‘You’ve got a bit OCD about all this handwashing, haven’t you?’ People say things like this all the time, to mock others’ habits and the routines they follow a little too closely. Usually, it’s not meant to be offensive. Just harmless teasing.
But when I hear someone say something like this, it hurts. Because I actually have OCD.
Obsessive compulsive disorder is a serious disease which interferes with daily functioning and causes significant distress. At its worst, it is totally debilitating. Those who suffer most severely can become housebound or resort to substance abuse as a coping mechanism.
The disorder has two aspects. Obsessions are intrusive, repetitive thoughts. Compulsions are actions which the sufferer cannot help performing over and over again. Often, compulsions are linked to obsessions. If someone worries obsessively about hygiene, they might wash their hands compulsively. If they worry obsessively about their home being burgled, they might check their locks repetitively before leaving home. But it is also possible to have obsessions without associated compulsions. Some people worry obsessively about whether they are acting morally or in accordance with religious beliefs; some have intrusive sexual thoughts that they cannot banish; others worry obsessively that they might lose control of themselves and do something violent.
There are obviously degrees of severity but, when you have strong compulsions, it can feel like you simply have no control over what you are doing. When you have severe obsessions, it can be like you are being suffocated by your own thoughts.
OCD is also relatively common. Around 2 per cent of the population in Australia has the condition. There is some treatment available, mostly in the form of counselling and medication, but it is often therapeutic rather than curative.
'I certainly do think people should stop treating OCD as a joke as soon as they know better. This joke stops being funny when you understand it.'
You might be thinking: if 2 per cent of the population have OCD, why don’t we always see people who cannot stop washing their hands or tidying their workspace? There are a few reasons.
First, for those sufferers who have obsessions and no compulsions, there simply is no visible manifestation of the condition.
Second, many compulsions are easy to hide. If someone saves every file on their computer in three different places before leaving the office each day because they worry obsessively about losing their work, it is not that hard to make sure no one notices.
Third, those people who suffer so severely that they become housebound, worrying perhaps about germs or the lack of hygiene outside, are just not out in public to see.
And, on top of all this, it may be that those people whom you playfully suggest might have OCD when you see them checking something a few too many times do in fact have the condition.
How might someone with the condition feel when they hear such remarks? Well, how would you feel if someone made a joke about whatever causes the most pain in your life?
Of course, no decent person would ever use the term in a flippant way if they realized that someone with the condition might hear them, but this is not a possibility most people would even countenance. People tend to think of the condition as extremely rare and strange.
Actually, I think there is a tendency to think of OCD as if it is a fictional disease. Maybe some character in a movie or TV sitcom has the condition — probably some sad, comic character — but it’s not really out there in the world.
And that is a reasonable thing to think. Probably, no one has ever told you that they have the condition and you may not see much evidence of it (or realise you are seeing evidence of it) when people in your midst do suffer from it.
But that’s the thing. Someone might be suffering terribly from OCD, but they won’t tell you about it, and they will try to hide its manifestations, because it is treated as a punchline. Would you tell anyone that you have high cholesterol, or low blood pressure, or an iron deficiency, if these were things people laughed about?
I don’t think anyone needs to feel guilty if they have sometimes used the term ‘OCD’ in a disrespectful way. I confess: I did it myself before I was diagnosed. (Strangely, I had no idea I had the condition until a psychiatrist told me, and then everything made sense). It was naïve of me to do so but I don’t think it was worse than that. Sometimes we do things innocently which cause unforeseen harm. We might regret doing those things, but we shouldn’t condemn ourselves for them.
But I certainly do think people should stop treating OCD as a joke as soon as they know better.
This joke stops being funny when you understand it.
The author is an Australian academic working overseas. He was diagnosed with obsessive compulsive disorder in 2016.
Image credit: Man telling joke to upset woman (fizkes/Getty Images)