[Numbers in square brackets refer to the notes given after each paragraph]
This page is a description of my own OCD [1] (and a little on BDD [2]) and some strategies that I have used to deal with them - often successfully. If you are reading this as a fellow sufferer of OCD, and even if your own OCD takes a different form to mine, the strategies may still be very helpful to you. My story shows how my OCD turned into the form that it has today.
[1] OCD = Obsessive Compulsive Disorder.
[2] BDD = Body Dysmorphic Disorder.
I have mainly 'pure-O' [3] OCD centred on doubts about whether I have harmed someone, or done something shameful in the past. The doubts come from intrusive bad thoughts (e.g. of hurting someone in the street, on a train, in a shop, etc.) and then worrying whether or not the thoughts were true (i.e. were my thoughts a memory of actually doing it?). In searching in books and on-line for accounts of other people's OCD, I find some symptoms that I don't personally relate to, but some that I do. When I do find a match to my own OCD I feel a sense of relief that I am not alone. For this reason, I hope that other OCD sufferers can gain something from this page. The content of OCD thoughts is very distressing and sufferers often fear that their worries (especially with regard to intrusive thoughts about harm, crime, and sex) will be misinterpreted if they admitted to having them. This is partly why I have decided to write this piece. There is nothing wrong with having any kind of intrusive thought no matter how 'bad' / 'violent' / 'disgusting' / 'perverted' it is. Thoughts of all kinds pop into everyone's mind spontaneously and the content of intrusive thoughts says little about the sort of person you are [4].
[3] Pure 'O' OCD is where the obsessions and the compulsions are thoughts (e.g. obsession = 'Did that thought of hitting that old lady mean I did hit her?'; compulsion = 'I must try to relive the past thought to see if I can work out whether it was real or not).
[4] In fact, a person who has frequent intrusive thoughts of harming people and is who troubled by the thoughts (by definition, intrusive thoughts are unwanted and troublesome) is someone who is likely to be a very gentle person. This is by the very fact that he or she doesn't like having the thoughts.
OCD centres on what an individual finds disturbing. My own gut-wrenching worry is that I am wanted by the police for a crime that I think that I may have committed. Most people might say that the way to avoid this is to be a good law-abiding citizen. This is true, but unfortunately for me, and even though I do my utmost to be law-abiding, my OCD has a way of making me believe that I may have committed a crime, which puts me into a highly unsettled state of worry.
The worst crimes that I can think of are murder, physical assault and sexual assault, especially of a child. These are acts that I find very disturbing. I also have fears that I may inadvertently come across child pornography on the internet. I wish to emphasize strongly here that all these things are abhorrent to me as I wish no harm on anyone - man, woman or child and I do not wish to look at any pornography [5]. Yet I often suffer from an overwhelming doubt that I may be 'guilty' of these acts. How does this happen?
[5] I don't wish to belittle anyone who does view legal pornography - if the subjects of the pornography freely and legally consent and no one is harmed then it's fine.
My OCD thoughts were originally not about whether I had harmed someone. Instead I was worried that I had accidentally scratched a car as I walked past it, or I had left a tap running, or I had left a door unlocked. For example I would check a door was locked, but the imp [6] in my imagination would unlock the door. In my mind I would actually see and feel my arm moving to unlock the door. This would lead to a checking cycle:
Check the door: yes I can see it is locked.
The imp in my imagination would then 'unlock' the door.
I would then ask myself, "Was this just a thought or did I unlock the door in reality?" The result of doing 1 is now invalid as I am no longer sure that the door is locked.
Return to 1.
Despite years of dealing with this annoying imp, my mind would never truly trust that the imp wasn't real. I would believe - even without a shred of evidence [7] - that my imp might be controlling my body to do things that I did not want to do. This is an example of something that psychologists call thought-action fusion. This leads to classic OCD, where the 'obsession' is the imp thought and the 'compulsion' is the excessive checking.
[6] The 'imp' is a useful metaphor for the part of my imagination that tries to torment me by doing the opposite of what I want. I have no control over the imp. Having an imp that acts in this way is thought to be a common human attribute, but the imp holds more power over some people's thoughts than others. The idea originates from 'The Imp of the Mind, Exploring the epidemic of obsessive bad thoughts' by Lee Baer.
[7] In fact 100% of evidence supports the fact that my imp has no control over my actions (100% is not a figure that has been rounded up - it is exactly 100%). Although I am scientist by profession, where evidence means everything, just the very idea that the imp might control my actions highlights the power that OCD has over me.
The starting of these imp thoughts coincided with a stage in my life when I began to take on personal responsibility and wanted to earn respect from my teachers (I was about 14 years old). This is important because failing to listen to my imp felt like I was being irresponsible.
When I got to 16 years old I started to see myself as physically unattractive. I was very envious of how other guys looked - with their trendy hair and clothes, and their admiring female companions. At school I was known as "The Alien", "Mr. Puniverse" and I was the guy many of the girls used as a joke subject of attraction. I used to compare myself with other guys obsessively to the point that I wouldn't even notice girls in the room (this was at a time in my life when I should really have been 'obsessed' with girls!) I just wanted to be like the other guys. That was the only thing I wanted. To be thought of as a desirable male and have female attention was my main concern in life. Without feeling attractive, life seemed meaningless. In fact I would say that without feeling attractive it was as though my sexuality was switched off [8]. I don't know whether I did, strictly speaking, have the condition BDD (I think that you have to have imagined appearance flaws to qualify), but I was certainly under a lot of pressure with image problems. This pressure is with me to this day - many decades on - I still don't feel good looking enough to have a partner. I still have no sexual interest from anyone, which I suppose confirms my beliefs [9].
I mention all of this here because I think that this 'BDD' played an important role in the development of my OCD.
[8] Psychologists talk about having low self-esteem and the advice often was to ask girls out to see what the reaction was or to focus on the things that I could offer a partner. The thing is that, for some reason, having a girlfriend is completely meaningless to me unless I have good looks to offer her. Without that my own sexuality is dead.
[9] To be honest I think that's not a completely bad thing in the bigger picture, as I don't want to be responsible for fathering children that inherit my faults and I don't want to contribute to population growth which is a huge problem facing humanity.
During my late teens and twenties, my appearance ruled my life, but my sub-clinical OCD was not a major problem. My OCD was just an inconvenience (e.g. locking-up a house or office alone would take a while). But my 'imp' thoughts started to slowly shift from unlocking doors to harming people. How? At university, one of my memories is reading a personal safety leaflet for students about the dangers of walking alone at night. Lone women (e.g. on their way home), as it said, are probably the most vulnerable from being attacked. In the safety leaflet the advice to men who encountered lone women is to keep a distance, so that the woman would not feel threatened. Before long I found myself walking at night and had encountered a lone woman. Promptly I crossed the road to avoid the woman feeling threatened, but then, out of the blue, I had some intrusive thoughts. What if I were a mugger or a rapist? Accompanying these thoughts were horrible images in my head of me attacking the woman. These thoughts had the same powerful impact on me as the imp did with the door locking. Did I just attack the woman in reality, or was it just my imagination? I had to look over to the woman to check that the thoughts weren't real. Was she running away, was she distressed? No, of course she was OK, so I was reassured that time that the violent thoughts were just in my head.
I don't remember the place or the year of this event, but this was certainly a chain of events that I had experienced. For years I had similar thoughts, but, like the door locking, as long as I could check that the intrusive thoughts weren't real I was confident that they were just in my imagination. Although I didn't know it at the time, these experiences were programming my brain to believe that thoughts could be dangerous and I had to be sure that they weren't. In retrospect I should have predicted that sooner or later I would have a violent intrusive thought that was impossible to check that it was unreal.
Before this were to happen, there was a chain of events reported in the media that shocked me. One event was the Soham murders in 2002 (Soham is a small town close to Cambridge in the Eastern UK). Two girls were murdered by a man who was about my age (at the time late twenties/early thirties). He was the caretaker of the school that the girls had attended. The murders happened in the caretaker's house and I had always presumed that the motive for the murders was to silence the girls for some inappropriate advance that the man had made towards them. I don't know whether this was ever established or not, but the important thing here is that it was on my mind. I had associated paedophiles with older men and this event made me now feel rather paranoid that people were looking at me with suspicion, simply because I am single.
Another significant event was a British newspaper campaign (in the now defunct News of the World) to name-and-shame paedophiles who were living in the community. This seemed to bring out a mob instinct in the public with street parades supporting the killing of paedophiles [10]. What if people think that I am a paedophile? The mental bullying and victimization that I experienced when I was younger, and the way that I felt different from other people (e.g. that I am single and unattractive) made me feel threatened by this campaign and it grated on my paranoia. I felt (and still feel) angry because of the damage that this campaign was to cause me given what my OCD was to turn into.
[10] My view is that all people deserve to be shown humanity, no matter what they have done. I do not believe that all paedophiles are fundamentally evil. Some do have to be punished and kept in check, but they are just like you and me, but with the misfortune of having a sexual orientation that is taboo and with a personality disorder that makes them less likely to be troubled or uninhibited by their actions. Their actions are wrong, but I don't believe that these people choose to be paedophiles and so they deserve compassion.
One day I was surfing the internet in the office. I was working late and I needed a break. I was googling for joke items that I used to find funny as a child. A list of links came up and I clicked on each in turn. Some took me to on-line joke shops, and other links were broken, leading nowhere. Then, all of a sudden (and without any hint from the google list) a link took me to a site filled with pornographic images. This wasn't meant to happen! I panicked and clicked the stop icon, but for some reason that made more browser windows open on the screen [11]. I killed the browser software from the command line. This all happened so quickly that I couldn't recall what the images actually were and I didn't want to go back to the porn site to find out. A day or two later I had a sudden thought, "WHAT IF they were child porn images!". Even though I have absolutely no reason to believe that they were, this uncertainty was horrible. It was my first serious taste of "what if" OCD, which is driven by the need for 100% proof. I had thoughts that I would be arrested and punished: "But I didn't intend for those images to appear officer", would be responded with, "That's what they all say sir, let's just see if the jury believe you.". After several weeks I was finally able to deal with the doubt with my own internal judgment - they can do what ever they want to me, I KNOW THAT I HAD NO INTENT, and that's all that matters. I think that this experience of OCD weakened me psychologically - not only am I alone and unattractive, I now had personal experience of pure fear.
[11] I still to this day don't understand why that happened - perhaps some virus had infected the browser software.
I carried on life as usual until one horrible day that changed my life in a very bad way. I was in a supermarket when a small boy appeared next to me and started to jump up and down so vigorously that no one could ignore him. I wanted him to stop as it was very irritating. Within seconds my imp suddenly awoke. In my thoughts I had reached out and grabbed the child between the legs. Was this just a thought or was it a memory of the imp taking over my body and making me do something that I didn't want to do? I certainly didn't want to touch the child. I will never know for sure why I had this thought, but a compelling hypothesis is that two thoughts had fused in my mind. I had an uncomfortably full bladder at the time and I had an urge to press my own penis to relieve the discomfort. The other thought was to push the child away from me. My intrusive thought of touching the child inappropriately was probably the blending of these two innocent thoughts. I left the supermarket only slightly bothered by the thoughts, but as I approached home I suddenly thought, "Am I a child molester?!". Was the supermarket experience just a thought or was it real? If it were real I would be arrested and become a convicted paedophile, even though I am not that way inclined! My mind became obsessed with the 'incident' and I developed terrible fears of arrest, shame, trial and prison. No one would believe that I had no intent. I realized from research that I was suffering from OCD. I was in such a bad state that I had to see a doctor and a psychologist confirmed my OCD. It was good to have this diagnosis, but it did not ease the terror.
Once this thought happened, it stuck. It was the uncertainty about it that was giving me anxiety. Did I do it or did I not do it? If I did, were the police going to arrest me today, tomorrow, next week, next year, 20 years time? I had two nervous breakdowns about these doubts and suffered for nearly four years with the crippling doubts and fears. What ended the doubts was the decision to ask the police if any incident had been reported. This was a very bold step to take for me [12], but I had help (although quite irregular help) from one psychologist. Once it has been established that no incident had happened, the gloom lifted almost immediately and I became my old self again ... until the next time the imp struck.
[12] I had to decide how to explain to a police officer that I think that I may have done something terrible, without wanting to, and without him being suspicious that I was just trying to find out if I had 'got away with it'. One police officer never got back, and another did respond. Even with that reassurance my OCD wanted to tell me that the police check hadn't been done correctly. I am extremely grateful to the police officers who have helped me over the years.
This was just the first of a whole string of 'incidents' that caused me distress (and more breakdowns) that I suffer with to this day. Once intense fear is experienced by having these intrusive thoughts, the mind invents more of these thoughts [13]. Some thoughts have a 'sexual' content (for want of a better term, since there is no sexual desire) of assaults of adults and children, and others have a violent content (again with no violent desire). I have become so afraid of these thoughts that the imp makes more of them. Sometimes I get a warning that an intrusive thought is about to come, but trying not to think the thought would make it more intense. Other times I get no warning and an intrusive thought arrives in my head like an explosion going off. My deep fear each time is that the thoughts are a blurry memory of my mind being taken over against my will by some evil force which made me to do something shameful that I did not wish to do.
[13] The increase in frequency of intrusive thoughts associated with fear is just our minds trying to protect us from danger. If you are in a life threatening situation - you are at the end of a gun, e.g., your mind has to have a thought of the gun going off to know that you're in danger - how else would it know that it's a dangerous situation rather than a person just pointing a lump of iron in your direction. In OCD this 'protection' mechanism has become pathological as it is applied to situations that are not dangerous.
Here is the most destructive part of this illness: the more I try to think back in my mind (rumination) in a desperate attempt to find the truth, the more my OCD tells me that I am guilty because it creates a false memory in my head. Also the more I try to do other things to take my mind off of the doubts, the stronger the urge becomes to ruminate. With help from psychologists and over time I can dismiss some thoughts, but for other thoughts I sometimes have the compulsion to ask the police for reassurance that nothing happened. Sometimes the police understand and want to help (for which I am very grateful), other times they treat me as a nuisance (for which I am not grateful).
It is difficult to show how serious this illness is as there is no physical injury or physical disability to show. But OCD has devastated my life. It gives me crippling anxiety, depression and suicidal thoughts. I can't even think about life while I'm experiencing a serious OCD doubt (my OCD mind is sending me a message that makes me think that I am a criminal and this message is so loud and decisive that my own logic can't compete with it). Trying to get on with life while in this mode is torture.
What is the treatment for these obsessive 'pure-O' doubts? One treatment for this kind of OCD is along similar lines to that used for the more conventional kinds of OCD where the compulsions are more overt. This is exposure and response prevention (ERP). This means I need to practise exposure to the troublesome thoughts but I must not respond to them in any way. This kind of exposure sometimes includes putting bad thoughts in my head on purpose without checking that they have any kind of harmful consequence. The key idea is to let the doubts be there and carry on with life regardless. This is an easy exercise to set, but it is extremely difficult to do [14]. The expected outcome in time is for the OCD doubts to become less and less troublesome [15] until they don't even bother me at all (even though the original question, e.g. "Did I do it?" is never answered). I believe that the success of this technique lies in my ability to do this to completion.
[14] I believe that the process of a sufferer confronting OCD head-on may well be one of the most difficult things a human can do.
[15] I say “less and less troublesome”, but in reality, progress is never linear and set-backs are almost inevitable.
I have OCD and so my OCD brain will still be urging me strongly to do the mental compulsions. The following is a table of helpful ways of responding to my OCD to encourage me along.
REMEMBER:
I have no choice about the intrusive thoughts that I have - don't punish myself for having them.
I have not got to be sure about anything! I can get better without knowing for sure. It's all about being comfortable with uncertainty.
I am unlikely to feel better immediately - getting better from OCD takes time for the benefits of rest and therapy to sink in to the subconscious parts of the brain that are alerting me to 'danger'.
Every time I try to 'resolve' an OCD thought with logic, my OCD affected brain will try to destroy the argument. Remember that my OCD has hijacked my brain and uses the resources it finds there to do its dirty work.
Act as if I don't have OCD - "fake it" until I "make it".
Take the risk.