Pure O: The OCD You Can’t See
While trying to figure out where the spark would carry me next, I found myself ruminating on something that I read last night. It all started while reading the preview for a book my therapist recommended.
A line stuck with me, about the common myths of OCD, how one of them is that if you don’t have visible compulsions, it’s not OCD. It shared something called “Pure O” OCD (Pure Obsessional Obsessive-Compulsive Disorder). It’s where the compulsions are mental and not necessarily seen. I get the same things, but instead of getting up and checking the door, I argue with the voice in my head. And it paralyses me.
- (Idea adapted from Alex J. Carter, The Integrated OCD Workbook.)
Reading this has been one of the biggest sources of hope since then. I couldn’t leave the thought alone (because of who I am as a person) and did a little research. It was a real thing! It just shifted my perspective.
I was originally diagnosed with OCD in the late 2010s. It was after a concussion, and I was having some memory issues. I ended up seeing a neuropsychologist, and after super fun, extensive testing, she asked if I’d ever been diagnosed with OCD. Similarly to when my doctor asked about narcolepsy… I laughed. (Not my proudest moment) There was another one of those preconceived notions that come from the media and trends. (I like to think I know better now, but then I didn’t). But it clicked. I checked all the boxes. She was the one who suggested Zoloft, which has been the biggest help in my whole journey (I’m talking turned down the obsessions from 10 to 5), and suggested that it was my main problem. She wasn’t sure how I was functioning (but in a nice doctor way). She referred me to a therapist and told me that if I needed help, to call her back. My anxiety never let me make that call, but thinking back, I wish I had. (There’s the self-sabotage in me.) My heart stuff started shortly after, so it fell off my radar.
I continued my Zoloft for years, but when I had my recent go off my meds situation, I stopped taking it. And everything that I had been shoving down for years came bubbling back to the surface. So much that it paralyzed me.
Some of My Obsessions and Compulsions:
I have a few compulsions that I would like to share, to show an example of what hidden OCD may look like. Most of them are things people wouldn’t notice or even ask about, because the comfort is in my head.
When I fall asleep, I always lie on my right side, then my left, then roll back to my right before I fall asleep. Somehow, I’ve convinced myself I can only fall asleep if I do this first. Otherwise, something awful might happen. The severity of the obsession can range from “You won’t get a good night’s sleep” to “If you don’t do this, someone will die”. Depending on my mood for the night. And the thought continues over and over and over again until I do something about it. Like roll over.
I’m very picky about where I sit.
At home, it looks like the same spot on the couch or the same chair. Every time I walk into a room. I get visibly uncomfortable if I can’t sit in my “favorite spot”, or at least that’s what the anxiety tells me. It starts with the chiding that people can tell I look weird, that I don’t know how to sit properly, that if I don’t move soon, they’ll surely notice that I will explode. While in reality, it’s a silent battle in my head.
On the rare occasion that I go places, I’m very picky about where I sit, and I hate standing. Normally, I find whatever corner I can and put my back to the wall. Always with an exit visible. I need to see what’s going on around me. This makes me feel better; it lets me watch the room and observe what is happening, so I don’t miss anything. If my back is to the door, someone may come and stab me?! (Really, brain?) What if someone I know comes in and I can’t see them? I won’t have time to prepare what to say, and I’m sure I’ll look like a fool. But somehow, if my back is to the wall and I can see an entrance/exit, then I’m okay.
I can’t sit with my feet on the floor. I’m not sure how this one came about, but it’s become worse and worse over the years. Something might crawl on my foot. What if the ground comes alive and swallows you up? What if… what if… what if… So, I cross my legs the second I can when I’m sitting. Foot prisons off if possible. (Yeah, I’m that person on airplanes.)
I wear mismatched socks. I’ve worn them that way since I was 12. What was later seen as a quirky rebellion was my first compulsion that I can remember, and probably is my longest-standing one. I’m in my mid-thirties, and I will to this day not match my knee-high socks that I wear under my tall boots when I ride horses. Secret confession: I will wear a dirty sock before I put on matching ones. All because I fell off wearing matching socks once, then the next time I rode my horse, I wore mismatched ones (just how laundry worked that day), and I didn’t fall off. That became my safety ritual or compulsion before I would get on my horses. To feel in control of something I couldn’t possibly control. One that I could hide from the world. People thought it was funny; they made a whole recurring joke out of it. But thinking back, that was my first compulsion that I remember. And the reactions to it probably were a link to why it’s stayed with me so long.
If there is anything I’ll be remembered for, it’ll be not matching my socks.
These were all visible compulsions, but they were so subtle that no one would notice. Because I didn’t want people to think I was crazy. So I did what I could while making the least noise possible.
The more I write, the more I educate myself, the more I understand, and the more I want to share. These are some of my biggest compulsions, but they are invisible to most. I am in no way an expert or offering any kind of advice. I just want to share my thoughts, so maybe it’ll help you connect the dots.
So I leave you with this. This has been my biggest tool as I continue to battle this.
Anyone who’s been to a 12-step program of any kind will be familiar with this,
Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.
That was my biggest takeaway from my inpatient stay. We did 12-step programs every night before medications were handed out. And we’d repeat that at the end of every one. 6 weeks straight, every day. And until very recently, I’d forgotten how much that resonated with me. The idea of a higher power, the idea that someone might die if I don’t roll over 2 times before bed every night… It became less real because I was learning how to tell the difference. And that wisdom is what I actively carry forward as I continue my recovery.
So I continue with my serenity prayer, my affirmations, my little things that I’m starting to remember work.
I continue therapy, and I keep showing up.
M. Drella
Originally published on Medium.