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A small grey room. Three bare light bulbs. White boxes of letters. A woman calmly relates a clinical checklist.This Room is an autobiographical one-woman play about obsessive–compulsive disorder (OCD), written and performed by Laura Jane Dean and part-supported by the Wellcome Trust.

Playwright Laura Jane Dean. Credit: James Drew/BAC

OCD affects 1–2% of UK and US people, and can devastate lives. As the play's scientific adviser, neuroscientist Trevor Robbins, told me: “Sufferers can spend half their waking hours performing a useless activity, such as compulsively washing their hands, confined to their home.”

Unwanted thoughts, images or urges dog the mind, causing anxiety, disgust or unease — for Dean, a fear of hanging herself in her sleep. Over and over, people with OCD perform behaviours or mental acts to relieve, temporarily, these negative feelings. Dean describes checking repeatedly for stockings, belts, scarfs — objects associated with hanging. The ritual used to take two hours every night.This Room is an affecting, sobering account of a life shaped by, yet transcending, a mental-health condition and treatment.

Dean reels off a reckoning. “Cognitive Behavioural Therapy (CBT): 18 in-depth questionnaires, 24 hours of therapy, 1 Clinical Psychologist, 31 behavioural experiments, 56 hours of homework, 501 days (and counting) since discharge.” This echo of compulsive counting frames a space in which therapy becomes possible. To her surprise, Dean's symptoms improved — as they do for the majority of people with OCD who participate in CBT, an evidence-based treatment. Dean stopped her bedtime rituals.

She underwent a technique called graded exposure and response prevention. In one riveting scene, she faces her worst fears (standing on chairs placing stockings around her neck) and lets her obsessive thoughts (of hanging) occur, but without trying to neutralize them with compulsions (the checking). Crucially, this happens not on a couch in a clinic, but in Dean's bedroom, with her therapist. The episode movingly captures the bravery of the patient and the skill of the therapist.

This Room is a reflection on identity and mental illness. Dean describes her ambivalence towards removing all symptoms, and how she feels when new ones emerge. “I want it to be easier, not easy,” she says. CBT aims not to erase all traces of OCD, but to change patterns of thought and behaviour. OCD can come and go; so does treatment.

Dean wants to know more about how OCD and therapy work. As I wrote last year, that understanding will require collaboration across many domains — from learning, habits and behaviours to emotions and cognition (see E. A. Holmeset al.Nature511, 287–289; 2014).

Robbins reflects: “Laura has interacted with our researchers studying OCD to bring their findings into register with her subjective experience.” Having talked to her extensively, he feels “even more convinced” that researchers should bring together psychological and neuroscientific experiences to improve treatments.

Dean puts this call to action centre stage by drawing us into her mental world. At the play's end, she leaves a chart showing that her symptoms got better. I count: 24 hours of therapy is equivalent to 12 nights' worth of compulsive checking. It seems a good investment. I leave with a renewed appreciation of the courage involved in shedding a deeply held fear and quite literally breaking the habits of a lifetime.