The Other OCD
When I was around eight years old, I sat in the office of my elementary school counselor’s office and he told me I was trying to force adult files into my child-sized filing cabinet. While it wasn’t a technical explanation or diagnosis, it gave me a greater understanding of what was happening in my head. I could not sort through complicated concepts without obsessing over their implications. I was fixated on nightmarish topics of harm, violence, and imprudence seemingly all the time. Why should an eight year old be burdened with this material, I often wondered. I cried, and cried often. I was longing to make it through the day unimpeded by what was happening in the confines of my mind, but somehow the fear always overcame me. Fear of what could happen to me, what could happen to loved ones, fear of what harm people are capable of. Eventually they called it OCD. Who would have thought?
Pure obsessional OCD is rather obscure, marked by intrusive imagery and mental obsessions not accompanied by the physical compulsions that shape the understanding most have of Obsessive Compulsive Disorder. While the content matter of the thought patterns may vary from person to person, recurring topics of harm, religious blasphemy, loss of control, impropriety, sexuality, and anything that the person finds reprehensible, dirty, or “bad” are common. Like a record on a loop, it plays on and on, anxiety growing with each rotation. The doubt is pervasive. Doubting one’s character, intentions, goodness, and worthiness are common. A cloud of irrational fears mercilessly feasts on your vulnerabilities. The song just keeps playing.
Research shows that pure O is so anxiety provoking because individuals who have the condition are among the least likely to act on the thoughts they experience. These individuals are gentle and kind, which is why the subject matter of intrusions is so repugnant and bothersome. Externally, there are few indicators of Pure Obsessional OCD; it’s quite invisible. My mother always tells me I look like I am immersed in thought, my brow furrowed in concern. As a society, we rely on what people reveal about their conditions, and thus much goes undisclosed. I think people rarely talk about Pure O because it is embarrassing and stigmatized. There is a level of shame and guilt associated with having thoughts of this kind. Therapists call it thought-reality fusion, or believing these fleeting thoughts mean you will do something bad, act out, hurt another person. Rest assured, it is an anxiety disorder and not a matter of impulse control. While I cannot speak for all, the way I find solace from the intrusions is with a healthy dose of distraction, physical activity, repetitive mantras, and cognitive behavioral therapy. From experience, I have seen that the worst habit is engaging with or trying to suppress the thoughts; suppression does not readily happen. Tell yourself not to think of something and believe me, it is sure to be the only thing on your mind.
Sometimes I feel as if I burden those closest to me because I crave reassurance to explain away the dissonance in my mind. I ask if “everything is ok” and I ask them often, embarrassingly often. Sometimes they enable me and answer, yes, that “everything is ok”. They see how desperately I need them to say just that. Other times they force me to rely on myself, to embrace the discomfort, to reside with what frightens me most, which in the long run is more helpful. Regardless, I’ve come to realize that nothing is ever really ok, and that in and of itself, is well, ok.