The Prisoner of 'What If': Life in the Grip of OCD

I don't remember a time before the fear. It's a strange thing to say, but looking back, it feels like the seeds of what I now know as Obsessive-Compulsive Disorder (OCD) were sown incredibly early. I was only four or five, a tiny human in a big world, but the terror of being alone in my room at night was all-consuming. My thoughts would spiral, painting vivid, terrifying scenarios, and I'd lie there, physically shaking, crying, desperately trying to push away the relentless whispers of "what if." Shadows from the tree outside my window would morph into monsters, every creak and groan of the house amplified into a harbinger of doom. I was trapped in a mental battle I couldn't win.

Then came so many moves. The big move, however, occurred when I was in fifth grade and involved a new country and a new house – with bars on every window. The previous occupants had experienced multiple break-ins, and suddenly, my childhood anxieties found concrete fuel. The bars, meant to protect, only intensified my fear, making the world outside seem even more menacing. My anxiety soared, and sleep became a distant, often unreachable, friend.

Fast forward to 2002, the year my first child was born. Motherhood, a time often celebrated for its joy, brought my OCD compulsions to a head. My nightly routine before bed, once a quick lock-check, morphed into a two to three-hour ritual. I’d meticulously check behind every closed door, under every bed, behind every shower curtain, behind every window curtain. Each lock on every door had to be tested, not just once, but repeatedly, until a feeling of "rightness" momentarily settled. It was exhausting, debilitating, and incredibly isolating.

Understanding the Language of OCD

For anyone who hasn't experienced it, OCD can be a confusing and often misunderstood condition. It's not just about being tidy or liking things a certain way; it's a deeply distressing neurological disorder characterized by two main components:

• OCD Thinking (Obsessions): These are persistent, unwanted, intrusive thoughts, images, or urges that cause significant anxiety or distress. They are not simply worries about real-life problems. For me, early on, these were the "what if something bad happens" thoughts that would replay endlessly in my mind, creating vivid and terrifying scenarios. Later, they manifested as a relentless feeling that if I didn't perform a certain action, something terrible would occur.

• Examples of Obsessions:

• Fear of contamination (e.g., intense worry about germs, dirt, or illness).

• Fear of causing harm to oneself or others (e.g., intrusive thoughts of accidents or violence).

• Need for symmetry or order (e.g., feeling that things must be perfectly aligned or arranged).

• Doubts about actions (e.g., constantly questioning if a task was done correctly, like turning off the stove).

• Intrusive sexual or religious thoughts (these can be particularly distressing due to their nature).

• OCD Compulsions: These are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession, or according to rigid rules. They are aimed at preventing or reducing anxiety or distress, or preventing a dreaded event or situation. However, these compulsions are often not realistically connected to what they are designed to neutralize or prevent, or they are clearly excessive. My nightly rituals of checking and re-checking were classic compulsions.

• Examples of Compulsions:

• Washing and cleaning (e.g., excessive hand washing, showering, or cleaning objects).

• Checking (e.g., repeatedly checking locks, appliances, or switches).

• Repeating (e.g., re-reading, re-writing, or re-doing actions).

• Counting (e.g., counting steps, objects, or performing mental calculations).

• Ordering and arranging (e.g., arranging items in a specific way).

• Seeking reassurance (e.g., repeatedly asking others if everything is okay).

The Echoes of Our Past: OCD and Family Dynamics

It's fascinating, and often painful, to see how OCD thinking and compulsions can manifest, especially in individuals who have grown up in certain environments. While OCD has a genetic component, our early experiences can significantly shape its expression.

• Dysfunctional Families: In environments lacking consistent emotional support, clear boundaries, or healthy communication, children might develop a heightened sense of anxiety and a need for control. This can translate into OCD where rituals become a way to create order in a chaotic internal or external world. The intense need to predict and prevent negative outcomes, even through irrational means, can be a coping mechanism developed in unpredictable environments.

• High-Control Families: Growing up in a household with rigid rules, perfectionistic expectations, and little room for error can foster a deep fear of making mistakes or failing. This can feed into obsessions about accuracy and compulsions like excessive checking or repeating tasks until they are "perfect." The internal critic, amplified by external pressures, becomes relentless.

• High-Performance Families: Similar to high-control families, those that emphasize achievement and success can inadvertently instill a fear of inadequacy. This can lead to obsessions about performance, fear of failure, and compulsions to over-prepare, re-do tasks, or seek constant validation. The internal pressure to be "enough" can be immense.

• Families Where Anxiety is Genetically Passed Down: If anxiety disorders run in a family, there's a higher predisposition for individuals to develop similar conditions, including OCD. The genetic vulnerability interacts with environmental factors, meaning that while the predisposition might be there, the specific manifestations and triggers can be shaped by family dynamics and life experiences.

For me, as I delved into therapy, I began to uncover layers of unprocessed and unresolved anger and fear that I had been holding onto for years. It was as if my OCD had become a container for all these unexpressed emotions, a frantic attempt to control an internal world that felt overwhelming. It wasn't just about the locks and the shadows; it was about the deeper fears that had taken root, the need for safety and certainty that had gone unmet in subtle, yet profound ways.

My journey is far from over, but understanding the mechanisms of OCD, recognizing its roots, and confronting the underlying emotions has been incredibly liberating. It's a continuous process of challenging those intrusive thoughts, resisting the urge to perform compulsions, and, most importantly, learning to be compassionate with myself.

©Lisa King, MS, LPC, NCC