I’ll preface this post by saying that none of this constitutes any qualified opinion or advice regarding mental health. I’m mainly putting this out to raise awareness and give people an idea of the lived experience of a misunderstood mental illness. For resources from charities, health bodies and psychologists, please see the bottom of this page. Cheers.
The French call it l’appel du vide, which is a very pretty way of saying ‘the call of the void’. A lot of the best phrases of the English language are French – like de-ja vu, or je ne sais quoi. They make the strange seem sexy, and the morbid sound mystique. Perhaps you’ve heard the call before; you’re somewhere high above ground, nothing but a navel-high barrier between you and a cataclysmic fall to a splatted end. The barrier communicates safety, protection. You grip the wooden banister and feel secure. Then you look down, and suddenly those ground floor tiles seem a whole lot smaller than you remember. And out of the nether of your mind, a thought pops out to you: “Jump.” Of course, your legs wouldn’t really just take control and fling you over the side. Or would they? You recoil from the vertigo, step back from the barrier, shrug off the funny thing that just happened, and carry on with your day.
Nearly all of us get these. They’re called intrusive thoughts. Sometimes you see them coming, most of the time they come crashing into your awareness like a cheap-shot jump-scare in a dim-lit cinema. And just like a jump-scare, the fright they give you is usually short-lived, gone by the moment you’ve landed back in your seat. It’s not that people with OCD are any different for having intrusive thoughts, it’s just that our minds are far less likely to see them as silly throwaways of the brain, and less inclined to let them pass on by.
What starts off as a weekday trip to the art gallery with the sheer drop from the third floor can descend into mental free fall for somebody with OCD. Instead of shrugging it off as most of us tend to do, a person with OCD will rewind the tape in their head. Maybe once, maybe six times if that makes us feel any safer. And we will interrogate it. Did I really just think that? Am I suicidal without even realising it? Can I trust my own emotions? Could my legs really just grab the wheel and fling me to my death without my say-so? Maybe best I avoid that barrier from now on, or any ledge that carries the risk of serious injury for that matter. From now on, I shall keep a six foot berth from any high places – just to be sure.
This is the weird, frightening, and heavily misunderstood world of OCD, or Obsessive Compulsive Disorder. In this case, an Obsession: my body can’t be trusted to not act on its own free will. And a Compulsion: maintaining a distance of 6 feet between me and the danger. The obsession is the threat, the compulsion the safeguard. It’s the perfect plan, because it means that if scary thoughts do rear their pesky heads again, you’ll be prepared. Can’t get a call of the void if I keep away from the barrier. Ha! But things never do go to plan.
See, now I’m in a first year freshers week lecture hall with all my many fellow students, and because I don’t trust that my body won’t do something I really don’t want it to do (my obsession), a new jump-scare thought bubble rises to the surface of my attention. Shout out the word ‘fanny’ at the top of your lungs, it suggests. See I would never do that, but maybe my mouth would in a Freudian Slip of loud enough proportion that everybody in the lecture hall (people I’ve only just met, people I would really prefer to make a good first impression on) would hear. Again: not an unusual intrusive thought to have, but one that people with OCD find impossible to ignore. Hand near-on covering my mouth to muffle any sounds that might burst from my lips, I keep six feet away from the outer column of seats as I make a hasty dash to the exit. Yet by giving into the compulsion to leave, I’ve only made stronger and validated further the threat of my obsession.
This is a fictionalised story of a first encounter with Obsessive Compulsive Disorder, but it’s not too dissimilar to that of my own. Moving away from home, a place of established order, rules, and expectations, I set out to university keen for the chance to set my own schedules and make my own decisions. In all the chaos and newness that my brain had to make sense of at that time, it established a new order, new rules, and new superstitions to protect me from perceived threats.
This is a standard life event for causing OCD to first show its face. Another is having a baby. When your world gets turned upside down for good or for bad, OCD presents itself as the handy little tool for turning it the right way up again and helping you feel in control of things once more. It was always there really – pulling a few strings, lurking in the shadows – but you never noticed it until now. It was latent, like an elastic band pulled back and ready to snap. But its time has now come to take the reins, and to provide the answers now that you don’t have any.
But there’s a fatal flaw in the loop of obsession to compulsion, and it is that it can’t quite predict what tomorrow will throw at you. As such, it never delivers on its promise to make you feel safe and in control. Note that in the example of the art gallery, it wasn’t a fear of heights that was the issue but instead an obsession related to not feeling in control. An obsession differs from a fear because it is not specific, meaning it can mould itself to any given situation.
This constant shape shifting means that compulsions never satisfy their role of alleviating the anxiety, and new ones constantly have to be invented to try and regain control. Like a top-heavy wheel, the loop manages to barrel itself forward on its own worried momentum. The obsession demands the compulsion, and the compulsion fuels the obsession. It’s a brutally efficient engine, and once you find yourself strapped to it it can escalate in terror faster than a runaway train.
Once it had me in its vice, daily life became hazardous and full of near-limitless risk bound only by my wicked imagination. My obsession with losing control spiralled from profanities in lecture halls to a far scarier place. Cutting onions in the presence of a flat mate spawned terrifying images of a bloodbath by my own hands. Driving down the street struck fear into me as I envisaged ploughing my car into a group of pedestrians on the pavement, Grand Theft Auto-style. Walking past a mother pushing a pram on the way to campus cast up a menacing scenario of booting it over and spitting in her face for good measure. The unthinkable became all that I could think about.
All of these mental images were shoved up in my mind’s eye, and there was no way I could turn to look away, nowhere I could run. It was all locked up in my head, and I was trapped inside along with it. This endless procession of unwelcome thoughts was exhausting, paralysing me as avoidance and constant reassurance seeking about my sense of morality (either in my own head, from others, or online) became my only fail-safes for keeping them at bay. Obsessive thoughts torment people with OCD, and they only assert themselves more the harder you try to reason with them or cram them back in their box.
When OCD first established itself, it truly felt as though I was going crazy. And in fact, as its hold on my life got stronger, this is precisely what my obsession with losing control led me to question: could I lose control of my own mind? This idea spun me into strange and muddled territory. Suddenly I was having intrusive thoughts that my best friends were figments of my imagination, carrying out checks that the sound of a bark was accompanied by a nearby dog to make double sure I wasn’t hearing things, and avoiding the letter ‘Z’ because it reminded me too much of the word ‘schizophrenia’. My once faithful strategy of reassurance seeking was now undermined by the creeping doubt that any information I found could easily be dismissed as a hallucination.
The worse part of all this was how it made me feel isolated even from the people I would ordinarily trust to open up to, as I felt I couldn’t share my thoughts with anyone because of how mad they sounded. Even now, with the distance of time, writing openly about any of this is enormously difficult. There’s a sort of duality to how OCD cuts you off from others: on the one hand, I held off from telling people what was bothering me in case they didn’t take it seriously and belittled me as silly and/or pathetic; on the other, I worried that people might think I was a dangerous mental case confessing to my insanity.
This mirrors the inner turmoil faced by OCD sufferers themselves. At least part of you sees the scenarios you invent to scare yourself as absurd (and maybe even darkly funny), while there remains the opposite (and convincing) part of you that is petrified of the possibility of them somehow coming true. All people with OCD fall somewhere on this spectrum of awareness, known as insight, and the tighter the grip it has over your life the more this insight can fade from view, making it harder to distinguish between thought and fact, intentions and fictions.
Your own mind becomes your own worst bully. In George Orwell’s novel 1984 there is a torture chamber called Room 101, and anybody brought into the room for questioning is subjected to uniquely tailored torture techniques – all designed to cater to the torturee’s worst nightmares. I think Room 101 stands as a fitting metaphor for what OCD makes of your own head. It mines it for potential vulnerabilities, picks out your inner-most anxieties, sprays out intrusive thoughts, and eventually finds one that sticks before ramping up the voltage. It has unfettered access to the recesses of your mind, and it exploits this to sustain itself. Like a captive who develops Stockholm Syndrome, you can gradually come to believe that you wouldn’t be able to function without the circular logic that it follows.
Because of this personalised nature OCD can take on an array of different forms, with each person that suffers from it a unique mental petri dish for the disorder to grow. In saying this, there are a handful of common ‘themes’ that many obsessions can fall under. These include: an obsession with losing control (one of the ones I have), an obsession with harming others through negligence, obsessions of perfectionism, religious obsessions, sexual obsessions, relationship obsessions, or the popularly known theme of contamination (with its associated compulsions of handwashing and cleaning).
As if all that weren’t confusing enough somebody with OCD tends to rarely be limited to just one theme, but can be affected by several of them all at once. These often interlock, layer over themselves and bounce ideas off one another to create new webs of worry. To keep our heads above water amid this swell of anxiety, people with OCD have to resort to equally complicated rituals of compulsions which in the worst cases can occupy most of someone’s day and severely jeopardise their relationships and wellbeing.
These rituals can be physical or mental, visible or invisible to others. Typical compulsions can include any combination of reassurance seeking, ruminating, checking, rulemaking, aligning, systematising, counting, arranging, cleaning, avoiding, hoarding, repeating, and the saying of mantras or prayers. Just as with our obsessions, so too are sufferers often well aware that our compulsions are damaging and in most cases counter-productive. Yet like an itch that simply demands to be scratched, it can be impossible to resist completing them. Even activities that start off as healthier alternatives to your rituals can swiftly be corrupted by the influence of OCD; when I tried my hand at meditation to make peace with my obsessions, remaining ‘present’ soon became subtly hijacked as a fresh form of compulsive behaviour.
Given the colourful ways that OCD can manifest, it’s little wonder that it remains so misunderstood within popular culture. When people think of OCD, they think hand-washing, meticulous cleaning and neatness. They associate it with appreciating symmetry, liking things to be in the right place and colour-coded wardrobes. They prefer the television volume being in multiples of five, and openly proclaim themselves ‘so OCD’ as if it’s a quirky descriptor. Our culture has fastened on to a small handful of highly visible compulsions as its stereotype of what OCD looks like, divorcing them entirely from the dark obsessions that these behaviours wouldn’t exist without. These misconceptions don’t necessarily come from a bad place, but the compulsions of those of us who live with OCD very much do.
People don’t seem to realise that something as innocent-seeming as rigorously ordering and re-ordering the cupboard by sell-by-date could be motivated by a person’s belief that neglecting to do so would result in the fatal poisoning of their own children. Folk simply aren’t aware that it’s not the germs someone is trying to scrub away in the sink but the nightmare imagery of a loved one on a hospital ventilator. There’s almost no awareness that obscured behind someone’s immaculate desk lay out might be a crippling fixation on failure that leaves them unable to complete basic tasks. How could there really be any understanding of this at all when there remains a mountain of stigma that prevents sufferers from speaking out about the often horrifying, often bizarre obsessions that captivate their daily lives.
You might be tempted to think that the controversy around using OCD as an adjective – as in, “I’m so O[bsessive] C[ompulsive] D[isorder]” – isn’t that big of a deal, but these words matter. The average person with OCD takes about 14 to 17 years to seek treatment. Lots of that time will be spent, as it was with me, totally unaware that the barrage of intrusive imagery isn’t some window into the soul of your personality but a normal and treatable mental illness. When I first despairingly googled ‘how to stop bad thoughts you don’t want’ back in first year and followed the rabbit hole to the OCD-UK website, I flat out denied that this could be a possibility. I shared with everyone else the view that OCD was squeaky-clean countertops, alphabetised vinyl collections and hoovering up crumbs. I reckon I would have admitted to myself that I had a problem and gone to the GP a lot sooner had I known the messier truth.
There’s been a good deal of scientific investigation into exactly what causes the brain to shout ‘Jump!’ at you as you peer over ledges. What’s the purpose of these intrusive thoughts that barge their way into our heads, and what do they say about human nature and the mind? Research suggests they’re probably a misinterpretation of an alarm signal, where your brain fires out a warning message to be careful that gets misheard by your conscious mind as an attempted command. I often think about what those findings mean for the atrocious things that fill my head. Though it’s hard at times, there’s double-edged solace to be found in reminding myself that the reason they bother me so greatly is precisely because of how much I don’t want them to happen. In other words, “an urge to jump affirms the urge to live”. But in reminding myself of this fact, perhaps I’m just carrying out another compulsion.
Words by Charlie Forbes
If you’d like to find out more about OCD (I’ve barely scratched the surface of it here), please do check out some of the resources below:
Scientific American – ‘An Inner Look into the Minds and Brains of People with OCD’
BBC Science Focus – “I still remember the day my brain broke”
VICE – ‘The Many Obsessions That Can Haunt a Person with OCD’
Any of The OCD Stories podcast episodes, though you could start with this one.
The OCD-UK Website
NHS – Obsessive Compulsive Disorder
Mind.org – Obsessive-compulsive disorder (OCD)