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Obsessions and compulsions – no, it is not necessarily a spectrum

As someone who lives with multiple mental illnesses and aspects of others, one thing that I dread hearing is this:

“Oh yeah, I’m so OCD. I hate mess! I love stacking my Tupperware containers. It’s all a spectrum, after all. Everyone is on the spectrum.”

That is, in fact, not completely true. The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) and the ICD (International Classification of Disease) are mostly categorical. These manuals are used by practitioners to diagnose disorders and disease. Both of these manuals acknowledge spectrums, but not necessarily as a means of diagnosis.

In their criteria, you mostly either have something or you do not. That is not to say that you can’t display aspects of certain disorders, but it does not mean you have some lesser form of the disorder, or that you are on some inventive spectrum where we all exist.

There is no diet OCD.

About ten years ago, when I was struggling with aspects of the relationship I was in, a well-intentioned GP suggested that I have OCD. Since seeing multiple psychiatrists, I have learned that I do not have OCD.

What I do have, are obsessions. For instance, I am obsessed with symmetry. I get pissed off when sentences or words have an odd number of letters in them. As I drive to work, my mind works like an abacus, looking at every sign along the way, to check for this symmetry. I have actually memorised every sign from The Gap to Ipswich based on its symmetry or lack thereof. I have memorised every sign in my work based on its number of letters.

multicolored abacus

I get particularly pleased when I find words that are twelve letters long. This is amazing to me. Peacekeepers, heterosexual, and organisation really scratch my itch.

However, I do not spend hours on this per day. I do it in the absence of other stimuli – so on the drive to work or when I am sitting around in a public place. I have an obsession, but not a compulsion. I don’t make my sentences fit into these symmetrical patterns. I don’t have rituals I follow around this symmetry. I do not feel that a lack of symmetry begets some scary outcome, like death or destruction. I don’t do much to scratch the itch of this obsession, it’s just a mind game for when I get bored.

In order to fit a diagnosis for OCD, a person must have a presence of obsessions, compulsions, or both. However, they must take up a lot of time, interfere with functioning, and serve the purpose of avoiding negative outcomes, or reducing anxiety and distress.

It also cannot be explained by another mental disorder. In my case, my need for symmetry is probably more indicative of my ASD or anxiety, both of which have been diagnosed.

So as you can imagine, with this criteria, your average person is actually not on the spectrum at all. Liking order is more a discrete aspect of personality or preference, as opposed to being part of psychopathology.

Assuming everyone is on the spectrum reduces the experience of those who are.

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