Excessive hand washing is a common symptom of Obsessive Compulsive Disorder (OCD). Photo / Clay Banks on Unsplash
When Isabella* first met Sonia Gray in person, she greeted her with a hug. This might not sound remarkable, but for years, she hadn’t been able to hug anyone - even her own family.
Isabella is 22, and had been living with severe contamination Obsessive Compulsive Disorder (OCD) for eight years. It had taken over her life. Touching people, objects, even parts of her own home, felt dangerous. Every interaction came with a cost: hours of cleaning, sanitising and rituals.
So this spontaneous hug was huge. “It’s not easy,” she admitted to Gray, “but yeah … I’m okay.”
The hug came moments after Isabella had completed an intensive treatment for obsessive compulsive disorder, the Bergen 4-day Treatment (B4DT). In the latest podcast episode of No Such Thing as Normal, she shares the story of her OCD, and reveals how the B4DT treatment was the circuit-breaker she needed.
Developed in Norway, the B4DT was brought to Aotearoa by charity Open Closed Doors, and the first trial took place in January of this year. It is confronting for clients, but the results are striking. International figures show around 90% of patients respond to the treatment, and 75% have clinical remission. Outcomes from the initial trial in Aotearoa closely mirror international results.
It’s desperately needed. Around 100,000 New Zealanders are believed to suffer from OCD, a figure which Open Closed Doors is committed to reducing. The gold-standard treatment, Exposure and Response Prevention (ERP) is difficult to access in New Zealand, and the treatment period is much longer.
The B4DT method takes the core elements of ERP and condenses it into four consecutive days of intensive, supported exposure work. Patients are taught a set of core skills, and learn to ‘lean into’ their anxiety, rather than avoid it.
Emma Chapman, clinical lead for the New Zealand B4DT trial, said district health services are beginning to integrate the B4DT model into their own offerings, with broader rollout anticipated later this year.
“While there is great pride in this momentum, there is also deep empathy for those across Aotearoa who are hearing about the treatment and feel a strong urgency for themselves or their whānau to access it,” Chapman said.
Co-founder of the treatment, Norwegian psychologist Dr Bjarne Hansen, travelled to New Zealand to support the initial trial here. He says one of the key elements of the treatment is helping clients change their perception of triggering situations.
“Procedure-wise you can go slowly, intention-wise you can’t,” Hansen says.
“You have to make a decision, am I going to act as if it’s dangerous or not? So you can’t really say, ‘Well, yes, like a little bit’, that’s sending the wrong message.”
But Hansen also believes that our view of those struggling with OCD is misguided.
“I think that we have kind of messed up this field by thinking about this as a medical condition and disorder”, he says. “These people are not broken, they’re actually strong and it’s really their strength that is maintaining and fuelling this process.”
Hansen goes so far as to say that he would personally love to have some of the skills those with OCD possess.
“If you had a box, and in that box you had whatever is increasing the risk and likelihood of people having OCD, and I could buy some of it, I would,” he says. “I’d just make sure I knew when to use it.”
This is validation for Gray whose own daughter has struggled with severe OCD.
“It really does take the whole family hostage,” she says, “but you can see that underneath all the rituals, there’s a unique strength …it just needs to somehow be channelled into something positive”.
Gray describes producing this episode of No Such Thing as Normal as an intensely emotional process, in part because of the courage she saw in Isabella.
“She’s been through so much, but her ability to describe her experience in such detail was incredible”, she says. “It really helped me understand my daughter, and I think it will really help others”.
Isabella’s world had narrowed over eight years to a cycle of fear and responsibility: a constant belief that if she wasn’t meticulously clean, she might pass on a disease to a loved one. It was relentless and all-consuming.
“I don’t care if I get sick,” she told Gray before the Bergen treatment. “I just don’t want to be responsible for anyone else getting sick.”
The vivid, intrusive fears drove compulsions that took up hours of her day. At times, she was sleeping just a few hours a night. Like many with OCD, she knew her fears weren’t logical. But logic does little to silence the intensity that OCD creates.
Before the Bergen trial, Isabella had tried multiple treatments, specialists and medications - nothing had lasting success. But in four days of intense therapy she was able to regain her life.
Two months on Isabella continues to do well.
“I’ve learned that just because I have the thoughts it doesn’t mean I have to act on them,” she says.
She still needs to take her recovery day by day, but something fundamental has shifted. For the first time in years, Isabella is no longer living a life dictated by OCD.
*Name has been changed to protect identity.
No Such Thing as Normal is an NZ Herald podcast, hosted by Sonia Gray, with new episodes available every Saturday.
Made with the support of NZ on Air.
You can listen to it on iHeartRadio, Apple Podcasts, Spotify or wherever you get your podcasts.