cw: graphic death descriptions, ocd obsessions
When I was nine or ten years old, I went to a birthday party at the local baths. My friend’s family had hired out the pool for a few hours; on top of the pool was this gigantic inflatable boat which took up nearly the entire width, and stretched out pretty far lengthwise too. I had never been a strong swimmer. When I got into the water, I stood awkwardly in my costume at the shallow end, my hard-won ten metre swimming badge sewn to my bodice, my dad watching me from the side lines. At some point I thought it wouldn’t be so bad if I had some help, so I took a foam float that some kid had probably taken a bite out of and started to kick my legs gingerly. Eventually, I reached the middle of the pool, dwarfed by this massive inflatable boat, and I thought I would be able to reach the other end if I simply swam underneath it. How hard could it be? Ducking my head below the surface, I scrunched my eyes shut and tried to propel myself forward. It wasn’t enough. I didn’t have enough momentum to go deeper or further, and the top half of my body got stuck underneath this giant vessel, which was crushingly heavy despite being full of air. My chubby little limbs weren’t strong enough to push myself out, so I started kicking and thrashing, hyperventilating and feeling my sinuses swell with chlorine water. It was a futile endeavour. I was then filled with this very strange feeling of acceptance that I was going to drown here, at my friend’s birthday party, under this stupid fucking inflatable boat. I’d always been scared of death. But there was nothing I could do; my lungs were screaming, and there was no point fighting it. Then I felt someone yank my legs, hard, and suddenly my head popped up above the surface. My dad had jumped in to save me.
I think there was a problem at a much earlier age than I realised. Even as a small child, I had built this internal system of logic, a network of assumptions which slotted into place just so, and if one of them went awry, they all did. When it started in earnest, at fifteen, I remember being gripped by the phrase that often comes out of the mouths of people who have been involved in the most unimaginable tragedies: you never think it’ll happen to you, until it does. In my attempt to evade this seemingly forgone conclusion, I convinced myself that if I pictured myself or my loved ones dying the most gruesome deaths in stunning HD detail, I would stay one step ahead of the possibility that any of us would ever have to suffer. It was just logic. Stage four glioblastoma; gory, destructive suicides; being hit by a double decker bus. Hospitals. Mortuaries. Funerals ringing with hysterical mourning. Indulging it made me feel like nothing could be worse than the scenarios I had tortured myself with. Then my brain decided to pull an uno reverse on me and persuaded me that because I had indulged it, I was evil incarnate, and that if these scenarios did indeed happen, it was my fault and mine alone. I wanted it to happen. I was choosing to think about it, wasn’t I?
Many of my obsessions feel like that initial moment of terror under the boat, the moment before the acceptance. All of the thrashing and screaming, none of the release, no one to pull your legs from under the weight of it all when you think you might be about to die.
It lay dormant for a few years. Lying in wait, ready for an opening. It’s a real opportunist. I was taking medication for a different mental health problem for two and a half years, which dulled the obsessions, along with any and all other feelings. COVID struck. I became militant with the rules and rituals, sticking to the law, following the science. It was justified. Anyone not doing so was irresponsible. It wasn’t me with the problem. I tapered off my medication - two and a half years was enough, and besides, it was time to treat my ADHD now. I did lockdown two and three to the letter in our tiny studio flat, tried one type of ADHD medication for a week that made me suicidal, then moved back home after a full six weeks of complete confinement so that I could be monitored by my parents as I started a different stimulant drug.
What followed was days in bed studying graphs. Graphs and data and policy, on the number of cases, number of deaths, number of vaccines, how many Pfizer, how many AstraZeneca, how many, how many, how much, how much longer. Who would be getting their vaccine soon? Would my mum be included in the vulnerable groups with her asthma, or would she be left to die like in the harrowing scenes I’d imagined years prior? I had to check the stats daily, even hourly if it was possible. I had the curves of how severe each wave would be under indieSAGE’s predicted scenarios memorised, x- and y-axes and primary-coloured peaks all I could see when I shut my eyes. All I knew how to do to prepare myself was to check and to think. And think. And think.
I wasn’t told by my prescriber that stimulants can throw the part of the brain responsible for obsessive-compulsive behaviour into overdrive. In retrospect, I should’ve seen the signs in the week where I tried the first medication: one evening, I realised my big toenail had split through the middle, and twenty minutes later, I had savaged the whole thing down to the quick. I don’t remember doing it. Even now, my focus seems to go when I engage in picking compulsions, and sometimes I will come back around and realise there’s blood under my fingernails.
It is a commonly floated idea that OCD latches onto the things that are most important to you. It’s a highly chimerical beast, and shapeshifts at will. While trying to stop myself and my loved ones from catching or dying of COVID through the power of compulsion alone, I had become convinced again that every part of me was evil and incapable of love, and that to spare my partner of the pain I would ultimately inflict on him and to absolve myself of the pre-emptive guilt, I needed to end things. This possibility consumed every waking moment, precisely because I didn’t want to, but felt I had to. I felt this life-or-death need to check every single bodily sensation and seek reassurance from every source possible, to make sure I was still in love, still committed, still attracted to men. If I didn’t, I was nothing but a manipulative monster, responsible for abusing the person I cared about most. At the peak of this obsession, I slept a mere 20 hours in the space of a week. I was bed bound for most of the day and couldn’t eat more than quarter of a meal at a time, and my mum was practically begging me to just take a diazepam.
At the core of all of these thoughts was both a preoccupation that I am fundamentally bad and wrong, but also a need for objective proof that simply doesn’t exist: proof of experiences as subjective as an ability to love and be loved, or proof of things that cannot be divined before they happen. It is a disease that feeds on doubt. Following the Spanish Golden Age, engaño, or deception, was so feared that cautionary messages warning of its dangers became a principal feature of much of the literature of the period, including the quintessential Spanish epic, Don Quixote. In perhaps the most famous scene, our knight-errant of La Mancha mistakes windmills for giants, due to not only a lack of discernment, but a refusal to be discerning. This active and imaginative engagement with delusion earns him the descriptor of ingenioso (ingenious) in the very title of his work, but at what cost? His reputation as this idiot-savant protagonist, who is seemingly both incapable and unwilling to accept the Baroque virtue of withholding judgement, permeates multiple layers of fictional and metafictional narration, to the point that discriminating between narrators becomes an epic task in itself. Merely this mode of reading instills doubt. Such is the genius of Cervantes.
While this obsession with trickery can be partially attributed to the shattered illusion of imperial power, leading to Baroque-era Spaniards feeling particularly deceived by the ephemeral nature of the colonial decadence from which they once benefitted, one thing that feels universal through time is the associated shame that comes with being duped. To be sceptical — to doubt — is thus a defence against being tricked into humiliation and sin, as documented by the rise of scepticism as a philosophical buffer against engaño. The very fabric of obsessive compulsive disorder encourages this mode of existence, with compulsions such as checking and reassurance-seeking acting as an epistemological remedy to the uncertainty that makes us so uncomfortable. The moralistic satire of El mundo por de dentro (The World from the Inside) by Francisco de Quevedo, my other favourite Golden Age writer, follows the narrator as he is led through a number of scenarios by a figure named Desengaño: as his name suggests, his role is to reveal truth in situations that are not all that they seem. One of the central premises of his cautionary message is that ‘la voluntad apetece lo malo debajo de razón de bien’ - literally, ‘the will desires evil under the pretence of good.’ I have virtually zero grounding in Christian philosophy, and negligible desire to develop one, but these seventeenth-century Spaniards and their fixation on avoiding being led into mortal sin feel awfully familiar. The obsessive-compulsive distress centred around moral transgression and the prospect that you may sleepwalk into causing untold harm, the terrible double-edged shame of feeling both irredeemably abject and, to add insult to injury, a complete fool. It is a glimpse into hell in itself.
Ultimately, though, to doubt is to be alive, and it is inscribed in the human experience as much as the urge to find something to eat, or to leave a situation that feels threatening. It is a survival mechanism: one which can go awry, of course, but something we cannot eradicate wholesale. This is the entire premise of Exposure Response Prevention therapy, or ERP, the gold-standard therapy for OCD. The aim is not to find the answer to your millions of questions, or even to stop or ignore the obsessive thoughts, as this can be a form of compulsion in itself known as thought neutralisation. The key is to use disengagement tactics in order to expose yourself to your obsessions without carrying out the compulsions which quieten them – that is, to stare doubt in the face, to submerge your head under it, and sit with the discomfort. Let your sinuses burn with chlorine water for as long as you can bear it.