Inside The Mind of the OCD Sufferer:The Insidious Nature of OCD and What Can Be Done

Author: Kristy Cobillas, LPC

We have all heard someone claim that they have Obsessive Compulsive Disorder because of their proclivity toward keeping things neat and organized. Many a joke has been made regarding having “OCD friends” over so that they can clean the house. Those truly suffering with the disorder could only wish it were simply a matter of being particular or neat; unfortunately, that is not the case.

OCD is an insidious, lifelong, painful, neuropsychobiological disorder in which the sufferer is besieged by intense intrusive thoughts and obsessive ideas. These uncomfortable thoughts and ideas are warded off by repetitive compensatory compulsive behaviors.

Obsessive Compulsive Disorder (OCD) could be thought of as a death by “1000 what ifs.”

What if... I'm contaminated?

What if... Someone trips over this item that I saw laying on the ground…. will it be my fault? (responsibility OCD)

What if… I am really a child molester?

What if ... I had an affair and forgot?

What if... I throw this out and I need this later? ( Hoarding)

What if...I am turning my enjoyment of watching baseball into an idol?” (scrupulosity)

What if... I'm evil?

What if... I really want my parents to die?

These are all questions that an OCD sufferer might ask.

It is common for everyone to have a fleeting “what if” thought. For example, one might have the thought “what if my parents died?” The thought would be there momentarily, perhaps causing a little bit of distress, but would easily fade into the background, especially if there is no evidence that one's parent’s lives are in peril. However, for the OCD sufferer, this “what if” thought would be followed up by repetitive questioning of the parent's health, driving by the parent’s house a couple times a day to make sure they're still alive, possibly even making pleas to the parents to not fly or drive in their car. The continuous obsessive thoughts and checking behaviors would not only be distressing for the client, but also for the family.

What the neurotypical brain views as not a “big deal”, becomes exponentially exaggerated in the mind of one who has OCD. For example, most people will think nothing of going 61 on the highway, but for the person who suffers from scrupulosity OCD, the thought that they are “sinning against God” by speeding will weigh heavily on them, and they will slow down. (Which only reinforces the ocd loop.) They will spend their existence making sure they are doing everything possible to be “perfect” and will come to the sad realization that it is impossible. The hyper-focus on perfection will lead to a tormented existence as neurologically, there are associated neural pathways being built with the attentiveness to imperfection. The sensation the client experiences feels as if there are tentacles reaching out of the brain grasping any slight indiscretion. This creates a heightened awareness and paranoia that can be overwhelming for the sufferer. The anxiety for the OCD sufferer is immense and there is no sense of peace until the issue of the moment is thoroughly examined, compulsed upon and/or “feels right.” The sufferer will rationalize, reason, fight with, research, question, seek assurance, and try to fight their way to a place of logic…. But there is one huge issue….

OCD does not listen to reason and it does not accept facts. Little traction is gained by therapeutic techniques such as socratic questioning or argumentation. Most who suffer from OCD already know it’s irrational. They cannot “just stop it” an