Trigger Warning: this post may contain content that can trigger a shift in mood, comfort, or mental status. Proceed at your own risk.
The first thing I thought when I was told I have Obsessive-Compulsive Disorder (OCD) was “but I don’t have any problems with washing my hands”. What I didn’t know was how broad a spectrum of behaviours OCD covers. Compulsive, repetitive hand washing is just one of the many ways OCD presents itself. My particular flavour of OCD is “checking”. Is the oven off, did I leave the door unlocked, are the car tires flat, did I flush the toilet – that sort of thing.
One of the best examples of my behaviour is where the keys are before I go to bed. Most people would remember where their keys are; some would take a quick glance to make sure they’re inside the house or something. In my case, I need to do the following:
1) I need to be able to see the keys
2) The keys need to be in the right order on the hooks
3) I need to touch the keys
4) I need to tell J that the keys are in the right place
5) I need J’s acknowledgement.
Some days I will be stuck on steps 1-3, repeating them over and over again, or even have to leave for a moment and redo the process all over again. I can’t help it.
Why do I do this? Well, despite seeing all of the keys on the right hooks right in front of me, in my mind’s eye, I keep seeing an image where it’s night time, the outside light above the front door is on, and there’s a set of keys hanging from the doorknob. Then I worry that someone will take the keys, which then escalates to include things like vandalism, theft, and even harm to J or myself.
Without satisfying my compulsion and proving to myself that the keys are in the right place and everything is okay, it is impossible for me to go to sleep. I just can’t do it.
Another example is the chest freezer in the basement. Until recently I couldn’t close the freezer lid without banging on it with my fist and scrutinizing the surface, looking for a reflection. Most people would close the lid and not give it any further thought. Others may worry that the food may spoil. My mind would go to irrationally huge and improbable circumstances. The typical result was that the freezer would warm up, which would make the compressor work harder, which could cause it to seize, which would cause it to heat up and start a fire, which would burn the house down, which would spread to the neighbour’s house and kill their kids.
I know how ridiculous that sounds, and in real life this would never happen. We might end up with some spoiled food, but that’s pretty much as bad as it would ever get. Unfortunately, once my mind started spiralling out of control I was unable to do anything about it. I had to thump the freezer lid with my fist and look for the reflection or horrible things would happen.
Another example is when I take exams. If I finish before the time runs out, I have to start from the beginning and redo all of the questions over and over until they announce that time’s up. Even then, I have a hard time passing the exam to the invigilator.
I could go on for many pages but hopefully by now you’ve got the picture. Like so many other things, it’s worse when I’m tired or under pressure.
Dr C began treating my OCD by asking me to stop and think about what was going on in my head when I was doing things like banging on the freezer. It was difficult at first, but I’ve become much more aware of what thoughts are going on in my head. After that, we did a lot of Exposure and Response Prevention (E&RP), where I’d resist a compulsion for as long as I could and chart the amount of anxiety I felt and what was going on in my head. Here’s one of my work sheets from when I was obsessing over whether I’d flushed a toilet. You can see my anxiety go up and then come back down. There were quite a few that went up and up before I had to give in but on that particular day, I was successful:
With Dr C guiding me and a lot of work, the E&RP has been quite effective for me. The freezer lid and many other triggers are no longer an issue. I still slip occasionally but for the most part, I can just stop, turn around, and walk away. While my OCD will never completely disappear, little victories like the freezer lid give me hope that I can break free of many of my other checking compulsions.