Challenging Misconceptions and Rewriting the Narrative
Obsessive-Compulsive Disorder (OCD), is misrepresented, misunderstood, and difficult for those who experience it. As a part of OCD Awareness Week this week from October 13th-19th, it is important to shed light on OCD because your knowledge can make a difference in changing the incorrect narrative around the disorder.
What do you think of when you hear the term OCD?
Most individuals may think of characters in TV shows such as Monica Geller in Friends or scenes from The Office, where Jim plays a prank on Dwight, who claims Jim is "messing with his OCD." Or they hear celebrities like Khloe Kardashian label herself as OCD because of her kitchen organization. The fact is that portrayals like these reduce OCD to more of a mere annoyance or quirky habit rather than a serious and, for some, debilitating mental health disorder. These examples show OCD as a punchline, which can trivialize the disorder, making it difficult for those who do experience it to feel validated and supported to disclose their symptoms.
According to the DSM-V-TR, which is the diagnostic manual used by mental health professionals, OCD is described as the presence of obsessions and/or compulsions:
“Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”
An important note is that obsessions and compulsions often take up a considerable amount of time and can impact functioning at school, work, and relationships. Individuals may also avoid certain environments for fear of exposure to obsessions or compulsions. This leads to one of the most valuable points in this disorder: fear. OCD drives individuals into thinking that something terrible will happen to themselves or others if they do not act on their compulsions and anxiety of what can not be controlled with an attempt to do so in their environment.
This occurs because OCD attacks what is important to you.
Obsessions
Individuals may experience a range of obsession categories or subtypes, often overlapping and not limited to just one. While there are many potential obsessions one may have, here are a few:
Contamination obsessions: Fears of germs, dirt, or illness, leading to excessive cleaning or avoidance of perceived contaminated objects or places.
Harm and violence obsessions: Intrusive thoughts about causing harm to oneself or others
Relationship obsessions: Doubts about the stability or fidelity of a relationship
Gender identity and sexual orientation obsessions: Doubts or fears questioning gender identity and sexual orientation
Moral or religious obsessions: Intrusive thoughts about being immoral or sinful
“Just right” and perfectionism obsessions: An overwhelming need for things to feel "just right" and causing distress when things feel disorganized or incomplete.
Postpartum obsessions: Intrusive thoughts related to the health and safety of a newborn
An important note is that everyone has intrusive thoughts. However, with OCD, these thoughts become inescapable. The OCD cycle typically begins when an individual encounters a distressing thought, which triggers feelings of anxiety, fear, or disgust. To alleviate this discomfort, they may engage in a compulsion, but this relief is only temporary, leading them back to the same distressing thoughts and starting the cycle over again.
Compulsions
Compulsions are often enacted in response to the obsessions. These are often preformed to give relief to the individual, but again, it is temporary. Common compulsions can include:
Cleaning and Washing:
Excessive hand washing, showering, or cleaning of personal items.
Checking:
Repeatedly checking if doors are locked, appliances are turned off, or items are in their proper place.
Mental Checking:
Checking one’s “true” feelings through bodily sensations
Seeking Reassurance:
Relying on others to validate beliefs or actions
(While not intentional, if loved ones provide reassurance to someone with OCD, this can encourage the behavior to continue)
Counting, Arranging, or Organizing:
Arranging or counting objects, steps, or repetitions of actions in a particular order and redoing it until it feels “just right” or to prevent something from happening.
Mental Compulsions:
Repeating specific phrases or prayers silently to prevent a feared event.
Mentally counting or reviewing events to ensure nothing has gone wrong.
Ruminating: Attempts to solve an obsession through mentally analyzing thoughts
Avoidance:
Avoiding certain places, people, or situations that trigger obsessions.
Steering clear of specific objects or activities to prevent distressing thoughts.
OCD cannot be confined to a single category; it encompasses a wide range of obsessions and/or compulsions that vary greatly among individuals. While contamination fears are a well-known subtype from the societal narrative, the disorder also includes many themes. Each person's experience with OCD is unique, reflecting the diverse ways the disorder can present.
This complexity underscores the importance of understanding OCD beyond a singular narrative. Recognizing the various forms it can take not only helps reduce stigma but also emphasizes the need for tailored support and treatment approaches for those affected. By acknowledging the multifaceted nature of OCD, we can foster greater empathy and awareness for individuals navigating this challenging disorder.
By Lily Quist
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