Backstage Rituals

Actor Tuppence Middleton may be a star of stage and screen but she has struggled with a condition that controls her every day. Now she has written about her experience in a new memoir to give people hope.

Imagine having to photograph your kitchen every day before you leave the house.  The tap - click. The hob - click.

This is how Tuppence behaves to help control her obsessive compulsive disorder (known as OCD), to reassure herself that her house will not be flooded or burned down while she is at work.

That work includes films, The Imitation Game and Downton Abbey, TV’s War and Peace and a recent run in the five star rated, The Years in London’s West End.

Her OCD began in childhood, following a prolonged case of chronic fatigue syndrome or ME (Myalgic Encephalomyelitis).

Speaking to ITV’s This Morning, Tuppence said she lost weight and was so tired she couldn’t get out of bed. But it was the prolonged, unexplained nausea which led to emetophobia - a fear of vomiting - and compulsions around cleanliness. She believed that counting rituals, especially around the number eight, would avoid her getting sick again.

“People with OCD often don’t even get pregnant because they are worried about morning sickness or that the children will pick up bugs.”

The good news is that Tuppence and her partner now have a child and she says that his support, plus preparing hygiene kits, help her cope.

OCD is often trivialised and Tuppence recalls receiving a gift of a mug with ‘Obsessive Compulsive’ written on it.

I can’t imagine giving someone a mug with ‘PTSD’ or ‘Anorexia’ on it and expect them to find that funny. I wrote the book to help everyone understand what it’s like inside the mind of someone with OCD and to provide hope.

Tuppence tried Cognitive Behavioural Therapy (CBT), antidepressant medication and talking therapies, which she admits helped her most.

Scorpions by Tuppence Middleton is a deeply personal and evocative exploration of obsessive compulsive disorder (OCD).

Understanding OCD?For more than a million people in the UK with the condition obsessive compulsive disorder, life can be exhausting and isolating.

Typically starting in early adulthood, symptoms include distressing ideas and images suddenly and repeatedly intruding your thoughts, often of harm being caused to you or your loved ones. Following specific patterns of behaviour becomes the only way to deal with the anxiety and distress, hence the compulsive nature of the condition.

“OCD impacts lives in countless different ways,” explains Dr Declan Hyland. A consultant psychiatrist at Mersey Care, his interest in helping people manage their mental health was sparked by his mum’s experience of OCD and depression.

“When I was growing up, it would take us a long time to leave the house. If mum hadn’t checked things a certain number of times, she’d have to start again. Simple tasks become quite time consuming, which is exhausting for the whole family.”

Some people, like Tuppence, learn to manage their OCD or it becomes less severe but for others, it prevents them from living a full life or can even lead to suicidal thoughts.

GPs can prescribe medication and cognitive behavioural therapy (CBT) which can be very helpful. People affected more severely are referred to mental health services. 

Declan always asks his patients what is the right treatment for them. He says, “Patient choice should underpin any psychiatric treatment.”

The NHS website has more information on obsessive compulsive disorder with more information on symptoms, treatments and support guides available.

Catherine who is featured in MC Magazine Summer 2025 is a volunteer for the charity OCD-UK. Read other people’s stories on their website.

OCD Action is the largest OCD charity in the UK, where you can read more personal stories.