An essay of encouragement for those battling OCD

• Contains adult language

I can be a grinch when it comes to roller coasters. A handful of times I’ve enjoyed riding them, but the types I’m talking about are the ones that your grandma takes you on at the state fair the summer before you start your first year of “big kid school.” 

The sensation of my insides being heaved back and forth and up and down is unsettling to me. Then, when you mix in my steady stream of thoughts reminding me that I am literally riding a glorified mining cart down steep declines at highway speeds for shits and giggles, I feel no joy – I feel pure terror.

The summer of 2022, we took our two girls and several close friends to Disneyland to celebrate our older daughter’s 5th birthday. I was prepared from the outset of the trip to turn down any peer-pressuring from our friends to get on any big roller coasters – I’ve got a big job, gotta watch the kids.

After a few trips on G-rated rides with the kiddo’s, a group of the adults decided to find a real ride to do without kids. I was immediately ready to whip out my excuse when one of our friends said she was thinking of a ride that would be within my comfort zone. 

The ride she had in mind was the Spider-Man Web-Slinger ride – the newest ride in the park at that time (sidenote: it’s fucking fantastic). When we arrived however, we found out it would be about two and a half hours’ wait. Quickly, another friend found a different ride nearby. Typically, this ride had long waits too, but at that moment, the wait was surprisingly short,

“Let’s do Guardians! It might be a little scary for you Sean, but it’s really not that bad.”

I followed like a sheep wondering what the hell “Guardians” could be. 

The moment we arrived, a mild panic washed over me. I craned my neck back to look towards the top of the high tower and realized my friends intended to free-fall from this thing for fun. 

Ermmmm. Nope. No bueno friends. I bid you farewell – I suddenly realized I have no time for waiting in the shortest of lines today – there are little kids I must attend to at once!

Then another voice crept into my head,

Psst! You are not required to run away here – you have a choice.

An inconceivable choice.

Today, the general public is starting to grasp the concept of anxiety – the feeling a person experiences when their body’s stress response is activated. In addition, most people understand that it can become excessive to the point of disrupting daily life; that’s when it becomes a disorder – Generalized Anxiety Disorder (GAD).

Anxiety is a primitive survival mechanism, and it can be useful in certain situations. It used to be helpful for the cavemen when escaping from predators and today, would be completely appropriate to feel if a burglar has entered your home. The body is physiologically changing in preparation to spring into action.

Those who struggle with GAD have chronic, undesirable anxiety. In the modern world, being hyper-alert with a racing heartbeat is not useful for normal day-to-day tasks such as impressing a first date or falling asleep at night.

There is another similar, but different, disorder involving intense anxiety, that most people don’t have an inkling about – Obsessive Compulsive Disorder (OCD). Being able to make a distinction between the two disorders becomes vital though, once you understand how dramatically different they are from each other.

Unfortunately, explaining OCD to others is a monumental challenge. I may appear highly qualified to do it:

• For 11 years I’ve suffered from OCD symptoms 
• I’ve received treatment for a total of 7 years for OCD and GAD
• I was hospitalized and literally almost lost my life due to undiagnosed OCD then decided to write a book about it 
• As a healthcare provider, I’m comfortable explaining complex medical conditions in layman’s terms

But it’s taken time for me to accept my portrayals of the condition as adequate enough to share. 

Others in the OCD community struggle with this as well, and this is one reason why OCD remains a misunderstood condition.

One of my favorite ways to describe what OCD feels like comes from Dr. Sam Greenblatt while he was a guest on the podcast, OCD Stories. Dr. Greenblatt refers to the disorder as an “emotional perfectionism.” The hallmark of the disorder is that sufferers fall into a trap of responding to certain intrusive thoughts or uncomfortable emotions by using compulsive behavior to fix or get rid of the thoughts or negative emotions. 

In both GAD and OCD, the sufferer would ideally like the bad feeling of anxiety to go away, but here’s the fundamental difference – in GAD, a person’s brain can typically be taught how to reduce anxiety by reasoning with their unrealistic fears. 

Cognitive behavioral therapy (CBT), which is incredibly effective for GAD, trains people to use sound reasoning to understand how unrealistic or improbable their fear is, reducing the body’s anxiety.

In OCD, there is no ability to reason. People with OCD already understand that there’s a lack of reasoning – but the completely illogical threat feels real. People like me resort to compulsive behaviors to try extinguishing the fear. Over time, the false sense of relief from the compulsions conditions us to do them more and more and more. Attempting to break this cycle with traditional CBT does an OCD sufferer no good. In essence, it simply points out to the sufferer what they are already aware of without providing any tools to help them.

OCD friends – you and I must rise up to prevent this bully called OCD from knocking us out. We have to be trained to battle it in a different way. We have to learn how to stand up for ourselves and deliver our own punches. We must learn how to fight!

All of us, with or without mental illness, have experienced anxiety and the physical changes it makes in your body. Biologically, the states of stress versus calm can be separated into what’s known as the sympathetic and parasympathetic branches of the autonomic nervous system. These are body processes that are automatically turned on and off based on how we interpret the world around us. 

When our stress response is turned on, heart rate goes up, breathing becomes deeper, and our pupils dilate. When it’s turned off, the heart rate slows, we feel calmer, and our body goes into rest and digest mode.

This is why if you are sitting quietly reading a book but suddenly receive distressing news, it can feel like your body zooms from zero-to-sixty in a split-second as it switches from rest to fight-or-flight mode.

Once it shows up, what do we do with it though? How are you going to respond? Your body has primed you for action by jacking up your heart rate and making you alert. Here are your possible options:

1. Fight – Face your fear head-on. Or…
2. Flight/freeze – Make an attempt to avoid or escape from the fear.

Let’s think about where OCD compulsions fall. Are they a fight response or flight response? I’d argue they are a means of escaping – a flight response. 

The purpose of compulsions, regardless of what type and how much physical movement or thinking is involved, is to reduce the feeling of anxiety. This is what makes them fit into the more passive category of anxiety responses. If you suffer from OCD, think about your compulsions and what you hope to achieve through them – they are likely aimed at avoiding, undoing, fixing, or escaping from the anxiety you are feeling. Furthermore, since you wish you didn’t feel obligated to do the rituals, I’d argue that getting stuck performing compulsions is like accepting defeat – the OCD is hijacking your actions to mandate how you spend your mental energy.

Choosing fight means you’re making the choice to reject the desire to perform compulsions and this means you are forced to face the anxiety. There is no escaping or avoiding the fear here.

Most OCD experts consider the gold standard of treatment Exposure and Response Prevention (ERP). The goal of ERP is to teach an OCD sufferer how to stop performing compulsions by intentionally triggering anxiety and using the anxiety to practice “response prevention.” In other words, tolerating the anxiety without doing any compulsions – fighting. 

For people unfamiliar with how OCD feels, I can tell you – initially, this does not sound like a viable option. When your brain asks you to do a compulsion, it’s not asking, it’s making demands. As though your brain is pressing a gun to the side of your head, it feels like you have no choice but to comply.

Well-known therapist Dr. Michael Greenberg has spoken about the benefit of simply helping his patients realize they don’t have to do their compulsions:

“The way [ERP] works – is by restoring a person’s sense of agency, reminding them they do have a choice.”

Michael Greenberg, Ph.D.

Doing the ritual feels like a much easier option than resisting the ritual, but ultimately, you are making a choice to do it.

Acknowledging your agency to choose gives you the reins. You are, in fact, the one in control, not the OCD, and with practice, you can learn to say no to compulsions. “Response prevention” is a fighter’s response that takes courage, discipline, and a fighting spirit, and consistently rejecting compulsions builds more confidence to continue saying no and heal from the disorder. 

Another argument supporting a fight response as the healthier response is that neurologically it may be enjoyable – that probably doesn’t make any sense, but I’ll try to explain with some science.

Research neuroscientist Dr. Andrew Huberman has conducted several studies about fear and anxiety at his lab at Stanford University. His lab has researched how human and mice brains react when confronted by fear, and the neurological difference between the fight, flight, or freeze responses^1,2. Anxiety levels of the participants were measured while they were presented with one of their greatest fears. The individuals who chose to confront the fear, rather than retreat or freeze, experienced higher anxiety levels than those who ran away or froze with fear. This means the most anxiety-provoking choice, and most challenging choice to make, was the fight response.

OK… resisting compulsions is harder than doing them – no shit, Sherlock. 

But the excruciating act of opting against compulsions may also be associated with gratifying feelings because of the fight response’s connection with the chemical dopamine. 

When studying the brain activity in the mice who made a consistent, conscious decision to confront fear, they noticed that one particular brain area kept getting activated². Incredibly, stimulating that same brain area in both animals and humans causes feelings of intense pleasure by releasing massive amounts of dopamine. This suggests that the act of choosing a fight response may be associated with a release of dopamine in your brain.

Regardless of how much you know about dopamine already, I guarantee that you love it. All humans love dopamine. Anytime you think that feels soooo good – that’s the dopamine talking. You can thank it for the way it feels to hit a last-second 3-point jumpshot, or bite into a warm cookie, or have an orgasm. Excluding the connection with dopamine and addiction, receiving loads of dopamine is good for your health. It boosts confidence and your ability to plan for the future. 

Perhaps this in-part forms a neurological basis for why ERP is such a powerful treatment tool. The concept is incredibly similar to the one in the study. Exposure is the fear-inducing stimulus while response prevention is the act of choosing to fight the instinct to do a compulsion. Performing a compulsion is not unlike fleeing. Getting stuck in an OCD cycle of performing compulsions brings feelings of desperation as you attempt to escape that awful feeling of fear.

Developing a fighter mentality can carry over to other parts of your life as you keep building your mental fighting muscles. I can still hear my therapist teaching me the value of practicing “opposite action” – building your tolerance to discomfort by doing the opposite of what your fear tells you to do. 

Well, that day at Disney, that’s exactly what I chose to do. 

The ride my group of friends was marching towards had been given a new name since I’d been to the theme park 11 years prior – I’d known it as “The Tower of Terror.” During the ride, guests are seated on an elevator that goes up and down a 183-foot elevator shaft repeatedly dropping them into free fall. Not a big deal for thrill-ride fans, but for me, I was petrified. 

My initial reaction was to excuse myself from the line, but I stopped long enough to recognize a good, but horrifying, opportunity was presenting itself to me:

This will be good practice, you can do this! 

I expected no enjoyment from the experience. As we crept closer to the elevator doors at the front of the line, I did my best to appear calm while my insides surged with adrenaline. 

When it was our turn to be seated on the ride, I nervously looked around to analyze the safeguards this ride was equipped with. There was no safety bar for your lap and nothing to secure you by your shoulders or chest either. Instead, my seat was equipped with a frayed, lap-only seat belt that looked like a replica of the middle seat belt from my grandfather’s Oldsmobile Cutlass that I rode in growing up.

Doesn’t this damn ride have any other safety features? This flimsy piece of cloth that looks older than me is responsible for preventing my terrifying death in about thirty seconds?! 

Eventually, I noticed one additional “feature” I’d previously overlooked – bonus handlebars flanking each seat.

Thank you, thank you, thank you Disney Corporation! If your seat belt fails, it’s up to me to cling on with my bare hands to avoid being slain by this death trap.

Filled with dread, I gripped the shit out of those handlebars and the ride began. I screamed my lungs out and couldn’t wait for it to end – until I realized –

This isn’t that bad! I thought this would be much worse! Am I… enjoying this?! What the fuck is happening to me? This is fun!

Pushing your way through obsessive thoughts without compulsions won’t end up being a fun ride that you’ll willingly wait in line to experience, but my theme park triumph illustrates how choosing the hard path can wind up rewarding you. OCD takes time, relationships, and experiences away from you, and beating it requires you to stand up for yourself. Making the choice to fight against OCD is hard – in the moment, it can feel nearly impossible. 

On his popular wellness podcast OnPurpose, Jay Shetty once said,

“The reason we quit doing something is because of the story we tell ourselves about it.”

Jay Shetty

I easily could have talked myself right out of the line that day and I never would have found out how capable I was.

There are rewards for putting up the fight. As you practice fighting, you’ll become more confident and more capable of handling fear when it arises, and each time you choose to dictate your own actions, it is a victory. Your hopes of living a normal life again might stop sounding delusional and a future that you aren’t dreading can emerge. My friend, you’re doing far more than beating OCD – you’re taking your life back.

Thank you for reading!

Citations with links

1.  Balban, Melis, Erin Cafaro, Lauren Fletcher, Marlon Washington, Maryam Bijanzadeh, A. Lee, Edward Chang, and Andrew Huberman. “Human Responses to Visually Evoked Threat”, Current Biology, 31, no. 3 (November 25, 2020): 601-12. https://doi.org/10.1016/j.cub.2020.11.035.
2. Salay, Lindsey, Nao Ishiko, and Andrew Huberman. “A Midline Thalamic Circuit Determines Reactions to Visual Threat”, Nature, no. 557 (May 2, 2018): 183-89. https://doi.org/10.1038/s41586-018-0078-2.