Is There Something More to OCD Than Suffering? A fresh perspective on obsessive-compulsive disorder with Dr. Michael Alcée.
Key points-
- OCD is a painful mental health condition associated with a heightened risk of suicide.
- Research suggests that many living with OCD have enhanced empathy.
- OCD expert and author Dr. Michael Alcee recommends a combination approach to treatment.
Tormented by repetitive thoughts, there are few conditions I have seen cause the level of suffering that obsessive-compulsive disorder can. While the media caricature of OCD involves super-organization and overachievement, this is rarely the story those diagnosed share.
OCD can trap a person in a single fear. It might whisper, "Are you sure you aren't secretly evil," as a person examines their motivation and behaviors, or it might cry, "What if you have cancer?" Unwanted images and urges can follow. A pull to check one's car once more just to be certain that there are no signs of having run someone over, or images of cancer cells multiplying are ways this might manifest.
The pain is real. Meta-analysis suggests that 1 in 10 individuals living with OCD attempt suicide (Pellegrini et al., 2020) and that the strength of the obsessions is one of the best predictors of suicide in those living with OCD.
When I came across work regarding OCD's bright spots, I admittedly felt briefly confused. How could such a cycle have anything good about it? I spoke with Dr. Michael Alcée, author of The Upside of OCD: Flip the Script to Reclaim Your Life, to learn more.
An upside?
If only by anecdotal evidence, I believe that those living with OCD are often highly compassionate people. In my lifetime, many I have met who have encountered extreme hurt seem to be. With OCD, there appears to be a unique flavor.
Alcée describes this as "an intuitive, emotional gift," sharing that many people with OCD seem to have a kind of extra-awareness of the internal worlds of others. It might sound odd, yet some research does support this. In a study comparing the performance of 64 people with OCD and 62 healthy controls on measures of empathy, those with the diagnosis showed a higher concern for others and greater empathy than those without (Salazar et al., 2022).
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Overwhelm
Yet, it is possible for the sensitivity OCD grants to reach a point of overwhelm. In Alcée's words, "People with OCD can get lost in their minds." In a space of high anxiety, OCD has a way of funneling overwhelm to a single point, the obsession. Yet, this does not always represent the cause of the stress. Like pain can be referred from one place in the body to another, Alcée shares a perspective that emotional tension can be displaced into an obsession.
At its worst, OCD can cruelly make more likely the feared outcome. For example, a person fearful of germs may wash their hands to a point where it harms their body. Or someone who cares deeply about being courteous might find themselves being so careful with their words as to withdraw and find it difficult to connect. Alcée reflects that this is a hallmark ironic conflict in OCD.
The ability to contain our own and other people's emotions is a significant task, particularly when one has a high level of awareness. For this reason, in addition to receiving psychotherapy for OCD, Alcée shares that it is crucial that a person with OCD practice quality self-care, including self-respect and developing healthy boundaries in relationships. Alcée states, "A person with OCD needs to register empathy for themselves."
Treatment
The most prominent psychotherapies for OCD involve exposure to the feared obsession without engagement in a compulsion. Alcée believes that a combination of traditional CBT to address the cognitive and behavioral dimensions of OCD, in addition to other approaches to address the metaphoric aspects of OCD, is ideal. This sort of one-two punch may give individuals space to hear the "messages" their anxiety has to share without the overpowering blasts of obsessions and compulsions.
With support, individuals with OCD can harness their gifts and recover from the tricker pieces of the experience.
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