Friday, May 29, 2015

Life with an anxiety disorder - Part VII: Obsessive-compulsive disorder

Last in the collection of anxiety issues I have personal experience with is obsessive-compulsive disorder. It is not nearly as pronounced or bothersome as my social anxiety or my somatoform autonomic dysfunction, but it is still a key puzzle piece of the big picture of what goes on in my mind, anxiety-wise. Perhaps some of you are familiar with some of it through various media, including that film with Jack Nicholson, but reality is often different from popular perception. 

As the name implies, OCD is split into two main components: Obsessive thoughts and compulsive actions. The latter is what you'll find popularised in mainstream depiction. People suffering from that component of the disorder are forced to constantly repeat certain rituals individual to the afflicted. This may include washing your hands after every time they are used, or checking whether the door is locked a particular number of times, or locking it a particular number of times, or arranging your silverware a particular way before eating, and so forth. This is generally for the afflicted to feel safe from whatever impending doom he associates with that ritual happening.  Psychologists call it "magical thinking", if I recall correctly, meaning there's a certain magical effect associated with the rituals. And that only performing them correctly and every time will allow the magic to work. 

Personally I don't really deal with any of that sort of stuff. I'm an obsessive thoughts kind of guy. Most OCD people have both types of symptoms, one more than the other, but for me the obsessive part absolutely dominates. It's some of the most bizarre stuff that goes on in my head, and the only reason I don't consider it a major issue is how relatively rarely it happens and how easily it goes away when it occurs. 

Obsessive thoughts aren't really what you'd think at first when hearing the term, having certain thoughts that you obsess over for extended periods of time. That would be ruminating. They're thoughts that just shoot into your head and kind of force themselves into you against your will. It pretty much always is deeply disturbing stuff. It goes against all your moral values, everything you stand for in a profound way. A psychiatrist once told me obsessive thoughts are pretty much the exact opposite of what the person experiencing them actually believes, and it seems quite true to me. 

Examples of obsessive thoughts include situations in which I ride my bicycle and a truck comes the other way and suddenly I have the thought of steering my bike (and myself) in front of the truck. Or jumping when I'm in a high place. Those are self-harm related thoughts. I also get a lot about harming others, such as the thought of kicking a child in the face when I see one. It gets a lot darker and more disturbing than that, but I'm not comfortable putting that in public. There are thoughts about taking off all my clothes and/or jacking off in public as well. All kinds of thoughts that just force themselves into your head against your will and make you think you're some sick, crazy sociopath. 

It's often not easy to talk about, because this stuff is so disturbing, and what gets you in particular is the nagging feeling that they are manifestations of someone you really are subconsciously. But as I said, they are not. They're the exact opposite. That's OCD. Someone has yet to explain to me what exactly causes these thoughts. Because it has never been a major issue to me I have never researched it. But I do know that obsessive thoughts in no way represent you as a person, and that technically, if you have them, you shouldn't think of yourself as the new Jack the Ripper, or whatever your thoughts are. 

I say "technically" because it isn't easy. For a long time I was deeply concerned about this stuff going on inside my head, and every time one of these obsessive thoughts occurred I used to grimace and try to force it out of my head. And there was a lot of shame about what kind of monster I thought I was. It wasn't until I got a little more information on what OCD is and how common it is that the shame started to subside a little. More so over time. I still hated the thoughts and tried everything to make them go away, which was an extremely stressful situation and only seemed to make it worse. 

In the end, a psychotherapist told me that trying to force obsessive thoughts to stop indeed makes them worse, because it gives your brain the information that these thoughts are extremely important and the neural connections for them need to be maintained and strengthened because they are so important. What actually does help is what some of you have learned or will learn in mindfulness exercises: Let the thoughts come, let them happen, know what they are, don't judge them or assign value to them, and just let them pass. May seem like an impossible task at first, but it's really very easy, and I can attest to that helping a lot in reducing frequency and especially severity of obsessive thoughts. Simple psychological trick that worked miracles for me. 

Yes, these thoughts can still be bothersome and disturbing sometimes, and there are still moments when I think I'm some kind of monster, but it really improved a lot, to the point that I consider OCD the least of my worries. But it's still up there and still a part of myself, probably interacting with my other issues to some degree. Will be interesting to see if I can ever fully get rid of it.

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