Today’s exposure

My posts have been getting a bit long so I’ll try and keep this short! My exposure therapy for this week is to walk to places without listening to/obeying what OCD says about how I should walk.

I’ve written previously about how OCD makes it hard to walk. Typically, I have to think about almost every step, and place my foot in a manner that is “safe”. This involves making a decision about each step based on the marks and objects (e.g. grids) on the pavement. Marks become particularly important if they are white, red, or comparable to white or red, e.g. a brown grid counts as red, an old chewing gum stain counts as white. This makes it tiring to walk because I’m doing so much in my head, and can end up with me walking back to walk past a spot again if I haven’t done it “safely” the first time.

Today and yesterday I deliberately tried not to adjust my walking according to OCD, as this is what my therapist and I decided I would do. This is a form of exposure therapy. It did raise my anxiety quite a lot, and I didn’t really experience the pattern of high anxiety followed by decreasing anxiety, which is what you would expect and aim for during exposure. This might have been because of the different levels of distraction I had at different times. The anxiety started high and fluctuated across the course of the walk – when I saw a dog and texted my partner about it, my anxiety went down a bit. I like to listen to music when walking but it does interact with my OCD. Generally, my OCD makes me concerned about where I step/what my foot is pointing at/what colour I’m looking at on certain beats in the music. I also have to be very careful how I’m standing/what I’m looking at when the artist says swear words or insults.

At one point I thought “I’m just walking, like people do!” which was a nice moment. I haven’t been able to just walk like other people do for a few years now. I’m cautiously optimistic that this is the start of getting back to being able to walk without OCD wittering on in the background. My therapist emphasised that I should reward myself for effort, not achievement, so I’m going to have some baklava and a sit down later on.

Trigger warnings

As far as I am aware, the concept of a “trigger” originates with post traumatic stress disorder (PTSD) – certain images, topics, smells etc. can trigger flashbacks from the traumatic event(s). As awareness of this concept has increased, so has the use of the phrase “trigger warning”. This is typically used at the beginning of an online post that contains content that could trigger flashbacks.

Over time the phrase has been used more and more, to cover a whole range of things that might upset readers. This has made me think about the OCD triggers that I live with. Some of these are recent, and others have been present most of my life. All of the triggers are connected to my deepest fears, which I discussed in more detail in earlier posts.

Some of my personal OCD triggers include:

  • the colour red
  • the colour white
  • the colour yellow/cream (I don’t have this so much now but it used to represent cancer)
  • marks on the floor
  • stepping up or down, stairs
  • the number 6
  • the number 3
  • hearing someone else use “bad” language – this inevitably happens with any word that is or could be used as an insult. Sometimes it is ridiculous – words like “bum” or “poo”, or hearing the word “country” (because it has a bad word within it).
  • left
  • right
  • Christian language – words and phrases

Having OCD often means living with these OCD triggers, in a world that wouldn’t even conceive of them as problematic. My OCD triggers are pretty much always there – you can’t escape the colour red or change the language people use. Even when I have my eyes closed I am aware of left and right.

OCD connections to numbers and colours are pretty common, but they vary between people – a friend with OCD once told me the colour green was “unsafe” for her. For me green is one of the only “safe” colours. The colour blue and the number 2 are “safe” for me – blue is my favourite colour and 2 features prominently in my date of birth. I assume this is why OCD designated them as “safe” when it first began to emerge.

People with OCD aren’t considered when people write their trigger warnings. In many ways this is how it should be – avoiding OCD triggers tends to increase their power. Also, OCD triggers vary so much between people that it would be impossible to cater for all of us – everything would need to come with a trigger warning!

In light of this I usually save the phrase “trigger warning” for PTSD-related contexts. I’m not an expert on PTSD but I know that sexual and physical violence are often at the root of PTSD, so posts about these topics should come with a trigger warning. For other topics which might be upsetting I prefer the term “content note”, with one or two words about the potentially upsetting content. That way it’s possible for people to make their own decision about whether to read the post, but it maintains the original flashback-focused meaning of the “trigger warning” itself.

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!