Confronting OCD with the Help of the IDF
When your brain no longer feels like the most evil thing on the planet
When I was a little kid my mum – concerned by my screaming insistence on not staying up past my allocated bedtime of 7:30, my long hours spent lining up toys on the living room carpet, and my tendency to take proclamations like “If you don’t get to sleep, you won’t be able to get up in the morning” with teeth-gnashingly fearful literalism – took me to a child psychologist. I was diagnosed with O.C.D. and, alongside counselling sessions involving what I now recognise as C.B.T., was giving a CD-ROM called ‘O.C.D. Why Me?’ and a leaflet explaining the condition to child. The leaflet depicted O.C.D. as a giant octopus squatting malevolently inside a child’s brain, puppeteering the child’s arms with its tentacles, controlling his behaviour. The child had to learn to use weapons to target the O.C.D. Octopus to shrink its tentacles and so reduce the Octopus’ control over their brain and behaviour.
I, of course, took this metaphor literally and was semi-convinced I was engaged in psychological warfare against some kind of demonic brain octopus!
Ever since, O.C.D. / the way my brain is structured has caused me countless trials and tribulations – hands rubbed raw and bleeding from compulsive cleaning; a year-and-a-half of my undergrad experience lost to intense hypochondria; poor, long-suffering partners alienated by my obsessive urge to confess to real and imagined indiscretions etc. etc. etc.
Sadly, for myself (and other O.C.D. sufferers) the only theraputic approach that reliably helps to manage the conditions is E.R.P. (aka Exposure Response Prevention).
Of course, medication can take the edge off the intrusive thoughts. I’m personally very thankful I’m now on clomipramine, a tricyclic that used to be the standard med proscribed to OCD sufferers, which seems to reduce the "stickiness" of my brain, with the only notable side-effect of also reducing the depth of my R.E.M. sleep. I find this preferable to Sertraline (and other S.S.R.I.s) which I was on for fifteen years and made me feel as though the intrusive thoughts and images were cordoned off behind a giant metal door that I couldn’t open even if I wanted to. Setraline made me feel like I lived my life behind a numbing cloak of cotton wool and also made my short-term memory fuzzy and unrealiable. It did reduce the doomy feelings that brought on suicidal ideation though, as I discovered when I rather abruptly stopped taking it.
I have had a lot of talk therapy and C.B.T. over the years. If the adverts for BetterHelp (and similar services) on YouTube are right that therapy makes you a better romatic prospect then my partner is a very lucky woman indeed! However, they have rarely touched my O.C.D. At its best, C.B.T. has elimited certain compulsions… which, when eliminated, have prompted switched to other compulsions! A classic example of this is when as a teenager I was obsessed with keeping doors closed because I became paranoid that the sudden shutting of a door would startle me, lighting up my nervous system like a firecracker. I would police the house, insisting that my siblings and parents obeyed my door closure edicts. The C.B.T. counsellor challenged the illogic of my thought processes and what would happen if I, instead, left a door open. I was challenged to keep increasing the number of doors left open in the house. I was cured… until I became obsessive about having doors open because I was paranoid that closing them would cut off air flow, making it hard for me to breathe! Rinse and repeat.
Honestly, compulsions are just the very thin edge of the O.C.D. brain wedge. They’re the tip of the iceberg that other people see. That’s why when O.C.D. has traditionally been depicted on television and in film – both primarily visual mediums – the afflicted character will only suffer from compulsions related to washing and tidying. It is much easier to depict these visually that the intrusive thoughts and images that prompt the rituals.
By contrast, not only does E.R.P. prevent you from performing the comforting rituals you want to perform which provide you with short-term release from internal suffering… it also requires you to look straight-on at your fears and throw yourself headfirst into the experience of them like an unhinged Bear Grylls faced with an alligator swamp!
This is not fun and frankly I can understand why a lot of people choose instead to pay for talk therapy which allows you to ruminate at leisure on all the topics that you spend the rest of your time internally ruminating upon.*
For someone who spent any time at university when they weren’t studying, or obsessively reading about the symptoms of brain tumours, performing comedy, I dislike most stand-up. One of the very few exceptions to that rule is the comedy of Maria Bamford who also suffers from O.C.D. Most O.C.D. sufferers won’t tell you directly about the kinds of thoughts and images they have because these tend to be so taboo and viscerally upsetting that voicing them aloud risks alienating others and even getting the O.C.D. sufferer in trouble [this having happened to me in both personal and professional contexts – if you can get a therapist who isn’t accountable to your manager, do]. By contrast, Bamford is fearless about discussing the kinds of thoughts and images that have plagued her and I highly recommend watching her three-part series Noooo-CD for a better understanding of the experience of the condition. I found it hugely relatable and cathartic to watch.
Having obscene violent and sexual thoughts can really make you feel like a shitty human being. Now, don’t get me wrong, I’ve also done things that make me a s̶h̶i̶t̶t̶y̶ human being, but if I’d done even one hundredth of the things I have experienced instrusive thoughts of me doing, I would be monstrous.
Many members of the I.D.F. are actually doing these things right now as I type.
Like many of your reading this, in some regards my mental health is at the lowest ebb its ever been… because how could it not be? There is an active genocide occurred and I live in a country that is materially supporting it. Maybe if I and others had worked a little harder in the 2010s we would have got Corbyn into Downing Street and then we wouldn’t have a Labour government complicit in Israeli war crimes. But we didn’t and we do. I, like many of you, have spent the last year refusing – or trying not – to turn our eyes away from images of humans crushed under tanks, children with bullets in their brains or severed limbs, whole families pulverised. All of us, whether with O.C.D. or not, have images that are now seared into our brains. For me, it is the undifferentiated flesh of residents of an apartment hanging from their window like shish kebab at a take-out. This image now leaps into my mind’s eye behind my eyelids when at home and when at work.
I used to feel guilty for such images. But now I feel grief and rage. Because those images aren’t coming from me – they never did really. They come for the horror of the so-called liberal international order. If I have guilt, it is due to my complicit in their crimes through my paying taxes and propping up the economy.
But I can no longer pretend that I am a uniquely sub-human monster when I see footage of I.D.F. soldiers dancing and cheering in the ruins of civilians’ homes. I don’t think these soldiers are sub-human monsters either, though their actions are unquestionably monstrous. If I’d grown up in their shoes maybe, grimly, I would be doing the same.
But I know that when my family’s friends were killed by the I.R.A. during the Omagh bombings (and I was lucky not to lose my cousin) – despite my feelings of anger and disgust [feelings which were challenged and undercut by an Irish lecturer some years later at uni who was sympathetic towards the I.R.A.] I still would never have supported bombing a school or hospital even if I knew that those who had perpetrated the bombing were in or beneath the building. No fucking way.
So, in a sense, I feel like being able to look at these injustices and atrocities in a clear-sighted way has allowed me to confront the O.C.D. octopus.
Finally, if you pray, I ask you to give a minute of silence for those Palestinian and Lebanese citizens who struggle with mental health, especially O.C.D. and schizophrenia. I can’t imagine a worse Hell than having such a condition while your country is bombed and besieged by a country much richer and more powerful than your own. I ask you to donate to Medical Aid for Palestinians, Doctors Without Borders or a similar organisation of your choice if you appreciated this article.
*I actually think talk therapy is potentially useful for self-insight and effective for some conditions. I think it seriously risks just indulging the confessional impulses of an O.C.D. sufferer, however.