Category: OCD

OCD makes it difficult to walk

I previously wrote about hand washing, a symptom of OCD that has generally reached public consciousness. Today I’m writing about how OCD makes it difficult for me to walk, a symptom that hasn’t reached public consciousness.

To explain this I’m going to label one of my worst fears ‘A’, and another of them ‘B’. For me, ‘A’ is associated with (amongst other things) the colour red, a range of colours that are similar to red, the number 6, and making a movement with my right hand or foot. ‘B’ is associated with (amongst other things) the colour white, a range of colours that are similar to white, the number 3, and making a movement with my left hand or foot. These meanings make it very difficult for me when I’m walking around.

When I walk I am highly aware of what is on the floor – where are the marks on the pavement and what colour are they? I usually have to navigate round these marks in a way that is ‘safe’. The ‘safe’ way to navigate around them varies from moment to moment, sometimes it’s safer to walk in between two marks (and make sure my foot doesn’t pass over either mark), sometimes it’s safer to walk to the left of a reddish mark, sometimes it’s safer to walk to the right. My OCD doesn’t have set rules in this sense – what is ‘safe’ varies. What stays the same is that anything vaguely similar to red or white in colour takes on excessive meaning, it is linked to one of my worst fears. For me, green and blue are safe colours, so I try to ‘direct’ my movements towards those colours (e.g. a weed between paving could be ‘safe’).

I like to listen to music, but this also interacts with my OCD when I’m walking – I have to be conscious of where I am standing on each beat of the music. I also have to be very careful what I am looking at if a singer uses insulting language, generally I try to ensure I’m looking at a ‘safe’ colour if I know bad language is coming up in a song.

Left and right are important, especially when I walk over a threshold of some kind. For example, I rarely walk from one room to another without being conscious of which foot I step with first. Whether left or right is more safe tends to vary. When I walk up/down a kerb or up/down stairs I have to be conscious which foot I step with first. If I stop walking I have to be mindful of which foot I use when I start walking again. I often think, or say, depending on who can hear me, “left right is safe, right left is also safe”. Sometimes I also add “left left is also safe, right right is also safe”.

It’s easier to walk if I can hold onto someone’s arm and look up/straight ahead, instead of at the floor. I do walk around though – I walk to and from work, and I have a dog who clearly needs to be walked! It just means that walking is quite tiring for me as I have these OCD thoughts at the same time. If I’m doing well I might manage to walk for a little while without an OCD thought, though never for a whole journey. More often OCD is present in the majority of my steps. I can usually do this whilst holding a conversation or keeping an eye on my dog – people with OCD do a lot of multi-tasking!

Hand washing

Unlike many areas of OCD, hand washing seems to be one symptom that has reached the general public’s consciousness. Yet most people don’t know what it truly means to wash your hands in the way OCD demands.

When I was about 13, hand washing was one of the things my OCD focused on. I washed my hands so much that the skin became dried out and red. I got more and more cuts on my hands, the most I counted at one time was 17.

Despite these cuts I used hand sanitiser (I think this was because the school toilets didn’t always have soap available, or perhaps it was for putting on after I had touched the door handle to leave the toilet block). If you’ve ever got hand sanitiser in a cut you’ll know how painful it is. To the young me, this pain was worth it to try and get rid of germs, and to feel like my hands were clean.

I remember hearing another teen who I didn’t know referring to me as the ‘girl with the hand cleaner’ (I kept most of my OCD symptoms well hidden, but being clinically obsessed with morality and hygiene doesn’t grant you much popularity amongst teenagers).

I can’t say for sure how I stopped, it was a long time ago. But I think it was partly making a conscious effort to limit the actual process of hand washing (I used to wash them a bit like you see on those NHS posters – going in between the fingers, the back of the hand and so on) so it was a shorter sequence. My OCD also moved on to other forms as I got older – perhaps because I was gaining strength against the symptoms I was familiar with (usually when I have beaten OCD symptoms it has morphed into a different kind of OCD), or perhaps just a natural progression of the illness. At this time I was still refusing to seek any medical help.

Nowadays I wash my hands more than the average person, but not an obsessive amount. My hands aren’t red and there aren’t any cuts. Writing this makes me feel sad for the teenage me, yet I would happily swap the mental OCD horrors I live with at the moment for 17 cuts on my hands.

Feeling disheartened

I wanted to share a bit about how my OCD is/has been today. I’m not going to delve into the contents of my OCD thoughts here, instead I want to give you an idea of what it’s like to live with OCD thoughts constantly. My OCD thoughts tell me that my worst fears will happen unless I do as OCD says. For the purposes of this post, let’s refer to these fears as ‘A’.

I have an event coming up on Friday at which I’d like to drink alcohol. Because this is something I’d like to do, I keep having OCD thoughts that A will happen if I drink alcohol on that day. To counteract this, I make another thought which says “A will not happen if I make my own choice about whether or not I drink alcohol on Friday.” Sometimes I feel the need to clarify that this means I should make my own choice about whether to drink some alcohol or no alcohol, because there is a chance that not every choice I make regarding alcohol will be my own choice (I might have an OCD thought about taking a sip at a certain moment, for example, and instinctively obey it before I’ve remembered that I’m supposed to be making my own choice). These thoughts that I make in an attempt to ‘overwrite’ the OCD thoughts are also a symptom of OCD; I am making them – they aren’t automatic – but I wouldn’t be making them if I was mentally well.

The OCD thoughts that I get concerning drinking (or any other thing I want to do) combine with other OCD thoughts. For example I had an OCD thought which said that if I retuned my TV (it’s lost Sky News in the wind…) and didn’t complete it before my partner came on Skype, then I wouldn’t be able to drink alcohol on Friday without A happening.

Basically, OCD takes every passing thought or action and attaches it to one or more of my worst fears. OCD has a fear for every little action I want to do, from typing a certain word to eating a chocolate.

How do I react to this? Sometimes I do what the initial OCD thought says, sometimes I make my own thought to try to overwrite the OCD thought (as described above), and sometimes I use cognitive reappraisal techniques to give me the strength to ignore what OCD is telling me.

It’s exhausting, and it gets me down. I have to do twice the mental workload all the time. There’s no way for me to find respite from these thoughts – I can’t relax and forget about them. OCD is a nightmare.

How can I tell what is OCD and what isn’t?

Sometimes people with OCD have trouble identifying which thoughts are OCD and which aren’t (see the bottom of this post for some tips on how to do this). I have had many years of therapy, and as a result I am relatively good at identifying when a thought comes from OCD. However, there are still times when I’m unsure. For this post I’ve divided OCD thoughts into ‘obvious’ ones and ‘subtle’ ones.

‘Obvious’ OCD

Obvious OCD thoughts are things like “my mum will die unless I touch the table 4 times”, “I knocked over the cyclist that I drove past”, “I can get cancer by breathing in when I look at the word ‘cancer'”.
You can usually spot the obvious OCD thoughts by imagining how someone else would react to the thought – they would know that it wasn’t true. The strange thing about these OCD thoughts is that even without asking anyone else, we know that others would see the thoughts for what they are – the output of a mental illness. (The reason why we still ‘obey’ them despite knowing this is discussed in other blog posts).

‘Subtle’ OCD

Subtle OCD thoughts are sometimes more extreme versions of everyday thoughts. For example “did I leave the cooker on?” People without OCD will wonder this from time to time, but they will usually forget about it quickly. In contrast, people with this form of OCD may check repeatedly that they turned the cooker off, and may worry about it constantly once they have left the house. In cases like this, if the thought interferes with your daily activities, and happens on a regular basis, it’s likely to be OCD.

OCD has been called the ‘doubting disease’ because it makes us doubt ourselves and the things that matter to us. For example, after a number of years of living with obvious OCD thoughts (e.g. “my mum will die if I touch the table”), I entered a period where I didn’t have many of these obvious OCD thoughts. What I did have, however, was constant doubts about my faith. It’s normal to have some doubts about faith and religion, but for me it was 2 years of doubts/fears which happened every hour of every day, irrespective of what I was doing at the time. It wasn’t immediately clear to me that this was another part of my OCD, because the content itself was something that many people think about at times, rather than a strange, obvious thought that doesn’t make sense to the average person. In this way it was an example of subtle OCD, it hid itself as something else (normal doubts).

OCD’s tactics

OCD is a crafty condition (though remember, you are always more intelligent than OCD is). Sometimes if you begin to resist it, it will try to recruit your emotions to make itself more powerful. For example, one of my OCD thoughts is that I will send loved ones to hell. I am usually relatively good at ignoring this thought, for reasons I’ll discuss in another post. However, this thought becomes much more powerful if I am feeling angry with someone. In this case, OCD will ‘tell’ me that not only can I send this person to hell [i.e. the basic OCD thought], but that I actually want to send them to hell because I’m angry. I have never wished for anyone to go to hell, never mind those that I love and care about. But OCD uses emotion to make me doubt that fact (there’s the ‘doubting disease’ again). This makes the thought more powerful – “what if I do ‘mean’ the OCD thought after all?” At this stage it becomes even more difficult to ignore, because it is recruiting additional feelings of inflated responsibility, guilt and fear.

Is it OCD? A few tips

The following list is intended to help people with OCD to work out whether the thought they are dealing with is a part of their OCD. It’s not designed to help people decide whether they have OCD or not. If you answer ‘yes’ to a few of these statements, it’s likely that OCD is driving the specific thought/fear. Note that you don’t need to answer ‘yes’ to all statements to label your thought as coming from OCD.

  • it focuses on something you care about in some way (e.g. loved ones, religion, work, things you enjoy doing)
  • it causes you distress
  • it interferes with your daily activities
  • it bothers you a lot of the time (not just occasionally)
  • it involves ‘magical thinking’ – the idea that thoughts or actions can cause real life events
  • it is the direct opposite of what you want to think
  • it involves symbolism, such as connecting unusual (typically frightening) meanings to left/right, colours or numbers e.g. yellow = cancer
  • it keeps coming back, even if you come up with a good ‘answer’ or reply to it
  • it gets stronger the more you think about it (even if the reason you are thinking about it is to contradict it); it gets weaker if you ignore it

How OCD ‘talks’

Throughout this blog you will see me writing that OCD ‘told’ me one thing, or that I did as OCD ‘said’ or ‘wanted’. I want to make it clear that this does not mean that I can hear OCD in my head – it is not a verbal hallucination. I can’t hear it in the way that a person with psychosis might hear a voice. OCD comes in the form of thoughts. For a small number of people, OCD can involve images of horrific events, but usually it involves thoughts and actions.

The reason I say that OCD ‘says’ something is that I distinguish the thoughts which are generated by OCD from the thoughts that I see as coming from me as a person. For example, the thought “my mum will die if I finish this blog post” is an OCD thought. The thought “I’d like to finish this blog post” is from me. It is not always easy to distinguish between OCD and not OCD, something which I discuss in another post. But by and large the experience of OCD is of an argument between two opposing positions in my head (OCD vs. me) – the opposing positions are both thoughts, not voices.

I know it’s not true but it feels true

OCD is difficult to understand if you haven’t experienced it. How can someone simultaneously feel that something is true, yet know that it’s not true? When I was younger my OCD took the form of thoughts that I could kill people by doing or not doing an unrelated action. For example, I felt that if I put my hand down in the wrong place, my mum would die. On some level I knew that was false, but it ‘felt’ true, and it terrified me so much that I did what OCD ‘told’ me to.

One of the reasons OCD is such a horrible illness is that generally we know that what we are doing has no connection to reality, but we do as OCD ‘asks’ anyway. This can lead to feelings of inadequacy – why can’t I stop this? The answer to this question is complex, but one part of it is difficulty tolerating uncertainty.

You can tell a person with OCD that there is a 99.9999% chance that their fear is unfounded, and all they will think about is the 0.0001% chance that their fear could be true. ‘What if?’ is a huge component of OCD – I was almost certain that I couldn’t kill my mum with my thoughts, but what if I was wrong? It would be intolerable to ‘know’ that I was responsible for such a terrible occurrence (this is inflated responsibility, a way of thinking that is common in OCD).