I am sitting in a therapist’s office that smells of old wood and scented candles. The black leather couch is cold against my sweaty legs, which are bare. It is summer and I’m nine years old. I shift in my seat until the therapist invites me to “go ahead and play.”
In front of me, there’s a sandbox with an array of toys, all farm-related: cows and chickens and horses and ducks and fences and trailers. They are strewn across the sand. The sand is messy. I, in turn, feel messy.
When I am invited to “go ahead and play,” I remove all of the toys. I then take my hand and smooth the sand. Once that’s done, I put each animal in a group of four, and place a fence around them.
When I am finished, the therapist takes a Polaroid photo. “We are going to keep a record of all the great work you do in my office,” she says.
I continued to go to the therapist and play, but was unaware of why exactly. I knew it had something to do with my mind, and something that didn’t feel quite right inside.
I Knew It Was Odd, But I Didn't Know How To Stop
My parents sent me to a therapist after realizing that I had organized everything in our entire apartment in terms of size and color. In the bathroom, I’d dismantle my parents’ medicine cabinet and organize the bath products in terms of what made sense to me. Usually that involved placing the blue bottles together, and in size order, and so on for other colors.
On the coffee table, I’d stack all the magazines and books so that they were flush. Sometimes, I’d carry a ruler around with me to measure a centimeter between the magazines and the edge of the table.
As my self-awareness grew, I knew that it was odd to be so compulsive, but I was at a loss for how to stop. I didn’t know any other kids who struggled this way. And I felt embarrassed by my mind, even though no one could see the patterns I saw in the world around me.
Now, of course, I understand that I have OCD, which is considered a subset of anxiety. It affects about two million Americans over a lifetime, men and women equally.
While today it's considered a manageable condition, this wasn't always so. In a renowned textbook from the 1800s, French psychiatrist Jean-Étienne Dominique Esquirol described these obsessions and compulsions as partial insanity and "monomania."
Thankfully, as advances in neurophysiology and pharmacology continued, psychiatrists, psychologists and other mental health specialists have come to embrace a more therapeutic approach to treating OCD, rather than treating it as a stigmatized pathology.
I feel grateful for the fact that I started therapy at such an early age. I feel even more fortunate that I am now being treated by SSRIs (prescribed at 17) and weekly behavioral therapy sessions with a psychiatrist whose background includes mindfulness and meditation.
I also know that my SSRIs bevel the edges of certain qualities I have — likely related to my obsessive-compulsive "shadow." Since starting SSRIs, I feel a little less sharp.
In my pre-SSRI days, I used to keep a notebook with me at all times in which I would transcribe interesting quotations from interactions I had throughout my day. The habit was obsessive, but it also was uniquely me. It was a hallmark of my emotional sensitivity and motivation to catalog my personal experiences with deliberateness.
Of course, I could still keep this quote book. But I don't have the energy. While the treatment of my OCD has made me feel markedly less trapped in the world of my own ruminations, I'd be lying if I said I didn't feel that I've lost something.
On some days, I feel emotionally balanced in a way that I find boring. Strangely, my SSRIs provide me with an emotional balance which helps me form a new relationship to my obsessions. The meds do not, in fact, remedy the obsessions themselves.
It's A Need For Order That Makes Me Feel Out Of Control
While I no longer organize my entire life in terms of size and color, my OCD still manifests as a constant, nagging feeling that my life — and particularly the concrete things that I encounter (objects, clothing and furniture, for example) — must be organized according to some arbitrary structure that I create.
When I walk up the subway stairs each morning, I count to the number eight four times until I reach street level. Knowing this provides me a great deal of comfort. It is not rational. (You may notice I have an arbitrary affinity for the number four and multiples thereof. I don’t know why.)
What most people don’t realize is that this doesn’t just make me a neat freak. I hear other people refer to themselves as “OCD” when they want to clean their room or rewrite their notes to be neater. That’s not what OCD is.
I don’t feel annoyed by this expression, but I want to emphasize that OCD isn’t just about being orderly. In fact, for me, the obsession with order can, on a bad day, make me feel incredibly out of control, lonely, and trapped within my own head.
I am not particularly organized, but sometimes I feel like something NEEDS to be in a particular place, and I suffer extreme anxiety if it’s moved. For instance, I always have to keep my sneakers beneath my dresser, on the right hand side. When I come home after wearing them, they go right back where they came from. Otherwise, I will feel incredibly panicked, especially if I’m having a bad day, have a lot of work to do or am PMS-ing.
That's the thing about OCD. It's worse on some days, and better on other days. Recently, there was a span of a few months where every time I’d talk to my mom about anything, I needed her to shake my hand four times until I felt like the conversation had reached a point of closure. My mom recognized it as an OCD tick, and thought it was vaguely endearing. “Again?” she would ask. “Yes, again,” I'd say, and she'd comply.
And when I’m experiencing more extreme emotional distress (like a breakup, or even just a tough conversation with a family member or friend), I have to count to eight over and over again while I walk anywhere. Otherwise, I feel like I am going utterly out of my mind.
There Are Parts Of My OCD That Are Actually Quite Useful
More than the SSRIs, I’ve learned to live with my OCD by accepting it. I used to feel “crazy” or like I needed to hide this part of myself. I simply wouldn’t tell anyone of the things happening in my mind. If I found myself counting while with friends, I hoped they thought I was distracted or daydreaming. I never admitted that my walking patterns involved taking a certain number of steps. I thought all of these patterns were embarrassing and indicative of some evolutionary failure. I am not fit to survive, because I am so nuts.
But I’ve learned that that’s not true. And in fact, there are parts of my OCD I've come to think are actually useful. For one, it seems quite aligned with the part of myself that is hyper-clear when it comes to setting priorities and getting sh*t done.
I have a compulsive need to be organized around time management, to the point where I often split my workdays into 25-minute and five-minute intervals in order to space out work time from relaxation breaks. This has proven to be productive. And sometimes, there are deep, dark compulsions to count to eight when I’m in a fight with a friend, or overloaded with things to do.
My meditation practice has played a big role in my understanding that there will always be things knocking at the door of my mind, trying to get in. Sometimes those things are feelings about an interaction. And sometimes I’ll have an inexplicable desire to count to eight.
These compulsions are simply my way of trying to gain control over things. On some level, they’ll always be there. But I can also choose how much I want to focus on “there.”
My psychiatrist has explained to me, time and time again, that habits make us feel comfortable. They are ultimately just survival mechanisms, telling us something like this: “I did this yesterday, and the day before, and the day before … so I need to do this again today in order to survive.”
Of course, this isn’t true. I don’t need to count to eight when I walk to the bathroom in order to survive. But at one point, my brain told me this, and I believed it.
Now that I have that awareness, I challenge myself on a daily basis to sit with the anxiety that emerges when I notice my desire to count, but choose not to. The sensation is similar to an itch: it keeps calling for attention. Uncomfortable, but not unbearable. Sometimes, I give in and count. I just try not to hate myself for it, and that takes practice.
Today, I treat my OCD as a nuisance at worst, and an invitation to practice mindfulness at best. And after all, what’s so bad about those moments when you just need to shake your mom’s hand? Or something.
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