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I’m about halfway through some really good therapy that I’m getting from the UK’s NHS. One of the things that’s good about it is that we are coming up to session 6 and we have only just started thinking about treatment; the process so far has been a deep discovery dive into what’s happening in my brain.

It was only at the beginning of this year (2022) that I realised that the thinking patterns responsible for most if not all of my decades of anxiety are the patterns followed by OCD. Simply put, an intrusive thought threatens the stability of my life with a potential disaster, and I feel compelled to perform endless mental review and/or research to reassure myself that everything around that thought is 100% safe. Or, sometimes, I will be caught in decision paralysis between two “equally bad” ways forwards. This results from a war between a part of me that knows that the intrusive thought is silly and would be embarrassing to disclose, and another part of me that wants to seek reassurance from other people.

I now realise that I have had what I’ve considered to be mild symptoms of fairly classical OCD since my late teens. By “classical” I mean that the presentation is about checking things physically such as checking doors to ensure they are locked. I pulled the door handle off my first car by doing this! It sometimes seems like OCD is a living, conscious and evil part of me that will find expression no matter what; win at one presentation of it and it will change tack and find another. And if I manage to say no to compulsions around one area of uncertainty, OCD will serve up another worry.

The mental review compulsion is part of what is known as “Pure O” OCD, though this is a bad title for it because it isn’t purely about obsessions. It’s just that the compulsive parts are hidden from the view of others.

What I’m finding fascinating at the moment, now that my therapist and I have almost completed the “formulation” – roughly speaking a map of my thoughts, feelings, behaviours and the context – is that everything is connected. Everything is connected to views that I formed about what a good person does and is, very early in my childhood. And, of course, autism weighs in with a huge dose of the need for correctness.

I need to rewire my brain so that leaving some uncertainties unmulled and uncared for is not reckless and doesn’t need to spoil my enjoyment of life. I deserve the same freedom here that most others seem to enjoy. I’m looking forward to the next part of therapy.


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