I had a feature article I wrote on the rituals of OCD published in the final 2016 issue of Catalyst Magazine. You can have a read of it below:
Have you ever heard someone complain about how seeing something unsymmetrical is “triggering their OCD”?
This is a common understanding of the anxiety condition, obsessive compulsive disorder.
This condition is characterised by obsessions and compulsions. Obsessions are persistent, obtrusive thoughts, while compulsions are repetitive and ritualistic actions which are often time-consuming and stressful.
It’s often seen as a quirky condition causing a minor inconvenience, yet for some it is extremely debilitating.
Opal Costello is a 20 year old baking student who has severe OCD. She started experiencing symptoms when she was just 12.
But these symptoms weren’t rearranging her peas to one side of her plate or keeping her pencils neatly arranged, like is often assumed of OCD sufferers.
Opal was convinced she had HIV.
This obsession led her to start having compulsions.
“I would have to tap on wood and I started doing it til my knuckles practically bled,” she says.
“But I didn’t really know that’s what OCD was, because of the common misconceptions.”
“I kind of just thought I was crazy.”
Opal used to believe OCD only involved issues with “cleanliness and symmetry and needing things to be neat”, but the manifestations are much more diverse than that.
When Opal was 15 she started having a sexual obsession, thinking she was a pedophile even though she had no sexual attraction or contact with children at all.
“I’d look at a computer and think there’s child pornography on that computer and all I’d think about was child pornography,” she says.
While this may seem like an especially rare and severe example, clinical psychologist and researcher from the Anxiety Clinic, Dr Christopher Morgan, says sexual obsessions are common for OCD sufferers.
“Many people have the intrusive thoughts around sexual issues and many have this fear of even being photographed in the presence of a child, which may lead to them being accused of being a child molester or a pedophile.”
“It’s a very pernicious and bullying type of condition. Once OCD takes hold in a person, it literally dominates their day.”
While Opal was suffering from the sexual obsessions, she did a project on OCD for her high school psychology class.
“But I didn’t make the connection at all,” she says laughing.
It wasn’t until she was 19 and went to a psychologist that she was officially diagnosed with OCD.
She wasn’t given medication immediately, but rather just talked about her childhood and how her OCD came to be.
Now she is seeing a psychiatrist to go on medication, because of the substantial impact OCD is having on her life.
Opal’s compulsions leave her feeling constantly tired and have got to the point where she has so many compulsions, she sometimes isn’t able to leave the house.
Her compulsion to tap on wood, began with a need to do so ten times. But this evolved to the point where she would have to do it a thousand times before she was satisfied.
As Opal’s compulsions come first, it has led her to miss buses and classes, as well as generally causing havoc on her social life.
Making it even more difficult for Opal, is the fact she feels she cannot tell people about her condition and the adverse effect it has on her life.
How do you explain to someone that you were late to something because you had to touch wood a thousand times?
While Opal is taking medication for her OCD, Dr Morgan says the most effective way to treat it is through psychological techniques which are known as exposure and response prevention.
This involves introducing people to the triggers which create anxiety and distress for them and then presenting a model of change to try and bring a gradual reduction in anxiety.
For example, if a person has anxiety attached to seeing a stain on a table and assumes it’s a blood stain, this treatment tries to help the person identify that while it seems in their mind to be a dangerous object, it is actually the person’s thoughts on the object which are the problem.
“So what we have to introduce, is a kind of exposure to it but then also response prevention. This means not running away from it, not washing it obsessively and not avoiding going near that object again,” Dr Morgan says.
“These are the kinds of ways in which people deal with the triggers for OCD, they avoid them, they ask people to reassure them they’re not a problem or they establish very elaborate rituals to enable them to cope with the challenges that contamination or responsibility might bring.”
Unfortunately for sufferers, treatment is not always easily available and Dr Morgan says this is a “scandal.”
“It is a treatable condition, but the access to psychological treatment for OCD is very poor.”
Opal believes the lack of understanding around OCD is making it difficult for sufferers to properly deal with it and “prevented people with a really dark side of OCD from opening up.”
As Opal felt she couldn’t open up to people, she instead isolated herself and ended up in hospital because she wanted to hurt herself.
“Most severe OCD cases would bleed into depression a lot,” she says.
Dealing with these mental health issues is not helped by the trivialisation of OCD online and in the media.
“There’s so many Facebook groups with OCD memes with captions like ‘My OCD senses are tingling’ for something that’s not symmetrical and people think OCD is just that,” Opal says.
She also recently saw a store sign which used an OCD related pun for advertising and she points this out as an example of the condition not being taken seriously.
“This is not okay, you are using my mental illness as an adjective, you wouldn’t do that with anorexia or schizophrenia because they are such serious mental illnesses.”
“OCD has become the butt of a joke because of the media’s representation of it.”
Dr Morgan agrees the trivialisation of OCD undermines the seriousness of the condition.
“People use that expression ‘Oh I’m just so OCD’ when it’s got no relationship whatsoever to the psychiatric condition,” he says.
But he can find some positives with its portrayal in the media.
“At least it’s now in the language and people are starting to talk about OCD, when once upon a time it was quite a hidden condition and people suffered terribly.”
Opal meanwhile, is hopeful about her future living with OCD, especially if people begin to have a better understanding of the condition.
“A large part of me getting better and everybody’s OCD getting better is that people need to educate themselves on what it actually is.”
“Because if someone can really understand my symptoms and my obsessions, it makes it a lot easier to have OCD.”
Dr Morgan emphasises however, that help is available and it is a treatable condition.
“People can free themselves from OCD.”
If you, or someone you know needs help, call Lifeline on 13 11 14 or Beyond Blue on 1300 224 636