Article
Christmas survival
Comment
4 min read

Challenging OCD on Christmas Eve

A night without usual fears allows faith to be reclaimed.

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
Ethics
6 min read

It's a dreadful thing when we regard the disabled, the dependent, and the different as disposable

A MND sufferer reflects on the historic vote to legalise assisted dying
A crowded House of Commons awaits a vote.
MPs await the result.
Parliament TV.

I can’t say I’m surprised, but I am disappointed. The euthanasia juggernaut has been gathering momentum throughout the western world. In this country it appeared as the Voluntary Euthanasia Society, to be later rebranded as the richly endowed Dignity in Dying. It’s been beavering away for decades, with well publicised personal stories and legal cases which have been very effective in persuading general opinion that dying is frequently nasty and that we should have the right to choose when and how to die. That organisation resisted using the term ‘suicide’, which is what they advocate, realising that it opens up the accusation of devaluing life. So, I’m not surprised that MPs have, after an impassioned debate, by a narrow majority, eventually given way to the pressure.

A fortnight ago, I had my annual check-up at the motor neurone disorder clinic and subsequently received the GP letter.

“Date seen 02/06/2025…  Diagnosis (this visit) Primary Lateral Sclerosis…  Symptom onset 2000”.

I well remember the year 2000, my voice deteriorating, my balance starting to fail me, resulting finally a year later in the consultant’s verdict, “You have a motor neurone disorder.”

I knew what that meant as at the time Diane Pretty, backed and publicised by the Voluntary Euthanasia Society, was fighting through the courts as far as the European Court of Human Rights for the right for her husband to take her to commit suicide in Switzerland in the Dignitas “clinic”. It was a frightening time to receive an MND diagnosis, and it still is today. The normal progression is both swift and relentless. However, the Motor Neurone Disease Association does say “in the majority of cases, death with MND is peaceful and dignified”.

At that time I could have been depressed; I could have known how much care I would need, how much it might eat into our savings; I could have feared the physical and emotional toll it would take on my wife; I could have been desperate about the future. Certainly I was vulnerable. Fortunately, I was of an optimistic nature and had plenty of reasons for living.

But it could easily have been otherwise. I might well have panicked and opted for a doctor to help me die, if the law debated in the Commons today was in effect. Then I wouldn’t have seen two sons getting married nor grandchildren being born and growing up. I would have missed out on twenty years of an increasingly restricted but paradoxically fulfilled life.

Of course you might argue that I’m ‘lucky’ to have, as became clear over the years, my exceptionally rare and slow form of MND, but I wasn’t to know that, as indeed none of us do despite our doctors’ best predictions. Indeed I am lucky to be alive.

However it was my experience that brought me face to face with the fact of my own mortality and the issue of assisted dying. There seemed to me to be four main drivers. First, the desire for autonomy; second, the insistence of independence; third, a sort of compassion, and fourth, finance. There were two further factors: fear of death and fear of being “a burden”.

Autonomy

It’s a modern western concept that humans are by nature autonomous beings, meaning that choice is an inalienable right. I once co-wrote a book with the title, I Choose Everything, based on a quote of Therèse of Lisieux. It was from a childhood incident, but it did not mean she reserved the right for total autonomy, but rather the opposite. As she later wrote, “I fear only one thing: to keep my own will; so take it, for ‘I choose all!’ that you (God) will!”

Absolute choice is not a virtue. Choosing where to drive your car is not a virtue as it can endanger other road users. There are many limitations on freedom or taboos that protect others in a society. Taking someone’s life directly or indirectly is a universal one. Individuals submitting to a higher authority holds a community and a nation together.  

Independence

Another related modern heresy is the ideal of independence. How utterly fatuous this is! None of us is born independent. We’re born relational. All of our lives we are interdependent. Being cared for is not to be lacking in dignity. Being 100% dependent does not deprive someone of their human dignity. Even the most disabled person is a human being made in the image of God. It is a dreadful thing when a society regards the disabled, the dependent, the different, the mentally deficient and the declining as inferior and potentially disposable. Of course the advocates of the Bill would vehemently deny that they or it implied any such thing. Yet the history of the twentieth century bears witness to how subtly a society can be seduced by the pernicious philosophy of eugenics.

Compassion

It is a modern paradox that medical advances have contributed to the illusion that death is to be feared. Yes, death has always been the last enemy and, yes, we hope it will be peaceful. But we shall all die. Contrary to received wisdom, the compassionate response to that fact of life is not to “put someone out of their misery”; compassion (literally suffering with) means to be with them in their suffering. This is what good palliative care provides, making the end of life dignified, worth living and even pain free.

As former Prime Minister Gordon Brown pertinently asked, “When only a small fraction of the population are expected to choose assisted dying, would it not be better to focus all our energies on improving all-round hospice care to reach everyone in need of end-of-life support?”

Finance

Of course palliative care costs more than facilitating patients to take their own lives. According to the Daily Mail “Legalising assisted dying would save the taxpayer £10million in NHS costs in its first year, rising to £60million after a decade, according to grim new estimates published by the government.” The estimates are indeed grim, but also attractive to politicians straining to balance the national budget. Yet they raise the fundamental question: do we want to live in a society which values money over life?

Which is the most fundamental of all the issues: the sanctity of life has been a core principle central to all the Abrahamic faiths, which undergird our culture and way of life. In the words of Job on hearing of the death of all his children, “The Lord gave and the Lord has taken away.” The start and end of life are not ours to determine. We lack the wisdom of God.

Apparently the majority of our parliamentarians have decided to place that prerogative into the hands of suggestible and distinctly fallible humans beings. We or our children shall, I fear, reap the whirlwind.

As an afterthought I have a number of friends who disagree with me, often after personal experience of watching a loved one die. I sympathise and I suppose that I must be glad for them that the MPs have represented their wishes. And I would never condemn them if they decided to choose the route of assisted dying for themselves. I hope they won’t have to.

Meanwhile I trust that, when the Bill comes to the upper house, their Lordships will fulfil their function of revising it wisely and effectively. They certainly have relevant expertise, for example in the field of palliative care - which is in danger of being squeezed following this bill.

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