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Understanding OCD

As a therapist, one of my specialties is working with those who suffer from Obsessive-Compulsive Disorder. Over time, something that has become like the sound of nails on a chalkboard has been when people flippantly state, “I’m sooo OCD” because they like their home to be clean and orderly or prefer their pizza without olives and will painstakingly pick them off each slice. It’s not uncommon to hear someone say “I’m sooo OCD” without knowing more about the mental illness.

When I ask you to picture someone with OCD, are these the images that come to mind? Someone who is chronically rearranging, ordering, or counting. Or you might even think that you have OCD due to your desire for order and tidiness, or that you developed OCD since the start of the Pandemic—to feel in control in such an out of control world.

But did you know that someone struggling with contamination or symmetry obsessions are only a small subset of those with obsessive-compulsive disorder? And while many of us may prefer order and cleanliness, or are more aware of contamination since the start of the pandemic, it’s just that—a preference or heightened awareness—not a true diagnosable mental illness.

So what exactly is OCD?

The definition is really in the name—it’s someone with a series of obsessions and compulsions where the frequency and severity of the symptoms creates a “disorder”. These obsessions are often thoughts, images, or urges that are unwanted, persistent, and terrifying for the person experiencing them. These obsessions are all-consuming and cause intense distress. Compulsions are repetitive behaviors or mental acts that the person uses to try to suppress or avoid the distress caused by these obsessions. They often become more frequent and change over time as the behaviors that once helped to suppress these distressing thoughts are no longer helpful.

So yes, someone with obsessive-compulsive disorder may have an intense fear of developing an illness so much so that they compulsively clean. But it’s also someone who is riddled with unwanted and intrusive thoughts that may be violent, sexual, or taboo in nature. While these thoughts in and of themselves have no danger of being acted upon, the person may still do anything in their power to suppress them. This could be through overt physical acts like shaking their head or avoiding objects and situations that may trigger the unwanted thoughts. It can also be through mental acts such as counting to neutralize the thoughts or telling themselves “it’s not true” over and over.

I often tell my clients that OCD tends to latch onto the things that we care about the most. Because of this, it may lead to running back into the house for the 5th time to check appliances, in order to ensure that a fire won’t start while your dog is home alone. It’s refusing to hold your new baby because each time you do you have unwanted images of dropping or harming your baby in some way and you want to avoid that at all costs. It’s avoiding using knives because “what if I use it to harm someone I love?” despite everything in you wanting to protect the people you love, not hurt them. 

So when you think of OCD, I also want you to think of the mom who woke up in the middle of the night for the 15th time to check and make sure their baby is still breathing. I want you to think of the person who turned their car around again to check and make sure that bump they felt was actually a pothole, not a person.

Remind yourself of this the next time you’re tempted to say, “I’m sooo OCD” about a quirk you have. Remind yourself that those with OCD are average people who often have the insight to recognize that their compulsions are unwarranted and they desperately want to stop, but the distress in doing so is debilitating and often leaves them feeling helpless. 

But most of all when you think of OCD, I want you to think about the fact that treatment is not only available, it is also very effective. It is possible to live a life where you are no longer constantly reacting to your fears. And as human beings who all deal with our own trials and tribulations, we can all extend our empathy and understanding to that. 

Lisa is a psychotherapist at Elle, specializing in OCD, anxiety, and perinatal mothers. Learn more about her and all our talk therapy services if you are in need of help or know someone else who is.