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OCD

OCD May Not Be What You Think It Is

Personal Perspective: My unconventional take on OCD.

Key points

  • Despite its prevalence, OCD has few treatment options, and many sufferers decline those that are available.
  • Research has only begun to explore the connection between OCD and personality traits like empathy.
  • Recent findings suggest there are hidden gifts linked to OCD that could help heal its many downsides.
  • A number of high-profile celebrities are bringing more awareness to these underexplored sides of OCD.
Nathan Cowley/Stock Photo
Source: Nathan Cowley/Stock Photo

"Hug my parents for 11 seconds or else they'll die, pray to God then kiss your fingers or else you'll have cancer... I had one time where I didn't have my period for a year and then I thought I was like the Virgin Mary... and then I'd pray every night for God to take away the new Jesus Christ that was being born in me."

Nathan Cowley/Stock Photo
Source: Nathan Cowley/Stock Photo

That’s singer Camila Cabello, in a recent conversation with Dax Shepard, sharing her experience of obsessive-compulsive disorder (OCD). Her story encapsulates just how OCD haunts sufferers with an interminable litany of doubts and protective countermeasures designed to ward them off, shining a light on a condition that plagues one to two percent of the American population, takes an average of 14 to 17 years to correctly treat, and currently has few proven interventions (the two most prominent being medication and exposure-response-prevention therapy, or ERP).

This week, which is dedicated in honor of OCD awareness, you're likely to hear experts share that OCD isn’t a Martha-Stewart-meets-Marie-Kondo devotion to beauty or joy, nor is it the potential for violence found in an M. Night Shyamalan movie involving a serial killer with OCD and mommy issues. They'll likely tell you that it’s a tortuous yet treatable condition that can be remedied by evidence-based care that teaches you to "stick with the ick" and "live towards your values" by staring down your worst fears without blinking. This means that, if you're treated for OCD, you might be asked to touch a stranger’s doorknob without washing your hands or entertain your scary, violent thoughts without asking for reassurance. Over time, they explain, you’ll learn to better live with uncertainty.

Yet what you may not hear is that between one-quarter and one-half of people with OCD turn down exposure and response prevention, citing difficulties in stomaching it. You also may not learn that even experts aren’t yet sure how exactly OCD is impacted by nature—genes, brain circuitry, or autoimmune reactions—or nurture, i.e. defense mechanisms gone awry as a result of trauma.

A 2023 analysis found that untreated OCD led to an annual loss of over 8.4 billion dollars in the U.S. alone, primarily due to missed work, decreased productivity, and medical costs. With such a big impact, shouldn’t we have more and better options for OCD?

A Different Perspective on OCD

Researchers and clinicians tend to focus primarily on relieving symptoms. But OCD isn't just a relentless thief of time and headspace; it's part of one’s personality.

Being so tuned in, especially to fears, can be harrowing, but with OCD, you may also find that you're aware of lots of other interesting things too. You may also have an exquisitely imaginative and creative mind and a profoundly open and generous heart. You might be more keenly aware of death, and all its many possible incarnations, but see clearly what makes life worth living.

Research shows that those with OCD tend to have higher empathy levels than healthy controls. And like OCD sufferer and author John Green, they often find it more difficult to easily ignore the fragility of the people and world they love.

I believe that what people with OCD need is more attention to what it’s like living with this wide range of feelings and how difficult it is to be so aware, without punishing oneself for not doing more. They require support learning how to take up their own space without becoming—their worst fear—a narcissistic a**hole.

Like notable OCD sufferers Charles Darwin or musician Jack Antonoff, OCD sufferers constantly tinker with what-if scenarios. They go down rabbit holes and get lost in thought spirals—but these same brushes with massive doses of uncertainty can also sometimes lead to innovation and possibility.

I've found that many OCD sufferers are not mentored in how to tame this roving mind and capitalize on its many gifts. As writer Elizabeth Gilbert notes, “Possessing a creative mind, after all, is like having a border collie for a pet: it needs work, or else it will cause you an outrageous amount of trouble."

I argue that we need more clinicians and researchers who know how to tap into this potential—who see the method to the "madness" of OCD. Imagine how much faster and better we could treat OCD with these answers.

I see my own unconventional take on OCD as akin to Elaine Aron’s views on the highly sensitive person or Susan Cain’s blockbuster revision of our understanding of introverts. OCD results from an improper understanding of how to harness the fire of profound emotional imagination. Without that connection, I feel, one is lost to senseless rituals that never quite satisfy but don’t answer the underlying question: Why am I so driven in the first place?

If you have OCD, I believe that you are driven because you are likely exquisitely aware and imbued with a Shakespearian range of feelings and thoughts that few have mapped. You might sense it in those who also have the same gift—but perhaps you, like many other people with OCD, have been told so many times that what you perceive isn’t really important that you stopped noticing.

In a world obsessed with a dystopian future or greatness just around the corner, it's easy to be seduced into a mindset of simplification rather than nuance. Yet in my experience, people with OCD think and feel deeply about this nuance, noticing how strongly we can both love and hate those we are closest to, how fragile and powerful all of us are, and just how easily the world could spin out of control or back into alignment.

Being able to master this capacity is not just the most human of all tasks set before us; I argue that we need it now more than ever. We owe it to shine a light on the true gifts of the OCD sufferer because they just might see—the clearest of all of us—our next steps forward.

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