used hand gel three times.
0:12:02 > 0:12:06Between four and seven, I washed my hands 12
0:12:06 > 0:12:08times and used hand gel once.
0:12:08 > 0:12:11Then, between seven and ten, I washed my hands 11 times.
0:12:11 > 0:12:15Right. So, all in all, ten, 13...
0:12:17 > 0:12:19..30... About 35...
0:12:19 > 0:12:22- 37 times that day.- Yeah. 37, yeah.
0:12:22 > 0:12:23That's quite a lot, isn't it?
0:12:23 > 0:12:26Yeah, that was less than I do it now.
0:12:27 > 0:12:29- That's less than you do now?- Yeah.
0:12:29 > 0:12:31So how often do you think you wash your hands now?
0:12:31 > 0:12:33Uh... Between about 40 and 50.
0:12:33 > 0:12:35- So it's gone up?- Yeah.
0:12:35 > 0:12:38- Quite a lot.- Yeah.
0:12:39 > 0:12:41Anna has her own bathroom,
0:12:41 > 0:12:45so much of her hand washing is hidden away from the rest of the family.
0:12:46 > 0:12:49We didn't sort of notice, it was harder to tell
0:12:49 > 0:12:52because she's in her room, which a lot of teenagers are.
0:12:52 > 0:12:54So we don't know what she's doing in there
0:12:54 > 0:12:58but, obviously, there were times when we'd be hammering on the doors.
0:13:02 > 0:13:04And also other times when we'd go out,
0:13:04 > 0:13:06you've still got to wait for Anna.
0:13:06 > 0:13:10- So, actually, yeah. You do lose your patience sometimes.- Yeah.
0:13:10 > 0:13:13Anna knows that her anxiety is irrational
0:13:13 > 0:13:17but it doesn't stop her having the obsessive thoughts.
0:13:17 > 0:13:20That's one of the effects of OCD -
0:13:20 > 0:13:23that sufferers can't get these intrusive thoughts out of their heads.
0:13:25 > 0:13:27My hunch is that there...
0:13:27 > 0:13:32there's another trait to do with your capacity to be imaginative
0:13:32 > 0:13:36and visionary and you're not fully anxious
0:13:36 > 0:13:38unless you're not only sensitive to threat,
0:13:38 > 0:13:42but also you've got this kind of abstract mindset
0:13:42 > 0:13:45where you tend to think a lot about stuff that isn't happening.
0:13:45 > 0:13:48If you've got both of those, you probably will end up
0:13:48 > 0:13:53being what we would call a highly neurotic or highly anxious person.
0:13:53 > 0:13:58The kind of person who may then end up having to have psychiatric help.
0:13:58 > 0:14:01- At the back of my head I'm thinking, "You don't need to do it."- Mm-hm.
0:14:01 > 0:14:04Like, "You're not going to get ill from touching a door handle."
0:14:04 > 0:14:07But then, there are still stronger voices in my head saying,
0:14:07 > 0:14:09"No, you will, you need to go and wash your hands."
0:14:09 > 0:14:14The latest hypothesis is that the brain systems that control defence,
0:14:14 > 0:14:18that have evolved over, you know, millions of years to keep us safe,
0:14:18 > 0:14:21these systems are just overactive.
0:14:24 > 0:14:28A combined team of scientists from the University of Oxford
0:14:28 > 0:14:30and the Institute of Psychiatry in London
0:14:30 > 0:14:35is doing some pioneering research into how the OCD brain works
0:14:35 > 0:14:38and, in particular, in teenagers.
0:14:42 > 0:14:47They are performing brain scans on children with and without OCD
0:14:47 > 0:14:49between the ages of 12 and 18
0:14:49 > 0:14:52to try and pinpoint which areas of the brain
0:14:52 > 0:14:54are affected by the condition.
0:14:56 > 0:14:58Well, the main question was, em,
0:14:58 > 0:15:02how does the brain of children with OCD develop?
0:15:02 > 0:15:06Because we know a fair amount about the brain in adults with OCD,
0:15:06 > 0:15:09eh, but very little about the children with OCD.
0:15:10 > 0:15:13What we are going to do is a very brief scan,
0:15:13 > 0:15:14just to start the planning.
0:15:14 > 0:15:17This will probably be one of the more comprehensive studies
0:15:17 > 0:15:20that...ever been done anywhere on, eh,
0:15:20 > 0:15:25the structure of the brain in young people with OCD.
0:15:25 > 0:15:26This is an MRI scan.
0:15:26 > 0:15:29It's a structural scan of the brain, giving you highly detailed pictures
0:15:29 > 0:15:31of the grey and white matter
0:15:31 > 0:15:34that composes the brain.
0:15:34 > 0:15:38Here you can see the...skull here...
0:15:38 > 0:15:41You can see the fluid-filled spaces here,
0:15:41 > 0:15:44and the grey, which is obviously the darker areas
0:15:44 > 0:15:45and the white matter tracts here.
0:15:45 > 0:15:47This is the first scan.
0:15:47 > 0:15:50And what we did find is that, actually, particular areas of the brain,
0:15:50 > 0:15:53the basal ganglia, were different.
0:15:53 > 0:15:56Some of the areas specifically were enlarged.
0:15:56 > 0:15:59And the actual connections between these two parts of the brain,
0:15:59 > 0:16:03the striatum and the fronter... frontal areas, were actually altered.
0:16:03 > 0:16:07We don't really understand the, the reasons for this.
0:16:07 > 0:16:11But we know the, eh, the brain takes several decades to mature fully,
0:16:11 > 0:16:16perhaps...in, eh, until people are 25 or so, or 30 even.
0:16:16 > 0:16:19Eh, so there's a dynamic process.
0:16:19 > 0:16:23And we're trying to understand what happens during development.
0:16:23 > 0:16:26If you want to have a look at some...
0:16:26 > 0:16:28As the scans from this research are fully analysed,
0:16:28 > 0:16:32they are producing some extraordinary three-dimensional images
0:16:32 > 0:16:36of a key area of the brain thought to be affected by OCD -
0:16:36 > 0:16:38the basal ganglia.
0:16:38 > 0:16:40The blue and green areas represent
0:16:40 > 0:16:44how much bigger it is in people with OCD.
0:16:44 > 0:16:46The basal ganglia is really
0:16:46 > 0:16:48a crucial part of the brain.
0:16:48 > 0:16:50Not to say that other parts of the brain are not crucial,
0:16:50 > 0:16:54but it is very important for a couple of reasons.
0:16:54 > 0:16:57One of them is that it really has connections
0:16:57 > 0:16:59to almost everywhere in the brain.
0:16:59 > 0:17:06And it has control over many functions in the brain.
0:17:06 > 0:17:09One of the most important functions is decision-making,
0:17:09 > 0:17:12shifting from one task to another, for example.
0:17:12 > 0:17:15- So key for OCD sufferers? - Yes, absolutely right.
0:17:16 > 0:17:19In addition, this study has uncovered some interesting results
0:17:19 > 0:17:21concerning the connectivity of the brain
0:17:21 > 0:17:25and how it may also differ in people with OCD.
0:17:25 > 0:17:31Now, these orange-looking regions are an area that has higher connections
0:17:31 > 0:17:37in subjects with OCD with the very front of the brain.
0:17:37 > 0:17:40The suggestion is that parts of the brains
0:17:40 > 0:17:42of teenagers with OCD, like Anna,
0:17:42 > 0:17:45are not only bigger but are working overtime
0:17:45 > 0:17:48as they process all the intrusive obsessive thoughts.
0:17:50 > 0:17:52And, in terms of physical contact,
0:17:52 > 0:17:55I mean, how does it impact on ordinary cuddles and getting close?
0:17:55 > 0:18:02- Well, you probably wouldn't let us touch your hands, would you?- No.
0:18:02 > 0:18:04- You don't really like me touching your face.- No.
0:18:04 > 0:18:06But then if, you know,
0:18:06 > 0:18:08she wanted me to do her make-up for her prom and everything,
0:18:08 > 0:18:10she'd let me do it.
0:18:13 > 0:18:17And have you tried yourself to stop?
0:18:17 > 0:18:19Yeah, but I can't do it.
0:18:19 > 0:18:21When you've tried, what happens?
0:18:21 > 0:18:24I just get too anxious and I can't do it.
0:18:29 > 0:18:33Anna has been in an out of treatment since she was 14.
0:18:33 > 0:18:36She is also on medication to reduce her anxiety,
0:18:36 > 0:18:38but nothing has proved successful so far.
0:18:44 > 0:18:47The Maudsley Hospital, in South London,
0:18:47 > 0:18:51currently has the only national specialist clinic for young people with OCD.
0:18:51 > 0:18:56The treatment they offer has proved remarkably successful.
0:18:57 > 0:19:00With the permission of a family and the psychologists,
0:19:00 > 0:19:02they have agreed that I can observe and record
0:19:02 > 0:19:05a session of treatment for this film.
0:19:06 > 0:19:08We are going to be
0:19:08 > 0:19:09spending five days together...
0:19:09 > 0:19:12'One option offered by the Maudsley
0:19:12 > 0:19:14'involves an intensive 5-day therapy
0:19:14 > 0:19:20'for teenagers and their families in Cognitive Behavioural Therapy, CBT.'
0:19:20 > 0:19:24I think it's, um, quite surprising, really,
0:19:24 > 0:19:27how the OCD has taken control
0:19:27 > 0:19:30in such really quite a short space of time,
0:19:30 > 0:19:33because it's only just over a year
0:19:33 > 0:19:37since he started with the irrational thoughts.
0:19:37 > 0:19:39So Jon, take me through some of the entries?
0:19:39 > 0:19:42Yeah, I mean, this one here,
0:19:42 > 0:19:45"Going to wake up in the night and do bad to someone."
0:19:45 > 0:19:48That was one of the really severe ones that I saw
0:19:48 > 0:19:50that really made me worry and anxious.
0:19:50 > 0:19:56Unlike Anna, Jon's OCD is characterised by obsessive irrational thoughts
0:19:56 > 0:19:58in which he thinks he has harmed someone,
0:19:58 > 0:20:02even though it is something he has never done.
0:20:02 > 0:20:04It would come to the point where you couldn't sleep at night
0:20:04 > 0:20:08and you'd sort of want to lock your door and, you know, make it so you couldn't do anything.
0:20:08 > 0:20:11But even then, you would still think that wouldn't be enough,
0:20:11 > 0:20:15cos you'd still have the thought and you'd still worry about it afterwards.
0:20:15 > 0:20:17Jon lives with his family in a small village in Devon.
0:20:17 > 0:20:21He is 17 and has just started sixth form.
0:20:21 > 0:20:25Carol, what was Jon like as a, as a baby, as a little boy?
0:20:25 > 0:20:29Just a normal, everyday little boy.
0:20:29 > 0:20:31Looking back, when would you say,
0:20:31 > 0:20:34"Actually I can see something was shifting,"
0:20:34 > 0:20:37in terms of how Jon was.
0:20:37 > 0:20:39When he was about seven, I would say,
0:20:39 > 0:20:43because Jonathan has always wanted to be top of the class,
0:20:43 > 0:20:45to be a perfectionist.
0:20:45 > 0:20:51In hindsight, I think I realised cos, when Jon was about seven,
0:20:51 > 0:20:53we went to the doctor because he couldn't stop thinking.
0:20:53 > 0:20:55And that's what Jon had said.
0:20:55 > 0:20:58And that's what he told me - "Mum, I can't stop thinking."
0:20:58 > 0:21:00Well, that's an incredible statement.
0:21:00 > 0:21:05Mm. Now, obviously, he couldn't articulate that it was OCD,
0:21:05 > 0:21:07we wouldn't have known it was OCD.
0:21:07 > 0:21:10And his headmaster in primary school said,
0:21:10 > 0:21:13"He constantly needs reassurance",
0:21:13 > 0:21:17and so I just thought, "Oh, he's just a little bit anxious.
0:21:17 > 0:21:21"It'll pass, just leave it, forget about it."
0:21:21 > 0:21:24And I realise now that, actually, I think,
0:21:24 > 0:21:26that was the start of the OCD.
0:21:26 > 0:21:29Unlike people suffering from psychosis,
0:21:29 > 0:21:31Jon doesn't hallucinate or have delusions
0:21:31 > 0:21:35or hear voices compelling him to do things.
0:21:35 > 0:21:38His OCD means he suffers from extreme anxiety,
0:21:38 > 0:21:42an obsessive fear that he has or will harm someone.
0:21:42 > 0:21:47And he just can't get these intrusive thoughts out of his head.
0:21:47 > 0:21:53When he was really bad, last year, we were really worried,
0:21:53 > 0:21:56we were worried that he was going to commit a crime.
0:21:56 > 0:22:01Cos at its very, very worst, Jon was having to ask his father
0:22:01 > 0:22:06to take him back to locations where he thought he may have done something
0:22:06 > 0:22:11and check that he hadn't actually committed a crime.
0:22:11 > 0:22:13I mean, that must have then raised your anxiety
0:22:13 > 0:22:15- to such an extent that you were in it with him.- Exactly.
0:22:15 > 0:22:19I was so scared that he was going to do something.
0:22:19 > 0:22:23I just knew then we, we've got to get some help.
0:22:23 > 0:22:27'One of the most distressing aspects of Jon's OCD
0:22:27 > 0:22:29'is that neither he nor his family realise
0:22:29 > 0:22:34'that his imaginary obsessive thoughts will never be acted out.'
0:22:34 > 0:22:38We sometimes like to think of...OCD
0:22:38 > 0:22:41as a bit of an over-sensitive car alarm,
0:22:41 > 0:22:45because if you think of a car alarm, that's a safety device, isn't it?
0:22:45 > 0:22:49And when it goes off, when someone's actually trying to steal the car,
0:22:49 > 0:22:52- that's really helpful, isn't it? - Yeah, yeah.
0:22:52 > 0:22:56But if a car alarm goes off when someone just walks past it,
0:22:56 > 0:23:00or a leaf falls on it, it's sort of like a really helpful safety system
0:23:00 > 0:23:02going off at the wrong time.
0:23:02 > 0:23:05'The treatment method used by the Maudsley is known as
0:23:05 > 0:23:07'Exposure and Response Prevention.
0:23:07 > 0:23:11'It involves teaching Jon that his anxiety WILL reduce
0:23:11 > 0:23:15'after sufficient exposure to any threatening situation.
0:23:15 > 0:23:21'A key tool for Jon to learn is how to rate his own anxiety levels.'
0:23:21 > 0:23:25- Sometimes, it's easier to start with the extremes.- Yeah, yeah.
0:23:25 > 0:23:27So if we think of a zero out of ten.
0:23:27 > 0:23:30Can you think of a situation, Jon, where you feel really chilled
0:23:30 > 0:23:32and don't feel any anxiety at all?
0:23:32 > 0:23:34'Start with holidays, probably.
0:23:34 > 0:23:36- 'Holidays?- Yeah.'
0:23:36 > 0:23:39'Jon can then use this anxiety rating system
0:23:39 > 0:23:44'to monitor his own progress as the treatment continues.'
0:23:44 > 0:23:48- Could be a car accident or something like that?- Yes, yeah.
0:23:48 > 0:23:50Great, so that's an excellent list.
0:23:50 > 0:23:53And this just hopefully exemplifies the fact that we don't always
0:23:53 > 0:23:56feel the same amount of anxiety.
0:23:56 > 0:23:59'The other key element of this treatment is to teach Jon
0:23:59 > 0:24:02'how to block his urge to compulsive behaviour,
0:24:02 > 0:24:06'to stop him constantly checking whether he has harmed anyone.'
0:24:06 > 0:24:10So where's the best place to break this vicious cycle, at what stage?
0:24:10 > 0:24:14Uh... I would say just after the feelings,
0:24:14 > 0:24:18so before you can actually do that behaviour. Yeah.
0:24:18 > 0:24:21We all have disturbing thoughts from time to time,
0:24:21 > 0:24:24but they are usually easily dealt with.
0:24:24 > 0:24:28The problem for Jon is that his obsessive imaginary thoughts
0:24:28 > 0:24:32are constant and, apparently, unavoidable.
0:24:32 > 0:24:35It does sound as if there are moments when the thinking really takes over
0:24:35 > 0:24:38and it must be almost as if you want to shut down thinking,
0:24:38 > 0:24:40you know, you don't want to think at all.
0:24:40 > 0:24:42Well, it's all, like, based around obsessive thoughts.
0:24:42 > 0:24:45I mean, a lot of people think of OCD as, you know, hand washing,
0:24:45 > 0:24:49cleanliness, ritualising... But it's not all about that.
0:24:49 > 0:24:52It's, a lot of it is obsessional thoughts on their own,
0:24:52 > 0:24:54so it's, you know, worrying about certain things,
0:24:54 > 0:24:56whether you might cause harm to someone,
0:24:56 > 0:24:59whether they might cause harm to, harm to you
0:24:59 > 0:25:01or whether anything might happen.
0:25:01 > 0:25:03So when you came in, in June,
0:25:03 > 0:25:06you were excessively checking over your shoulder
0:25:06 > 0:25:08to make sure you hadn't harmed somebody by pushing them
0:25:08 > 0:25:10- or stabbing them.- Yeah.
0:25:10 > 0:25:12- Are you still doing that? - Yeah, yeah.- OK.
0:25:12 > 0:25:15When Jon's OCD is at its worst,
0:25:15 > 0:25:19sometimes, he can't even leave the house.
0:25:19 > 0:25:22It's cos that I knew that would trigger the fear off, almost.
0:25:22 > 0:25:24I remember I wouldn't look at people
0:25:24 > 0:25:27cos you'd think that would, might trigger off a, you know, a thought.
0:25:27 > 0:25:30- But could things be triggered in the home?- Yeah, definitely.
0:25:30 > 0:25:32I remember I used to have this, you know,
0:25:32 > 0:25:35these intrusive thoughts of thinking I'd get up in the night,
0:25:35 > 0:25:39maybe sleep walking, and do some, do, go outside the house
0:25:39 > 0:25:43and do some things to other people, even when you knew you didn't do it.
0:25:43 > 0:25:45I got to the point of thinking,
0:25:45 > 0:25:48"I'd rather just strap myself into bed with a belt almost",
0:25:48 > 0:25:52to reassure yourself you haven't done anything.
0:25:52 > 0:25:56And, through that period, I didn't get much sleep at all.
0:25:56 > 0:26:00'A key part of the treatment will be to teach Jon
0:26:00 > 0:26:04'that, despite what he thinks, he does not represent a risk to anyone.'
0:26:04 > 0:26:07Are you still avoiding being near knives at work
0:26:07 > 0:26:09in case you stab someone?
0:26:09 > 0:26:11Um... Not so much at home as such,
0:26:11 > 0:26:16but you can still get the intrusive thoughts sometimes, such as in work.
0:26:16 > 0:26:20And are you still having intrusive violent images
0:26:20 > 0:26:22followed by a thought that if you have this image,
0:26:22 > 0:26:23then, it must be true?
0:26:23 > 0:26:27Um... Yeah, it's sort of like you get the images and then you think
0:26:27 > 0:26:29cos you've had that image, it sort of thinks, you know,
0:26:29 > 0:26:31"That must have happened." So, yeah.
0:26:31 > 0:26:33Yeah, so that's still troubling you.
0:26:33 > 0:26:37You could be sitting up in your bedroom and then you'd have that thought.
0:26:37 > 0:26:40Yeah, exactly. And I could sort of call it, even today, I call it spiking,
0:26:40 > 0:26:43- where it...it just goes straight into your mind and that's it.- Right.
0:26:43 > 0:26:47And a lot of the time, straight from then, the anxiety grows.
0:26:52 > 0:26:54Day two of Jon's intensive treatment
0:26:54 > 0:26:59and he's been sent out on the streets to test his OCD alone,
0:26:59 > 0:27:02to help him understand that, despite what he thinks,
0:27:02 > 0:27:06he represents no risk to others.
0:27:06 > 0:27:10Isobel, I wonder, can you take me through your explanation of OCD?
0:27:10 > 0:27:14Really, very honestly, the point we are at in understanding,
0:27:14 > 0:27:17which is that we don't know the cause of OCD,
0:27:17 > 0:27:19but we do have some clues from research.
0:27:19 > 0:27:24One of the clues, for example, is that this is quite a biological illness.
0:27:24 > 0:27:30So it's not, for example, caused by the way you bring up your children.
0:27:30 > 0:27:37OCD can occur in any kind of family, any race, any background, any class.
0:27:37 > 0:27:40So, you know, it's very biologically driven.
0:27:40 > 0:27:43It's actually quite genetic, so doesn't explain all of it,
0:27:43 > 0:27:46but it does tend to run in families.
0:27:46 > 0:27:50And I guess it's only been in the last 20-30 years,
0:27:50 > 0:27:56we've really got strong evidence for how treatable OCD is.
0:27:58 > 0:28:01Normally, when Jon walks down a crowded street,
0:28:01 > 0:28:04his OCD compels him to check behind him continually
0:28:04 > 0:28:07to see whether he has harmed anyone.
0:28:09 > 0:28:11Amita and Holly are trying
0:28:11 > 0:28:15to get him to resist this compulsive behaviour.
0:28:17 > 0:28:19And, thinking about Jon, you know,
0:28:19 > 0:28:25he's come with sort of this obsessional component to his OCD
0:28:25 > 0:28:29- where, you know, he feels flooded by the thoughts.- Yes.
0:28:29 > 0:28:31And how he can really, you know, manage them himself.
0:28:31 > 0:28:34And, I think, in some ways, he's managing it on his own.
0:28:34 > 0:28:36He's not really, but it feels as if he is.
0:28:36 > 0:28:38How did it go?
0:28:38 > 0:28:41Um... I, lowest I went to was a three,
0:28:41 > 0:28:43highest it went to was a six,
0:28:43 > 0:28:45- but that was only for a short time. - OK.
0:28:45 > 0:28:49We've got a very good talking treatment - Cognitive Behaviour Therapy -
0:28:49 > 0:28:53and what that means is helping the person with OCD
0:28:53 > 0:28:57identify the rituals that they're doing,
0:28:57 > 0:29:00or the things that they're not doing sometimes because of their OCD,
0:29:00 > 0:29:04and teaching them that, actually, with practice,
0:29:04 > 0:29:09they can do those things, even though it involves getting anxious.
0:29:09 > 0:29:12OK. So do you want to tell us a little bit about what happened?
0:29:12 > 0:29:14- Yeah.- It sounds like you resisted at least twice.
0:29:14 > 0:29:18- Yeah, um... On two occasions, I did look.- Yeah.
0:29:18 > 0:29:23- About eight occasions when I wanted to, but resisted it.- Fantastic!
0:29:23 > 0:29:28What Amita and Holly are trying to do is habituate Jon to his fears,
0:29:28 > 0:29:32get him so used to them that they are no longer fearful.
0:29:32 > 0:29:38So it's actually a lot about learning that anxiety is a normal emotion
0:29:38 > 0:29:42that we all have in various circumstances,
0:29:42 > 0:29:46that it's sort of artificially heightened if you've got OCD.
0:29:46 > 0:29:48And, although it's unpleasant,
0:29:48 > 0:29:52the sort of fight and flight and fear reaction that they're experiencing
0:29:52 > 0:29:54doesn't mean they have to take it seriously.
0:29:54 > 0:29:57They don't have to do anything. They can just sit there
0:29:57 > 0:29:58and experience the anxiety
0:29:58 > 0:30:02and wait for it to go away on its own, which it does.
0:30:02 > 0:30:05- It's one thing us saying, Jon, that these are just tricks of OCD... - Yeah, yeah.
0:30:05 > 0:30:09..but what we need to help you do is collect evidence to say,
0:30:09 > 0:30:12"These aren't fact, these are OCD..."
0:30:12 > 0:30:14Yeah, to control it.
0:30:14 > 0:30:17- "..playing some nasty tricks."- Yeah.
0:30:21 > 0:30:23When Jon's OCD was at its worst,
0:30:23 > 0:30:27he kept a diary in which he detailed his obsessive thoughts
0:30:27 > 0:30:31and rated his anxiety when he had them.
0:30:31 > 0:30:34He agreed to share it with me.
0:30:34 > 0:30:36The date where I got it really bad - 15th of August.
0:30:36 > 0:30:39And it's sort of dates like that, you can still remember today.
0:30:39 > 0:30:43- I mean, I know it got bad on the 15th of August.- So what does it say on here?- Oh, stuff like, er...
0:30:43 > 0:30:48"I thought I'd deleted someone's coursework at school," or "poking someone in the eye" or something.
0:30:48 > 0:30:51I used to think, you know, "What happens if you blinded someone with a sharp object,
0:30:51 > 0:30:53"waking up in the night," thinking, er...
0:30:53 > 0:30:55"killed or done something to someone,
0:30:55 > 0:30:58"buried someone in the garden" or something.
0:30:58 > 0:31:03It was completely ridiculous stuff but, up here, it was just all real.
0:31:03 > 0:31:06It's almost as if you were living in a parallel world where things were happening.
0:31:06 > 0:31:09Even when you could see they weren't, but it's all up here.
0:31:09 > 0:31:11You know, I put down chronology
0:31:11 > 0:31:14of what happened when it was getting bad.
0:31:14 > 0:31:16I was putting down stuff.
0:31:16 > 0:31:18You've got little sort of flow diagrams.
0:31:18 > 0:31:19Yeah, I was doing stuff like that.
0:31:19 > 0:31:22This goes right up until March this year, you know,
0:31:22 > 0:31:25dates of how bad it would get from, you know, one being...
0:31:25 > 0:31:26And you're rating it, are you?
0:31:26 > 0:31:29Yeah, so one would be normal, ten would be really bad,
0:31:29 > 0:31:32and it got to points where I'd rate it at nines.
0:31:32 > 0:31:33So what does nine feel like?
0:31:33 > 0:31:35Nine's really bad, sort of really stressed out.
0:31:35 > 0:31:38I mean, it would get to points where you'd come home from school
0:31:38 > 0:31:41and you would go straight to sleep or you'd go straight to bed
0:31:41 > 0:31:42because you felt that ill.
0:31:42 > 0:31:45- A sort of depression. - Yeah, I think it did go through a depressive period,
0:31:45 > 0:31:48cos you used to get suicidal thoughts, as well, with that.
0:31:48 > 0:31:52I mean, thinking, you know, it's best just to end it now almost.
0:31:52 > 0:31:55That, to me, says that your mind was just exploding at some level.
0:31:55 > 0:31:56Yeah.
0:31:56 > 0:31:59Yeah, you did... It got to the point where you felt these...
0:31:59 > 0:32:01You actually thought you were doing these things
0:32:01 > 0:32:05and at times you thought, you know, "Why don't you just hand yourself in", almost.
0:32:07 > 0:32:11- If OCD's saying you're going to do something...- Yeah.
0:32:11 > 0:32:13You know, you're going to hurt somebody,
0:32:13 > 0:32:17why don't we just really go for it? If OCD thinks that's going to happen, just up the risk.
0:32:17 > 0:32:19- Are you up for that? - Yeah, that will be OK.
0:32:19 > 0:32:20Fantastic.
0:32:23 > 0:32:26Jon lives in a very rural part of Devon
0:32:26 > 0:32:29and often needs to travel by train.
0:32:29 > 0:32:32One of his most regular obsessive intrusive thoughts
0:32:32 > 0:32:35occurs whenever he uses a station.
0:32:35 > 0:32:36As he waits on the platform,
0:32:36 > 0:32:40he thinks that he will push someone under a train.
0:32:42 > 0:32:45So what if say, I or Holly, whoever, stood right in front of you
0:32:45 > 0:32:48- and we stood right on the edge and we just stood there.- Yeah.
0:32:48 > 0:32:50- And trains are coming and going. - Yeah.
0:32:50 > 0:32:52What would OCD be saying to you?
0:32:52 > 0:32:54It would be like saying, you know, "Push them", and stuff,
0:32:54 > 0:32:57"and start harming them", and...
0:32:57 > 0:33:00And then, what shall we do when we're at the station,
0:33:00 > 0:33:01how far do you want to...
0:33:01 > 0:33:04I was going to say "Push it", but you don't want to say push.
0:33:04 > 0:33:07Um... Yeah, you could go, do as much as you want, really,
0:33:07 > 0:33:11to see how anxious you can get in that situation.
0:33:11 > 0:33:13- Test it out.- Yeah.
0:33:19 > 0:33:22To really test Jon's OCD,
0:33:22 > 0:33:26Amita and Holly have decided to take him to a local train station,
0:33:26 > 0:33:30to prove to him that he has no intention of harming anyone.
0:33:32 > 0:33:38- It must be a dangerous situation, but it's just a trick.- Yeah, yeah.
0:33:38 > 0:33:40And I wonder, actually, if you were to do it,
0:33:40 > 0:33:42why would I be standing in front of you
0:33:42 > 0:33:45and letting you put your hand on my shoulder
0:33:45 > 0:33:48- if I honestly believed that you would do something?- Yeah, yeah.
0:33:48 > 0:33:51So what would you rate your anxiety at now?
0:33:51 > 0:33:54It's gone down a bit. A six, maybe.
0:33:54 > 0:33:59Yeah! Fantastic! So that's a bit of habituation, isn't it?
0:33:59 > 0:34:02You're kind of... Your body is getting used to it.
0:34:02 > 0:34:05- You know, we don't stay at that high level of anxiety for long. - Yes, yes.
0:34:09 > 0:34:11Let's look at the time.
0:34:11 > 0:34:14I think it's coming at 20,
0:34:14 > 0:34:17I think it comes at 15 this one.
0:34:17 > 0:34:21- TANNOY:- The train now approaching platform four is the...
0:34:32 > 0:34:34Yeah.
0:34:36 > 0:34:39- Well done.- Well done, Jon. - Really well done.
0:34:39 > 0:34:42- Well done!- Yeah.- Fantastic!
0:34:42 > 0:34:45Well, I'd say the obsession got, like, a lot more...
0:34:45 > 0:34:48And how anxious did that make you feel when the obsession got so intense?
0:34:48 > 0:34:50What number did it go up to?
0:34:50 > 0:34:51I'd say an eight.
0:34:51 > 0:34:52- And I'm alive!- Yeah.
0:34:52 > 0:34:55- Yeah! Well done!- Yeah.
0:34:55 > 0:34:59'It seems to me that this is a really important moment in Jon's treatment.
0:34:59 > 0:35:03'He's got Holly and Amita with him giving him the confidence to realise
0:35:03 > 0:35:05'that actually, he isn't going to push anybody,
0:35:05 > 0:35:07'that actually, he is in control.'
0:35:07 > 0:35:09And, I think, because he's gained that confidence,
0:35:09 > 0:35:12he'll realise that this is the first step,
0:35:12 > 0:35:16the first quite big step forward in his recovery.
0:35:17 > 0:35:21OK, so, for starters, I am going to set you up with the...
0:35:21 > 0:35:26'Scientists at the Department of Experimental Psychology at Cambridge University
0:35:26 > 0:35:31'have been studying how OCD relates to typical brain function
0:35:31 > 0:35:33'and, in particular, how the obsessive thoughts
0:35:33 > 0:35:38'and the compulsive behaviours, the O and the C, are related.'
0:35:38 > 0:35:41You're going to tell us how you feel about the different stimuli...
0:35:41 > 0:35:44'The research tested subjects suffering from OCD
0:35:44 > 0:35:47'and those without OCD
0:35:47 > 0:35:51'on a task which looked at their tendency to develop habit-like behaviour.
0:35:51 > 0:35:56'Volunteers were taught how to avoid a mild electric shock
0:35:56 > 0:35:58'by pushing a pedal with their foot.
0:36:01 > 0:36:03'Their fear response was monitored
0:36:03 > 0:36:08'via changes in their skin conductance their sweat.
0:36:08 > 0:36:11'After 30 minutes, the electrodes were removed
0:36:11 > 0:36:14'and they were asked to perform the same task,
0:36:14 > 0:36:17'but without the danger of being shocked.'
0:36:17 > 0:36:20When I disconnect it, you can incorporate that knowledge
0:36:20 > 0:36:22and update your fear response accordingly.
0:36:22 > 0:36:25Also, your skin response reflected that you managed
0:36:25 > 0:36:28to inhibit your fear response as well
0:36:28 > 0:36:31and you learnt that this stimulus is no longer threatening.
0:36:31 > 0:36:34'When Claire tested the OCD subjects,
0:36:34 > 0:36:38'their response tended to be very different to mine.'
0:36:38 > 0:36:40They confirm with me that they can no longer be shocked,
0:36:40 > 0:36:43but, still, when that stimulus comes on the screen,
0:36:43 > 0:36:47you see they still, um, have an anxious fear response to it.
0:36:49 > 0:36:51Claire's initial results appear to suggest
0:36:51 > 0:36:55that rather than being the direct outcome of their obsessive thoughts,
0:36:55 > 0:37:00the repetitive compulsive behaviours of teenagers like Jon are habits.
0:37:01 > 0:37:04Maybe these obsessions, which can form an...an awful,
0:37:04 > 0:37:07a large part of the overt symptoms of the disorder,
0:37:07 > 0:37:10are maybe not so critical to its maintenance.
0:37:10 > 0:37:13And that, in fact, it may be an underlying propensity
0:37:13 > 0:37:18towards compulsive habitual behaviour that actually leads it.
0:37:20 > 0:37:25Claire believes the reason why people with OCD develop obsessive thoughts,
0:37:25 > 0:37:27is that it's the human brain filling in the gaps
0:37:27 > 0:37:30to justify their compulsive behaviours.
0:37:32 > 0:37:34You know, everybody has anxieties, don't they?
0:37:34 > 0:37:36And everybody has these thoughts or feelings
0:37:36 > 0:37:38about what they might need to do,
0:37:38 > 0:37:41but actually I know, sometimes, when I have those thoughts,
0:37:41 > 0:37:44I can calm myself down in order to, you know,
0:37:44 > 0:37:46not have that thought any more or not act on it.
0:37:46 > 0:37:48I think it's really critical to know
0:37:48 > 0:37:51that these disturbing intrusive thoughts that OCD patients have
0:37:51 > 0:37:56are no different in content from normal intrusive thoughts, as it were,
0:37:56 > 0:38:00that most people experience at one point in their life or another.
0:38:00 > 0:38:04And maybe the key to it is these compulsive repetitive habits
0:38:04 > 0:38:06that keep these obsessions alive,
0:38:06 > 0:38:09that fuel them, that force you to ruminate on them,
0:38:09 > 0:38:12and that also, um, as we've shown, preserve your anxiety.
0:38:12 > 0:38:15Claire's research appears to confirm
0:38:15 > 0:38:18the potential of the treatment method used at the Maudsley
0:38:18 > 0:38:23in that it shows if OCD sufferers like Jon stop their compulsive behaviour,
0:38:23 > 0:38:26the feared consequences don't happen
0:38:26 > 0:38:29and their anxiety will come down of its own accord.
0:38:33 > 0:38:35I think it's very important that,
0:38:35 > 0:38:38if you go through one round of exposure and response prevention that it works,
0:38:38 > 0:38:41that you really try and apply that in every other domain.
0:38:41 > 0:38:44So the idea is that if you, if you prevent doing the response,
0:38:44 > 0:38:48while your anxiety gets high initially,
0:38:48 > 0:38:49it will gradually decline,
0:38:49 > 0:38:52and then, it will stop this vicious cycle
0:38:52 > 0:38:54of reinforcement of these avoidance responses.
0:38:56 > 0:38:59It's day three of Jon's intensive treatment course.
0:38:59 > 0:39:03Holly and Amita have decided to increase the challenge to his OCD
0:39:03 > 0:39:09'by confronting him with one of his biggest anxieties - knives.'
0:39:09 > 0:39:12I know that OCD in the past has made you feel a bit nervous
0:39:12 > 0:39:15about being around knives and things like that,
0:39:15 > 0:39:18- and I know that it used to make you avoid using them.- Yeah, yeah.
0:39:18 > 0:39:22One of Jon's most frightening obsessive thoughts
0:39:22 > 0:39:26is that he believes he will harm someone, stab them with a knife.
0:39:26 > 0:39:28Even a close friend.
0:39:29 > 0:39:32So, Jon, we've got your friends here this afternoon, Sophie and Harry.
0:39:32 > 0:39:33I'm just wondering,
0:39:33 > 0:39:37what do you think it must be like for Jon to have OCD?
0:39:37 > 0:39:39I think it's very difficult, um,
0:39:39 > 0:39:42I think he struggles a lot, um,
0:39:42 > 0:39:45because I feel like he wants to talk about it a lot,
0:39:45 > 0:39:47but doesn't really know how to.
0:39:47 > 0:39:50And Jon's, you know, he said he's held back a little bit
0:39:50 > 0:39:52in terms of how much he tells you...
0:39:52 > 0:39:55You know, he's allowed to keep things to himself if he wants to,
0:39:55 > 0:39:57I don't tell everybody everything.
0:39:57 > 0:39:58He already feels different enough
0:39:58 > 0:40:01with being diagnosed with the condition,
0:40:01 > 0:40:05so I think it's important to stay how you've always been.
0:40:05 > 0:40:09OK. So we've got two types of knives here, as you can see.
0:40:09 > 0:40:12We've got a knife that you might use to eat your dinner
0:40:12 > 0:40:15- and then we've got a bit of a sharper knife here.- Yeah.
0:40:15 > 0:40:17And, actually, I was just wondering, Jon, having them here,
0:40:17 > 0:40:19has that increased your anxiety a little bit?
0:40:19 > 0:40:23Yeah, and it's already, like, already today it's a lot higher, the anxiety,
0:40:23 > 0:40:26than it was yesterday. So, yeah.
0:40:26 > 0:40:27Probably at a nine.
0:40:27 > 0:40:30And, again, just to remind you why we are doing things.
0:40:30 > 0:40:33We are going beyond normal everyday life here, aren't we?
0:40:33 > 0:40:38- We are really doing an extreme task to prove OCD wrong.- Yeah.
0:40:38 > 0:40:40'There is extensive clinical and research evidence
0:40:40 > 0:40:44'that people with OCD do not behave violently.
0:40:44 > 0:40:48'This is why Holly and Amita can have absolute confidence
0:40:48 > 0:40:52'that there is no chance Jon will harm anyone.'
0:40:52 > 0:40:54Last summer, I could really see
0:40:54 > 0:40:57how much it had taken over his life.
0:40:57 > 0:41:02Everything, even on Facebook talking normally and casually,
0:41:02 > 0:41:06that it would enter the conversation
0:41:06 > 0:41:09and he'd be worried about something
0:41:09 > 0:41:12and you could really see how difficult it was for him
0:41:12 > 0:41:14and how much it was taking up.
0:41:14 > 0:41:16- So you felt something was bubbling, in a way?- Yeah, yeah.
0:41:16 > 0:41:19So I wonder whether we could do a really quick thing here,
0:41:19 > 0:41:21- just in preparation.- Yeah.
0:41:21 > 0:41:23Just kind of...just holding it.
0:41:23 > 0:41:27- Do you think with us here, would that...- Yeah.
0:41:27 > 0:41:31- Would that do anything to your anxiety?- Not really.
0:41:31 > 0:41:32I can tell I'm getting a bit hotter.
0:41:32 > 0:41:34So I wouldn't say it's a great anxiety,
0:41:34 > 0:41:36but you can tell it's just sort of changed a bit.
0:41:36 > 0:41:39What if I came and sat nearer to you? Would that be OK?
0:41:39 > 0:41:40That's OK. Yeah, go on, then.
0:41:43 > 0:41:46I'm...a bit hotter again.
0:41:46 > 0:41:48- I can see it in your cheeks, Jon, actually.- Yeah.
0:41:48 > 0:41:50Your cheeks have gone a little bit redder
0:41:50 > 0:41:53- so that's a bit of a physical sign, isn't it...- Yeah.
0:41:53 > 0:41:55..that it's getting a bit trickier?
0:41:55 > 0:41:58Yeah, so I wouldn't say it's a great leap,
0:41:58 > 0:42:01but you can just tell that it keeps sort of making it a bit more intense,
0:42:01 > 0:42:04that anxiety level. Definitely. Yeah.
0:42:04 > 0:42:06- I'd say about a seven...- A seven?
0:42:06 > 0:42:09- Yeah.- Yeah, so it's gone up.
0:42:09 > 0:42:11- Could you direct it towards Amita? - Yeah.
0:42:11 > 0:42:13Hold it with a tighter grip? It could be as close as you want.
0:42:13 > 0:42:15'Amita and Holly know from experience
0:42:15 > 0:42:18'that Jon's intrusive obsessive thoughts,
0:42:18 > 0:42:20'his fear that he might stab someone with a knife,
0:42:20 > 0:42:22'are totally without foundation.
0:42:22 > 0:42:25'They are fears created by his anxiety.
0:42:25 > 0:42:29'So the purpose of this challenge is to prove to Jon
0:42:29 > 0:42:32'that he has nothing to fear from holding a knife,
0:42:32 > 0:42:36'that, in reality, he has no intention of harming anyone.'
0:42:36 > 0:42:40OK, so let's just sit as we are now for a minute,
0:42:40 > 0:42:44and see what happens to that anxiety.
0:42:51 > 0:42:53But what are you learning about this situation?
0:42:53 > 0:42:57- So you have had that knife in your hand for a few minutes now, Jon. - Yeah.
0:42:57 > 0:43:00I mean, it's sort of like the obsessive thought is still there,
0:43:00 > 0:43:03so you definitely get these mental images.
0:43:03 > 0:43:06But the anxiety isn't so great.
0:43:06 > 0:43:10So I wonder whether once you get a bit more evidence
0:43:10 > 0:43:13that actually it's just the worry.
0:43:13 > 0:43:16'I remember he used to say,'
0:43:16 > 0:43:17"Oh, I feel like such a monster."
0:43:17 > 0:43:19And I know that now he's told people
0:43:19 > 0:43:23and it's kind of getting itself sorted and he talks about it,
0:43:23 > 0:43:25that he feels better.
0:43:28 > 0:43:31'With this challenge, Amita and Holly have finally shown Jon
0:43:31 > 0:43:34'that he is no risk to anyone,
0:43:34 > 0:43:36'even with a knife in his hand.'
0:43:37 > 0:43:40When the knives came out this morning,
0:43:40 > 0:43:45- I was thinking... You know, we are really going to use knives, you know?- Yeah.
0:43:45 > 0:43:48'The way we do therapy is to really push it to the extremes'
0:43:48 > 0:43:51to really prove that what OCD's saying is not going to happen.
0:43:51 > 0:43:54Well done. Fantastic!
0:43:54 > 0:43:57- 'He's a real thinker, isn't he? - Yeah, he is.'
0:43:57 > 0:43:58He's in that moment of thinking,
0:43:58 > 0:44:02"Well, what is it that's really making me have these compulsions, you know,
0:44:02 > 0:44:05"these thoughts and these compulsions?"
0:44:05 > 0:44:08'I think so, I think he's been very open with us.
0:44:08 > 0:44:11'He's aware that the more he tells us,
0:44:11 > 0:44:14'the better position we are in to fight the OCD
0:44:14 > 0:44:16'and I think it's incredibly hard for him to do that.'
0:44:16 > 0:44:18And yet, he really wants to get rid of this,
0:44:18 > 0:44:21so he's sort of taking the plunge and doing that.
0:44:21 > 0:44:24And I think this is the way to really prove OCD wrong,
0:44:24 > 0:44:27is that, you know, without having us there...
0:44:27 > 0:44:29- Here he is!- Hi, Jon!- Hiya!
0:44:29 > 0:44:31- All right?- Mm-mm.
0:44:31 > 0:44:32HE CHUCKLES
0:44:34 > 0:44:38I was wondering if part of what you were doing was
0:44:38 > 0:44:40really trying to help him to see
0:44:40 > 0:44:43that we are not going to give any weight to these thoughts.
0:44:43 > 0:44:48'But I wasn't sure that he could really see that,
0:44:48 > 0:44:49'because he is so obsessed with them.
0:44:49 > 0:44:52'I think that's really common at this point in treatment,
0:44:52 > 0:44:56'because they are so powerful, so persistent, so intrusive and frequent.
0:44:56 > 0:44:58'And it's only once we keep doing these tasks
0:44:58 > 0:45:00'that he can challenge them and the heat,'
0:45:00 > 0:45:02kind of the heat will come out of it
0:45:02 > 0:45:05and he might find them a bit easier to kind of think about them
0:45:05 > 0:45:06in the way that we do.
0:45:06 > 0:45:10- And the trick is to do nothing with those thoughts.- Yeah.
0:45:24 > 0:45:26So, the weekend, how was it?
0:45:26 > 0:45:29- Not that good, to be honest.- OK.
0:45:29 > 0:45:31Jon has been given a break from his treatment
0:45:31 > 0:45:35so he can practise some of the techniques he has learnt on his own.
0:45:35 > 0:45:40But, over the weekend, he seems to have taken a step backwards.
0:45:40 > 0:45:43It's the weekend, it's Saturday evening...
0:45:43 > 0:45:47Um... Yeah, OCD's taking quite a big toll, to be honest,
0:45:47 > 0:45:49with, like, the obsessive thoughts.
0:45:49 > 0:45:56Not exactly physical anxiety but just, like, really low in general.
0:45:56 > 0:45:58I remember talking about, the other day, about, you know,
0:45:58 > 0:46:02the obsessive thoughts being like a mental battle, like...I don't know.
0:46:02 > 0:46:03HE SIGHS
0:46:03 > 0:46:05Sort of played its toll.
0:46:05 > 0:46:07And just makes you feel generally really low and sort of...
0:46:07 > 0:46:10I mean, you wake up and you feel pretty sad,
0:46:10 > 0:46:12and you go to bed and you feel pretty sad.
0:46:12 > 0:46:15It's almost like the OCD is, like, shouting at you
0:46:15 > 0:46:18and it's the only thing and it's always at the forefront of your mind,
0:46:18 > 0:46:22- so everything else sort of goes below it almost.- Yeah.
0:46:22 > 0:46:25And when you are, like, in a conversation with someone,
0:46:25 > 0:46:27you are not really in that conversation
0:46:27 > 0:46:32- cos you're still just thinking about these thoughts that just go around, around, around.- Yeah.
0:46:32 > 0:46:34Take it, then.
0:46:34 > 0:46:37'It's one of the very characteristic aspects'
0:46:37 > 0:46:39of OCD that it's...
0:46:39 > 0:46:42Some people call it the secret problem or the hidden illness,
0:46:42 > 0:46:45that it remains hidden for a long time
0:46:45 > 0:46:48before it's detected or diagnosed,
0:46:48 > 0:46:54and sometimes that's because the individual's very embarrassed about it.
0:46:54 > 0:46:57And it's also because it does blur into normality
0:46:57 > 0:47:00and so, it can just creep up at home
0:47:00 > 0:47:03and what could be just a normal bit of childhood behaviour,
0:47:03 > 0:47:05before people realise it, it's become daily
0:47:05 > 0:47:09and it's become prolonged, and it's become distressing.
0:47:09 > 0:47:12The compulsions you always felt you could deal with somehow
0:47:12 > 0:47:15and they weren't as strong as just having the thoughts though,
0:47:15 > 0:47:18and that's probably the worst bit.
0:47:18 > 0:47:21'You can't do anything without something coming into your head
0:47:21 > 0:47:24'and that causing anxiety.'
0:47:24 > 0:47:27Can you explain, you know, the process that somebody
0:47:27 > 0:47:29who...who's really struggling with OCD is going through?
0:47:29 > 0:47:32One of the themes that often comes out
0:47:32 > 0:47:38is that they're just very preoccupied and distracted all the time
0:47:38 > 0:47:41by thoughts that keep popping in to their head.
0:47:41 > 0:47:46And it can be the smallest trigger that can make, for example,
0:47:46 > 0:47:49the specific fear come into their minds.
0:47:49 > 0:47:53So, almost relentlessly, thoughts are just...
0:47:53 > 0:47:57almost, like, we sometimes call them um, you know, mental hiccups almost.
0:47:57 > 0:48:01Their mind is just popping out another worry, you know.
0:48:01 > 0:48:02Have I got germs on me?
0:48:02 > 0:48:06Is that blood on that table? Do I need to wash my hands?
0:48:06 > 0:48:09It's sort of...the tools work with the compulsions,
0:48:09 > 0:48:13but they don't help with, like, the thoughts themselves.
0:48:13 > 0:48:17Jon's making great progress with stopping his compulsive behaviour,
0:48:17 > 0:48:22but he still doesn't seem to be able to get his obsessive thoughts out of his head.
0:48:22 > 0:48:28At one time, this would have been tackled through psychoanalysis.
0:48:28 > 0:48:29I would actually specifically say
0:48:29 > 0:48:32that psychoanalysis doesn't help at all.
0:48:32 > 0:48:36And, in fact, there's even some evidence that it may make OCD worse.
0:48:36 > 0:48:41The whole premise of psychoanalysis is looking into the past,
0:48:41 > 0:48:44looking into past experiences and patterns
0:48:44 > 0:48:49and trying to understand how they shape the present and the future.
0:48:49 > 0:48:51And trying to do that with somebody with OCD
0:48:51 > 0:48:54can actually make them EVEN more obsessive.
0:48:54 > 0:48:56SHE CHUCKLES
0:48:56 > 0:48:59- You just get really fed up with it. - Yeah.
0:48:59 > 0:49:04Cos it's like you can't really live, sort of, in the moment
0:49:04 > 0:49:06cos you are always thinking about other things
0:49:06 > 0:49:08It's quite distracting.
0:49:08 > 0:49:12Yeah. You're sort of, it's never sort of... It doesn't hardly ever let up.
0:49:12 > 0:49:16A young man of his age should be able to go out without worry,
0:49:16 > 0:49:18should be able to see his friends.
0:49:18 > 0:49:22His mind is in turmoil and that's why he is exhausted.
0:49:22 > 0:49:26People of his age shouldn't worry, you know, he should be carefree,
0:49:26 > 0:49:30but the way he is at the moment, it's all internalised.
0:49:30 > 0:49:35And it shouldn't be. He shouldn't be worrying about contamination.
0:49:35 > 0:49:37He shouldn't have to be worrying all the time.
0:49:37 > 0:49:40It's not normal, is it? It's not normal behaviour.
0:49:47 > 0:49:49The following day, Amita and Holly
0:49:49 > 0:49:51decide that they must get Jon out on the streets again
0:49:51 > 0:49:55to concentrate on beating his compulsive behaviour
0:49:55 > 0:49:59and to overcome his obsessive thoughts.
0:49:59 > 0:50:01So let's just sit here
0:50:01 > 0:50:04and let's just kind of watch people go by.
0:50:04 > 0:50:07And that's why exposing yourself to these fears is so important,
0:50:07 > 0:50:10- because you get desensitised.- Yeah.
0:50:10 > 0:50:12The potency goes from the thoughts
0:50:12 > 0:50:16- and you can kind of deal with them a little bit easier.- Yeah.
0:50:16 > 0:50:18- So let's have another go.- Yeah.
0:50:18 > 0:50:20- And I'll go ahead.- Yeah.
0:50:20 > 0:50:23And so, think of these things again.
0:50:23 > 0:50:25And I won't be there...
0:50:25 > 0:50:27And drop all of those rituals.
0:50:27 > 0:50:29- Good to go?- Yeah, go on, then.
0:50:29 > 0:50:32- OK. I'll see you back there? - Yeah, see you in a minute.
0:50:33 > 0:50:35The goal of Jon's treatment
0:50:35 > 0:50:38is to get him to focus on his obsessive thoughts,
0:50:38 > 0:50:42to help him become de-sensitised to them on his own
0:50:42 > 0:50:43without anyone to reassure him.
0:50:49 > 0:50:52Jon's treatment is nearly over and he seems to be back on track,
0:50:52 > 0:50:57but what he now needs to do is start fighting OCD on his own.
0:50:57 > 0:50:59It's all very well here in London with Holly and Amita,
0:50:59 > 0:51:02but how will he cope when he gets back home?
0:51:02 > 0:51:06So what sorts of things could you have a go at practising
0:51:06 > 0:51:08whilst you are in school?
0:51:08 > 0:51:12Like not checking back if you get an obsessive thought.
0:51:12 > 0:51:15Like not checking to make sure it hasn't happened.
0:51:15 > 0:51:19- Just doing the opposite. That's the golden rule.- Yeah, yeah. - Do the opposite to OCD.
0:51:19 > 0:51:22But what's the end goal?
0:51:22 > 0:51:24By dropping these rituals, what are we trying to do?
0:51:24 > 0:51:27- Stop the compulsion of asking others to help you.- Yeah.
0:51:27 > 0:51:29So what you are actually saying is
0:51:29 > 0:51:32no matter how bad his stress level is,
0:51:32 > 0:51:34I'm still to resist helping him.
0:51:34 > 0:51:37Is that what you're actually telling me?
0:51:37 > 0:51:38- It's hard, isn't it?- Yeah.
0:51:38 > 0:51:41- Yeah, I think so, and I think Jon agrees, don't you?- Yeah.
0:51:41 > 0:51:44Although you know it's not going to be easy at times,
0:51:44 > 0:51:47that's what's going to get rid of the OCD, isn't it?
0:51:49 > 0:51:52- We think you've done really brilliantly, Jon.- Yeah.
0:51:52 > 0:51:55- It's a tough few days, isn't it? - Definitely.
0:51:55 > 0:51:58So soon as you walk out of this door, Jon, you start fighting.
0:51:58 > 0:52:00You start using all those tools,
0:52:00 > 0:52:03things will come up just even walking out going to the car.
0:52:05 > 0:52:06So final day,
0:52:06 > 0:52:09what do you think might happen over the next few weeks?
0:52:09 > 0:52:13I think his confidence will increase and his ability to fight OCD
0:52:13 > 0:52:17and I think he will be able to beat it.
0:52:17 > 0:52:20There is no reason why he can't have a life without OCD.
0:52:20 > 0:52:22Jon, how are you feeling now?
0:52:22 > 0:52:24Yeah. Um...tiring, but it's sort of...
0:52:24 > 0:52:26It's quite optimistic about the future
0:52:26 > 0:52:30and I've got these tools to cope with when times get bad with OCD.
0:52:30 > 0:52:32And, Carol, you're the one that's sort of
0:52:32 > 0:52:34up close and personal to it, really.
0:52:34 > 0:52:36What are you feeling at the moment?
0:52:36 > 0:52:39He's very determined and I know he's going to make it.
0:52:39 > 0:52:43I just know. No, this is it.
0:52:48 > 0:52:52Anna has been suffering from OCD since she was 14.
0:52:52 > 0:52:54Because of her fear of contamination,
0:52:54 > 0:52:58she can't visit the local surgery for a check-up,
0:52:58 > 0:53:00so the doctor has to come to her.
0:53:00 > 0:53:03Would I be able to check your blood pressure, do you think?
0:53:03 > 0:53:05Dunno.
0:53:05 > 0:53:08Can I do it on your upper arm, and perhaps through your clothing,
0:53:08 > 0:53:11- as far as the blood pressure's concerned, that would be easier. - Yeah.
0:53:11 > 0:53:15Most people will recover with treatment from their local NHS,
0:53:15 > 0:53:19but Anna is still trying to find the right treatment for her OCD.
0:53:19 > 0:53:25Her mother Karen wants her to be referred to the Maudsley's specialist clinic.
0:53:25 > 0:53:28Is that the sort of place that you can refer her to?
0:53:28 > 0:53:31I probably can make a referral to the Maudsley, certainly.
0:53:31 > 0:53:34You've already been seen by a local psychiatrist
0:53:34 > 0:53:36and there's not been any improvement.
0:53:36 > 0:53:39- Righto, so cheerio, then.- Yeah.
0:53:39 > 0:53:41All right, I won't shake hands.
0:53:41 > 0:53:43HE LAUGHS
0:53:43 > 0:53:48And to feel sort of more ordinary, as, you know, like your friends,
0:53:48 > 0:53:50what do you think would need to happen?
0:53:50 > 0:53:54Just to not cover my hands up, not wash my hands as much,
0:53:54 > 0:53:57- to be able to, like, touch things. - Mm-mm.
0:53:57 > 0:54:00And not worry about getting ill or things like that.
0:54:07 > 0:54:10I had a couple of spikes this evening.
0:54:10 > 0:54:13Spikes just like the thoughts that come straight into your head
0:54:13 > 0:54:15without you really thinking about it.
0:54:15 > 0:54:18I mean, if I was to give it a scale out of ten on the anxiety,
0:54:18 > 0:54:21I would say six, but it's manageable at the moment.
0:54:26 > 0:54:29A few weeks after his intensive treatment in London,
0:54:29 > 0:54:31one of Jon's psychologists, Amita,
0:54:31 > 0:54:35has come to meet him at home to monitor his progress.
0:54:35 > 0:54:38- Hi!- Hello!- Hello.
0:54:38 > 0:54:40How's the last week been since...?
0:54:40 > 0:54:42Um... It's been quite good.
0:54:42 > 0:54:46There's been sometimes when it's been a bit, you know, the anxiety's gone up.
0:54:46 > 0:54:49- But, most of the times, you've been able to control it...- OK.
0:54:49 > 0:54:51Yeah, quite well.
0:54:51 > 0:54:54And how have you been able to control it?
0:54:54 > 0:54:57Um... Just by not doing the compulsions that go along with it, really.
0:54:57 > 0:55:00At the end of his treatment in London,
0:55:00 > 0:55:01Jon was asked to do homework,
0:55:01 > 0:55:04certain tasks to keep challenging his OCD.
0:55:04 > 0:55:09In particular, he was told to go to unfamiliar places on his own
0:55:09 > 0:55:12and resist any urge to do any compulsions.
0:55:15 > 0:55:20Yesterday, I said I was going to be trying to go down to a place
0:55:20 > 0:55:24that I don't, haven't been on my own because of the OCD,
0:55:24 > 0:55:27and that's down to the woods over there.
0:55:27 > 0:55:32OK, so, I mean, I have come down to this end of the village before.
0:55:32 > 0:55:33HE LAUGHS
0:55:33 > 0:55:36But never on my own.
0:55:36 > 0:55:40And I think, it's always...
0:55:40 > 0:55:44with OCD, it's always sort of been certain areas you know
0:55:44 > 0:55:47you don't want to go because you know you will trigger it.
0:55:47 > 0:55:50And this is probably one of the places
0:55:50 > 0:55:53where I would not have dared go down a year ago.
0:55:53 > 0:55:58So... I mean, at the moment, if I had to rate the anxiety out of ten,
0:55:58 > 0:56:00I would score it about four.
0:56:09 > 0:56:12So I am going to see what's going to happen, really,
0:56:12 > 0:56:16over the next 24 hours, just see whether the anxiety gets worse
0:56:16 > 0:56:18or whether you feel better for doing it.
0:56:18 > 0:56:23I did want to put it off but, now doing it,
0:56:23 > 0:56:26you know, it sort of shows you you can overcome these things
0:56:26 > 0:56:31even when OCD is telling you not to do it.
0:56:31 > 0:56:34And the army of sheep are there on the horizon again.
0:56:34 > 0:56:36HE LAUGHS
0:56:39 > 0:56:42Do you feel a bit more confident about fighting OCD
0:56:42 > 0:56:44compared to two weeks ago?
0:56:44 > 0:56:48Um... Yeah, I think there's definitely, sort of, you can...
0:56:48 > 0:56:51you're getting into a routine of doing things, I fear.
0:56:51 > 0:56:54Yeah, I really noticed a change in you.
0:56:54 > 0:56:56You probably don't notice it as much,
0:56:56 > 0:56:58but I've noticed a real change in, kind of, the tone.
0:56:58 > 0:57:00But we'll just take it as it comes.
0:57:00 > 0:57:03- If we feel you need further input, we'll definitely support that.- Yeah.
0:57:07 > 0:57:10The key to Jon's treatment is that he has to keep
0:57:10 > 0:57:13challenging his OCD, on his own,
0:57:13 > 0:57:15using all of the techniques that he's learnt.
0:57:15 > 0:57:19He has already made some amazing progress.
0:57:19 > 0:57:22He now feels much less anxious around the home.
0:57:28 > 0:57:30And when he goes to train stations,
0:57:30 > 0:57:35he can now control his obsessive fear about pushing someone under a train.
0:57:35 > 0:57:38The treatment is beginning to transform his life.
0:57:41 > 0:57:46- The more you keep facing these situations then, eventually, OCD will give up.- Yeah.
0:57:46 > 0:57:48But I think, on the whole,
0:57:48 > 0:57:51my sense is that you are a bit more in control
0:57:51 > 0:57:54- compared to when I saw you two weeks ago.- Yeah.
0:57:54 > 0:57:57I think you've really used what you've learnt in sessions here
0:57:57 > 0:57:59and that really shows, so just keep going.
0:57:59 > 0:58:01- Yeah.- Fantastic.
0:58:04 > 0:58:09With the right treatment and the commitment and determination of all those involved,
0:58:09 > 0:58:11OCD can be treated.
0:58:11 > 0:58:14According to the Maudsley Hospital's latest figures,
0:58:14 > 0:58:1984% of their patients saw significant improvement or full recovery.
0:58:19 > 0:58:23It doesn't happen overnight, but OCD can be cured.
0:58:23 > 0:58:25To find out more about OCD
0:58:25 > 0:58:27and to separate fact from fiction,
0:58:27 > 0:58:29go to...
0:58:32 > 0:58:35..and follow the links to the Open University.
0:58:53 > 0:58:57Subtitles by Red Bee Media Ltd