My current OCD explained
Before I begin, I would like to state, that the following entry contains sensitive/explicit material, that people may find distressing or upsetting, and which is not suitable for anyone under the age of 18.
Currently, I am dealing with, what some professionals refer to as, ‘Pure O’. The reason they have dubbed it ‘Pure O’ is because it does not involve any outwardly visible compulsions/rituals, it is purely contained within the individual’s own mind, purely ‘obsessional’ as opposed to ‘obsessive compulsive’, whereby individuals engage in physical and outwardly visible compulsions in response to the obsessions they experience within their mind.
To call it ‘Pure O,’ and to suggest that it is purely obsessional, is however, an over simplification, and quite frankly, fallacious. I do, in fact, engage in many compulsions/rituals, in response to the obsessions/intrusive thoughts I experience. The difference is, as I have already alluded to, that they cannot physically be seen, they are not overt physical actions, they are cover, mental rituals.
It all starts with an intrusive thought. An intrusive thought is a thought that comes into your mind, of its own accord and against your will. Studies show that all humans, OCD sufferers and non-sufferers alike, experience intrusive thoughts. The same studies show that the types of intrusive thought that OCD sufferers and non- OCD sufferers experience are identical. There is no discrepancy between the two, in terms of thought content.
Here is a table showing the types of intrusive thoughts those without OCD or any mental health problem reported having as part of the study.
normal intrusive thoughts
The table below shows the results of research findings from a survey of 293 students (198 female, 95 male), none of who had a diagnosed mental health problem. The column on the left shows the type of intrusive thought and the 2 columns on the right show the percentage of women and men who said they had experienced that particular thought.
driving into a window
running car off the road
hitting animals or people with car
swerving into traffic
smashing into objects
cutting off finger
jumping off a high place
fatally pushing a stranger
fatally pushing friend
jumping in front of train/car
pushing stranger in front of train/car
pushing family in front of train/car
bumping into people
insulting authority figure
choking family member
stabbing family member
accidentally leaving heat/stove on
home unlocked, intruder there
taps left on, home flooded
swearing in public
breaking wind in public
causing a public scene
scratching car paint
holding up bank
sex with unacceptable person
sex with authority figure
kissing authority figure
acts against sexual preference
authority figures naked
sex in public
disgusting sex act
catching sexually transmitted disease
contamination from doors
contamination from phones
getting fatal disease from strangers
giving fatal disease to strangers
giving everything away
removing all dust from the floor
removing dust from unseen places
Purdon C. & Clark D. Obsessive intrusive thoughts in nonclinical subjects. Part 1 Content & relation with depressive, anxious & obsessional symptoms. Behav Res Ther 1992;31:713-20
Sourced from: www.goodmedicine.org.uk
I would like to state for the record now, that people with OCD (including myself), do not mean any of the intrusive thoughts that we have. We are not dangerous; we have no intention or wish to harm anyone. No-one with OCD has ever acted on an intrusive thought they have had. OCD experts have stated that people with OCD are the safest people to be around and least likely to cause harm to anyone.
What differentiates OCD sufferers from those without the disorder, is the way in which they react to, and deal with, such intrusive thoughts.
The intrusive thoughts that OCD sufferers experience, are often described by professionals as being ‘egodystonic’. Put simply, this means they are inconsistent/conflict with the person’s general character, nature and self (personality). It is because of this that OCD suffers find them so harrowing and abhorrent. This is not to say that such thoughts are in keeping with non-OCD sufferer’s personalities (egosyntonic), or that they do not find them equally repugnant.
The big difference, and what separates those who suffer with OCD, from those who don’t, is the way in which, those with OCD, react to, and deal with, such thoughts.
People without OCD are immediately able to identify such thoughts as being random and alien to them (egodystonic). Consequently, they give them no weight or consideration and simply shrug them off, allowing them to leave their mind as quickly as they entered it.
People with OCD on the other hand, are unable to do this. They latch on to the thought and begin to engage with it. In doing so they immediately attribute meaning to the thought. They identify it as something significant that warrants thought and consideration. This is the first step in what becomes a downward spiral.
Whatever the thought may be, the OCD sufferer will begin to obsess and worry over it. Questioning what it means? And Why they have had it? What does it say about them? Do they really mean it? Etc. They get caught up overanalysing and debating such questions. They begin to doubt themselves, “maybe I do mean it!” Before they know it they/OCD have convinced themselves that they do mean it.
This is exactly what happened with me and my intrusive thoughts. Examples of intrusive thoughts I have had over the last year are:
I want to harm/kill people
I want to sexually assault women
I’m a paedophile and I want to sexually abuse children
The thought that you might be any of these things, or that you might cause harm to someone as a result, is absolutely terrifying! I cannot begin to describe the anguish and torment it causes. As a result, you begin to engage in what are known by professional as ‘safety behaviours’. These are unhelpful behaviours you adopt in order to eradicate the thoughts, the anxiety and distress they cause, and to eliminate the danger/threat you now feel you pose to others. These behaviours can be a combination of avoidances, compulsions and rituals. In my case, as I alluded to earlier, they are mostly covert, taking place in my mind. Examples of such behaviours may be:
Debating/arguing against the thoughts/beliefs – I’m not a paedophile because…I would never harm anyone because…I don’t mean any of this because…
Neutralising (cancelling out) the bad thoughts by repeating a phrase/mantra – “I don’t mean that” “That’s not me” “I’m not that, and never will be”. I would repeat a phrase such as those every time an intrusive thought entered my mind.
Thought Suppression – Actively trying to repress and push down the thoughts, preventing them from entering your mind, desperately trying not to have the thoughts.
Reassurance seeking – Constantly asking a friend or family member to reassure you that you are not any of these things, that you don’t mean these thoughts, and that you would never act on any of them etc.
Avoidance – Avoiding places or situations that are likely to trigger such thoughts. Avoiding people and children.
Rather than alleviating your anxiety, distress and fear, expunging the thoughts from your mind, and convincing yourself that you are not these things, and do not mean, or want, to act on these thoughts, these ‘safety behaviours’ actually have the opposite effect, exacerbating the situation.
The number of thoughts you have increases, your anxiety, distress and fear rise, and your belief/conviction that you are these things, mean these thoughts, and want to act on them, strengthens and solidifies.
It is absolutely sickening and torturous!
Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention Therapy (ERP), teach OCD sufferers that there is an alternative, and better way to respond to these intrusive thoughts. There is a variety of different techniques that can be applied, however the main principle is that you do not need to engage in any of the aforementioned ‘safety behaviours’. By exposing yourself to situations which bring on the thoughts, dropping the safety behaviours, and ceasing to engage with the thoughts, you come to realise that your anxiety will decrease on its own. The more you do this, the less powerful, distressing and numerate the thoughts become, and your conviction/belief in them begins to wane. Slowly you come to gain space between you and these thoughts. You become able to treat them as meaningless thoughts, and allow them to pass in and out of your mind, in the way that those without OCD do.
Below is a life map of my OCD, denoting the various types of OCD I have had throughout my life, right up to the present moment. It includes information relating to the event/experience/thing that precipitated the OCD, the ‘trigger’, and the OCD symptoms that resulted from it, ‘obsession/avoidance/compulsion/ritual’.
I would like to reiterate at this point, that people with OCD (including myself), do not mean any of the intrusive thoughts that we have. We are not dangerous; we have no intention or wish to harm anyone. No-one with OCD has ever acted on an intrusive thought they have had. OCD experts have stated that people with OCD are the safest people to be around and least likely to cause harm to anyone.
OCD Life Map
Trigger – RE teacher told us a story about “Judgment Day”. She told us that when we die our lives our measured in terms of our good and bad deeds. Our deeds are measured on a scales (the bad deeds being placed on the “left” side, and the good on the “right”) and if the bad outweigh the good then we go to Hell and vice versa. Going to heaven meant you would sit on the “right” side of God.
Symptoms - obsession/avoidance/compulsion/ritual – I began to associate the left side of my body with sin and wrongdoing, and the right side with virtue and good deeds. I became obsessed with balancing my physical actions as a consequence. I felt that anything I touched, or did, with the left side of my body, was contributing to the left/bad side of the scales I would one day be judged upon. Consequently, If I touched or brushed an object with my left hand or foot, I would have to touch it with my right hand or foot (the good/virtuous side), to balance or neutralise the scales.
I told my parents who arranged for me to see our parish priest. He spoke to me, rationalising the situation and reassuring me. My compulsions stopped soon after. This is the only time that reassurance actually helped to quell the obsession/compulsions. I think it was a one off (perhaps it worked because, as such a young child, I trusted implicitly, anything that an adult priest said) , as although it may seem counterintuitive, reassurance actually serves to fuel and exacerbate OCD, and this has been my experience when it comes to every other obsession I have had.
The association with left being bad, and right being good, did however, linger for quite some time. I think it may even still be there to some extent today. From that point on however, I have never had/acted upon the urge/compulsion to physically counteract/match any left sided bodily action with a corresponding right sided bodily action.
Trigger – Religion. I believe a lot of my OCD, especially my earlier OCD, was influenced/fuelled by my religious (Catholic) upbringing/schooling. The idea of always trying to do the right thing, righting any wrongs you may have done, and being hard on yourself when you have sinned/strayed has been present in my mind since I can remember. I have always experienced an overwhelming sense of guilt, a hyper-inflated sense of responsibility, and an overactive conscience, as a result. This is sometimes referred to as “Scrupulosity OCD”.
Symptoms - obsession/avoidance/compulsion/ritual - I would always try to do “the right thing” and if I didn’t I would berate and chastise myself. I would feel a huge and overwhelming sense of guilt and feel compelled to do whatever I could to atone for the wrong I had done. I would constantly assess in my mind if what I was doing at the time was “right”, or ponder and ruminate over things I had done, “were they right?” “were they wrong? And if so, what did I need to do to make it right?”.
I always felt a weight and a heaviness, even at a very young age. I would spend a lot of time pondering and brooding over heavy subject matter and things that were going on in the world around me. Thinking deeply about the morality and ethics of whatever it was that was playing on my mind. I went to some dark places in my mind often feeling very upset and distressed. I never felt like I was carefree and able to have fun in the way my peers were. There was always something weighing on me and detracting from whatever activity I was engaging in.
I also worried that if I did not do the “right” thing, that I would be punished by God, either in my life now (bad things would happen to me), or when I died. This became particularly intense after I broke a promise I had made to God when I was 17.
Intermittently up until about 12
Trigger – I was on my own in the living room, I looked at the television and saw that 999 (a television programme involving re-enactments of real life emergencies) was on. The programme was showing a reconstruction of a girl choking on her dinner. I found this terrifying.
Symptom-Obsession/avoidance/compulsion/ritual - I found eating very difficult, especially food with bones in it. I would avoid certain foods, mainly eat soft food, cut my food up into small pieces and chew excessively. Sometimes I would panic and go out to the toilet or kitchen to spit food out or wipe it on my sleeve. I found it difficult to eat in public places, as part of me feared the potential embarrassment/kerfuffle that may ensue, were I to choke. Also eating in central London was very difficult, as I often worried that were I to choke, the traffic would mean that an ambulance would not be able to arrive in time.
Trigger - Hearing stories of people dying in gruesome, and often rare circumstances, whilst sitting with my mum and her friends in Ireland.
Symptoms – obsession/avoidance/compulsion/ritual - Health anxieties. Heart/Stomach. Homing in on bodily sensations/feelings and worrying/ruminating about what they meant or might be. Reluctance to take medicine due to potential side effects. Researching illnesses online and self-diagnosing. Constantly asking family members for reassurance that I was not ill. Reluctance to try new foods in case of anaphylaxis. Also had a fear of having to have an operation and a general anaesthetic.
Trigger – People calling me skinny, or saying I was too small/short to play sports.
Symptoms – obsession/avoidance/compulsion/ritual - Body Dysmorphic Disorder (BDD) Feeling inadequate, hurt, upset and depressed. I couldn’t look at myself in the mirror. I overate to gain weight. I would compare myself to others and obsess about my inadequacies. I would obsessively pray to grow taller or bigger.
Trigger – Boys were messing around at school and simulating sex with one another. One of them pinched my bum and I reacted badly, he told me “I must be uncomfortable with my sexuality and might be gay”. I was also often teased and told that I was gay. I would like to say at this point that, there is absolutely nothing wrong with being homosexual, it just bothered me because I wasn’t. I wanted to meet a girl and have a family with her one day, and being gay would mean I wouldn’t be able to have those things. It was like an attack on my identity and a threat to the things I wanted from life. It makes no sense because, wanting to meet a girl and have a family with her, is the kind of desire/want that a heterosexual man would experience, and not something that a homosexual man would, and by that rational, how could I be gay? However, that is the power of OCD, I became almost certain/convinced that I was gay.
Symptoms – obsession/avoidance/compulsion/ritual - I avoided physical contact with my male friends. Looked at homosexual porn to check/see if I was aroused. Images of men would pop into my head when I was masturbating. I Would feel very uncomfortable around gay men or effeminate men. I found the concept of a transgender person confusing, especially if I found a MTF Transgender woman attractive (I realise this is an immature outlook, as it makes perfect sense for a heterosexual man to be attracted to a MTF Transgender woman, however I was still very young and naïve at the time). I think I would watch heterosexual porn and masturbate to prove I was not gay.
Talking to my mum and other family members for support and reassurance that I was heterosexual.
15 onwards, possibly before 15 also, I’m not sure.
Trigger – Working in my mum’s school. I was given a strict talking to, (which felt almost accusatory), relating to the rules regarding appropriate and inappropriate contact with the children. I thought, “Why are you telling me this so seriously? I’m not a paedophile”. “Does he think I’m a paedophile?” “Oh my God, maybe I am a paedophile!!!” “Maybe the way I interact with children is inappropriate and sexually motivated!” etc.
Symptoms – obsession/avoidance/compulsion/ritual - I began to constantly worry that I might be a paedophile, that I had inappropriate sexual thoughts/urges/desires towards children. I constantly assessed every interaction I had with a child, “Was it appropriate?” “Was it motivated by something friendly and innocent, or by an inappropriate sexual desire?” “Was I aroused by it?” “Did I molest or harm the child?”
I would hone in on my thoughts and bodily sensations while around children. Especially focusing on my genital area, focussing/scanning it in my mind to establish if I was experiencing inappropriate arousal.
I would often avoid contact with children completely, and ask my family for reassurance that I was not a paedophile.
It became incredibly difficult, upsetting, harrowing, and torturous really, to be around children.
After I had been around children, I would spend hours/days ruminating and going over the interactions I had had with them, mentally checking to see if they were appropriate and acceptable.
This still goes on constantly, on a daily basis, in the here and now. However, I often find myself ruminating over/replaying past events and interactions I’ve had with children (some which took place over 10 years ago).
It has been so bad over the last couple of years, that I have completely avoided all contact with children. This has been particularly upsetting for me, as it has meant that I have not been able to see any of my cousins.
University, 18 onwards
Trigger – Change of environment (living away from home for the first time, University life, completely new course etc.) and neck injury. Change and a trauma (such as my neck injury) can often induce OCD that was lurking in the background, or exacerbated existing symptoms.
Symptoms – obsession/avoidance/compulsion/ritual - My OCD went into overdrive. An amalgamation of the aforementioned symptoms and beliefs were present. The religious element was very strong, I was constantly trying to do the right thing/atone when I hadn’t, and excessively praying, an hour + at night. I felt that I had to be good, and pray, or God would not allow my injury to heal. Living with other individuals for the first time, I became obsessed with causing accidents by leaving things plugged in or leaving the gas or cooker on. This led to excessive checking/rituals which added more time to my night time ritual. I would constantly obsess/ruminate about my neck injury, “Would it get better?” “Would I be able to return to playing sports or not?” “Would I always be in pain? This along with other ruminations led to a real low-level depression.
University, second year, 19 onwards
Trigger – Giving money to a homeless lady/prostitute (it was in a well-known red light area we had to pass through to get to Tesco while at Uni) who had open sores on her hand, when I too had open cuts on my hands, due to the cold weather.
Symptoms – obsession/avoidance/compulsion/ritual - I worried/became convinced that I must have contracted HIV from the lady, or that I might contract it from someplace else, such as a public place, or bodily contact with a potentially infected person. I became extremely worried/fearful that I might contaminate/infect other people with HIV. I began to excessively wash my hands, cover cuts with plasters, and avoid using public toilets. I obsessively researched HIV contamination. I Had an HIV test and spoke to the doctor for reassurance. I also spoke to family and friends for reassurance. I began excessively scanning for red stains (which I felt could be infected/contaminated blood) or white sticky stains (which I felt could be contaminated semen) practically everywhere I went
University, third year, 20 onwards.
Trigger – Difficulties/arguments I was having with a therapist at the time.
Symptoms - obsession/avoidance/compulsion/ritual - The HIV contamination fears, along with many of the aforementioned obsessions/compulsions continued, however I also began to experience intrusive thoughts of causing harm to others on ‘purpose’, with ‘intent’. Prior to this, all my thoughts of causing harm to people were via carelessness and by accident i.e. forgetting to turn off the gas tap on the cooker, causing an explosion. This was precipitated by difficulties/arguments I was having with a therapist at the time. It began with having intrusive thoughts of causing harm to her on purpose specifically, however it soon generalised and extended to basically everyone I passed/encountered during the course of my day.
The thoughts of causing harm ‘intentionally’ were more or less the same as those I had experienced when the thought/intrusion was that I may do so accidently. For example, by infecting them with HIV, causing them to slip and break their neck, kicking nails or sharp pieces of glass/shrapnel at car tires to cause an accident. Causing food poisoning or Anaphylaxis – especially with nuts. Hitting them with golf balls. Shouting or making loud noises to scare people and cause a fatal heart attack. Causing car accidents by distracting the driver etc.
I would often avoid people, or situations which were likely to bring such thoughts to mind. I would try to supress the thoughts, in an attempt to prevent them from entering my mind. I would argue with the thoughts, getting into a debate with them, trying to prove to myself that I did not mean them. I would repeat certain phrases or mantras in my mind in order to neutralise/eradicate/cancel out the bad thoughts I was having. If I felt I had harmed someone, I would often revisit the place/site where I felt I had hurt them, and check to see if they were there and hurt or dead. A number of times I spoke to the police on the phone, or went down to the station, to confess to what I thought I had done, and turn myself in.
Over the last couple of years, 2015-2017
Many of the thoughts/intrusions I have spoken about already, are still present, and something I battle with on a daily basis e.g. the thoughts that I am homosexual, a paedophile, that I want to harm/kill people. However quite a few new ones have arisen.
Triggers – Various things I have read, or watched, seen, experienced, or heard. Sometimes there is no stimulus or trigger, a random intrusive thought just enters my mind and it begins to obsess/worry and run with it.
Symptoms - obsession/avoidance/compulsion/ritual
Intrusive thoughts that I am/want to:
In response to these thoughts, again, as with other similar thoughts, I have often found myself trying to supress them, and prevent them from entering my mind, repeating certain phrases/mantras to cancel out/neutralise the bad thoughts, engaging in argument/debate in an attempt to convince myself that I don’t believe or mean them (the thoughts), avoiding situations which are likely to arouse/awaken such thoughts, asking family members and friends for reassurance, (that I am not in fact any of the above things, and that I don’t want to, and won’t, act on any of the thoughts I have). I also avoid people for fear that I may harm them, to the point where I didn’t leave my house for 8 months.