A wild time to have OCD
“I’m not much of a germ guy” is how I open Standard Reply #3 to people asking how my OCD’s doing during the pandemic. It’s true — my obsessive-compulsive disorder is a binary star system. Sigma Orionis A is intrusive thoughts (along with the real heart of the disorder, compulsive mental rituals to resist or avoid them). And Sigma Orionis B is “moral scrupulosity,” which is the compulsion to always act perfectly towards other people, and the tendency to dwell on the details of my words and actions, looking for anything that could have caused harm. OCD attacks the things that are most important to you. The most important things to me are imagination and the public good.
Along with these two loud signals, my OCD also has a lot of general static of small obsessions. It’s a standard-issue kit. As a child, I had ticcy physical compulsions and prayer stuff. As an adult, it’s a tidy package of lock-checking, symmetry, and, yes, hand-washing and germs. These things aren’t the life-ruiner that my mental obsessions and compulsions are. I can mostly handle them without meds; the meds are for the interior stuff. But they’re around, and during the current pandemic, I’ve certainly become more germphobic and anxious about the physical world.
It’s been observed that this is a difficult time for people with OCD. What I wish I could convey is how funny it is, too. After years of treatment for my tendency to worry about the cleanliness of my hands, to perform odd mental rituals, to worry about whether there’s an invisible layer of danger over things I touch, and to assume that my smallest unconsidered action could destroy somebody’s life, I’m now living in a world where it’s true. Our hands are filthy; there is danger everywhere; sing a song while you wash, everyone — and remember, lives depend on your doorknobs being sterilized properly. They do!
Exposure and response prevention therapy, a common and effective talk treatment for OCD, involves asking the sufferer to assume the same reasonable risks as a person without OCD. Right now, the reasonable risks are very small ones. The protective measures we’ve been told to observe are things that — in a normal population, and at a normal time — would be compulsions typical of a person with severe, untreated OCD. So the practice I’m embracing is to follow the stringent CDC guidelines, and the even more stringent California shelter-in-place order. That’s my guide to what’s “normal risk” right now. I will take no risks beyond that, but I also am trying not to take fewer. When compulsions arise to worry about virus on my shoes, to keep one hand clean all the time, or to over-launder my clothes (a genuine COVID-19 risk, as I need to do it at a cramped and busy neighborhood laundromat), I have to ignore them.
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I live with two roommates. Neither of them is sheltering in place. They feel that going out daily to see a closed group of friends in two other households is a reasonable risk to take, considering the psychological risks of isolation, the attendant increased risk of suicide, and the benefits of sharing burdens with their found family.
I think their moral calculus is wrong. I think that the way to care for our found family right now is to call them. I have no other friends or family who are continuing to visit each other, and I’ve told them that I think what they’re doing is outside the standards of our community. They strongly feel that this disagreement is something we should all process together, and that some compromise is possible that will make everyone comfortable without requiring them to shelter in place. I’m doing my best to halt these discussions, and to stay in my room, trying my best to privately keep to the terms of the order.
My God, it makes me feel insane. It makes me feel as if my OCD has gotten wildly, cartoonishly out of control, and I’m living in a movie about a person who’s so germphobic that they can’t leave their bedroom. Intellectually, I know that it is normal right now to do what I’m doing. But my OCD tells me to ask: am I acting out of keeping with the standards of my community? Am I the person in my house who’s not acting right? Am I too “crazy” to be responsible for my own well-being? By asking my roommates to quarantine with me, am I driving them towards breakdown and suicide? Many of these questions are inflected with internalized mental health stigma that I would never encourage in anyone else, but OCD, like a virus, will seize on anything it finds inside of us.
With those obsessions come compulsions, primarily the urge to submit what’s happening to my friends for judgement, to seek external reassurance that I’m doing the right thing. It will never satisfy me, because I have OCD, and the whole point of a compulsion is that it doesn’t work for long. The handwashing is invalidated by touching the wall. You might have checked the lock, but maybe the very act of checking dislodged it. The friend’s reassurance needs renewing an hour later. To be honest, this is the worst COVID-19-themed OCD I’ve been dealing with, not the germ stuff: this overwhelming anxiety about whether my quarantine is harming people.
It’s a rough time. I don’t have a solution. All I can do is keep myself, take my meds, follow medical orders to isolate, ignore what I can, take lots of walks, and keep working on my day job and my writing. I am cautious of “work” as a cure-all, both personally and as a part of a work-obsessed society, but there’s a difference between empty productivity and active labor to make the world better, and the latter is what I try to do with both my writing and my archiving. Right now, archiving is limited to backend improvements to the catalog and online collections, but each thing I do provides a fresh neural link between information and the people who want it. And writing is always unlimited. Nothing comforts me — really comforts me, warms me, without the need for renewal, because it’s not a compulsive comforting but something solid and real — like knowing that.