6 Harmful Misconceptions about OCD
In my 18 years with OCD, I have heard many strange things.
Obsessive-compulsive disorder, as it is clinically called, is a mental illness characterized by physical or mental ritualistic behavior (compulsions) that are designed by the person to reduce the negative feelings that are elicited by certain uncomfortable thoughts or experiences (obsessions). From the perspective of the person, their compulsions will reduce the likelihood of a certain feared outcome coming to pass (like their family dying, or getting cancer). As with most mental illnesses, it involves high levels of stress.
And as with any illness, our society is plagued with misunderstandings.
The information provided below is based on almost two decades of personal experience with OCD, as well as clinical information garnered from licensed therapists and OCD specialists through numerous rounds of consultation and treatment. Importantly, I am not a psychologist myself. Therefore, you should absolutely not apply any of the things you read below to your own life, without help from a professional healthcare worker. This article merely seeks to correct common misinformation.
Honorable mention: OCD is about washing, apparently. No, it is not. Some people have anxieties regarding dirtiness or contamination, but there is an endless number of topics that a person’s OCD can revolve around.
Misconception 1: You (or Someone You Know) Probably Has OCD
OCD is not something that just comes and goes within a person’s life.
It is a clinically assessed mental illness: so, in order to get the diagnosis, you need to fulfill a myriad of criteria outside of just having the symptoms. It is not enough to relate to some of the emotional or behavioral patterns of OCD (like washing your hands very often or being afraid of the number 13). Only about two percent of the population ever has OCD; and suspicions are only suspicions until they have been assessed professionally and clinically.
Most likely, you do not have OCD, and neither does that person you know.
Misconception 2: OCD Is about Being Perfectionistic
Perfectionism and OCD are two completely different things.
Whereas perfectionism revolves around performance and flawlessness, OCD is about intense anxieties regarding a personal threat. Naturally, being perfectionistic might involve severe negative feelings, but the behaviors of a perfectionistic individual and one with OCD have different foundations. In some ways, perfectionism is more like a personality dimension that applies to us all (because anyone is either high or low or somewhere in between), while OCD is a symptomatic cluster of specific patterns of thoughts, feelings, and actions.
They are not the same, and you can have one without having the other.
Misconception 3: OCD Can Be Used as A Personality Trait
To my disappointment, some people use the label as an adjective.
Common sayings like “I am kind of OCD” or “That is so OCD” are heavily misguided and disgustingly common. Obsessive-compulsive disorder is not some cute descriptive word that you can use to seem relatable or funny or interesting, or even to communicate the fact that you are a perfectionist. It is a deeply challenging and utterly exhausting mental illness, which steals time and energy from everyday activities.
You cannot “be” OCD any more than you can “be” depression or a stroke.
Misconception 4: OCD Is about Fear
Despite involving strong feelings of fear, OCD is not about that at its core.
On the other hand, obsessive-compulsive disorder is about uncertainty. Fear is more of an aftereffect of not being entirely certain that something is safe, because the compulsions (that is, the ritualistic behaviors) that people with OCD exhibit are essentially about making sure to prevent something frightening from potentially happening, rather than merely being afraid of that thing happening; and all OCD anxieties can be traced back to thoughts that start with “What if” (like “What if writing the number 13 will cause my family to die?”). OCD treatments fortunately do not directly target the fears but, rather, the uncertainties of their patients (so, rather than doing the fairly dangerous thing of having a germaphobic person actually touch a contaminated object, they are encouraged to do everyday activities that might involve bacteria but also might not).
In the end, it is not about the fear of a specific outcome but about the uncertainty of possibly causing this outcome to happen.
Misconception 5: People with OCD Just Need to Think Rationally
No mental illness (to my knowledge) is cured from logical thinking alone.
Emotions cannot be manipulated through rational thought: the fear, anxiety, and uncertainty that frequent a person with OCD, need to be targeted by other means. OCD is about irrational uncertainties. For that reason, the disorder is often strengthened by such logical thinking: often called rumination, which might involve the attempt of “logic-ing your way out” of feeling uncertain (and, thus, failing to properly process this feeling that needs to be felt), by providing a rational perspective on the matter.
Thinking that you are safe does not make your mind feel like you are.
Misconception 6: OCD Can Be Cured Through Exposure Alone
Like all irrational fears, OCD can be cured through exposure therapy.
Contrary to social consensus, exposure therapy involves not one, but two, principles: (1) Exposing yourself to the object of your fear (like deliberately writing down the letter 13 whilst thinking of your family), and (2) behaving like you are calm and content during the task. Without this second act, the exposure part would be pointless. After all, you need to teach your body to be calm and comfortable in the situation that makes you irrationally scared — and this can only be done by acting unbothered despite being in a state of discomfort and uncertainty.
While the exposure part covers the external or internal object that stresses you, the behavior part of the treatment corrects your personal reaction to it.
In other words, here are the truths tied to the misconceptions above:
- Truth 1: You likely do not have OCD. It is rare and must be assessed.
- Truth 2: OCD is not perfectionism. One can exist without the other.
- Truth 3: OCD is not a descriptive word. It is a serious mental illness.
- Truth 4: At its core, OCD is about uncertainty. It asks, “What if?”
- Truth 5: Rational thinking does not solve OCD. It might worsen it.
- Truth 6: Exposure therapy involves both exposure and correct action
OCD is much different and more serious than what it seems to most people.
And so it is important that we do not misunderstand it.
