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

Comment

Death & life

Politics

23 May 2024

5 min read

The careless conflation of independence, autonomy and dignity

As Jersey begins to legalise assisted dying, there’s keyword confusion.

Henna Cundill

Henna is a researcher with the Centre for Autism and Theology at the University of Aberdeen.

A elderly women in a care home stands and places her hands on the shoulders of a seated woman.

Eberhard Grossgasteiger on Unsplash.

Reviewing Canada’s legislation on assisted dying, one article raises the concern: “Does it make dying with dignity easier than living with dignity?” This insightful question cuts to the centre of the debate: dignity. Or more particularly, the unwitting conflation of dignity with independence, and of independence with autonomy.

As Jersey becomes the first place in the British Isles to begin the process of legalising assisted dying, I feel that we should listen carefully as to how and where these terms are being used, both in the formal debate, and in the commentary that surrounds it. The States Assembly in Jersey voted to allow the development of assisted dying legislation for those with six months to live (or twelve months if their condition is neurodegenerative). A second vote to make assisted dying available more broadly to those who experience conditions that entail “unbearable suffering” was defeated by a narrower margin. Reading the flurry of press releases that followed the vote, these keywords, autonomy, independence, and dignity, are everywhere. But are we really thinking about what these words communicate?

People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position.

The word dignity comes from the Latin word dignus, meaning ‘worthy’, and this is still the primary definition given to the English word dignity today. The OED dictionary has it as “the quality of being worthy or honourable”, immediately followed by reference to “honourable or high estate”. If this is so, then dignity is not something that can be bought, nor assumed – it is a status conferred upon someone by the esteem in which other people hold them. The haughtiest person in the world can still be esteemed undignified, as can the richest. Moreover, the opposite is also true: we are never prevented from conferring dignity upon, and esteeming the worthiness of, those who live the humblest of lives.

And yet, if we are honest with ourselves – do many of us not quietly associate the idea of becoming rich and powerful with becoming dignified? Do we not tend to assume the worthiness of those in high office – at least until we meet them and realise pretty quickly that they all put their trousers on one leg at a time, the same as the rest of us. This association happens because we have such a tendency to conflate dignity with independence (the ability to live without assistance from others) and autonomy (the ability to make one’s own decisions, and not have those decisions limited or interfered with). People in positions of wealth and power have more independence and autonomy, more choices and freedoms, but it is we who ascribe dignity to those in that position. It is society who sees the autonomy of those in high status, and esteems it as dignified.

Does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Repeatedly ancient wisdom, in the Bible, warns us not to assume that dignity comes with the freedom of wealth or power. All the great ‘heroes’ of that book suffer their indignities. Fresh from the success of his Ark project, Noah gets drunk and exposes himself. Elated from a victory against an enemy, King David dances half-naked through the streets. These are just two examples of the catalogue of embarrassments and mishaps that beset nearly all the kings and leaders whose stories are told as part of the Christian story. One after another, they stumble and struggle with life and leadership. The apostle Paul explains that this is because God uses the foolish things of this world to shame human pride, “for even the foolishness of God is still wiser than human wisdom.” Therefore, Paul argues, God chooses to speak to us through the weak and the lowly things and people of this world. Never was this demonstrated so clearly as when Jesus was born in a draughty stable, lived a life of poverty, and died a criminal’s death on a cross.

But what has all this to do with the debate over assisted dying? Well, I am struck by how often the idea of losing one’s independence (through disabling or terminal illness) is conflated with losing one’s dignity, and so dying through personal choice (autonomy) is presented as regaining it. One campaign group that speaks to this debate even calls itself ‘Dignity in Dying’ – but does this not unwittingly suggest that choosing to live in a state of extreme dependence on palliative care is, by implication, undignified?

Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone.

The Dean of Jersey, the Very Reverend Mike Keirle, has spoken of his concern that the change in legislation will make vulnerable people feel pressured to end their lives. Examples from Canada, where physician assisted dying is already available, show that his concern is not unfounded. In 2022, Canadian veteran and Paralympian Christine Gauthier phoned her caseworker to chase up the over-due installation of her new wheelchair ramp. She then describes how she was horrified to find herself being advised to consider assisted dying instead.

"It is remotely just what they're doing,” says Gauthier, “exhausting us to the point of no return. […] I was like, 'Are you serious?' Like that easy, you're going to be helping me to die but you won't help me to live?"

Gauthier is not alone – she spoke out when she learned that four other Canadian veterans had reported similar experiences. In these unhappy moments, one can see how dangerous the assumption can be – the assumption that no one would want to live a life of needing help. Here are disabled people who do want to live, and this assumption, this careless conflation of independence, autonomy, and dignity, leaves them fighting for their right to do so. Why should anyone have to fight or even speak for their right not to commit suicide? It is little wonder that disabled actress, Liz Carr, describes assisted dying legislation as “terrifying” for disabled people.

I respect that there are terminally ill people, and those who love them, who speak from a desire to end their suffering; it is clear that people on all sides of the debate need to have this difficult and emotionally charged conversation. But whatever the eventual outcome in terms of legislation, we must be careful that it is not based on careless assumptions, or on the conflation of one thing with an entirely different other. Independence is not possible for everybody, or not possible to the same degree. And dignity? Well, dignity is possible for anyone – it is a state that can be conferred whenever, and upon whomever society chooses to confer it. Autonomy is the matter in question – we are talking about autonomy in dying. And whatever happens, we should by no means legislate in a way that leaves disabled people esteemed unworthy, left open to the indignity of fighting for their right to live.