Who doesn’t like those fun quizzes you see on Facebook? You know the ones I’m talking about: What color is your personality? What type of pizza are you? Which Parks & Recreation character are you? By the way, I’m purple, cheese pizza, and Leslie Knope. But today, I stumbled across a particularly interesting quiz: How OCD are you?
The problem with this is that Obsessive-Compulsive Disorder is a mental illness and not a personality trait, yet we like to label people as “OCD” when they are simply organized and attentive to detail. This illness is not synonymous with these types of personality traits because OCD is dysfunctional and causes great emotional distress, while being organized and attentive to detail does not hinder one’s functioning. What the quiz should have asked was “How attentive to detail are you?”
To the left are the results I got from the quiz. I can assure you that I am attentive to detail, as I am a photographer and interior designer. However, I am not a perfectionist, nor am I a particularly organized person. Just look at my room in the photo to the right. You should see the entire closet. (To be honest, I’m slipping into a depressive episode which means my room is unusually messy, so you only get a shot of the less embarrassing side of it).
People don’t understand that OCD is not about being a perfectionist or viewing the correction of inaccuracies as “important.” OCD is a debilitating anxiety disorder that is much more complicated than our normalization of it makes it seem. What happens is someone experiences obsessions, or intrusive thoughts/mental images, that then cause severe anxiety. The individual with OCD will then perform a compulsion, which is a behavioral ritual that relieves the anxiety. The compulsion may be congruent with what the obsession is. For example, if someone obsesses about germs crawling on them, they may feel the need to wash their hands every ten minutes. They may not be able to concentrate on anything else until they give into their compulsion and relieve that anxiety. Compulsions can also be incongruent, meaning they don’t necessarily “solve” the problem that the obsessive thoughts are about, but simply relieve the anxiety the obsessive thoughts are triggering. For example, someone may irrationally obsess over whether or not a loved one will die, but relieve the anxiety by pulling their hair out. The issue with OCD is that the compulsion never permanently gets rid of the anxiety and the OCD cycle becomes faster and more debilitating the longer it goes untreated.
Additionally, not everyone’s OCD is visible, meaning their compulsions are strictly cognitive. This is what is known as Pure-Obsessional OCD, which is the form of OCD I was diagnosed with about 18 months ago. This means I have unwanted, intrusive, and disturbing thoughts/images that pop into my head throughout the day that trigger my anxiety and I absolutely obsess over them. Unfortunately, I do not yet feel comfortable going into detail about my own experience with obsessive thoughts because it is disturbing and I know it will be judged because the themes are so dark, making the disorder easily misunderstood. However, a common thought/image that people have with this illness may be the thought of harming another person. What sets this thought apart from homicidal ideation is that the disturbing, and often vivid, thought/image causes extreme anxiety because it is incongruent with what the person wants to do. Let me give you an example of the train of thought that a person with Pure-O OCD may experience after an image pops into their head of them stabbing someone.
I don’t want to do that stop thinking about it. I don’t want to do that. I said I don’t want to fucking do that. What if I am a murderer. I am not a murderer, I’ve never wanted to kill anyone. I’m not a murderer. But what if I am. I used to play those fighting games on Playstation when I was a kid and would get excited when I killed my opponent. I bet that was an early warning sign. That shouldn’t have made me happy. I don’t want to be around people ever again. I don’t want to be a murderer. What if I do kill them or something. Even if it’s on accident. I don’t want to hurt anyone. Why would I have this thought though? I must be a murderer. Why else would I have it? Should I call the police? I don’t want to be in prison. I don’t think I would kill anyone. What if I’m on the brink of insanity and then I kill someone? Maybe this is a warning sign that I am going to become a murderer. Nobody will love me anymore if I kill someone. What if I kill someone I love. I can’t stand to look at the scissors on my desk. I need to get them out of here. Maybe I can give them to a friend to hold onto. But then they’ll think I’m murderer. I AM NOT A MURDERER. I AM NOT A MURDERER. I AM NOT A MURDERER. I DON’T WANT TO KILL ANYONE. IT WAS JUST AN IMAGE. But what if it’s more than that. One time I felt really angry and said I wanted to kill someone. I didn’t think I meant it, but did I? Maybe I meant it. Maybe I will say that again and mean it and do it. Okay, okay, let me look up signs of being homicidal. I can’t find many signs of being homicidal. How do I know if I’m homicidal? I’ll look at the person walking outside of my window to see if I get the urge to kill them… okay, I don’t think I did. But what if I do another time? What if I am just in denial and actually do want to murder them? I can’t go to work today. I can’t be seen like this. I am a murderer and am not hurting anyone today. Even just seeing people triggers the thoughts. I don’t want to kill them. I don’t want anyone to see me. I wish I would die.
So, there are many cognitive compulsions in the above example, but two that I often experience are:
- Checking behavior. In this situation, the person looked online for warning signs and looked at the person outside to test their thoughts. The problem with this is it does not always relieve anxiety and in fact, the individual may convince themselves that they have those warning signs even when they do not.
- Looking for past evidence. In this example, the person viewed playing the PlayStation game and being angry with someone before as evidence of them being a murderer. The problem with this that we are in a panic and view our past experiences in a skewed way; in a way that actually supports the obsessive thoughts, even if the actual event is not supportive of the thoughts at all.
There are several common obsessions people with Pure-O have, some of which include (1) the obsessive fear of harming someone, (2) the obsessive fear of molesting a child, and (3) the obsessive fear of committing sin or engaging in a sacrilegious act. Of course, there are many more and everyone’s looks different. In fact, most people with Pure-O have a default obsession, but experience others from time-to-time. When I was hospitalized after just developing the disorder, the intake social worker told me that he works with a lot of clients who have this particular illness. Something he said that stuck with me is that people with OCD are usually the most gentle and loving people, even when they have the most disturbing thoughts.