Pulling the trigger: The Definitive Survival and Recovery Approach for OCD, Anxiety, Panic Attacks and Related Depression
Adam Shaw spent his life running away from the terrifying thoughts which tormented him. This lifelong struggle with mental illness ultimately lead him to a railway bridge and the brink of suicide, and it was at that point that he met psychologist Lauren Callaghan and was finally able to get the help he needed.
They share this practical approach in their new book, Pulling The Trigger: The Definitive Survival and Recovery Approach for OCD, Anxiety, Panic Attacks and Related Depression. The book, divided into two helpful parts, provides both first-hand evidence for sufferers that recovery is possible, and a user-friendly blueprint for mental health support and recovery.
For my review of this book, I enlisted the help of Huw Davies, football journalist and OCD sufferer. Davies has written about his own experiences with OCD for publications such as The Guardian and ShortList.
People with obsessive-compulsive disorder, perhaps more than others with a mental health issue, often feel they’ve heard it all before. I know I have, after experiencing various treatments and coping strategies for my own OCD over the years, as well as interviewing people when writing about the condition. For some sufferers it’s mere ennui, but for others it can feel more like despair.
So it’s refreshing to read about a new approach – or, at the very least, an approach presented in a new manner. To my mind, there’s nothing revolutionary about most of the tasks, both physical and mental, that psychologist Lauren Callaghan sets. However, the focus on compassion as well as practical solutions, emphasised by Callaghan and OCD sufferer Adam Shaw alike, is something often missing from books outlining a treatment.
During my work as a psychiatrist, I have helped treat a number of people with OCD, including at the National Specialist Service in South West London. I therefore have a good (if inexpert) knowledge of the diagnosis and treatment approaches in OCD.
While there is nothing novel about the “Pulling the trigger” approach, the combination of Shaw’s personal story with Callaghan’s professional commentary really aids understanding of OCD. The book also deals with the common mistakes in attempting to self-manage OCD, and gives an accurate impression of the impact of the disease. The Accept, Embrace, Control model is also easy to remember and understand.
The book’s biggest asset is its accessibility. In the first section, Shaw recounts his lifelong battle with OCD in a memoir that will engage the vast majority of its target audience (although as much as he strives to be neutral, Shaw’s own experiences inevitably paint other approaches to treatment in a negative light). Callaghan interjects regularly to explain Shaw’s malfunctioning thought process and how she helped him to tackle it head-on. It’s enlightening and occasionally a little shocking: more than a few OCD sufferers reading the book will gulp as she persuades Shaw to hold a knife to her neck, even as she feels safe in the knowledge he will not enact on his fears of being violent to others.
While very accessible to its intended audience, the PTT approach is quite vague – for example, it doesn’t go through breaking down the worries into a hierarchy, as would be common in OCD management (and cognitive-behavioural therapy in general), and then tackling them in a stepwise fashion.
From what information is given in the book, PTT appears to be based on a basic CBT model, though without the typical emphasis on preventing a response to the exposure, such as strategies to resist rituals. I therefore feel it would be difficult to design your own programme of OCD treatment solely by reading the book.
There’s arguably nothing much radical about “Pulling the trigger”, but then Shaw and Callaghan call it “the definitive survival and recovery approach” – not “an entirely new one”. Most sufferers will have heard their advice before, dressed in different robes. But perhaps because of its compassion element, readers of the book are still likely to feel more confident about recovery after reading it.
“Pulling the trigger” is not without its problems. The repetition of “you’re not going mad” supports OCD sufferers at the expense of people with other mental health problems, reinforcing old stigmatising stereotypes. The section on exercise, while framed as useful encouragement, does not address issues of ableism by exploring exercise alternatives or support available.
While adopting a healthy attitude to medication, the book perhaps overly emphasises independence of the OCD sufferer from the wider healthcare system. This is perhaps because Shaw took this approach, due to his inability to access NHS services.
Overall, “Pulling the trigger” is a good background book to help understand the experience and management of obsessive-compulsive disorder, but I feel it needs further development to be used as a standalone self-help book for people with OCD.
Pulling the trigger: The Definitive Survival and Recovery Approach for OCD, Anxiety, Panic Attacks and Related Depression by Adam Shaw & Lauren Callaghan (CPsychol, PGDipClinPsych, PgCert, MA (hons), LLB (hons), BA) (Trigger Press Limited, 1st September 2016)
Find out more at Pullingthetrigger.