Have you ever heard someone describe themselves, or someone they know, as ‘a little bit OCD’? Thought so. This phrase has become a lazy way for people to explain their love of neatness, order or hygiene, but it’s hugely offensive to anyone who lives with a diagnosis of OCD (Obsessive Compulsive Disorder), which they must manage day after day, and isn’t something they experience mildly.
We can all help dispel the myth that OCD is a joke. In fact, until sufferers find the right treatment and are able to manage their compulsions, it can be highly debilitating. Let’s put you in the shoes of someone with OCD to show you how.
What is OCD?
Obsessions are recurring thoughts, images or fears connected to danger – either believing you are in danger, or you are a danger to someone else. Importantly, these thoughts are unwanted, but they can last for hours or days at a time. You might be at work, in the supermarket, giving a presentation or on a sunny holiday, but the obsessions don’t care; they appear regardless.
Compulsions are actions or reactions you feel you must take to stop something bad happening to yourself or others. To the outside world, these actions can seem strange and disproportionate, but to you they feel realistic.
People with OCD are driven to extreme lengths to try and stop the obsessions, but these coping mechanisms can often make things worse: for example, you may break all contact with a friend because their brain tells you you’ll physically attack your friend. However, you have no history of attacking your friends, or being violent towards anyone.
What drives the compulsion to break contact is the stream of unwanted thoughts and images of attacking your friend, and the worry that this will come true, despite knowing deep down you aren’t a violent person.
Certain situations, places, objects or images can become a ‘trigger’ for obsessive thoughts. In the case above, OCD makes you believe that seeing or hearing from your friend will trigger obsessive thoughts about attacking them. You might also feel triggered by watching violent scenes on TV and in films, or reading news reports of violent crime.
OCD in Children and Young People
OCD can affect children and young people, but parents, carers and teachers may find it hard to pinpoint, being more likely to assume a child is ‘a worrier’, ‘tidy’ or ‘careful’. The Royal College of Psychiatrists estimates that 130,000 children and young people in the UK may be living with OCD, so it’s nothing to gloss over, especially as many people’s OCD symptoms appear in childhood but aren’t diagnosed until years later.
You may find specific resources for young people useful, such as Ellen’s OCD Blog, which won a Mind Media Award in 2014, or a New York Times article on a mother living with her daughter’s OCD and Tourette’s Syndrome (the two conditions can often coexist).
What is ‘Pure O’?
A lesser-known type of OCD is nicknamed Pure O, where obsessive thoughts are the main symptom, and compulsive behaviour might not be as obvious from the outside. However, it is a misconception to say that Pure O sufferers don’t exhibit compulsions. Some support organisations believe the Pure O label is inappropriate and misleading, and they prefer not to use it, but sufferers often prefer to identify themselves as having Pure O to explain the differences they feel in their condition.
Many people with Pure O have described unwanted thoughts and mental imagery connected to sex – for example, worrying you might become a sexual abuser, experience unwanted and distressing sexual thoughts, cheat on your partner or change your sexual orientation. As with all forms of OCD, these obsessions aren’t driven by facts, but the intensity and frequency of the thoughts makes them seem more plausible. This can be confusing and lead to feelings of guilt, anxiety and stress.
Misconceptions Around OCD
Fear of contamination or illness can be a big obsession for some – but not all – OCD sufferers. You might dread physical contact, being convinced you have a disease; you might avoid hospitals for fear of getting sick; you might stop going to restaurants, convinced you’ll get food poisoning. Yet the popular media image of contamination obsessions is someone repeatedly washing their hands or cleaning their house, and people without mental illness who are known for neatness or hygiene can often be jokingly labelled ‘a little bit OCD’.
To make things worse, there was even a television programme a few years ago called Obsessive Compulsive Cleaners, which matched messy homeowners with people either diagnosed as having OCD or exhibiting traits of it. With the houses being in absolute disarray, and the owners often having hoarding tendencies, the cleaning compulsions were normalised and viewers didn’t see the extreme consequences of living with OCD.
The programme was entertainment-focused and therefore didn’t spend much time discussing the mental health implications of OCD, but depicted it as a skill rather than a debilitating condition. The issue of hoarding, as seen in some of the homeowners, can also be a type of OCD in its own right, but this was also not addressed.
How is OCD Treated?
Cognitive Behavioural Therapy (CBT) is the most common treatment for OCD. It is effective because you are able to analyse your thought patterns and work back to the origins of your thoughts, which can usually be linked to core beliefs you’ve held about yourself for years, if not decades.
Triggers for your OCD can be explored, and your therapist can work on gently adjusting and reducing your compulsions, to be replaced with mentally healthy coping strategies that don’t reinforce your obsessions. Someone who describes themselves as ‘a little bit OCD’ won’t need talking therapy, because their thoughts are fleeting and their so-called OCD cleanliness is a habit, not an unwanted behaviour.
OCD UK suggests you don’t need your therapist to specialise in your particular type of OCD – therapists use techniques that work for any type, and they will tailor CBT to your specific obsessions and compulsions. Because Christine Tizzard Psychology covers a wide range of the UK, including South East England, the Midlands and parts of Northern England, you may find CBT treatment is available closer to home than you thought.
If you or anyone you know can relate to the OCD information described above, don’t hesitate to get in touch with us and arrange an initial consultation, because OCD is a real condition that deserves to be taken seriously.
Written by guest contributor Polly Allen for Dr Chrissie Tizzard, Chartered Consultant Psychologist, PsychD, BSc, MSc, C.Psychol, C.Sci, AFBPS. Dr Tizzard is the Clinical Director of Christine Tizzard Psychology (ctpsy.co.uk).