Change can, of course, lead to anxiety. But perhaps it’s challenging yourself to face this, to be open to the world and all it has to offer, that also opens you to the beauty and variety of a deeply fulfilling life.
I was diagnosed with obsessive compulsive disorder at eleven years old, but while it was then I was first offered a label for some aspects of my thought processes and behaviour, it would be some years later, as a young adult, that I finally feel I developed an understanding and insight into the depth and variety of my obsessive compulsive tendencies, and how they had come to affect my life.
In life, we often find ourselves pushing beyond our comfort zones, and as a result, we may experience anxiety in the face of uncertainty and the unknown. To feel anxious is innately human; to feel anxious over decisions we’ve made, to feel anxious about the past and future. While closely intertwined and co-morbid with anxiety in a general sense, OCD is a separate diagnosis. As a condition, it is dichotomous; on one hand, a recognisable pattern of thoughts and actions feeding into one another in an identifiable obsessive-compulsive spiral, on the other, a nebulous concept, with obsessions and compulsions varying enormously for each individual sufferer.
Obsessions may be generalised as ideas relating to harm or misfortune befalling the sufferer or people around them. It is key to remember that obsessions are not indicative of a person’s desires, nor are they indicative of a way a person wishes to act. Everybody, at some point in their lives, will experience ‘ego-dystonic’ intrusive thoughts, or thoughts which are alien to their sense of self and personality. A conscientious driver may have a fleeting thought about swerving his car into an oncoming vehicle or upcoming pedestrian; a person who prizes themselves on being calm and collected may experience a sudden thought about acting in an aggressive or violent way towards somebody; a person manoeuvring to avoid entering somebody’s personal space on the street may suddenly have an intrusive thought about groping or touching the other person in a sexually inappropriate way; a person waiting behind another on a station platform may have a sudden mental image of pushing the bystander into an oncoming train.
In each of these situations, the sufferers wish to act in what they perceive to be a considerate and responsible way, naturally leading the brain to conjure images of the opposite; in choosing to act in the way they wish to (e.g. driving carefully), it’s natural to have an awareness of alternative actions that they are choosing to avoid (e.g. driving dangerously). The problem in OCD is not the thoughts themselves; it is the reaction to these thoughts. Intrusive thoughts of an aggressive, sexual or destructive nature are something almost everybody will experience, and most people dismiss them for what they are: mere thoughts, generated by the brain as it churns out countless meaningless cognitions of the sort that cross the mind, but which will never be acted upon. In OCD, however, the sufferers’ sense of morality means the very thought of causing harm to another person is so distressing and at odds with their personality that it jars violently with them; rather than dismissing the thought as meaningless mental debris, they attach an unnecessary value to it, and fear that the very fact this thought has crossed their mind indicates some non-existent deeper meaning: does it mean that they are, at heart, malicious and unscrupulous people? Even after rationally learning that this is not the case, the emotional response to the fear of harm befalling others remains. Ironically, the fact that the sufferer attaches value to the thought strengthens it, and it may begin to recur as the sufferer attempts to make sense of this clash between rationality and emotion.
In some cases, the sufferer may attempt to avoid thinking about the thought after they have assigned it a mental weight. But attempting to repress a thought ironically causes it to recur more frequently. The often cited example of Wegner’s ‘white bear’ experiment is a perfect example of this phenomenon: in his study, Wegner asked his participants to describe the flow of their thoughts over a period of time, while asking them explicitly not to think of white bears. Every time an image of a white bear entered the participants’ heads, they were asked to ring a bell to indicate this. When specifically asked not to have a certain thought, the act of repressing these thoughts was based on an awareness of what it was they were supposed to avoiding thinking about i.e. white bears, and so images of these creatures recurred more regularly. In OCD, these repetitive intrusive thoughts are known as ‘obsessions’.
A ‘compulsion’ is a response to such ‘obsessions’, and an attempt to nullify the anxiety generated by them. These compulsions may be overt (physically observable activities such as checking light switches, washing hands etc.) or covert (cognitive activities, such as ruminating over an obsession in an attempt to ‘make sense’ of it, attempting to replay past memories in a particular way or to achieve a specific sensation, reviewing or repeating thoughts, counting and repeating mantras as an internal monologue etc.). In the short term, even if the compulsion seems to have no logical connection to the obsession, it serves to create the sensation within the sufferer of regaining a degree of control over their thoughts and emotions, and the anxiety they experience will decrease temporarily. However, as the obsession recurs, the sufferer may resort to the same compulsive behaviour, with diminishing results in the reduction of anxiety; in this way, they find themselves caught in an endless loop of obsessive thoughts and compulsive responses, all the while drained by the background drone, the misplaced fear, that they are somehow unscrupulous or dangerous people.
Obsessive and compulsive cycles are unproductive responses to anxiety; they self-perpetuate and maintain the feeling that compulsions must be completed to overcome anxiety. This cyclical process is both exhausting and emotionally crushing. Ironically, however, there came a point for me when obsessive compulsive thinking in itself came to offer a perverse form of stability in its gruelling predictability. Certain modes of thinking, and core beliefs born from this thinking, can persist throughout a sufferer’s life, but can also leach into all other aspects of their self-perception and worldview. As a child and teenager, with a limited understanding of my diagnosis, the internalised doubt and self-loathing, the fear and lack of sense of self generated by constantly questioning my thoughts, led to a severe knock to my self-esteem, my feeling of worth and the idea that I didn’t deserve the friendship and support of other people. This is turn led to the development of coping mechanisms, to some extent the need for isolation to collect myself in times of anxiety, and maintaining an emotional distance from others. In some form or other, OCD permeated a great deal of my development into the person I am today.
OCD became like an integral pillar or girder at the centre of a structure analogous to the psyche; as my experience of the world broadened and my ideas about myself and the world around me developed, I tore out old rooms and refitted them, removed features and replaced them, but the vital support dictated and shaped, even without my active thought, the decisions and choices I felt able to make, the refurbishments I could manage. For sufferers, rebuilding ourselves after an external trauma, the loss of a loved one, the breakdown of a friendship, viewing ourselves in a fresh way through a new job or moving to live in a new location, is all experienced through the lens of thought patterns deeply ingrained and born out of obsessive compulsive tendencies; if unchallenged and unapproached, this pillar of our own internal cognition remains unchanged. In challenging OCD through therapy, it can feel like tearing out a central tenement of consistency and stability in thinking, leading to a seismic shift in the stability of ourselves. Unbeknown to me, analysing my OCD and delving into my understanding of myself led to the collapse of many long-held ideas about me as a person. Perhaps in the long term it would be for the best, as many of these ideas were rooted in deeply negative beliefs, but, it lead to a sense of being adrift after experiencing a crumbling of self. If these assumptions and beliefs I held about myself had been filtered through the irrational viewpoint of neuroses, then who was I, really? All those years I’d adhered to rituals and made decisions based on the fear of harm befalling myself and others; could I accept, admit to myself, that it was all for nothing? In many ways, it was easier to cling to OCD, to believe that all the time I’d sunk into compulsive actions, was worth something in protecting the people I cared about, rather than accepting it as time sunk into a mental illness. Counter-productively, for a period of time during my second year at university, I identified myself first and foremost as ‘obsessive compulsive’, subsuming the diagnosis into myself and, while undergoing therapy and opening up to my friends about my experiences for the first time, also incorporating them into myself in such a way that they would become difficult to relinquish. I suppose, at the time, the diagnosis seemed like the most stable thing I had in my life.
For all this stretching for analogies, all the attempts to capture everything in words, it can still be difficult to encapsulate the confusion. I know how convoluted all this must seem to anybody reading. I suppose the question I want to pose, is: just because it can be hard, does this mean you shouldn’t challenge OCD, shouldn’t risk upsetting the balance of your mental landscape, however much pain your current situation may cause you, just because you fear in the short term that it will make things worse? For me, mining into the depths of myself, despite periods of doubting the very core of my self-understanding during the process, is one of the most beneficial things I feel I’ve ever attempted. I still have a way to go, but I’ve come to understand OCD not as some form of alien symbiote, something which latches onto an innately rational mind and begins to direct and shape your thinking, but as a collection of modes of thinking which reside in my infinitely complex human brain. Acknowledging that these are ways of thinking within my broader cognition, that I have ownership of my OCD and not the other way around, in itself gives me a sense of power. In learning to be more open with myself and other people, I can acknowledge that maybe I don’t have a complete understanding of myself, maybe I never will, and maybe, maybe, that’s OK.
If I were to offer advice to any OCD sufferers reading this, it would be: try not to let OCD be the only pillar in your life. There are so many other facets of your experience that you can cultivate to offer stability and a sense of self; relationships with friends, family, hobbies, communities, passions and interests. At your lowest points, the world and everything in it may seem meaningless, inconsequential. But in moments of clarity and relative peace of mind, even a simple action, to read a book, to watch a film, to meet a friend, can help build a repertoire of connections and engagements with the world around you, rather than the one in your head. Life is rich, and obsessive compulsive thinking may be a part of it, but it can be reduced to exactly that: only a part. When such thinking seems as though it has dominated and shaped your life, unthreading it in an attempt to understand it can lead to a great deal of doubt and pain, but through it comes the capacity for change. Change can, of course, lead to anxiety. But perhaps it’s challenging yourself to face this, to be open to the world and all it has to offer, that also opens you to the beauty and variety of a deeply fulfilling life.