A How-To Guide on Dealing with Those with OCD
All people have some form of obsession in their lives, it is what drives the human condition. For most people, they can simply rate these things on the standard scale of wants to needs. And with those wants and needs come compulsions to quell these wants and needs in their heads by doing something. Every want and need has a counterpart—something emotional, something tangible, maybe something physical... something to get or do.
I am speaking intentionally broad here—extremely broad, maybe vague—to take you to a place of normality: that which people experience and act on every minute of their lives. In as much as I'd like you to imagine your needs and wants as minor obsessions and what you do with them as minor compulsions. Basically, just think of your normal life.
We with Obsessive–Compulsive Disorder (OCD) have needs and wants as well, but they are wired completely differently in our brains. By this I mean a few things. For one, the placement of things on the scale from want to need is skewed heavily toward "need." Everything is a need in our brains. This may seem selfish, but it is very difficult to control, as OCD is really a worldview. Our world is a constant state of need, not able to move these things (obsessions) into simple "wants."
Secondly, we operate in a state of hyper-sensitivity. Everything we observe is magnified—because we have this need to consider every eventuality of every event. Think of it as this: every action you take, or someone near you takes, is going to have an outcome. You consider a few of these outcomes, and deal with however the cards fall. We with OCD must consider every single outcome that we can possibly think of: from the benign to the worst possible scenario and everything (and I mean everything) in between.
So that is the basis of we with OCD. There is a lot more to it (which I write about on my blog yeahocd.com), but for the sake of brevity in this single article we'll stop there and move on to the subject at hand: dealing with us. Oh boy!
You're probably used to seeing OCD as it is portrayed in media (movies, TV, and the like) where compulsions are focused on. Washing hands over and over, making sure the stove is turned off over and over, all of that. You know these things. And they are real! But they are not the entirety of OCD. This disorder comes in many flavors.
There is even a site (ocdtypes.com) dedicated to explaining all the types, which we don't need to go into that extreme of detail here. (Ha! Says the author here with OCD!)
What is important is understanding that OCD is an (often) uncontrollable hyperactivity of things the normal brain that you have actually does also. We are normal at the core, but our brains simply amplify everything that would be considered normal into an abnormal state.
For example, you check to make sure the oven is off at times. You cooked something for dinner, are ready for bed, and just want to make sure. For many with a hyper-compulsive OCD, checking once is not enough. We must make sure of things, because we are thinking of every eventuality, and the worst case here is the house burning down. We are obsessed with making sure the house does not burn down, so it is perfectly rational to spend a lot of time making sure the oven is off. Over and over. To our brains, it is worth the time. Note the coloration between the normal and abnormal: they both have a basis in the rational. We are in a sense irrationally rational. Abnormally normal.
So for the sake of dealing with us in this context of compulsion, allow us to do the checking and over checking of things. It may be annoying, but think of it this way, as a colloquial example: if you go out on the town with us, you'll be sure to know your door is locked. We checked it. Ten times. Let it be.
Now, we've gotten the hyper-compulsion type of OCD out of the way. But there are more types. Let's focus on Pure Obsessional OCD (Pure O). This is a type of OCD where the obsession is the main disorder, and compulsions are rare or seemingly non-existent. (Note: the compulsions are technically there from a medical standpoint, they just don't manifest themselves like the above-mentioned hyper-checking of things and the like—but that debate is for another time.)
I have something akin to this. People with Pure O are obsessed. We live in the universe of the "constant every-eventuality" brain. A figurative statement there, but very close to literal. We are trapped in a cycle of thought that is unending. Every possible thing that can be thought of, we're thinking it if we can. It is as if we cannot get enough thinking. I generally don't like the term "over thinking" because it suggests that this condition is bad or wrong. The key here is not to judge—I bring us back to the coloration between our brains and the normal brain. We're abnormally normal, irrationally rational.
Like holding something slippery, the more we try to control our brains (and world) the harder it becomes. But control is human nature. We just take that normal to extremes. Things become more slippery the more we obsess.
An example of pure obsessional thinking often roots itself in fear. Say we need to communicate something that may or may not be seen as confrontational. What kicks in, in our brains, is every possible outcome of said communication. Mostly, by human instinct, focusing on the negative much more than the positive. We need things to be ok. And the potential for a negative, confrontational outcome is a not ok. Thus we obsess over the spiral that could happen if this not ok situation manifests. And we go very, very far with it.
We tell stories to ourselves of where this confrontation (that may never happen!) could lead. We could be fired. We could start on the path to break-up or divorce with a loved one. We could end up in jail. Do note, these are indeed wholly irrational outcomes we consider, but we have to consider them. I am not speaking of confrontation that in any way runs any normal outcome of firing, divorce, or jail. We're talking about, in this example, most likely a simple email that needs to be sent saying things aren't going quite right!
Here's where you come in. What helps us the most is if you just let these thoughts be. We actually know they are irrational, we just cannot stop them. And, unfortunately, neither can you. So I'm kinda making this easy on you! Let us obsess, and let it pass. I am, personally, a big fan of medication for OCD. It, in my experience, is the only thing that is going to help on the front line. (beyond that there may be therapy involved by licensed professionals.)
I am not discounting your willingness to try to help with obsessions, and thus not discounting your love of a person with this disorder. The key is to be somewhat hands-off and let things play out. In the above example, it may take days for this communication to happen; we will let pulling the trigger on it sit for quite awhile.
This non-action resulting from a spell of obsession may come off as procrastination, laziness—and it may frustrate you if you're involved in the outcome of the action that needs to be taken that is not being taken. Understand that we know the action is not being taken, we know this is essentially not good, but we need to consider every possibility before taking any action.
We need space to be able to obsess. You are not going to stop us from obsessing, but knowing we have the space and permission to do so helps a lot. Seriously, give us permission to be our faulty selves.
It is frustrating for you, one thing you can do in these cases is to possibly run interference on the potential bad outcomes we're obsessing over. By that I mean, offer to somehow take over if things go bad. Noting of course, that there is usually somewhere in the range of a 0.001% chance that something will go bad. And eventually we will jump over the obsession keeping us back, wincing all the way.
Again, I am making this easy for you, but It does require you to be involved. As protection.
This brings us to the crux of this article: protection. One thing people with OCD can use is some form of knowing they are safe and protected. In fact, this is a constant need. And it may feel to you as too much. But to us, we need to be constantly reassured that things will both be ok (check on the oven for us), and that if things do go horribly wrong (they won't), you'll be there to possibly take the brunt of some of that. Just trusting in you that you will help us be protected goes a long way.
As well, another part of OCD is instant regret. The need to rewind time and do things over, and better. Or go back and not do it at all, if we now fear the worst. It would help if you empathize with that inevitable regret—which brings on anxiety, depression and moodiness in general—and understand those reactions are personal to us and aren't going away.
Like I said, most of this—from you—should be easy. Because we are looking to be protected from things that very, very likely do not and will not exist.
We are normal. Just a hyperactive, hypersensitive version of normal. And we seek not much more than space and protection. We don’t expect anyone to solve what we know is irrational. If anyone was going to solve it without medication and maybe professional therapy, it would only be us anyway. But there are ways you can help, and hopefully this journey through the mind of someone with OCD will help you do so for someone you care about.
Commissioner Chris runs the site/blog Yeah OCD (https://yeahocd.com). Diagnosed with Generalized Anxiety Disorder for years, he worked with doctors to uncover his very atypical OCD, which he explores on his site. As well, he is an advocate for mental health issues and writes frequently about the world of mental illness.