When I was in fifth grade, I convinced myself I was pregnant. I had never even kissed a boy. A slight stomachache after guzzling down my morning glass of milk became the beginning of early-onset morning sickness. A fleeting urge for bacon at a time that wasn’t breakfast suddenly meant that I was experiencing a full-fledged pregnancy craving. I would look around the band room and stare at the other girls in my class, wishing so deeply I was them so I wouldn’t have to deal with this phantom baby.
The following summer, I was certain I had developed a powerful addiction to making my little sister’s Barbie doll, a foxy brunette called Nancy, do back walkovers. During a sixteen-hour road trip from Chicago to Vermont, I picked up Nancy and mindlessly began kicking her leg back over her head and onto my thigh. As I flipped her in circles over and over, I started to worry I would never be able to stop. I pictured a future bound to this motion alone, where the only escape would be a bedridden life with my hands permanently restrained to my sides. Terrified of the fate ahead of me, I cried and pleaded with my mother to hide the Barbie in the glovebox, out of sight.
By the end of sixth grade, I convinced myself that I was going blind (I couldn’t see in the dark), that my lung had collapsed (I realized I could breathe manually), that I was dying of cancer (I discovered a mole on my chest), and that I was passionately suicidal (I got too close to the edge of my father’s balcony). I slept with the lights on, went to the emergency room when I felt my breaths were too shallow, and spent every other night on a mattress in my mother’s room on the off chance I’d sleepwalk to the kitchen and stab myself in the heart.
Of course, none of these fears came true. My imagined due date rolled around with no contractions, I didn’t suffer from any Barbie-related withdrawals, and I learned to trust the doctors who told me I was healthy. But despite the high turnover rate of my neuroses, I lacked the essential concoction of insight and perspective to realize they would eventually fade.
For most of my life, I chalked up my intolerance for uncertainty as a symptom of being a “worrywort.” My parents seemed to tie my perpetual doom to my capacity for empathy, telling me that I “just cared too much.” My middle school therapist, an older woman who sat me down with a mound of clay and a mug of lemonade each session, labeled my disposition as “irrational.” Though I can’t quite disagree with them, my concerns were operating along an axis far more penetrating than worry alone.
By the time I was a seasoned high schooler, the themes of my fears had morphed from absurd to abhorrent. My wide-eyed childhood irrationality turned inward, shifting into existential questions aimed at navigating the liminal space between truth and delusion. I cycled through the more universal dilemmas: Is this all a simulation? Are dreams our reality? Is everything you see, everyone you love, merely a figment of your imagination? Each question would surge me into obsessive contemplation, driving a wedge between the life around me and the doubt that threatened to squash it.
Sometime in my sophomore year amidst a weed-induced existential rant with my best friend, a question of my own mortality crept out from the depths of my “what ifs.” Am I immortal? It was a fleeting idea that turned over in my brain one too many times—causing that deep sense of doom to slither out and turn a hypothetical into an actuality.
Later that night in the safety of my bathtub, I gave myself an ultimatum: to conquer this new reality before I got out of the tub. I leaned back, avoiding the faucet, and questions and doubts and guilt over my questions and doubts seemed to cloud over the colorful splotches behind my eyelids. The waterline moved up and down my thighs and I wondered how I would cope with seeing everyone I love die over and over again. I decided that if I was right, and my life never ended, I would put myself in a sort of anesthetized state—like Woody Allen did in the movie Sleeper.
The next bout of fears shifted my focus from mortality to morality, casting doubt on the substance of my personhood. Are your morals authentic or manufactured? How can you trust your ethics if they are determined by a world that is simulated, synthetic, or nonexistent? Are you a sociopath? Are you a deviant? The urgency to internalize the weight of these questions escalated as they threatened to crumble the parts of myself I held most close. I knew I was a good person, in action. I had a big group of friends, a solid love life, an endless pit of empathy, and an unwavering drive to make my loved ones giggle. Still, I wasn’t convinced that the “good” parts of me were enough to make up for the darkness that could be lurking behind them.
In attempts to prepare for a life in case my fears were, in fact, true, I spent most nights planning for my latent demise. If you ever feel out of control, like hurting yourself or hurting someone else, drop everything and check yourself into a psych ward. If everyone you love turns against you, do everything you can to make amends… if that fails and you have no choice but to cut your life short, take comfort in your condemned fate with the knowledge that underneath it all, you mean well. I clung to reading, writing, and cooking for comfort as I ruminated over the probably impossible possibility of a horrifying timeline. In my final high school English class, a Shakespeare elective, a sliver of my anxiety was assuaged upon the realization that I could read Hamlet in the confines of a cell if it came to that. At least then, I wouldn’t be alone in my madness.
It was sometime soon after my prison delusion that I finally sought out an official explanation for my propensity to catastrophize (one with greater jurisdiction than merely a worried temperament or a Reddit speculation). In the spring before I started college, I met a psychiatrist who diagnosed me with Obsessive-Compulsive Disorder. I sat across from her on a cold couch in a room covered in chevron-framed inspirational quotes as she listed off a series of resoundingly familiar statements. She was nodding enthusiastically with each affirmative, jotting down notes in a fancy turquoise binder. It was strange, seeing the test resting daintily on her lap, as if it wasn’t about to determine my neurological shortcomings.
“Concerns or disgust with bodily waste or secretions,” the psychiatrist said.
Besides the obvious ones?
“Um… never,” I responded unsteadily.
“Need to reread or rewrite a sentence, phrase, or passage until ‘just right’.”
I can’t finish reading a sentence until each letter moves along the perfectly horizontal imagined axis that extends to my periphery. If the letters run askew, I must blink five times.
“Current.”
“Fear might harm self.”
I avoided balconies all through middle school.
“Past.”
“Fear might harm others.”
10949253 search results for: does childhood bed-wetting mean I am a sociopath?
“Current.” I felt my cheeks burning up.
“Fear involving homosexuality.”
Turned out to just be denial.
“Past.”
“Need to touch, tap, or rub.”
I tap each side of the doorknob while entering and exiting any room, even this one.
“Current.”
The diagnosis itself was not much of a surprise, but the clarification that I fell into a subtype of the disorder that is often overlooked was more relieving than I could have hoped. In what is known colloquially as Pure OCD, a sufferer’s obsessions are abstract and ego-dystonic while their compulsions are invisible and ruminative. Pure stands for purely obsessional, meaning that the fabric of its diagnostic criteria shows up in thought and not in action. As opposed to scrubbing hands until they bleed or checking that the stove is off fifty-five times in a row, the compulsions of the Pure OCD sufferer are to think and think and think until they can breathe again.
I knew I never fit into the standard obsessive-compulsive mold, with my messy room, strong stomach, and penchant for spontaneity. I can stick my hand in an arm’s length of dirty dishwater without grimacing and leave the house with the door unlocked without a second thought. But inside my mind, every sentiment and every conviction is filed neatly into a system that allows me to keep my feet on the ground and not float miles and miles from it. I explained this to my psychiatrist after she deemed me purely obsessional, which prompted a reply more graceful than I could have expected: Your brain is as organized as their closets.
It’s easy to cling to my diagnosis for comfort. In fact, externalizing obsessions the way you would an alien invasion or a metastasized tumor is a foundational part of OCD’s gold standard of treatment. One of my therapists even asked me to give my thoughts a name, a request that initially caught me off guard but ultimately led to months of discussion over a monstrous entity in my head we called Patricia. I created a narrative for Patricia, a woman who caught wind of my propensity to doubt, crawled into my brain, hooked onto all the wiring that made me weary, and bent it, over and over again. It was Patricia’s sole purpose to tinker with my mind—to solder happy memories into guilty ones, to tether love to fear and joy to shame, pain to merit and truth to lie. I was her puppet, her prisoner, her pawn, trapped in an invisible cage with a key she dangled just out of reach. Supposedly, hating Patricia was more productive than hating myself.
Yet in all honesty, the line that divided “me” from “it” only added fuel to the fire. I stopped obsessing over my obsessions and focused my attention on the legitimacy of my diagnosis. Was I to chalk up visceral intrusions or philosophical questions as mere symptoms of a supposed chemical imbalance? Where did the bounds of the self end and where did the nonself begin? Was I to forever inhabit the bleeding mess that lay between them? I’ve never been able to answer those questions. And recently, I’ve decided to stop trying to.
Since my diagnosis, I’ve ghosted two therapists and broken up with two more. I’m not proud of this, but I have begun to realize why I can’t help but run when the sessions begin to get serious. The standard “evidence-based” treatment for clients with OCD is called Exposure and Response Therapy (ERP). In it, the client is gradually exposed to their deepest and darkest fears, under the assumption that they will begin to tolerate distress without engaging in counterproductive behaviors. If someone is afraid of contamination, their therapist might take them to a park to touch a dirty slide. If someone is afraid of harm, their therapist might show them crime scene photos or have them hold a knife for the length of the session. I sought out ERP therapists for years because Google and the DSM told me to. Some of these therapists were helpful, particularly in solidifying the belief that my thoughts weren’t always to be trusted. However, I always left these sessions feeling worse than when I entered them. Maybe that is because I didn’t try hard enough or wait long enough or give up enough of my sanity to see it through.
It wasn’t until I found my current therapist that I was able to ease into the life my brain has carved out for me. My therapist does not practice ERP, but rather a fluid form of therapy built upon the belief that the radical acceptance of every distressing possibility within an OCD mind is more important than the eradication of one source of distress. For me, this radical acceptance has allowed me to linger peacefully in the purgatorial space between reverie and nightmare. While I am afraid of worst-case scenarios, on the other side of the bridge (or the rainbow or inside another chocolate in the box) are all of the other possibilities that may feel too good or too simple to trust. I have learned to lean into the bountiful possibilities just as much as the scary ones.
I can’t remember a time when my thoughts weren’t whirring constantly and catastrophically. Sure, a diagnosis provided me with a reason and medication quieted them just a little. It’s easy to patch on a clinical bandaid over gaps in ourselves, but diving headfirst into a narrative that seeks to suppress human turbulence under the guise of treatment has never felt right. We do not have to barricade our curiosities. We do not have to brand our idiosyncrasies. We do not have to scoop out our sensitivities and tame them. We can hold all of our mess and our aches and our doubts as we would a crying child who has seen too much. Rather than push it away for security, I welcome my pendulum-like mind, taking with me both the stress and the gratification that comes with uncertainty. I like to hope that in my dying breaths, I will be glad I lived a hundred lives more than just the one I can see and touch.
