What is OCD?
Obsessive Compulsive Disorder is a sort of anxiety disorder that features obsessive thoughts, compulsive behavior or rituals, or both. Obsessive thoughts are unwanted and distressing thoughts, ideas, mental images, or impulses that intrude into a person’s mind repeatedly. Often these thoughts are violent, obscene, disturbing, or illogical, but they cause a person a great deal of anxiety when they occur. To relieve that anxiety, many people engage in unenjoyable compulsive or ritualistic behavior that is perceived to help extinguish those thoughts. For example, someone might repeatedly check locks, wash their hands, count steps, tap things, or something else. To be diagnosed as OCD, these thoughts and/or behaviors must cause distress, be time-consuming, and significantly interfere with normal functioning.
How was I diagnosed?
I was diagnosed with OCD pretty late in the game as far as my treatment history goes, probably because of the particular type of OCD that I have. I have Harm OCD, which means that my obsessional thoughts and behaviors revolve around harming other people or myself. Looking back at my medical records, this was mistaken as homicidal thinking, which just isn’t accurate. I never wanted to hurt anyone, I just couldn’t stop worrying about doing it. I was put on antipsychotic medication, but that didn’t help because my thoughts weren’t due to psychosis. It wasn’t until after I had gone through long-term psychiatric rehabilitation in the UK that I was finally diagnosed with OCD. I did a lot of cognitive-behavioral therapy and exposure and response prevention treatment to help me learn to cope.
Living in recovery
Living in recovery doesn’t mean that my obsessive thinking has gone away. It doesn’t mean I don’t have spikes of anxiety when I experience a thought about hurting someone. What it does mean is that I have learned to accept that these thoughts occur and deal with the uncertainty of not knowing if it’s something I’m actually capable of. Before I entered recovery, my OCD thinking might have followed this kind of pattern:
I’m in the kitchen using a knife, and I have an intrusive thought about throwing the knife at my cat. I’m horrified by this thought but I can’t stop thinking it. I start trying to determine if it’s something I would actually do. I would monitor myself for signs that I was angry, try to figure out how I could tell if I was going to “snap.” I would get really anxious about this idea, thinking that if I had this thought, that obviously meant that I DID want to do it. I would criticize myself for being an awful person. I wouldn’t want to touch my cat because I was afraid of hurting her. I would try really hard to stop thinking the thought, and then question if the thought was just a thought or if it was really a memory.
Now, if I have that same thought, it still causes me anxiety. I might shake a little bit and feel scared about doing it. But I know to interrupt that obsessive thinking about whether or not I’m capable of doing that. Maybe I am. I don’t think I am, but I’m not 100% sure because nothing is certain. Just because I thought about it doesn’t mean I’m going to do it. It definitely wasn’t a memory, because I wouldn’t be questioning that if it really happened. I might be afraid of touching her, but I’ll go pick her up anyway to confront that fear.
What helps me stay well?
Some things that help me cope with my OCD symptoms from day to day are:
- Expressing my fear and anxiety to trusted people. It’s easy to fall into a cycle of obsessive thinking and compulsive rumination if I don’t express what’s happening, but one of the best ways to accept the thought and move on is to just say it out loud.
- Exposing myself to feared situations regularly. I hate driving because it’s an extended exercise in anxious thinking with a side dish of real risk. I have to do it anyway. I’m allowed to hate it, I’m allowed to be anxious the entire time, but I know that it will only get worse if I avoid it. So I do it.
- Taking an SSRI daily and going to individual therapy however much my current life circumstances dictate. Sometimes I don’t go to therapy at all, and sometimes I go once a week, it just depends on what’s going on in my life and how much extra support I need.
- Resisting compulsive urges. I can’t stop the thoughts from occurring, but I can resist urges to engage in compulsive behaviors like checking, rumination, and avoidance. I know from experience that indulging in my compulsive behavior might make me feel better in the moment, but it makes it that much harder to resist next time.
If you’d like more information about Harm OCD, I really like these articles:
- Rethinking the Unthinkable by Steven J. Phillipson
- Harm OCD: Symptoms and Treatment by OCD enter of Los Angeles
- How I Treat OCD Killer Thoughts: Treating Violent Obsessions by Fred Penzel