Challenging OCD on Christmas Eve

A night without usual fears allows faith to be reclaimed.

Paula Duncan

Paula Duncan is a PhD candidate at the University of Aberdeen, researching OCD and faith.

A nocturnal snow-covered scene of a tree, chapel and Christmas tree casting shadows.

A chapel in Krün Germany.

Andreas Kretschmer on Unsplash.

The display on my car tells me that it’s just gone 11pm on Christmas Eve, and the temperature is below freezing. It’s the sort of cold that catches your breath the minute you step outside. The trees are glittering with frost. The stars are sharp and clear in the sky. Everything feels still and clean. In the carpark, I can hear the muffled notes of the organ playing familiar Christmas carols. People in Christmas jumpers are trickling in through the main church door. I can see Santa hats, some reindeer antler headbands; some kids have woolly hats tugged down over their ears. I haven’t been to a Christmas Eve service since I was a child.

I take a deep breath and try to let go of some of the anxiety about being here. My Obsessive-Compulsive Disorder doesn’t take a break for the festive season. I have previously written about my experience with OCD: the way that it impacts my experience of faith and how it makes going to church feel difficult. I find it a challenge to sit with the doubt and uncertainty of not being 100 per cent sure that I believe in God but badly wanting to. I struggle with not knowing what verses of the Bible will be read and how I will feel. I worry about something sparking my OCD and then being held hostage by my own intrusive thoughts. This always feels worse when I’m tired, too. I am far more likely to engage with the intrusive thoughts my OCD offers up when I’m not well rested. But I’m here. Despite feeling nervous, I am happy to be here. The warm glow of the light inside the church is welcoming and the low hum of happy voices feels reassuring as everyone discusses their Christmas plans.

There is a flurry of chatter as we are all invited to wish one another a ‘merry Christmas!’ and then we fall into a restless and expectant silence as Christmas day begins.

I don’t have the usual fear of the unknown today. We are here for the carols and the watchnight service – eagerly awaiting midnight and the dawn of Christmas Day. I might not know exactly what the structure of the service will be, but I can almost guarantee that the reading will begin with words from the Gospel of Luke. We’ll be told of the census of the Roman world, and we’ll hear that Mary and Joseph would have to travel to Bethlehem. There will be no room in the inn. The baby Jesus will be born, and laid in a manger.

This story is one that I heard at childhood Christingle services. It’s the one that we were told every year in primary school with abundant colourful crafts to help us to remember the key points. I’m reminded of nativity plays – watching them and being part of them, and the slightly off-key renditions of ‘Away in a Manger’. I remember doing the reading as a Girl Guide – nervously practicing beforehand to make sure that I could pronounce all the words correctly. I remember being proud of myself for standing up and reading at all.

Armed with those memories as I cross the carpark, I know there is going to be nothing unexpected in the Christmas Eve service. My OCD still finds ways to make its presence known – I insist that I get to sit at the end of a row because that’s where I feel most comfortable. I read the order of service a few times to check that everything there is as I expect. I make some concessions to anxiety for the sake of being able to turn up at all. But I am here, and I feel safe.

The readings are exactly as I expected. I know all of the Christmas carols that we sing. At midnight, there is a flurry of chatter as we are all invited to wish one another a ‘merry Christmas!’ and then we fall into a restless and expectant silence as Christmas day begins and we wait for the minister to say a few words about what this means. I am with my family and there are familiar faces in the congregation – people I know from various places. It’s nice knowing that we are all here for the same reason and with the same intention.

There are many cheerful Christmas wishes as we leave the church and I’m proud of myself for being here. Maybe my faith is something I can reclaim from my OCD eventually, however slowly. For now, I look up to the sky as we head back out into the carpark and smile at the stars twinkling down at us. I feel perfectly fine.

Since that year, lockdown excluded, my family have been to the watchnight or the Christingle services most years. As a theology student, I sometimes feel a little self-conscious about how infrequently I go to church. I sometimes joke about being a Christmas Christian in terms of my church attendance and certainly in how I engage with the Bible. I like to read a little on Christmas day and I love watching the televised service on the BBC on Christmas morning. It’s the time of year where I am perhaps most active in my engagement with my faith. I look forward to going to the Christmas Eve church services now. It’s the one time where I don’t have to battle with anxiety about going to church and know that plenty of other people are here as infrequently as I am. My OCD comes along with me, certainly, but I feel safe to be here just as I am.

Article

Assisted dying

Care

Comment

Death & life

Suffering

27 November 2024

5 min read

Why end of life agony is not a good reason to allow death on demand

Assisted dying and the unintended consequences of compassion.

Graham Tomlin

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

Towfiqu Barbhuiya on Unsplash.

Those advocating Assisted Dying really have only one strong argument on their side – the argument from compassion. People who have seen relatives dying in extreme pain and discomfort understandably want to avoid that scenario. Surely the best way is to allow assisted dying as an early way out for such people to avoid the agony that such a death involves?

Now it’s a powerful argument. To be honest I can’t say what I would feel if I faced such a death, or if I had to watch a loved one go through such an ordeal. All the same, there are good reasons to hold back from legalising assisted dying even in the face of distress at the prospect of enduring or having to watch a painful and agonising death.

In any legislation, you have to bear in mind unintended consequences. A law may benefit one particular group, but have knock-on effects for another group, or wider social implications that are profoundly harmful. Few laws benefit everyone, so lawmakers have to make difficult decisions balancing the rights and benefits of different groups of people.

It feels odd to be citing percentages and numbers faced with something so elemental and personal and death and suffering, but it is estimated that around two per cent of us will die in extreme pain and discomfort. Add in the 'safeguards' this bill proposes (a person must be suffering from a terminal disease with fewer than six months to live, capable of making such a decision, with two doctors and a judge to approve it) and the number of people this directly affects becomes really quite small. Much as we all sympathise and feel the force of stories of agonising suffering - and of course, every individual matters - to put it bluntly, is it right to entertain the knock-on effects on other groups in society and to make such a fundamental shift in our moral landscape, for the sake of the small number of us who will face this dreadful prospect? Reading the personal stories of those who have endured extreme pain as they approached death, or those who have to watch over ones do so is heart-rending - yet are they enough on their own to sanction a change to the law?

Much has been made of the subtle pressure put upon elderly or disabled people to end it all, to stop being a burden on others. I have argued elsewhere on Seen and Unseen that that numerous elderly people will feel a moral obligation to safeguard the family inheritance by choosing an early death rather than spend the family fortune on end of life care, or turning their kids into carers for their elderly parents. Individual choice for those who face end of life pain unintentionally lands an unenviable and unfair choice on many more vulnerable people in our society. Giles Fraser describes the indirect pressure well:

“You can say “think of the children” with the tiniest inflection of the voice, make the subtlest of reference to money worries. We communicate with each other, often most powerfully, through almost imperceptible gestures of body language and facial expression. No legal safeguard on earth can detect such subliminal messaging.”

There is also plenty of testimony that suggests that even with constant pain, life is still worth living. Michelle Anna-Moffatt writes movingly of her brush with assisted suicide and why she pulled back from it, despite living life in constant pain.

Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.

Despite the safeguards mentioned above, the move towards death on the NHS is bound to lead to a slippery slope – extending the right to die to wider groups with lesser obvious needs. As I wrote in The Times recently, given the grounds on which the case for change is being made – the priority of individual choice – there are no logical grounds for denying the right to die of anyone who chooses that option, regardless of their reasons. If a teenager going through a bout of depression, or a homeless person who cannot see a way out of their situation chooses to end it all, and their choice is absolute, on what grounds could we stop them? Once we have based our ethics on this territory, the slippery slope is not just likely, it is inevitable.

Then there is the radical shift to our moral landscape. A disabled campaigner argues that asking for someone to help her to die “is no different for me than asking my caregiver to help me on the toilet, or to give me a shower, or a drink, or to help me to eat.” Sorry - but it is different, and we know it. Once we have blurred the line between a carer offering a drink to relieve thirst and effectively killing them, a moral line has been crossed that should make us shudder.

In Canada, many doctors refuse, or don’t have time to administer the fatal dose so companies have sprung up, offering ‘medical professionals’ to come round with the syringe to finish you off. In other words, companies make money out of killing people. It is the commodification of death. When we have got to that point, you know we have wandered from the path somewhere.

You would have to be stony-hearted indeed not to feel the force of the argument to avoid pain-filled deaths. Yet is a change to benefit such people worth the radical shift of moral value, the knock-on effects on vulnerable people who will come under pressure to die before their time, the move towards death on demand?

Surely there are better ways to approach this? Doctors can decide to cease treatment to enable a natural death to take its course, or increase painkillers that will may hasten death - that is humane and falls on the right side of the line of treatment as it is done primarily to relieve pain, not to kill. Christian faith does not argue that life is to be preserved at any cost – our belief in martyrdom gives the lie to that. More importantly, a renewed effort to invest in palliative care and improved anaesthetics will surely reduce such deaths in the longer term. These approaches are surely much wiser and less impactful on the large numbers of vulnerable people in our society than the drastic step of legalising killing on the NHS.