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Cover your face, scrub your hands, repeat. The pandemic has heightened anxieties of infection, even more so for people with obsessive compulsive disorder
Once in every 20 minutes, like clockwork, Sivakumar Bharati* washes his hands and checks if the window are shut. “I have not ‘relaxed’ in three months aside from my REM sleep,” he says. “There is the prevalent fear of germs and contamination which is why the pandemic has been particularly stressful.”
This is the reality of OCD or obsessive compulsive disorder.
“You don’t really take notice of it until someone else points it out — and a lot of people did,” says 59-year-old retiree Sivakumar . “And back in the 70s, mental health was not taken seriously. People back then just thought I was militant about being neat, some poked fun at it.”
Sivakumar’s home in Hyderabad is evident of his obsessive compulsive disorder: to want everything symmetrical, no clutter, even the presence of muted tones. There are moments of anger and frustration where if things are not lined up, there would be a meltdown, curable only by the correct positioning and considerable time to cool off.
Chennai-based Professor Dr Gauthamadas Udipi, specialist in neuro-behavioural medicine, who has worked with people with OCD for almost many years explains, “OCD may only be the behavioural marker of a more extensive systemic disorder. “After all, the mind is only an expression of the functioning of the brain, and the brain is only a part of the body. At one end of the OC spectrum is ‘normal’ obsessive thinking and ordered behaviour in daily life, which does not interfere significantly with daily functioning. At the other end is severe obsessive rumination and compulsive behaviour that does not allow daily function.”
Essentially, the underlying pathology is in the Salience Network (SalNet) or ‘worry-loop’ of the brain, which sees a person having uncontrollable, reoccurring thoughts and/or behaviours that they feel the urge to repeat over and over; it can be especially harrowing now, owing to the COVID-19 pandemic which invites uncertainty, rising tensions and innumerable risk factors. Often caused by severe psychological stresses, OCD manifests in different forms, from ritualistic obsessions to suicidal compulsions. Sivakumar is on the lower end of this spectrum, and it took a long time for him to realise what he had.
‘I’m OCD about that’
Sivakumar, during the late 2010s, was finally formally diagnosed by a neurologist in South Africa, who stated that OCD is a legitimate condition — and not one about which to be ashamed. “I remember him mentioning how popular culture had not even normalised but trivialised OCD. The parameters of what was ‘deemed’ OCD had shifted in a big way; people thought being tidy was OCD,” recalls Sivakumar.
And things have not been easy as the pandemic trudges on.
Dr Udipi affirms that the pandemic can be a heightener, explaining, it could “result in triggering underlying OC spectrum disorders in a genetically prone person, tilt the balance from ‘normal’ obsessions to a pathological OC pattern, or worsen an already existing OC disorder.”
The International OCD Foundation, Boston, sees the unique challenges for the OCD-afflicted and has offered numerous online resources, which are free-to-use and which help people run through their OCD anxiety with some ease while maintaining physical distancing. These options include WHO-approved tips on how to deal with contamination fears, video teletherapy, which helps those with OCD find a licensed teletherapy provider while retaining physical distancing, and printable coping cards. These cards, not a replacement for help from a medical professional, are written reminders and questions for the self to be mindful, breathe easy, take back control and understand that progress is better than perfection.
Dr Udipi adds that empathy from close friends and family is helpful. “[They] must understand that this is a disorder originating in brain circuits over which the person has little control, and advising the person that ‘it is all in the mind’, and ‘learn to control it’ is of no use, and that yoga, meditation, and other ‘self-therapies’ will not work in the case of a ‘pure obsessive thinking’ (which occurs in a very small percentage of people with SalNet disorder), as the person cannot bring the mind to focus on them due to pure circuit overdrive.” He emphasises that early identification and proper treatment by a qualified psychiatrist and team is the key.
Sivakumar agrees, concluding, “There are times you may not feel worthy because you feel like you are adding stress to home life or work life. But when you start humanising yourself with the help of a mindful and informed healthcare professional, it helps tremendously. It also helped that my family and I could find common ground with patience. But for other OCD folks out there, you have to want to accept it as a condition and not as an extension of the self. It’s emotionally taxing to go through it because your mind is telling you that this obsessive order of things is paramount.”
* Name changed to protect identity
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Coming between a child and his feelings should not be an easy thing to do.
After all, every child’s feelings are literally neurologically and biologically wired into them. Every child’s feelings are a crucial expression of their deepest selves. Every child’s feelings are a vital resource for connection, direction, stimulation, and motivation for a lifetime.
And yet, it happens all the time. Lovable, adorable children grow up in homes where their parents are simply not able to fully see, know, or adore them. Sweet, healthy children reach out to their moms and dads for emotional support and too often find it lacking. Excited, energetic children just want to share their pure joy with their parents and too often end up being tamped down instead.
Childhood Emotional Neglect or CEN happens when your parents fail to respond to your emotions enough. Believe it or not, that is all they need to do to separate you from your feelings for a lifetime
Childhood Emotional Neglect is far more common in this world than any of us would care to believe. Every household is different and every child is different. But every time Childhood Emotional Neglect happens in the life of a child, no matter what form it takes, it leaves its indelible footprint there.
This simple definition says a lot about what CEN is, but the reality is that not all Childhood Emotional Neglect is the same. It can be quite a complicated thing and it can happen in many different ways. Keep in mind that you may have experienced just one of these versions of CEN or even all of them.
5 Varieties of Childhood Emotional Neglect
1. Physical Presence
Was one or both of your parents physically present enough as they raised you to meet your needs for supervision, attention, and response? When most people first hear the term, “Childhood Emotional Neglect,” this is the kind they think of. They assume it refers to a latch-key kid who sat home alone, unattended, too much, or too young. This version of CEN is the easiest to see and remember because it’s concrete. You are likely to recall whether your parents were home or not.
CEN Effects: You learn to be very independent and perhaps, hyper-competent. You have learned not to need anyone, and asking for help or accepting it is a challenge.
2. Structure and Consequences
Did your parents enforce rules and responsibilities in your home? This may involve homework, household chores, mealtimes, and bedtimes. Did they give you rewards and consequences based on your behaviors and choices? If your household was too unstructured, too unpredictable, or too inattentive you may have been left to your own devices to figure things out on your own. But children’s brains are not prepared or able to effectively process this.
CEN Effects: Having received too little discipline from your parents, you now struggle to discipline yourself. It’s hard for you to organize yourself and make yourself do what you know you should do, and you may also have a hard time stopping yourself from doing things you shouldn’t do. Chances are high that you blame all of this on yourself, assuming that you are weak or defective in some way.
3. Observation and Feedback
Did your parents see you? Did they notice who you are and then share their observations with you? Children are not self-aware. They learn who they are by looking into their parents’ eyes and seeing themselves reflected there. Your preferences, abilities, weaknesses, challenges, talents, and needs are all important information for you to have about yourself. What happens if you are launched into adulthood without enough of it?
CEN Effects: Not knowing yourself well enough, you have difficulty making good choices for yourself. You may marry wrong, choose the wrong field or trade, or end up simply going with the flow instead of making choices for yourself. When people ask you what you want it may be hard for you to know. Unaware of what you’re good at, what you like or what you want makes it difficult for you to pursue it.
4. Quality of Love
What were the true depth and quality of your parents’ love for you? This one is difficult to write about because I know it may be painful for you to read about. The reality is that even though emotionally neglectful love can be real, honest, and earnestly delivered, it does not deliver the full package of parental love that every child needs. How can you feel fully and deeply loved by your parents if you don’t feel fully and deeply seen and known by them? Sadly, what seems like real quality love in the CEN family is, actually, not.
CEN Effects: You are set up to feel most comfortable when people don’t fully see or know you because it feels familiar and somehow right. You have internalized emotionally neglectful love as the gold standard for love because all children’s brains naturally do this with the type of love they receive from their parents. You may be attracted to other CEN people or tend to keep your friendships and relationships focused more on the other person. Deep down, you’re not sure you deserve to be loved the way you see other people loved.
Did your parents respond enough to your feelings? Did they act like your emotions mattered? This form of Emotional Neglect envelopes all the others because emotions underly everything in your childhood home. A major parental responsibility is to emotionally validate and educate the child. Your parents need to teach you what you are feeling and why you are feeling it and that it’s OK to feel it. They are meant to help you navigate the world of emotions, both your own and others’ so that you will understand people and how to navigate relationships in every area of life.
CEN Effects: You grow up under-valuing and under-attending to your own feelings. You may even feel ashamed for having them. You may be blind to the world of emotions (as your parents likely were) and focus too much on facts or plans or concrete things. You may be deeply uncomfortable with intense feelings whether your own or another person’s and wall yourself off when you are challenged to deal with feelings. You may feel empty or numb at times and this may cause you to question whether you are somehow different or flawed. Since you’re unschooled in the world of feeling, you may find relationships with others somewhat confusing and perplexing.
Whether you grew up with one or all of these forms of Emotional Neglect or somewhere in-between you can be sure that it has left its mark on you. But the imprint of CEN has a silver lining that’s meaningful and real and important for you to know about.
Childhood Emotional Neglect is not an illness or disease, nor is it a life sentence. All of its effects are rooted in the way you had to cope as a child. Think about it. If your parents acted consistently as if your left arm was a useless, unpleasant burden for the family you would, eventually, learn how to hide it. The same applies to your emotions.
So now, just as your arm is still there, so are your feelings. You can reclaim them now and you will see that the vital aspects of life that you have been denied thus far will be within your reach.
Coming between a child and his feelings should not be an easy thing to do, it’s true. The amazing thing is that rejoining that adult with their feelings is remarkably well possible and has a deep and lasting impact on the quality of your life. And there is a well-worn path to take you there.
What makes a good person do a bad thing? Why do people partake in events when they know what they are doing is contrary to their own moral beliefs? Group mentality and conformity play major roles in human behavior. We explore the Stanford Prison Experiment, Asch Conformity Experiment, and the social roles these psychological concepts play in history and today.
For children and adolescents, staying at home may not be so bad; they get to play more video games, read more books or indulge in whatever activity they always craved when they used to be in school. But I’m sure some adolescents are also feeling depressed as they cannot gather in their social cliques as frequently as they used to. There’s no doubt that social distancing is increasing the rate of depression worldwide.