'I thought I was a monster,’ says Catherine Benfield, 38, who, shortly after the birth of her son, kept thinking she was going to harm him: ‘I had intrusive thoughts about hurting him on purpose. I had a thought about throwing him down the stairs.’
Catherine didn’t know it at the time, but eventually learned – via an anxiety diagnosis from her doctor – that she was suffering from Pure O, a form of Obsessive Compulsive Disorder (OCD) and the subject of a recent Channel 4 series, Pure.
The six-part series follows 24-year-old Marnie as she begins to find out why she can’t stop having terrifying, near-constant thoughts about sex. In an exercise of what therapists would identify as ‘avoidance’, she moves from her home in Scotland to London in a bid to never again have thoughts of snogging her mum.
The witty dialogue and smart dissections of the absurdities of modern life in a big city gives this show merits beyond the exploration of a much-stigmatised mental health condition, yet it also helps us to understand Marnie as she journeys into discovering what is messing her up so much.
Until Pure, most TV shows portrayed OCD as a condition where sufferers would, say, be obsessive about germs and so compulsively clean, or, as Rachel Boyd, information manager at mental health charity Mind puts it, ’where a sufferer worries about something bad happening to someone they care about, so tap a table a certain amount of times.’
Pure O, however, is a manifestation of OCD wherein the obsession has no outwardly-visible compulsion. Simply put, it’s a pure obsession, meaning that, while disturbing thoughts whirred round Catherine’s mind – and while she also ‘replayed the memory of that intrusive thought, to see it I wanted to do it’ – an outsider would be unable to tell that anything was wrong.
Catherine never acted on her intrusive thoughts, yet the continuous fear that she would left her unable to properly eat, sleep (‘these thoughts don’t let up just because you’re tired’) or do anything for her son for two entire months. She eventually went to a doctor, who prescribed Diazepam to ‘help lower the extreme anxiety in the early days’ followed by Citalopram which, Catherine says, ‘helped me enormously.’
The intrusive thoughts subsided a bit, however, it wasn’t until months later that Catherine recognised, via internet forums, that her intrusive thoughts were part of the OCD that she’d been diagnosed with aged 18. ‘Back then I was turning off switches and the cooker, but apart from the odd setback it didn’t massively impact my life. I went to uni, became a teacher, got married.’ The Pure O, she says, only manifested later.
Pure O’s origins are uncertain – as Rachel explains, ‘Mental health problems aren’t always clear about where they come from.’ However, she adds, ‘intrusive thoughts tend to be about areas of life we might struggle to talk about out loud.’
Catherine started worrying shortly after her son was born. ‘I started worrying – all normal worries – about harm coming to him,’ she says. ‘But it went to the extreme. OCD is a bully; once you become accustomed to one thing it goes onto the next.
‘I worried about someone breaking into the house and hurting him, I was worried about chemicals in the house so I threw them all out, and then I started to think “What if I hurt him? What if I don’t look after him properly? What if he slips when he is in the bath?”’
The severity of Catherine’s thoughts continued to escalate until, eventually, she was plagued by thoughts of harming her baby on purpose.
The thoughts are, of course, socially unethical (which, aside from anything else, makes them all the more difficult to talk about and treat). But Catherine is far from alone in suffering them. In fact, they are simply amplified versions of thoughts that we all experience from time to time. Nicky Lidbetter, CEO of Anxiety UK, explains that ‘A lot of mentally healthy people get that “what if I jump in front of a bus?” feeling, yet never act on it, or, as people with Pure O will do, hang onto it.’
She cites One 1992 study into intrusive thoughts, which produced a table indicating that of 293 mentally healthy students, 53.5% had intrusive thoughts of swerving into traffic, 19.5% had the same about ‘acts against sexual preference’ and 32.5% had the same about wrecking something.
The men and women surveyed experience different levels of intrusive thoughts, and Nicky says that women more so than men fear, for example, vomiting in public, ‘because it’s less socially acceptable for women to vomit in public.’
‘We also see a lot more women coming forward with problems with OCD. Whether that’s because women are better at help-seeking than men,’ Nicky wonders, ‘Or if they’re truly more anxious than men, we don’t know. The answers to these questions deserve to be looked into more.’
Finding people to talk about Pure O is tough, though. Rose Cartwright, who wrote the eponymous book that Pure was based on, has helped give a face to this issue, as has Catherine, who blogs about her OCD on TamingOlivia.com. Since Pure, she has seen a spike of people getting in touch to share their own experience of Pure O. However, the intrusive thoughts are a stigma wrapped in a taboo, which creates, Rachel says: ‘a barrier when sufferers try to speak to friends, family or professionals about it.’
With so few public role models around this very unglamorous mental health condition, there was particular pressure on Pure to represent its subject accurately, and the producers worked closely with both Rose and Mind’s advisors to get it right. Catherine thought the show was ‘perfect’, adding, ‘The use of humour humanised it and kept people watching it. The conversations I’ve seen about it online have been amazing.’
Six years ago, after Catherine took her notes to the doctors at a dedicated NHS mental health service in her area, and the link between her intrusive thoughts and OCD was recognised, she underwent months of Cognitive Behavioural Therapy (CBT), and eventually built up to Exposure and Response Prevention (ERP) therapy. In Pure, ERP is depicted as watching porn, because that’s what Rose did to recover from her intrusive thoughts of sex. In Catherine’s case, confronting her intrusive thoughts meant going as close as possible to the situation she was obsessing over, and most scared of: hurting her son.
‘I slowly built it up to the point where I would go with my son in the pram to the train platform.’ Catherine, now a volunteer with OCD Action, says. Accompanied by her ‘incredible’ therapist, and well away from the edge, she would ‘Bring on the thoughts of pushing him under. It was all about building up to the most terrifying aspects then exposing them.’
Nicky says: ‘Treating Pure O is about getting to the point where you’re controlling the anxiety rather than it controlling you,’ and Rachel points out that if ERP and CBT don’t work, other options include ‘mindfulness, talking therapies and medications’.
Recovery isn’t simple: last year, on a trip with her family to HMS Belfast, an ex-WWII ship stationed on the Thames, Catherine ‘had this weird thought about chucking my son over the edge.’ With the tools to confront her intrusive thoughts, though, Catherine could say to herself ‘“You know what, I’m going to stand near the edge and think about it until it means nothing to me.”’
Eventually, the thought drifted away. As Catherine says: ‘OCD attacks the loveliest people in society. If you were an arsehole, you wouldn’t care about those thoughts, would you?’
Pure is available on All4 now. If you need help or support with a mental health issue like Catherine's, visit your doctor and visit Mind, Anxiety UK, or OCD Action.