“OMG! My OCD”

This article explains the important difference between true Obsessive Compulsive Disorder, which involves distressing ego-dystonic intrusive thoughts and compulsions to relieve anxiety, and rigid, preference-based behaviors that are more aligned with personality traits, highlighting why casually saying “I’m so OCD” can minimize the lived experience of those with clinical OCD.

Written by Trevor Holak, MA, LAC - OCD Specialist

     It is common to hear people using phrases like “I am so OCD”, or “My OCD makes me keep up

on cleaning”. As common as these passing comments are, we need to acknowledge the

differences between rigid preferences and Obsessive Compulsive Disorder. Without distinction,

those struggling with Obsessive Compulsive Disorder may be overlooked and marginalized.

Understanding OCD as it is defined in the Diagnostic and Statistical Manual of Mental

Disorders, relies on the presence of intrusive thoughts that are most commonly distressing

because of their content. The term for the relationship people have with these types of intrusive

thoughts is “ego-dystonic”. Think “dys” like “disagree”, which is often the reaction people have to

the thought. An example of an ego-dystonic thought is the belief that unless the countertop is

cleaned thoroughly enough, someone in the house will absolutely get severely ill. This thought

then leads to a compulsive act, and in the case of the countertop example, this may be

excessively cleaning the countertop beyond what would be considered objectively necessary.

Here, we can understand the relationship to the intrusive thought and the compulsive behavior

that happens as a result. The compulsive behavior is oriented entirely toward the alleviation of

the distress brought on by the ego-dystonic thought. This is however a very logical example,

and not always are obsessive-compulsive couplings so straight forward. It is entirely possible

that a distressing intrusion about a loved one getting hurt is followed by an objectively

nonsensical act, like repeating a phrase some specific number of times.

Now, we consider the rigidity in preferences that often is accompanied by a blame on “My OCD”.

Frequently, these types of preferences can be understood as “ego-syntonic”, with “Syn” echoing

“synergy” or agreement. This is someone who has a rigid preference for the placement of the

dishes in the cupboard and scrupulously holds their spouse accountable to this order. This

same person may find themselves cleaning and organizing frequently because “this is the right

way to live”. This person better fits criteria for Obsessive Compulsive Personality Disorder than

classic OCD. Exploring mental flexibility and values associated with meaningful relationships

and the impact of these rigid preferences on these relationships should be the focus of

individuals struggling with this type of experience.

It may seem like splitting hairs, though there is a distinct difference between these two

experiences that does not benefit from blurring the line. Next time you want to say “OMG my

OCD”, reflect on your relationship to the thought, and ask yourself what type of relationship you

have to these thoughts and preferences.