It goes without saying that most of the general public has a very well-intentioned, yet misguided understanding of obsessive compulsive disorder (OCD). Media tends to portray the experience of struggling with OCD as someone who is simply particular about color coordination, or does not love the idea of touching the door handle in a public restroom. However, OCD is so much more complex and this limited understanding of what it means to struggle with OCD is damaging to us all in the long run.
The OCD Cycle can be broken down into four parts: Trigger, Obsession, Anxiety, & Compulsion. To back up a bit, an obsession is any "What if..." which produces a spike of fear/adrenaline, typically surrounding one or more specific topics. Yes, contamination is a common example, but other common examples include fears surrounding harm, sex, health, relationships, rabies, and driving to name a few. A trigger is anything which prompts the "What if..." to come up (e.g. What if I really want to hurt my partner?). Importantly, triggers can be external or internal: (1) External meaning something that happens around us, something we can see or hear; (2) Internal meaning something that comes from inside, a thought, feeling, memory, etc. The core difference which sets OCD apart from normative errant thoughts or personality quirks is the intense fear and discomfort which accompanies these deeply unwanted thoughts. This is where anxiety comes in.
As beings, generally we hate anxiety. Therefore, we will do anything in our power to get rid of it immediately (i.e. compulsions). The problem with this lies in the understanding that avoidance of our fears only makes them stronger, because we are reinforcing to our brains that the fear was right to begin with, and thus we surely need more and more reminders to keep us as safe as possible. As you may be aware, this provides an incredibly easy opportunity for anxiety to grow exponentially, slowly taking control over our lives. Where at one point it may have been easier to just let someone else chop the vegetables with dinner so you didn't have to worry about hurting someone with the knife, now you may find yourself avoiding the kitchen altogether (perhaps along with any and all objects which may remotely be considered "dangerous"). So, what do OCD and fire drills have in common?
Imagine yourself in a building that has a planned fire drill, possibly your workplace or school. Imagine you are alone when this happens, and no one told you the fire drill was scheduled today. The alarms start blaring - how do you feel? Scared, confused, ready to do anything to get out of a now seemingly burning building? This is how OCD often feels to those struggling: Isolating and emergent.
Through treatment, we take a moment to posit, "Maybe this is only a fire drill" before sprinting out of the building at top speed, instead of repeatedly checking whether or not a drill has been scheduled each day, or without carrying a travel size fire extinguisher everywhere you go. Within the context of OCD (and many other anxiety-based struggles) we can reasonably predict with some confidence whether or not we are actively in danger, or whether OCD has simply convinced us that the building really is on fire despite limited evidence beyond how it feels to be hearing the fire alarm.
The good news: Treatment through exposure with response prevention (ERP) is incredibly effective at allowing our brains to learn new ways to respond to those fire alarms. This helps our brain to realize we may not need to practice fire drills every day. We can also improve our ability to trust ourselves to manage feelings of anxiety until they pass naturally. Altogether, with time, support, courage, and the ability to move at your own pace, OCD can become so much quieter than it may be right now.
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