Tuppence Middleton does not like to make a fuss. The actor – best known for Downton Abbey, Sense8 and The Imitation Game – says she relishes burying herself in a role but finds being herself “terrifying”. Being the centre of attention is just not her style.
And yet we are meeting to talk about her memoir Scorpions. Out this week, it’s an unflinching description of Middleton’s life with obsessive compulsive disorder (OCD), a mental health disorder defined by intrusive thoughts that cause intense distress, and compulsions performed to soothe that distress. As a child, Middleton would feel convinced her parents would die, or she would become very sick, unless she repeatedly counted up to eight.
She first developed the condition at 10: a vomiting bug resulted in a diagnosis of chronic fatigue syndrome and she wasted away for much of the year, battling constant fatigue and nausea. Shortly after she recovered she began to obsess over the safety of herself and her loved ones, with a particular focus on contamination.
She imagines these intrusive thoughts as an infestation of scorpions that were claiming to protect her, that would crawl, skitter, and nestle in the corners of her mind. The only way she found to quell the panic they brought was by compulsively counting.
She writes in Scorpions: “If I didn’t count, my protective little critters would thrash and stir, turning thoughts over and over until they span on one continuous loop. My blood would bubble and a feeling like a wave rising in a tsunami would build inside my chest, only to be stopped by the incessant counting.” If she didn’t perform the ritual, her parents would die. Or her house would burn down. Or she’d throw up. And so she’d count.
She has lived with her OCD ever since, trying various forms of treatment and medication before eventually settling on talking therapy (with the back-up of medication to manage physical symptoms when needed). This has remained a largely private part of her life, with its impacts felt most acutely in her personal life – though when really bad it could spill into her work life.
She has had to apologise to directors for her lateness, blaming traffic (she couldn’t leave the house until she had performed her checking ritual completely correctly), and once alienated her personal dresser at the theatre after interrogating her relentlessly about why she had vomited the night before.
That changed in 2021 when she made a series for BBC Radio 4 about OCD which eventually led to her memoir (the passages that open her radio series – her past experiences with OCD – appear in the book). In the book’s introduction, she says responses to the series motivated her to write. “I realised how many people are still too afraid to talk about it, and as a result are not receiving the help that they desperately need.”
“After I’d spoken about OCD on the radio, I was always asked about it alongside interviews on my work,” she says, “and that always ended up being the headline.”
While she didn’t mind talking about it, she felt like the subject was barely explored while still making headlines. Scorpions is her way of rectifying this.
“Putting everything into a book enables me to say ‘everything that I want to say about it is in here’,” she says. “Then I can publicise a film or whatever else I’m doing without always having to touch upon that. I want to give both things their due weight.”
It helps that she was fascinated by writing anyway. “This felt like the obvious first step into that world because I was very drawn to creative, non-fiction memoir.” She points to Maggie O’Farrell’s I Am I Am I Am as an inspiration for the way it plays with structure and narrative, while still telling the story of someone’s life.
“I wanted it to be as immersive as possible, and people reading who didn’t have OCD could put themselves inside the head of someone who had it. And hopefully, if someone had OCD they might recognise elements of themselves.”
Scorpions is vividly written. Middleton conveys the experience of having your mind consumed by intrusive thoughts in a way that is immediate and urgent. Even as the nature of the thought cycles or rituals shift, there is a real sense of how suffocating it is to be trapped in a tide of panic.
There is self-awareness too. Middleton describes the experience of knowing it’s irrational to, for example, check that the tap is off again for the umpteenth time, but have her mind insist she does it anyway.
“I think there is this misconception that because the condition centres around thoughts that are often illogical, that as a person you are not logical,” she explains. “But I think most people who have OCD are probably, all in all, pretty logical, sensible and self-aware people. They just have this completely different side to their brain which allows them to see what’s happening, but has no control over what is happening.”
Middleton’s OCD – which focuses largely on fear of contamination and in particular, vomiting (known as emetophobia) – is only one form the condition can take. Intrusive thoughts can focus on health and cleanliness, but can also be incredibly taboo, centring on sexuality, relationships, violence or incest. In her writing, she wanted to make it clear that her experience is just one of many. “I can’t speak to all people who have the condition, but for me it was important to give an example of what it feels like and hopefully eradicate some of those misconceptions about it being an inclination towards order and cleanliness.”
She found writing cathartic and emotional. Revisiting the ways it shaped her younger life has given her a new perspective. “I felt proud of myself as a younger girl and young woman for having got through all those things which, at the time, you just accepted as your reality.” And it was for that young girl that she was often writing. She says her childhood was lonely and terrifying as she felt she was truly the only person who thought this way.
“This was the book I always wanted to read when I was younger,” she tells me. “I would hope it shows OCD can affect you with varying levels of severity throughout your life, but ultimately, you can go on to live as close to a normal life as possible.”
In the time since she started writing, she gave birth to her daughter with Swedish film director Måns Mårlind. She says becoming a mother, much like writing, has had an immensely clarifying effect on her relationship with her OCD. “It’s given me perspective on both sides of the coin. On the one hand, going through pregnancy, birth and parenthood brought me a lot of stress and anxiety about sickness and infection. And on the flip side, she’s made me live completely in the now, to the extent that some rituals I normally might do are forgotten.”
Middleton does worry about the effect that her OCD, and speaking about it so publicly, will have. In her personal life, she says “there’s a lot of guilt and shame around how selfish it can make you feel when you’re caring for your child and this illogical, meaningless thought or compulsion still manages to affect you.” And even though the writing was cathartic, she also has found it exposing – particularly now that it’s publicly available.
“That’s of course the intention, but I also find it quite nerve-wracking: it’s exposing and intimate, and people will know things about you that they might not know about other people. You’re really letting people into your head and your heart.” She particularly worries that it will come to define her and she will just be “that person with OCD”.
“The idea of being a poster person for something is really unnerving. You’re talking about something you care passionately about, and want to help other people understand, but there is that conflicted part of yourself that feels like doing press is somehow trivialising it.”
She pauses, reckoning with this. This memoir, unlike how she has lived until now, is as exposing as it gets, which she finds terrifying, strange and embarrassing. But she says she has chosen to put that aside. “My desire for people to feel seen or understood is stronger than my cringe factor at being a spokesperson.”
‘Scorpions’ (Rider, £18.99) is out now
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