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At the crux of the anguish of most OCD sufferers is the obsessive thought. The originator of the obsessive compulsive cycle, it is the result of a genetic predisposition that is given size and shape by childhood influences. My brain was born with the tendency to obsess, and compulse (I’m inventing the word, shh!) accordingly. The experiences my brain was exposed to in my 20 years are directly correlated to the cyclical fears that continually jab at it today. Those incessant, prodding fears are commonly referred to as intrusive thoughts.
The nature of my OCD is wide-ranged, so I can’t pinpoint a specific category of intrusive thought and present as an expert upon it, nor could I explain my entire swath of intrusive thought types without boring you to tears if your eyes didn’t glaze over first. I’ve left out some even within these categories- my hair brushing and deodorant applying being notable exclusions- in favor of those that I feel most exemplify my experience. I hope, however, that by exposing this sampling of them, you’ll come away with a better sense of how OCD ravages the untreated brain.
Intrusive Symmetry Obsessions
This area of my illness is what first tipped off both myself and my parents that I was affected by OCD. I’ve partially inherited the disorder from my father, and when I told him I could relate to his interest in symmetry, OCD popped onto the radar for me. Truthfully, symmetry doesn’t summon very many negative implications to my life. More specifically, other categories of obsession are far more life disrupting. It’s not upsetting to myself or others when I arrange my desk just so, when I adjust hanging picture frames, erase and re-do equations and pictures on whiteboards. A small selection of my symmetry obsession’s implications are painful, however, and they have nothing to do with how people usually think of OCD symmetry. They are, in a word, sensory.
Imagine you’re walking down a sidewalk and your pace is somewhat brisk. You have somewhere you need to be, there’s a tinge of urgency to your stride. As you walk, the tip of your right shoe brushes against the inside of your left calf. In your brain (assuming you do not have OCD), this brief touch is registered and forgotten about. It’s just a quick snag by your own shoe, after all, and you’ve got somewhere to be! My brain, however, gets stuck on this touch. I need to straighten out my calves by brushing against my right inner calf with my left shoe, now! I slow my pace in order to achieve a touch of the exact same pressure and duration. If I can do it, I move on, but what usually happens is my brain doesn’t accept that the two touches were the same, and in an effort to make things right again, I will continue to touch my calves with the opposite shoe, over and over, with increasing intensity. Eventually, I’ll stop being so measured and just keep kicking myself until my brain decides it’s satisfied. I do this with accidental touches of all kinds, with arms, feet and others, whether I initiate the touch or not.
Satisfied is arbitrary. Even I don’t understand it. Whatever it means, it’s key to my experience with OCD. I check until I’m satisfied, kick until I’m satisfied, ask until I’m satisfied, worry until I’m satisfied. Unfortunately for my clothing, satisfied dictates that anything and everything be done to achieve it. Sometimes- I’d say once a week, or a bit more often- my brain suddenly, in an immediate flash, decides that my clothing is wrong. It fits wrong, it’s constricting me. I’ve ruined three pairs of leggings through the years because my need to release my calves from the leggings’ airtight constriction was so strong that I used my nails and ripped big, fist sized holes in the cloth to set them free. If I’m going to be somewhere for a while- a friend’s house, a long event- I carry a pair of loose sweatpants with me to swap out with my tighter, more fashionable pants. If I don’t remember to do this and am suddenly struck by a need to change, I have been known to leave school, events, or whatever else I’m doing (my buzzing brain prevents focus on anything else), or spend money on cheap alternative bottoms at the closest clothing store. I like wearing dresses and skirts to avoid this possibility altogether, and am known for braving freezing, winter weather bare-legged. It’s not because I’m looking to show more skin (though there’d be nothing wrong with that!); I want to avoid the embarrassment of frantically scrolling through Google Maps to find the nearest Forever 21 or tearfully calling my mom to pick me up so that I can huddle under my covers in huge sweatpants and mournfully wish I had any brain other than the one I have.
Intrusive Cleaning/Contamination Obsessions
For years, I thought this was an area of OCD I’d managed to evade. I didn’t wash my hands repetitively and the word “germ” meant little to me, which is what I entirely associated this category of obsession with, so it couldn’t apply to me, right? OCD was not a primary focus of my earlier treatment, so I didn’t have a good way of understanding what exactly contamination obsessions were. If I had, I’d likely have known since Day 1 that intrusive contamination obsessions were a major issue for me.
All throughout high school I’ve clung onto a fear that I have colon cancer. My grandfather had it years ago, and he is as alive and well today as my fear that I’m sick. Obviously, I do not have colon cancer. Not even I truly think that I do. However, I’ve likely called my pediatrician half a dozen times over the years in a panic, scheduling an appointment to try to pitch to her, yet again, that I could have cancer. When she reminds me of the obvious- that colon cancer almost always happens to older folks, that I have absolutely no symptoms of the illness- my focus switches to worms. What if I have intestinal worms? My mind plays loops of worms wiggling about my insides and I spend dozens of hours, late at night, googling cancer symptoms, tapeworm symptoms, ringworm, hookworm. What if? In a neurotypical brain, a thought such as this might crop up every once in a while, but it is able to immediately recognize that the thought is irrational and let it go. My OCD brain has a lot more trouble with this. Once the thought crops up, it replays over and over in my head until I’ve googled, called, checked just the right number of times. Even then, the obsessive fear never really goes away. To be crystal clear, no one is more sure than I am that I do not have colon cancer or worms, and no one is more afraid than I am that I do.
Intrusive Harm Obsessions
As someone who’s experienced suicidality and been in some dangerous physical situations, it can be difficult to distinguish between that part of my emotional experience and OCD-related intrusive harm obsessions. I’m going to strictly stick to describing thoughts that are exclusively based in Obsessive Compulsive Disorder and have no basis in my reality.
I’m very coordinated, have perfect vision, and possess good instant decision making skills. I know I’d be a good driver. I’d probably be a great driver. I’ve done my 40 hour training course and have driven many hours in practice, with parents or other adult drivers to my right. I’m calm, calculated, and skilled at the wheel. I could get my license tomorrow. I’m also paralyzingly consumed by a fear that I’m going to kill someone with my car, and refuse to drive.
Some degree of this is normal, of course. We’re all aware that, as drivers, we’re at the wheel of a metal death machine that has a great capacity for harm, that we need to be exceedingly careful, that with one bad decision or unforeseen event, our life could change forever and for the infinitely worse. In my brain, I experience those thoughts with enormous intensity, and many more thoughts after that. When I think of driving, all I can see is myself making one mistake, any mistake, and accidentally killing someone. I see myself resting at the wheel in the rubble of an accident, having just hurt someone. There is nothing more terrifying to me than the possibility of accidentally killing someone, and with even a slightly higher chance of hurting someone behind the wheel than away from it, I can’t imagine ever choosing to get my license. Not only that, but getting a license (increasing the odds, given another driver on the road, of someone getting hurt) would be selfish, for I could just spend worthwhile money on an Uber and avert a catastrophe. Part of my therapy does and will include working to get me to a place where my obsessive fear of hurting someone doesn’t hold me back from driving. I intellectually understand that my fears, while technically possible, are irrationally severe. I’m just not emotionally there yet, and that’s okay. It will come.
Apart from prior suicidality that I’ve discussed, I’ve housed two recurring intrusive thoughts about harming myself since I was an older child, far before I ever considered self harm. For as long as I can remember, my brain has replayed two specific violent images in my head, presumably in moments of stress. In a reeled image, a sword is mounted on a wall, facing outward. I run at the sword over and over again at top speed, impaling myself in the forehead on an endless loop. In the other scene, I suddenly unlock a car door and jump from it while the vehicle is still moving, tumbling onto a highway. Over, over, over again, again, again. To me they are horrifying, nauseating, and if I were religious I’d pray every day to be relieved of them. All I can do is choose not to judge myself for having them.
That’s the nature of OCD. I want so badly to be forever and fully rid of it. All sufferers of it do. The obsessions and compulsions we experience are uncomfortable, painful, horrifying, time consuming, and everything in between. They induce helplessness and self hatred. In no way is this more apparent than in my relationship with my harm based intrusive thoughts. There are more beyond the one I’ve shared, and each haunts me particularly, insidiously, in my saddest, most helpless, fearful moments. Everyone experiences moments like that all the time, all around us, but very few experience a resulting thought about impaling themselves. Normally, should someone jump out of a car or be impaled, those unfortunately in the vicinity can simply close their eyes and stop themselves from witnessing it. Imagine being prisoner to witnessing violent images, and imagine that closing your eyes only embeds you more intimately into them. Imagine being unable to walk down a street, most days, without kicking or prodding yourself for no logical reason. Imagine accumulating 10 missed school days because you forgot your deodorant stick at home and needed your mom to pick you up, for you were rendered non-functional the moment you realized. Imagine what it’s like to be a family member or friend to someone like that. Utterly exhausting, is what it is.
Surprisingly common, too. We’re between 1% and 3% of the population, so yet again, you assuredly know someone who suffers from OCD in the way that I’ve described it. Lots of folks experience thoughts that make them squirm, but for that niche of the population, squirmy, slimy thoughts won’t naturally leave. Medication and therapy have to perform that otherwise natural function.
Next time you see someone doing something repetitive, someone needing to repeat, have patience. You may be somewhat perturbed by the muttering stranger on the subway, but that muttering stranger, or any example of someone clearly trapped within their head, is far more disturbed by themselves than you are. You can choose to project yourself into the shoes of those who are running not from external threats, like neurotypical humans, but from their own minds, the thoughts their brains churn out. There are so many of them, us I should say, and we are enduring. Such patience would go a long way in alleviating the extra burden of shame that folks with OCD contend with every day.
You can choose to project yourself into the shoes of those who are running not from external threats, like neurotypical humans, but from their own minds, the thoughts their brains churn out.