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- I am Autistic. - June 17, 2020
I’m so OCD is a recurring theme. Obsessive Compulsive Disorder is my primary diagnosis and I’ve noticed that there are many circulating misconceptions and misunderstandings of the disorder. I’ll be writing about different compulsions and areas within OCD’s jurisdiction, in the hopes that discussion of it will help foster understanding and compassion.
Severe OCD is my primary diagnosis. It took time for my doctors to understand the role that OCD played in my overall pathology, for while my picking and various other classic compulsions indicated that I did have the disorder, some digging by skilled psychologists and uncomfortable honesty on my part was required to reveal the festering underbelly of my mental experience. I’d been previously both under-diagnosed and incorrectly diagnosed, for OCD is often mistaken for other disorders or unrecognized. Now, I live in the classically frustrating state of understanding my disorder perfectly while having a long road ahead of me to actually change the way my brain works. Understanding is just the beginning step.
The biggest battle I face is the confrontation between my true self and my obsessive/intrusive thoughts. OCD is now understood to be a chemically disproportionate dance between three sections of the brain: the basal ganglia, the orbitofrontal cortex (OFC), and the anterior cingulate gyrus (ACG). In the OCD brain, the OFC and ACG become overstimulated and send hyper-excited messages to the basal ganglia, messages that essentially scream “there is a problem!” While the properly functioning parts of the brain can sense that there is no problem, there remains a system that traps the OCD sufferer within a loop of irrational fear. Though OCD is chronic, and PTSD is also theorized to play a substantial role in these obsessive brain locks, medication and therapy are/will be able to coax my brain out of these loops.
My obsessions fall into a few categories. There are many more categories out there and their scope is impressive. Some folks obsess over things that fall into just one category but to an extreme extent, but while most of my obsessions could be described as extreme, my range is generous. An unanticipated (and ultimately minimally consoling) plus side of this is my ability to speak to so many areas of OCD. In writing this piece, I discovered that if I shoved every category into one post, y’all would be reading for far too long. I figured I should start with my obsessive compulsive relationship with moral scrupulosity, for it’s probably my most functionally interfering.
A common type of OCD is religious scrupulosity, wherein sufferers experience normal thoughts and desires that they punish themselves for out of fear that they’ve broken their religious code of ethics (sinning, church traditions, etc). Being genetically predisposed to this obsession while also being raised in a non-religious household, I have developed my own set of moral rules that are not to be broken, lest I become a bad or selfish person. I developed this set of rules through childhood influences, for without a religious book or spiritual leader, I had to start from scratch. The difference between this rule set and a general ethical code that folks live by is its reasonability and the consequences of deviation. I’ll let you judge for yourself whether or not you think these rules are justified (I sure don’t!).
Three days ago I burst into tears because a piece of paperwork I needed to fill out for my job asked for my last three addresses and the dates I lived at them, and my father insisted they would only need my current one (he would know, he’s been a member of the workforce for a hundred years, or however old millenial parents are these days…). I immediately launched into an explanation that not filling out the paperwork exactly and extensively would be akin to a crime, and it didn’t matter that they reasonably wouldn’t need all of my addresses since birth to run a background check on me, I couldn’t convey incomplete or mis-information or else I would be a bad person.
When I was in my eating disorder treatment center, I was given a 4 inch binder full of the rules of the house, the legalities of the program, and endless pages of technicalities. I read it over four times, which took me many hours, three nights in a row, only to discover that nobody followed most of the rules in the binder; it was a formality. When I discovered that, rather than shrugging it off and going with the flow, I became extremely, physically distressed. I knew I’d be the weird one now if I tried to stick to all of the rules in the obsolete binder, but I had to! No one else was reporting to the nursing staff if they saw someone else online shopping for clothes. I didn’t want to be seen as a snitch, and I didn’t genuinely morally judge the people who were doing it, but I could not possibly imagine breaking one of the written rules.
Those are recent examples, but I have hundreds of them dating back to my early childhood. I despise jaywalking and will snap at my family and friends for doing it (only because I’m then expected to do it, too). I feel extremely uncomfortable when I swear, and really only do it when it would help me in the social environment I’m in (i.e. when my friends in the moment would think I was weird if I didn’t). I don’t judge others for swearing, but it feels like I’m breaking rules when I do and it makes my body itch and brain buzz. Raising my voice in public, being loud when walking, pointing, are all held by my OCD brain as socially unacceptable, morally unacceptable, offenses that I cannot commit.
Most painfully, I punish myself if I do anything that I have determined to be a selfish thing. Selfishness is my ultimate moral infraction. Accidentally interrupting someone, raising my hand too much, walking in front of someone, failing to tip at least 25%, neglecting to give at least ten dollars to any homeless person I encounter, failing to hold the door open for the next person, making someone jealous, getting something that I know others wanted, receiving specific praise, being praised at all, asking for anything from a piece of gum to a birthday present, a phone call to a hug, “making” people listen to me or talk with me, even be in my presence, all elicit intense internal self-berating and the corresponding compulsion, “sorry!”
“Sorry” is a bit of a buzzword in my treatment, for it’s a pure compulsion of mine, meant to “neutralize” a perceived infraction that I have committed. I say it when I enter a room, when I start speaking, when I finish speaking, when I request anything from anyone. When in ED treatment, I was given a ticker to count the number of times I said it in a day; I averaged around forty. It is genuine, but I am not attempting to craft a heartfelt apology with it (when I am trying to do so, I’ll say “I am so sorry” or “I apologize”). When I commit an aforementioned infraction, my brain’s OFC and ACG send frantic messages to my basal ganglia that something is very, urgently wrong, and I must fix it! That’s where the compulsive “sorry!” comes in, and I shrink into myself. When I “commit an infraction,” my brain loses its mind, to put it academically. I panic, I repeat “sorry!” over and over while becoming visibly distressed, which has the effect of both scaring those who observe it and, unfortunately, making them feel guilty for reasons they don’t understand. Why is Olivia tearing up and saying sorry for the seventeenth time? She literally just ran out of paper and had to tell me she didn’t have any to give me. Did I do something wrong? This doesn’t seem right.
That, generic observer, is because it isn’t! I know it isn’t. The logical, rational and intelligent part of my brain knows that my compulsions are unjustified, but the chemically imbalanced part does them anyway. The chemical imbalance is created by OCD (and sometimes PTSD), but knowing where it comes from doesn’t make it go away. That’s the trickiest part of Obsessive Compulsive Disorder. Knowing simply empowers me to go down the right path towards ridding myself of it. That path involves internally challenging my self-punishing thoughts and doing the things that I fear would be selfish. I raise my hand anyway, I make my opinion known. I tip 20%, I give only what I have. I let myself be proud of accomplishments and praise. I stop myself before I say sorry, and substitute in a thank you, instead.
The most harmful effect of my experience with moral scrupulosity is the degree to which it stops me from living freely. A large percentage of my days are consumed by either fearfully avoiding potential infractions or fearfully neutralizing ones already committed. Underneath my OCD, I’m an assertive, vivacious, even confident (sometimes!) person. My true self has a lot of trouble clawing to the surface, and when it does, the backlash my OCD reflects onto it makes exposure seem not worth it.
Even now, I’m sitting at my laptop questioning whether or not I’ve spent too long in this piece talking about myself. What if I didn’t include enough references to objective OCD experiences? Will I be perceived as self absorbed, selfish?
This is literally titled I’M so OCD.
So no, I’m not sorry for writing about myself. Not one bit!