Written by, Megan #YEGgirl
I’m writing this piece because I meet the criteria for obsessive-compulsive disorder. Everyone with this diagnosis conceptualizes it a little differently. Loves it, hates it, denies it, clings to it, a little differently. I don’t usually think of myself as “having” or “being” OCD as much as I think I meet criteria for it.
It’s very common to compare mental and physical illnesses for a myriad of reasons. One of which is to reduce stigma and to have mental illness taken more seriously—which is still urgently needed and necessary. Comparisons can be made in all angles and directions. I personally do not think of OCD in the same way I might think of a chronic physical condition such as [insert your chosen condition here].
Mental illnesses undoubtedly have a biological and genetic basis. With OCD, we know certain structures like the basal ganglia are involved, and we know certain neurotransmitters such as serotonin are involved. But the vast majority of us weren’t diagnosed because of a brain scan; we were diagnosed because of how we experience the world.
With OCD, our experiences of the world are markedly difficult. We have similar distressing thoughts to most people, but have them perhaps 100x more often, and we interpret them and reason with them in rather unconventional and overall unpleasant ways. What those thoughts are, that is their content, can be categorized in certain ways which has led to the idea of OCD “themes.”
My primary theme has been harm OCD—a form of Pure-O. Pure-O describes obsessions and compulsions that may not be physically observable but which instead remain in the mind. I obsessively worry that I’ll die in an auto wreck, or have someone break into my house; that I’ll burn down my house, that I’ll cause harm to someone else, or that someone will harm me, or [choose your own disaster here].
I have done the “gold-standard” of treatment to manage my thoughts and symptoms, known as exposure and response prevention (ERP). I’ve done all types of exercises to this end, cooking more, using knives, imaginal scripts, going to certain places, all of which were immensely helpful. I still carry the principles of exposure with me everywhere I go. However, my primary critique of the treatment method as someone with the disorder and as someone who completed the treatment very thoroughly and diligently, is that it only helped me halfway.
What I mean by this is that exposure and response prevention is a type of cognitive-behavioural therapy. And it helped with my behaviour more than my cognitions. It helped my compulsions more than my obsessions. The link that states “if you change your behaviours, you’ll change your thoughts as well” is often grossly overstated, in my opinion. I think we as a culture are obsessed with very linear and direct relations that poorly reflect how messy, vulnerable, and complicated the human experience is.
Which is why I am okay that I have not overcome OCD and I am okay that treatment has erased neither obsessions nor compulsions from my life. At the peak of my symptoms, I was not living a meaningful life I was happy with nor proud of. I don’t need to be obsession or compulsion free to live a meaningful life that I am happy with and am proud of. I need them reduced, absolutely; OCD is one of the most time-consuming, mentally-sticky conditions out there.
I still struggle with sticky thoughts and I still struggle with being unhappy. Having a diagnosis means that you have an incredibly significant problem. A problem that many people certainly do not understand, and may even actively create myths against. However, a philosophy I’ve come to follow from psychologist Ross Greene (2014, Lost at School) is that “you don’t need a diagnosis to have a problem; you simply need a problem to have a problem.” My life will never stop having problems, and those problems will never stop being amplified due to my obsessive nature. Healthy behaviours will always take more effort than how effortless and instinctive compulsions seem to be. Like they’re an extension of my mind and my hands. But with a mix of self-awareness, insight, involvement, amazing friends and community, therapy, and life changes, I’ll keep making the best of this hand I was dealt and hopefully keep loosening its grip bit by bit.
OCD is often given the metaphor of a weed. You need to manage it from the roots or it will keep growing back. But whether OCD is a flower or a weed, I’m not too concerned with its growth, as long as it doesn’t stunt mine—as long as I grow too.