by Mairead Ruane
As I grew from child into teenager, the seeds of dreaded doubt that had lived within me for as long as I can remember grew into gnarled branches wrapping around me for the next 8 years, tugging me further down into the rigid roots of the ‘doubting disease’— OCD. At my darkest moments, it wrapped itself so tightly around my young body that I felt strangled by my thoughts. I spent eight years either believing the critical voice that told me I was bad, or obsessively trying to figure out why my internal critic told me this every minute of every day. I was in fact suffering with one of the top ten most disabling illnesses, OCD, along with 1.2% of the population (regardless of age, race, gender, social or cultural background).
The taboo, stigma and ridicule surrounding OCD has led to many sufferers not realising that the debilitating distress we are suffering is a result of this disease. How could we know when there are no authentic representations of OCD? It is represented as a hand-washing, light-switching, oven-checking disease and casually used as an adjective-slur — ‘a bit OCD’. ‘Obsessive-compulsive cleaners’ shows sufferers cleaning the living daylight out of kitchens (so debilitating) when OCD in fact forces its sufferers to watch their nightmares play out in their minds. OCD has the power to leave a sufferer so distressed that you question your very sense of self. As a sufferer, it feels intolerable to live inside your own brain. You feel constantly endangered by your own thoughts and are held captive by them until you ‘clean’ them away. ‘Cleaning’ can take many forms, from internal rumination to physical scrubbing. With my form of OCD, Pure O (standing for purely obsessional) the compulsions are primarily internal and invisible to the outside world, making it more difficult for the OCD to be spotted by the Pure O sufferer or their family and friends.
Regardless of theme or content, I felt the need to wash away every intrusive thought: to fight it, to get rid of it, and the only way I knew how was through my internal compulsions. These took the form of reassurance-seeking and mental rumination, whereby I would torture myself with unsolvable questions like “why did I think that, it must mean something bad about me, no ‘normal’ person would have that image, is it connected to something in my past, am I capable of doing that? How can I prove or disprove this? What could I do to gain 100% certainty?”— the answer to which, is of course, nothing. No one of us can ever gain 100% certainty about ourselves, but OCD sufferers seek this to the point of their own destruction.
All people suffer with intrusive thoughts, but whilst a non-OCD sufferer can shrug off the occasional odd thought, an OCD sufferer’s hypersensitive state means that our brains overreact to the thought and form an association between the intrusive thought-image and distressed reaction. As the brain creates these associations, it changes the neuroplasticity (neural pathways) forming ‘routes’ that then become more habitual with every thought and reaction. Without any OCD treatment, the only way sufferers know how to fight away our anxiety is by compulsively trying to get rid of, or ‘censor’, our thoughts. Whilst compulsions offer a short-term easing of pain (similar to the effect of heroin for a drug addict) the more a sufferer tries to fight the thoughts, the stronger associations become, catalysing more graphic and distressing thoughts and driving the downwards spiral. As an untreated sufferer of OCD you live in a state of anxiety, believing you are an unworthy and evil person for having ‘bad’ thoughts. In reality, an OCD sufferer is an attuned, hypersensitive individual who feels, thinks and cares so much it is overwhelming. Intrusive thoughts only represent what we are most frightened about in this world. So, if you were wondering, an OCD sufferer is the safest person to be around and the least likely to act upon anything that is a danger to others.
A friend of mine and fellow sufferer explained his personal experience: “OCD gets worse with stress, last year I had just started a new job and the themes that had plagued me in the past came back with a bang. These distressing thoughts included violent or sexual thoughts about people I care about, contamination fears leading to eating problems, compulsive hand-washing, health fears, fears regarding my appearance and fears surrounding driving. One day, I had just left work stressed, as I was travelling along the dual carriageway at 50mph, ‘bang’ a thought came in— imagine driving into an opposite car. I started to panic and had an anxiety attack. I started to cry as I was driving and wondered why this happened to me. I thought I couldn't cope but manage to drive home. Every time I got in my car after, I thought I was going to drive into someone. Even as a passenger, I would be worried I was going to push the steering wheel and the more I fought it, I more I thought I must be evil and that I might end up killing someone and go to jail.”
You may be questioning why sufferers are so stuck on distressing thoughts. Are OCD sufferers simply bad people in denial? Don’t worry, I plagued myself with this same question throughout my adolescence. The answer is the amygdala. When an intrusive thought appears in an OCD-affected brain, the amygdala (the fight-or-flight switch in the brain) misfires: the switch turns on and causes the sufferer to feel endangered through physiological processes, such as sweating or a fastened heart rate. This feeds the OCD by confirming to the sufferer that our thoughts are dangerous. The disease is therefore physically as well as mentally debilitating, confirming why it is crucial that OCD sufferers seek treatment regardless of how long they have been suffering.
Helpful treatment is excruciatingly difficult to access and can be a triggering process in itself. OCD convinces you that your GP will think the thoughts are true and that you are a danger. Sadly, many GPs aren’t adequately trained and every time I attempted to receive help, I would leave feeling more helpless, broken and confused. Traditional counselling can be damaging as it can fuel the OCD by paying further attention to analysis of the insignificant obsessions, which inevitably change over time. Common CBT practice alone cannot lead to recovery, as one cannot cognitively teach the amygdala or ‘outlogic’ the OCD; it must be behaviourally taught through ERP— Exposure Response Prevention. With ERP, you learn to accept that the amygdala will switch on when triggered by OCD, causing overwhelming anxiety. You teach yourself to sit through it, avoiding censorship and after 30 minutes the anxiety decreases. The amygdala is behaviourally shown that the thought-association is not actually dangerous and is simply just a thought.
We are not our thoughts.
100% of humans receive intrusive thoughts. We can learn to view them not as dangerous but as insignificant as they are not actions. We can actually learn to laugh at our thoughts and thank our creative imaginations.
“OCD stopped me from living the life I wanted to but I have learnt all these thoughts, urges and images are normal to an OCD sufferer, and with the right treatment you can start to take your life back from the OCD strangle.”— Scott
OCD Action: 0845 390 6232
OCD Treatment Centre: 01823 619374 (for a 20 minute free consultation)
Websites I found helpful:
Featured Image Credits: Artallery https://www.zealous.co/mandypurchase%2Fproject%2FOCD-Mind%2F&fbclid=IwAR1q69wEadGerBXpfoJmGqLOewl8FwrJCMjokawebwqjWEZXq_7u72guysI