Broken Spines #10: How to write a character suffering from OCD

Disclaimer: This blog mentions sensitive topics like mental illnesses (Obsessive compulsive Disorder, to be specific) and how they are carried out in media and literature. This blog also talks about ways in which one can write about such topics with sensitivity and responsibility. Please feel free to leave this page, if you do not feel comfortable reading about such topics. I urge you to talk to someone you love and trust, or anyone that can help. Do not hesitate in seeking help from a professional someone. You will be fine and we are all here for you.

Also, please note that I am not a professional in the mental health sector, so please do not rely entirely on this post. Although I will be posting the referential links down below for you to cross check, I urge you to do your own research and talking to people in the profession before writing something you are unsure of.

Hello everyone. How are you all doing?

So, a long time back I had started this series of broken spines where I debunk writing stereotypes and misrepresentations of certain characters as they are written in fiction. The whole point of this series is so that writers can get a better, more realistic experience of writing diverse characters and demystifying certain taboo topics about character stereotypes that are not widely practiced. It is an opportunity for writers to experiment freely while steering clear from writing anything inappropriate or harmful to the readers. I also want to put a spotlight on the audience reading these books and the influence it has on them, through my blogs.

Some of the posts from this series that I’m very proud of are focused especially on writing books about sensitive topics, suicide, self harm and mental illnesses, and so, continuing with the series I had promised the people who read my blogs here that I will be separately focusing on specific mental disorders that are widely used in writing characters in fiction after doing a thorough research on the topics.

Today I’ll be discussing a mental disorder that is widely seen in fiction and in media, in general- Obsessive Compulsive Disorder (OCD). In this short essay, I will be focusing on:

1. What is OCD

2. Types of OCD

3. How this particular mental disorder is written in fiction

4. How OCD portrayal affects people suffering from OCD

5. How it SHOULD be written

What is Obsessive Compulsive Disorder (OCD)

This disorder is pretty common in use of daily communication and in media, almost everywhere and you probably must have heard of it at least once. It is mostly used in the context of being excessively orderly, organized and while referring to one self as a “clean-freak”. But the reality is different. OCD isn’t that simple.

Take this for example. There’s this person- let’s say their name is Bob- and he has this fear that if he doesn’t lock their door and keep his windows closed, somebody is going to barge in and do him harm. So, what does he do to prevent this from happening? Obviously, he’ll make sure that his house is locked and all the windows are closed. That’s only natural.

But when Bob is continuously obsessing over his fear that someone is going to barge in and kill him regardless of the fifty times that he has already checked the doors and the windows, almost to the point that he can’t focus on anything else he does and is compelled to check the doors and the windows again for another fifty times- now that is extreme. That can be considered as OCD.

The reason why I’m emphasizing “can” in the above statement is because it depends on how much time Bob wastes while practicing this ritual and how much does he obsess over his fear. Considering the above example, if there’s someone who obsesses over a fear to the point that he can’t stop thinking about it, and ensures to prevent the said fear from coming true, practices certain rituals and routines repeatedly (that may or may not make sense to the outside world) to the point that it hinders their ability to carry out normal activities and affects their social, personal and professional life, it can be said that the person is suffering from OCD.

“The obsessions are intrusive as they have the ability to create considerable mental discomfort. In response to the anxiety-inducing thoughts or urges, individuals will either suppress their obsessions or perform compulsion, that either are or not connected realistically with the feared event or are clearly excessive.”

So, yeah, next time when you’re about to say- “I’m so OCD” or “this triggered my OCD”, think twice. OCD is not a quirk or a desirable trait, it’s an illness.

Types Of OCD

Although OCD is mostly linked with obsessively checking, ordering and tidying things, these aren’t the only types of OCD:

1. Harm OCD: In this type, the person suffering from the OCD is mostly obsessed with the fear that they will cause harm to themselves or other people. The intrusive thoughts are mostly about them conducting a violence to themselves or specific individuals and then having being compelled to complete the rituals to prevent those acts from happening.

2. Infection/contamination OCD: This is mostly related to the fear of catching germs and with maintaining hygiene. People suffering from this kind of OCD have compulsions related to washing their hands obsessively, avoiding dirty places and things.

3. Checking OCD: As discussed in the above example, this type of OCD involves hyper checking the facts repeatedly such as alarm clocks, closing the doors, checking the symptoms to a disease again and again from the fear that you might have it.

4. Symmetry and Ordering OCD: The need to have things organized neatly, in a certain order or category. Ps. This does NOT mean that this person is necessarily a clean freak. A lot of people who have this kind of OCD have messy rooms. This just means that maybe they like to eat their candies in a specific colour code/order. Maybe they like to put their books alphabetically on the shelf, and if someone messes up with their order, they fear that something extremely bad will happen.

5. Hoarding OCD: When a person suffering from this kind of OCD has difficulty in getting rid of any item they’ve ever possessed.

OCD portrayal in media and literature

As discussed above, a lot of people discuss OCD in the wrong light and make it sound like a fun or a desirable or even a cute characteristic of a person, when it clearly isn’t. I want to show how it’s done in fiction in general. So, I’m going to dissect the portrayal of OCD in Big Bang Theory. It’s one of my favourite sitcoms and I love this show. Sheldon is shown as an extraordinary, highly intellectual physicist who suffers from OCD and other mental disorders like autism, etc. But today, I’ll only be focusing on how his OCD is portrayed in the series, for obvious reasons.

On watching the sitcom, you may come across certain practices that Sheldon conducts that makes him the highlight of the sitcom, such as:

1. His issue with closure as discussed in the “Closure Alternative” episode of the 6th season. It’s the episode where Amy, Sheldon’s love interest, tells him that he suffers from OCD and that because of it, he makes do things to make sure that everything he does is completed and can’t be left halfway. One of the practices that can be seen throughout the show is how he knocks three times on the door before letting himself in.

2. Another one of his issues can be seen with how he deals with change. It can be seen through his strict bathroom schedule, making roommate and relationship agreements/contracts, and how every Saturday night is laundry night. It can be also seen in the episode “The Cushion Saturation” of season 2 when Penny shoots a paintball on Sheldon’s spot by mistake and he feels disturbed even after the cushion comes back dry cleaned. It can also be seen when everything in Sheldon’s life changes after he wins the noble prize and he panics.

3. Sheldon also may have the infection OCD. There are many episodes where Sheldon is afraid of catching infections or diseases, and thus practices strict precautions.

Although for the most part, Sheldon’s OCD portrayal is pretty accurate but in my opinion, there was a lack in showing the internal monologue that goes through Sheldon’s mind each time he conducts his practices. I think it is shown only once when in one of the episodes (Cohabitation Experimentation) where he doesn’t knock the door of his own apartment and tries to silence his intrusive thoughts by repeatedly telling this to himself that, “See, I didn’t knock but it’s fine.”

The reason why this internal monologue of the intrusive rumination is important, in my opinion, because this way the audience can see what happens inside Sheldon’s mind when he doesn’t conduct his rituals and why the rituals mean so much to him. Otherwise these rituals followed by the sound of the laughter indicates “the attitude of people when individuals who deal with obsessive or compulsive are treated as subjects of mockery by their peers. It becomes problematic because it reduces troubling behaviours to a punch line rather than a source of concern, sympathy or even an attempt at understanding.

One other thing that seems problematic with OCD portrayals in media and literature is how media loves to glorify the illness as something that can be desirable or beneficial for the person suffering from it. This is problematic because it promises the people that OCD is something that will somehow benefit them with an extraordinary habit or way of life. For example, if someone likes to keep things a certain way, someone might think that it makes their organization style way more effective and beneficial.

How OCD portrayal affects people suffering from OCD

According to a research conducted by Fennell and Boyd in 2014 on people who suffered from OCD and how OCD is portrayed in media and literature, the stigma around the OCD is so much that many people suffering from the illness are not even aware half of the time that they have OCD, and even if they do, because the characters with OCD in media often do not seek help, they also encourage making those with OCD in real life fearful of seeking help.

The study also reveals that the people suffering with OCD were “concerned that the media only shows a limited range of thoughts/behaviours as OCD , thereby stereotyping the disorder.”

There was also seen an occurrence of practicing “passing” by people suffering from OCD which basically refers to the phenomenon where the person suffering is stigmatised and so are compelled to hide their illness to blend in with others.

There are other research findings by Fennell says that participants suffering from OCD recalled “creating alternative, less stigmatising, explanations for their behaviour. Many of them explained that if they needed to explain their daily life to someone, they usually omitted out their rituals and compulsions and covered them with excuses.”

“While participants recalled trying to fit in within public settings, they also recorded that, due to self-stigma, they would try to convince themselves that they did not have OCD,” revealed Fennell and Liberato. This can be understood by noting the why many people suffering from OCD are hesitant to disclose because they fear the response that they are likely to get, as predisposed by misrepresentation in media and literature. Like, many people hide their OCD from their peers because they think that they will be treated differently or because they fear being misunderstood and what OCD means to them (because everyone’s OCD is different) or even because they fear that they will not be believed or might be taken as a subject of mockery and humour.

There were many instances where “the participants wanted to inform the public about their OCD and how it is misrepresented in media and literature, however, they still had their own version of privacy control and boundaries established which prevented them from telling others about the whole truth of the disorder, and informing the people less of the truth.”

Things to keep in mind while writing characters with OCD

1. Causes of OCD

Most of the times OCD can be understood as a learned behaviour, where certain things can trigger the anxiety and may compel the person suffering to practice their prevention rituals to reduce their anxiety. Rachman and Hodgson had done a couple of experiments where they found that “most people with OCD exposure to a situation that provoked their obsession induced their distress. If the person was made to conduct the compulsive ritual immediately after the provocation, the anxiety reduces rapidly and therefore reinforces the obsessive compulsive ritual as their learned behaviour.”

An example of this can be shown with the theory of aversion, so if I say that whenever I look at my phone the moment I wake up, my day goes bad. As I notice this happening repeatedly, I may create a learned association between looking at my phone in the morning and then having a bad day. Evidently, I may choose to avoid looking at my phone in the morning by doing some ritual and that will in turn become my compulsive behaviour every time I wake up in the morning, just so I can avoid looking at my phone the first thing when I wake up. (Ps. this is just a vague example to make you understand how this works. OCD is extreme and not so simple in real life).

2. OCD has no cure but it is manageable with therapy

Therapy for OCD is terrifying but it’s effective. The most effective treatment for OCD is Exposure and Response Prevention. The exposure part of this therapy is having the person suffering from OCD come in contact with the anxiety provoking stimuli (through guided fantasy, hypnosis or through direct exposure). So, for example, someone who has contamination OCD will be asked to touch a dirty shoe and not wash their hands. The therapy starts with baby steps and then big leaps. It does not suddenly jump to having the person with contamination OCD to sit on the floor of a dirty public toilet. So, yes, it’s definitely terrifying but it works.

3. Relapse

Like any other major illness, a person with OCD can also go through a relapse. Remember that a person with OCD cannot completely be cured. The recovery itself is not linear. Some days are good, some days are bad.

4. Make sure you also include internal dialogue of intrusive thoughts/obsessions along with the compulsions and SHOW how the compulsions affect their life when they do the ritual vs. choose to avoid the ritual.

5. OCD frequently co-occurs with other anxiety disorders and is most common with people suffering from Tourette syndrome.

6. According to research, “diagnosis requires that obsessions and compulsions take at least one hour per day, and in severe cases, they may take most of the person’s waking hours.”

7. Do NOT make it sound quirky. OCD IS AN ILLNESS. IT’S NOT A CUTE PERSONALITY TRAIT.

8. Please do your own research. Read books. PLEASE DO NOT RELY ON ONE SOURCE. Every person has a biased opinion. I can talk about mental illnesses from the point of view of feminism, Marxism, radicals, Freudians, behaviouralists, colonialists etc. Each of these point of views will be different from the other. One might prove something and the other something completely different. Please read and research everything. No one source is completely correct or objectively true. Talk to professionals in the field if you can.

9. People suffering from OCD have a life that is not defined by their OCD. Just having a mental illness does not give this person a trait that may somehow benefit other parts of their life or makes them extraordinary, highly functioning being. Stop glorifying it.

10. Avoid explicit descriptions of obsessions. TELL the obsessions. SHOW the compulsions. Because obsessions can be common amongst people and can be distressing. Just telling them would seem fine. However, compulsions can be shown for a more vivid depiction of how their OCD plays out.

11. Use 3rd person point of view to so that the reader only observes the scene from outside and so that empathy is limited. This way even if the reader is suffering from OCD, it wouldn’t trigger their OCD so much.

12. Use papageno effect and encourage seeking treatment with your story by making your character get therapy as well!

I hope that this was informative or an eye-opener for you. If you are working on a book with these topics, please do your research outside blogs like mine and Wikipedia. Read research papers and talk to people who have knowledge about it. Ps. I will try to read a few books that has characters with OCD and will try to dissect them in the future! If you have any OCD related recommendations, please drop them in the comment section below. (Books and movies).

If you are a new visitor, I hope this post made you feel responsible for your writing project because a writer’s job is a huge responsibility. If you are a writer, you have the power to change the way the people look at things. Use it well.

Thank you so much for reading. See you soon!

References:

Spencer, L., & Carel, H. (2021). ‘Isn’t Everyone a Little OCD?’: The Epistemic Harms of Wrongful Depathologization. Philosophy of Medicine, 2(1). https://doi.org/10.5195/philmed.2021.19

Lily Werner. (2021). “I’m so OCD!”: A Qualitative Study Examining Disclosure ofObsessive-Compulsive Disorder. https://www.uwlax.edu/globalassets/offices-services/urc/jur-online/pdf/2021/werner.lily.cst.pdf

Martin, Sam. “Madness in the Media: Demystifying the Emergence of an OCD Trope in Television.” (2017).

A youtube playlist for OCD: https://youtube.com/playlist?list=PLw7fNvH__eUockxTKer2fI4rcuSffuiIP