Not All Door Knobs and Towels

/ The EFT Clinic/

Not All Door Knobs and Towels: Autogenous OCD and the Fear of Seeking Help and Healing

by Patrick Powers, LMFT

Obsessive-Compulsive Disorder is characterized by unwanted, distressing thoughts of essentially unlimited variety (obsessions) that lead to engaging in time- and energy-consuming efforts to stop or neutralize the thoughts and/or soothe the anxiety brought on by obsessions (compulsions). Paradoxically, over time, these responses actually:

  1. Ensure the thoughts persist and even increase in frequency

  2. Increase the anxiety that accompanies the thoughts

  3. Require more and more time and energy, slowly decreasing the ability to engage with and enjoy life

When most people think of Obsessive-Compulsive Disorder, their minds conjure up images of people who might be very particular about how towels are to be folded and other such things, or perhaps a person who appears more fearful than most about using public bathrooms or catching the flu from railings and door knobs. 

While ordering (needing things to be “just so”) and contamination fears can all be present for someone with OCD — in addition to their portrayal in media typically failing to adequately capture the often debilitating nature of the struggle faced by those with OCD — ignorance, taboo and natural storytelling limitations keep viewers from seeing the diversity of obsessional thoughts that plague sufferers and can keep them from seeking the help they need. 

The truth is that the obsessions can be about nearly anything and frequently center around themes that are most dissimilar to a person’s genuine self. It is precisely because the thought’s initial presence feels so out-of-nowhere, bizarre and contrary to one’s truest values and desires that it becomes anchored in the brain in the first place. Whereas others ignore or dismiss random, disturbing thoughts or mental images, a person with OCD becomes caught in a terrifying loop, haunted by these thoughts that come to represent their greatest fears.

For example, a woman who loves her children with all her heart, reminded of a news story or TV movie about an abusive mother, has the image flash across her mind of harming her own children. Knowing it is the last thing she would ever want to do, the presence of this thought sets off her emotional fire alarm. The physiological sensations that follow reinforce to her brain that the thought, rather than being a random, uncontrollable cognitive blip, is meaningful and potentially dangerous. The intensity of this feeling causes that same thought (and similar ones) to return frequently.

When behaviors are adjusted in response to these feared thoughts, the neurological rut becomes deeper and the cycle more difficult to break. 

Compulsions can difficult to spot — at least initially. Constant analysis of feelings, sensations, impulses (past and present); avoidance of situations that might inspire additional thoughts of possible harm; avoidance of sources of information that might include news of abuse, compulsive reassurance seeking, either from loved ones or strangers online; and various other self-soothing strategies are utilized to achieve temporary relief. The tragic trade-off is that these behaviors further reinforce to the brain that the thoughts are significant and dangerous.

Now, consider for a moment the additional layer of fear, guilt, and shame that would seem nearly inevitable to a person reaching out for help with this particular problem. 

How does one bring up to a friend or family member the fact that they experience terrible thoughts about harming their children and are so afraid of themselves that they avoid making sandwiches around them due to the need to hold knives? Would the person she disclosed this to judge her harshly? Be fearful of her? Call child protective services? Act as if her worst fears were true? 

Now, consider these additional obsessional themes and ponder how it might feel to be beset by constant, intrusive thoughts about: 

  • Causing physical harm to others, either strangers of loved ones, accidentally or intentionally.

  • Engaging in taboo sexual behaviors outside of your values, including infidelity, incest, pedophilia etc.

  • Inadvertently committing blasphemy or sacrilege

  • Being secretly gay or transgender

  • Inevitably cheating on or breaking the heart of your partner or spouse

  • Committing property crimes like theft or vandalism

Considering how difficult it would be to disclose these things to another person (even a therapist), is it any wonder the average length of time it takes for people with OCD to find competent treatment is 17 years from the onset of symptoms? That is a long time to suffer in silence. 

The good news is that Obsessive-Compulsive Disorder is one of the most well understood and treatable problems in the field of mental health.

If you struggle with distressing, intrusive thoughts:

You are not alone.

You are not a monster.

Help is available.