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Nikki Murphy plays with her 18-month-old son, Lochlan.Kevin Van Paassen/ Sunnybrook Health Sciences Centre

Nikki Murphy didn’t think she could ever be a mom because of her debilitating obsessive-compulsive disorder. Now, she can hug and play with her son, thanks to Canada’s first intensive live-in treatment centre

Nikki Murphy doesn’t take cuddling her 18-month-old son for granted. There was a time when she didn’t think such a thing would ever be possible.

For decades, Nikki struggled with severe symptoms of obsessive-compulsive disorder (OCD), a mental health condition in which a person’s unwanted thoughts and fears lead them to perform repetitive behaviours. The symptoms began when she was eight years old.

“If the pencil I was holding was pointed towards me, I thought something dangerous was going to happen,” she says. To “protect herself,” Nikki would knock on wood for good luck.

By her late 20s, things had escalated. Newly married and with a job at a university, the stresses of everyday life intensified her symptoms, profoundly affecting Nikki’s quality of life. She would knock on wood 500 to 600 times a day based on her thought that it would prevent bad things from happening to her family. She would contort her body, convinced that if a body part – like a finger or toe – pointed at another person, it would harm them. She stopped working, driving and interacting with others. She could not even hug her husband properly, fearing she would point at him.

“I would have to curl my toes and fingers back – and my tongue too,” she says. “I couldn’t eat properly, my body had to be perfectly symmetrical and I couldn’t be around most of my family members. I couldn’t even brush my hair at one point.”

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Although Nikki had long suspected she had OCD, the stigma around her disorder prevented her from seeking help. “I was embarrassed that I couldn’t get a handle on it,” she says. “I knew these were odd things to do. It was scary.”

The future seemed bleak. Nikki and her husband hoped to have a child together, but with her debilitating condition, it seemed impossible.

Desperate, Nikki finally told her GP about her struggles. A prescription for anti-anxiety drugs helped a little but failed to curb her symptoms. In June 2018, she was admitted to the psychiatric ward of a local hospital. While there, her doctors and family members worked to get her referred to Canada’s first intensive live-in treatment centre for patients with severe OCD at the Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook Health Sciences Centre.

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Nikki Murphy, with husband Ryan and son Lochlan, says of life after OCD treatment: “It’s incredible to be present in my own life."Kevin Van Paassen/ Sunnybrook Health Sciences Centre

In the months that followed, she worked on numerous therapies with the centre’s psychologists, physicians, occupational therapists and social workers and made amazing progress. “I felt like I was in the right hands… finally,” she says.

After the treatment, Nikki felt ready to have a child, something she had thought would never be possible. Now, she is able to hug her family, play with her son and interact comfortably with others. She’s no longer a prisoner in her own body.

“It’s incredible to be present in my own life,” she says.

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Dr. Peggy Richter, head of the Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook.Kevin Van Paassen/ Sunnybrook Health Sciences Centre

Learning the skills to live with OCD

Treating severe OCD at the live-in program, the largest of its kind in Canada, comes down to three important elements, says Dr. Peggy Richter, head of the Frederick W. Thompson Anxiety Disorders Centre.

First, an individual must be willing to face their worst fears. “The treatment relies on their willingness to trigger symptoms and tolerate the distress as they learn new skills to put into practice,” she says.

Secondly, a team of experts works with them on the slow and often painstaking process to help them reduce unhelpful behaviours with proven treatments. “Our typical patients are working with the team six hours a day,” says Dr. Richter.

A third crucial element is the support of peers participating in the program, says Dr. Richter. “It’s a sense of inspiration and connection: those who are doing well become more involved in the support of those doing less well.”

Treatment focuses on cognitive behavioural therapy (CBT), which involves helping individuals learn to challenge their OCD by resisting their rituals and changing their faulty thinking patterns. Other forms of treatment include mindfulness, which is learning to pay attention to the present moment in a non-judgmental way, and dialectical behavioural therapy (DBT), a form of CBT that helps individuals regulate intense emotions and improve their interpersonal relationships. Other activities include yoga, occupational therapy, art therapy and nature walks.

“I felt like I was in the right hands… finally.”

Nikki Murphy on treatment at Sunnybrook’s Frederick W. Thompson Anxiety Disorders Centre

Goals are set for patients, says Dr. Richter, which gradually increase in magnitude until the patient is able to overcome their fear. For example, a patient afraid of germs might be encouraged to touch a surface in their own room, gradually touching other items in public spaces until they can handle touching any doorknob.

Central to Nikki’s treatment was exposure and response prevention, where patients are slowly exposed to their fear triggers and learn to resist performing any compulsions, using new tools to help them cope and manage the anxiety.

The team worked with her to first discuss her biggest fear – pointing. She worked up to pointing at inanimate objects and finally at other people.

Program participants typically stay on-site for eight weeks but can stay for 10 weeks or more depending on their progress and treatment plan. After that time, participants are discharged and have a two-week “step down” program that supports them as they leave this highly structured program and try to apply their new skills at home.

Dr. Richter says the program’s benefits are profound. “When you think of how much people with OCD lose after years of being dysfunctional, this treatment can have dramatic benefits for many,” she says.

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Nikki and her infant son in Aruba on their first family holiday, an outing that wouldn’t have been possible just a few years ago.SUPPLIED

Driving the next generation of treatments

Having seen first-hand how effective the live-in program is, Dr. Richter is excited by the evolution of the Thompson Centre, which will work synergistically with Sunnybrook’s under-construction Garry Hurvitz Brain Sciences Centre (GHBSC). At this new state-of-the-art facility, a multidisciplinary team of physicians and researchers will work together to develop the next generation of treatments and prevention for the most devastating brain disorders.

“The way we see it, the [GHBSC] brings us all closer together,” says Dr. Richter. “We all share and we all learn from each other.”

Bringing more clinicians under one roof will also lead to more multifaceted treatments for patients, she adds. For example, at Sunnybrook’s Harquail Centre for Neuromodulation, researchers have pioneered focused ultrasound – a minimally-invasive, image-guided treatment where ultrasound waves are targeted to specific areas of the brain – to treat severe OCD, which is used in tandem with psychiatric therapies.

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Architectural rendering of the Garry Hurvitz Brain Sciences Centre (GHBSC).SUPPLIED

Dr. Richter attributes such breakthroughs to the generous gifts of donors, such as the transformational $10-million donation from the late Frederick Thompson which was fundamental to building the Thompson Centre and driving new modalities to treat severe psychiatric illnesses at Sunnybrook. For example, the donation supported a recent study of the impact of mindfulness on OCD, which in turn led to this treatment becoming routinely offered in the centre and a more comprehensive study with government research funding.

As for Nikki, her stay at the Thompson Centre was a turning point. While she recognizes that her OCD symptoms will always need to be managed, she is enjoying her new normal.

This past November, she and her infant son flew to Aruba on their first family holiday with her parents, an outing that wouldn’t have been possible just a few years ago.

“It’s about learning to cope with OCD,” she says. “It’s allowing me to live with uncertainty.”

Nikki says she will always be grateful for her time at the Thompson Centre’s OCD Program. “It changed my life.”

To learn more about Sunnybrook’s Garry Hurvitz Brain Sciences Centre and how you can support the future of brain health, visit Sunnybrook.ca/brain


Advertising feature produced by Globe Content Studio with Sunnybrook Health Sciences Centre. The Globe’s editorial department was not involved.

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