“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.
