Obsessive-Compulsive Disorder (OCD)
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It may be me (often is, I’m sure!) but certain wording in David Veale’s book upset me. Professor Salkovskis writes in the foreword that OCD sufferers are often told to ‘pull themselves together’. He goes on to say ‘Good advice, but pretty pointless by itself’. His next paragraph describes how David Veale’s book can help us ‘pull ourselves together’.
As I said, it is possibly me, but I find this rather offensive.
I agree that that is offensive, would he also suggest that someone with depression pull themselves together? Or perhaps we should all just stop buying their books if it is that easy and they think that we should just pull oursleves together. If it is that simple then are they merely making money from our misery? Ironic when these are supposed experts in the condition if they think that then who can blame other people for saying the same. Perhaps they should experience what it is like to spend hours on end sweating in terror and then see if they can pull themselves together. Isn't professor Salkovskis a patron or something for OCD action?
I think that they’re going by the dictionary definition of ‘pull yourself together’ which defines the phrase as
To control your emotions and behave calmly after being very upset, angry, shocked etc. So in a way it describes what CBT does. Though it’s not appropriate in this case as the term is usually used in a derogatory way to someone that you don’t think is trying.
Having OCD is like a living hell. We’d all love to be able to ‘pull ourselves together’ but it’s not that simple. If it were they’d all be out of a job and we’d all be OCD free 
There are far better ways of describing how the book can help with out using a term that is commonly used in a derogatory way. To many, me included it's offensive and makes light of our daily struggle.
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Jo, I feel rather guilty now! I know that Paul Salkovskis cares very much about us and he knows better than most how OCD can destroy lives. He says he hates the condition for what it does to us. However, his wording wasn’t the best! He did go on to say there’s nothing we want more than to pull ourselves together, we just need to know how to go about it. ‘Nothing more than to overcome OCD’ would have been preferable.
I also believe he gives his time to charities for free. I would hate to malign him. I just wish he had realized that those words are so distressing, because many of us hear them frequently from our relatives.
David Veale’s book and those of other professionals, do make it sound as if overcoming OCD is quite easy. Certainly Paul Salkovskis made it seem very simple in his documentaries. I know little about David Veale, but I do believe that Paul has our best interests at heart. He is convinced that his message of ‘cure’(in a very short space of time, if we go by the documentaries) is an encouraging and positive approach. What he doesn’t seem aware of is that those who don’t respond quickly (or at all) are left feeling like complete failures and are more despondent and depressed than they were before they faced treatment.
Tricia x
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Sorry, Trudy, not ignoring you, just slower to write my message than you obviously were yours!! xx
I appreciate what you've said Tricia, but the book is aimed at people who are on the whole at rock bottom and the wording should have been a little more sensitive, especially as most of us hear that phrase repeatedly and find it demoralising when we're doing our best in a bad situation. They may have our best interests at heart but they do need to use a little more discretion when using phrases that are often misused by the public.
There is no way you can imagine what someone with OCD goes through unless you too have OCD and so they should listen to us a little more when it comes to this sort of thing.
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I know, Trudy, and you are aware of my views better than most! It's only by getting to know people on the forum and by reading Fred Toates' book that I have emerged from a deep pit of despair. I felt a failure and that was down to experts' views more than the OCD!
Oh dear,
Sorry guys, I think perhaps my previous experience has made my wording rather strong and a little inappropriate on a small peice of wording. Tricia, I apologise please don't feel guilty, I don't know much of this professor, and perhaps he meant it with the best of intentions. I just find the term he used rather offensive, as when I was very bad with my OCD when I was young, I was told this amongst a number of offensive comments, 
Which led me to feel that I was like peice of animal excrement on the bottom of someones shoe. Now being older i know that I was just ill with OCD and depression, but I am now intolerant of peoples judgements when they have not experinced something themselves. So I apoplogise, sorry x
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Teresa, Some say therapy can never make us worse, but I disagree with this and so does my psychologist.
Jo, There is no need to apologize! Besides, I reacted the same, which is why I wrote my message. Although I like and respect Paul Salkovskis, I believe he is doing harm as well as good. It’s a shame, because a slight adjustment in his wording (as in the foreword of David Veale’s book and in his documentaries) would eliminate the harm.
I cannot quote him precisely, but I will paraphrase his comments from the ‘House of Obsessive Compulsives’. He remarked that at that point in the programme, the question might be raised as to how hard the professionals would be pushing the three OCD sufferers. He went on to say they wouldn’t be pushing them, they would be encouraging them to push themselves, and he believed these were people who would be able to push themselves to the point of cure. (This was in just two weeks, wasn’t it? We were also told that the OCD sufferers were three of the most severe in the country. Strange that at Professor Salkovskis’ clinic I was told I was too severe for such short intensive treatment!).
I know how some people, who had not responded to therapy, bitterly regretted that their relatives watched the documentary, because they gave them such a hard time about ‘not trying hard enough’. At one U.S. conference the documentary was shown and OCD sufferers in the audience were expressing their relief that their relatives were not watching it with them!
In another of the professor’s documentaries, the narrator spoke about the one in three people too terrified to face therapy who therefore remains in the vicious circle of OCD. At no point was it stated, in either programme, that 75% of patients willing to face CBT will respond to it, which obviously leaves 25%, who are equally determined, but unfortunately find themselves no better off. This 25% appears to be overlooked. We are left feeling like failures and I find this totally unacceptable.
I was angry with the good professor and wrote to him after the first documentary (before ‘House of…’). However, I was surprised by the length of his reply and his friendly manner. One of the questions I asked was this: ‘If I follow your therapy to the letter can you guarantee I will overcome my OCD?’. His honest reply was ‘There is no treatment that works for everyone’.
David Veale says as much in his book, and yet it somehow gives the impression that those with courage and determination will overcome their OCD. I have several good friends with incredible courage, who have faced exposure therapy many times. They still suffer badly with their OCD. I still take issue with David Veale’s statement that exposure is hard, but not too hard. This is certainly not the case for all.
It is possible to write a book which encourages and guides OCD sufferers through treatment, without sounding patronizing or making them feel like utter failures. Likewise, it is possible to make a positive documentary about the condition, and its treatment, without making those still suffering feel like failures (as the BBC did prior to the professor’s programmes).
A psychiatrist once said this to me: ‘I’ve travelled the world, met people from all walks of life and the bravest people I have ever met are my patients with OCD, who face fears daily and require such courage, just to get through each day.’
Tricia x
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I’ve just realized that Professor Salkovskis’ foreword to David Veale’s book can be viewed on Amazon if anyone is interested in reading it.
The first sentence states: ‘Obsessive compulsive disorder is a solvable problem and the solution is in your hands’. It’s another of those remarks that can leave some of us feeling overwhelmed by guilt and despondency!
I wonder if the professor is keeping abreast of events across the Atlantic? Apparently, they have gone one better with their latest OCD documentary. Six sufferers in a house who are asked to perform the following: entering a restaurant and going to the ‘bathroom’ to wipe scones over the toilet seat, before dipping in toilet bowl and eating. There is also rolling in rubbish, blood and urine. Don’t know if it’s a multiple choice or whether you have to work your way through each of these ‘adventures‘. Sorry, but either I am going mad or the behaviourists are!!
Reminds me of the therapist at the Bethlem who told me I must handle dog doo with my bare hands. I was joking when I asked if I would then be asked to eat a sandwich without washing. He, however, was not when he told me not to look that far ahead. Apparently, if my anxiety rose high enough, handing it alone would probably be sufficient. Are these people insured?!!
I know most have the best intentions, but when this extreme therapy is being dished out at the hands of someone with sadistic tendencies, it is even more alarming (and there are therapists out there who do get pleasure from seeing patients suffer).
I don't care what the theory is, that's barmy. I'd say it was actually more dangerous for someone who's had contamination OCD for a long time. Somebody else would quite likely get away with it (though I wouldn't do it myself, and I'm quite happy to eat peas that have been dropped on the floor), because their immune system is more used to germs (within reason, which that isn't).
Anyway, I'm not sure what's the point of taking it that far. If your OCD objects even to normal levels of possible "contamination", surely it's enough of a challenge to expose yourself to those? And when those are no longer a problem, the problem is solved. I can sort of see the point of ending up with slightly exaggerated things, like touching a toilet seat, when you can only just manage normal things and want to get past that point. But this... I think it's probably inspired by a feeling that the more drastic the treatment the more drastic the effect.
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I agree, Wombat. When I overcame my obsession with germs (which was extreme and disabling) I did no ‘over-the-top’ exposure. I behaved in a ‘normal’ way which was very challenging and it worked very well.
In actual fact, David Veale tells us to choose exposure that is ‘challenging, but not overwhelming‘. He then seems to contradict himself with his suggestions for exposure.
I would imagine with the American ‘show’ it’s more for sensationalism and to achieve high audience ratings, but I may be wrong, I know nothing of the psychologist involved with the documentary. Not sure I’d want to!! Seems more like a Japanese game show than a programme about overcoming OCD.
You are also right about the immune systems of people who have severe contamination worries who avoid germs. After exposure to public toilets in this way they are more likely than the general population to succumb to an illness.
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I would like to reiterate that I had no intention of maligning Professor Salkovskis. I merely disagree with some of the wording he uses. I stand by this, as I am sure he stands by his view that his wording is perfectly accurate and acceptable. We will agree to differ.
I have realized that I have mentioned (in this thread) that some therapists are sadistic. I would imagine they are a tiny minority and I doubt any attain a position of authority. Because the thread began with my criticizing Paul Salkovskis’ wording, I would hate to think the comment about sadistic therapists was linked in any way to him. Nothing could be further from the truth!
I believe the reason I reacted so vehemently over phrases like ‘pull themselves together', is because this was how a very close friend of mine was spoken to by an occupational therapist, weeks before he died. He had advanced lung cancer at the time and was in a very weak condition. Two therapists stood over him and forced him to carry out tasks in his kitchen - this was ‘therapy’ for his OCD. He was too ill, physically, to cope with these chores and his wife was in tears, pleading with the therapists to stop. They replied he had to learn to face his fears. The kettle was too heavy for him even to lift. He was told he must ‘pull himself together’. When he spilled boiling water over himself they laughed. His wife (wheelchair bound) had to see to his injury.
My friend was very optimistic when he was diagnosed with cancer. He hoped I wouldn’t be upset with him, when he admitted to being relieved he had developed it! The reason for his reaction was two-fold. Firstly, he believed his OCD would take a back seat (sadly, the opposite happened). Secondly, his sister, whom he adored, had never had any tolerance (in sixty years) and was forever telling him to ‘pull himself together‘. His biggest wish was that she would show him some love and compassion. Neither was forthcoming. Her response, when told he had cancer, was ‘Maybe you can stop all the nonsense now you have a proper illness, and you’ll be able to pull yourself together’.
I am sorry, Professor. I will not change my mind. No matter how good a professional is, and your expertise has never been in question, words can cause great distress, especially when dealing with a very sensitive section of the population. The tragedy here is the distress could all be avoided, with just the odd change of phrasing here and there!!
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Dear Tricia
I agree with you 100% with this. That phrase makes my blood boil. It takes me back to 20 years ago when my GP behaved in such a patronising way every time I visited him that I used to come out of room with a bright red face - from the embarassment he caused me. Alas, as much of his words were said in front of my husband, the effect was doubled.
The only good part of all this was that I had to get all those degrees to show that I was not 'a pair of curtains' but an intelligent sensitive person who, depite huge efforts, could not control my compulsions. And even then one specialist who had been seeing me for years was surprised that I was intelligent enough to succeed at Uni.
So this is much more about choice of words than anything else, as the therapy does work for many. But I am shocked that trained nurses talked in that way to your friend. I remember a friend of mine saying that her aunt got depression after getting her cancer under control and remarked that it was far worse than the cancer as it was so very hard to beat.
I agree whole heartedly with you Tricia.
I believe that this thread was never meant to malign anybody rather to initiate open discussion. We are always being told by therapists and psychiatrists to be open and honest and quite rightly so. The best way for all concerned to find out more about OCD and the impact that it has on the lives of not only the sufferers but also their family and friends is for people to be open and honest with each other.
Although the book doesn’t provide all the answers (no one publication can) I would always recommend the book as it’s a good book to start with as it covers most aspects of OCD and CBT.
I too have the utmost respect for Professor Salkovskis and all his work in the field of OCD. However I did feel that I had to express how I felt about that phrase. I have had that phrase quoted to me so many times even by professionals but it was always used in a derogatory way.
It's certainly not the person or the therapy that I took exception to, it was purely the choice of words.
I do think that this thread like many before it has given food for thought for us all. It just goes to prove how complex our beloved language is.
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Hello Stu, I appreciate what you are saying, but, with your interpretation in mind, I have re-read the paragraph and cannot see the irony. Even if that were the case, it will obviously be misunderstood by many. I have asked an unbiased person, with a greater intellect than mine, to comment, she interprets it the same as me (she read the whole foreword).
Stu, the following is not aimed at you!
I would just like to stress to anyone who believes I am opposed to all therapy and prefer to wallow in my misery, that nothing could be further from the truth! My goodness, yes, I am guilty of giving reassurance at times. Must try to avoid that in the future!
HI Tricia
totally know wht u meant by the post,,, do not feel i think u r opposed.. I can see your point exactly.
i been told to "pull myself together" alot and that is the worst thing to hear. So i can see he has chosen not the best wording.
yours sincerely
stu
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