Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Moral Theme, Harm OCD, Sexual Theme

The long road toward recovery

By David Guo

I remember as a child, looking back, it was a time of calmness. It was fun. Things felt easy and laid back. In elementary school and throughout middle school things were enjoyable. It felt pure. I looked forward to my 1 hour of computer time, playing outside, attending birthday parties with friends, and swimming lessons. 

The first signs of OCD

My first memory of OCD followed a fire safety class at my school. I became concerned that a fire was going to start at night, killing both me and my mom. I began to frequently check the stove to ensure it was off, but over time this obsession faded. I also developed a fear of a zombie apocalypse and how I would survive if one did occur. I’m pretty sure this fear came from video game videos I watched around that time period. I would also experience intense dreams about a world devoid of humans and agonize over the possibility of an apocalypse. 

It was in 7th grade when my symptoms returned, this time manifesting in moral scrupulosity. My intrusive thoughts latched onto pornography I had viewed on my school computer; I couldn’t seem to shake the guilt and fear I felt. I worried constantly that someone would find out and that I would get in trouble. Another fear was that people saw me naked in my house when I would masturbate, and were secretly distributing my nude photos over the internet. 

Later on, I developed a fear surrounding cheating on school tests and assignments. I wondered if I had been dishonest in my work in some way, and would feel guilt over plagiarism and usage of an online translator. This was amplified later, in 8th grade, after I was caught cheating on a geometry test. This event started a downward spiral that would land me in a darkness that I had never anticipated getting to know. Memory hoarding was also a key theme during this period of my life. I obsessed over remembering everything I did and ensuring that I didn’t forget things that I deemed as important. I sometimes spent hours trying to rearrange thoughts in my mind. I didn’t understand what was happening to me. I entered high school and the first two years were spent battling my anxiety. Moral scrupulosity expanded its reach while new themes began to fester, though I was still oblivious to exactly what was happening.

During my sophomore year, I began to obsess about whether I would grope or sexually assault someone. I felt intense shame and guilt over these ideas and tried desperately to figure out if I would actually do these things. Sexual harm themes haunted my mind for months but eventually faded. During my junior year of high school, the idea that I had been academically dishonest was again front and center. This worsened after I took the NMSQT (PSAT 10) and went back to change my answer even after the time control had expired. I obsessed constantly over how I was such a bad person and likely didn’t deserve any of my grades because of my dishonest behavior. My functioning started to decline further and at an accelerating pace. Pornography and intrusive thoughts returned as a major theme. I worried about whether masturbation was moral. I had tormenting thoughts about the possibility that children had been present in videos I viewed or that the videos had been created without the consent of the people in them. I was a victim of my own mind, totally controlled by my thoughts and emotions. I became avoidant of women. The color black became a trigger. I started to have fears of racism and that I was a bigot for saying the n-word. I felt that I needed to steer clear of the color black. It seemed that anything I had a strong opinion on would become a target of these intrusive thoughts and feelings.

Beastiality became a fear of mine as I began to worry that I would sexually assault my friend’s pet dog. By this point, I was spiraling past a point of no return. I was confined for most of the day to my bed or the couch. It seemed safer in those places; all my worries would somehow become less significant and more manageable. All I could seem to do was ruminate. I looked forward to sleeping so I could avoid the torture. I wished I would never wake up.  I wanted to solve what I was thinking and feeling but it felt like a fruitless struggle, an endless task with no end in sight. I needed to know why I was going through this pain while my peers continued their lives without such burdens. I was uninterested in doing anything I had previously enjoyed until I solved these problems. I began to dread my weekly piano lessons and lost interest in gaming. The topics of my thoughts would jump rapidly, sometimes in a matter of hours. I would have somatic fears around blinking that would suddenly shift to real event fears. I felt my life was crumbling and that I was powerless to stop the destruction.

Often I felt “too far gone” to be saved. I wondered if I would ever get better, and feared that I wouldn’t. I knew, deep down, that something was seriously wrong.

I wanted help and begged my mom to get me the help I needed. However, in Chinese culture mental health is stigmatized heavily. There seemed to me to be a notion that if you cannot deal with problems internally that it is a sign of weakness. That you are inadequate and a failure, that your reputation would be irreparably damaged. If you do need help, it is frowned upon to ask outside of your immediate circle of family and friends. The idea of mental illness is an issue tied to willpower runs deep. In Asian culture, often, mental health seems to not be taken seriously. There is an idea that you can choose to worry or not to, and that you should be able to just stop feeling anxious. I was taught that you shouldn’t tell others when you are struggling. Some people see therapy as a sign of weakness. It’s obviously not taken as seriously as physical illness. There’s this idea that you have control over your mind and what you allow yourself to experience. Although this seems to be changing, it is still something that is very embedded.

I struggled with immense guilt and shame. I was so afraid of being judged by my family, and once I told them what I was struggling with, they were in a period of denial for months, during which I continued to struggle. I was having false memory themes, worrying that I may have killed someone and somehow “forgot” what I had done. Ideas of offending entire genders continued to torment me, and school became overwhelmingly difficult. 

Finally, I decided to go to the hospital. I felt a cocktail of emotions: relief, confusion, depression yet hope. Still, even with being hospitalized, I was not made aware of the treatment that could help me. I had still not heard about Exposure and Response Prevention (ERP) therapy. I started with a therapist but was not getting the correct treatment. I was engaged in traditional “talk therapy” and nothing seemed to be getting much better. I still felt very unwell and struggled through each school day. I spent my days feeling nauseous, on edge, and largely unable to function normally. My first semester of senior year was when I finally reached a breaking point: I was miserable, having frequent panic attacks, refusing to go to school, and arguing with my mom about my need for proper treatment.

The term Obsessive Compulsive Disorder (OCD) had been brought up at some point. Following my diagnosis in December 2021, I felt confused and lost: I still retained a stereotypical mindset of what OCD looked like and it couldn’t have been farther from what I struggled with. OCD was about being clean and about contamination, symmetry, and order, things that had never brought much distress to me. At least that is what I thought. I had a very narrow view of what OCD actually was. 

Then came the second hospitalization, after the IOP program I was at failed to treat me with the correct therapy. After being discharged once again I started to dive in and research OCD and the most effective methods of treatment. I realized that I had to do something on my own. I needed to understand more about what was happening to me. That is when I found ERP. I immediately began to throw myself into the exposures without recognizing that I had to take it slowly and methodically. I also struggled to locate any OCD specialists in my area that could help me with this process. Even when I did find someone who could treat OCD they had long wait lists or were just simply unavailable. I just kept living in survival mode, going to bi-weekly therapy and chugging along on my own. 

Then one day I found NOCD. I was looking for ERP online and stumbled across this service that I thought might be helpful. After everything I had experienced, all of the failed treatment attempts, to be honest I was not very hopeful. I had extreme doubts about the potential of overcoming this problem that had ruled my life for a better part of a decade. I felt like I had a long road ahead of me, I couldn’t see the end. But I knew I had to start somewhere. This turned out to be one of the best decisions of my life. ERP slowly became a new lifestyle.

I learned that when you have OCD you shouldn’t take the thoughts at face value, and that acceptance is one of the most powerful tools for healing.

This was so impactful. I also recognized that difficult feelings are tolerable. They’re unpleasant and you will likely not like feeling your emotions and moving on. However, you will not always be “stuck” feeling that way. This was a powerful revelation. I cannot tell you when exactly you will get better, but if you adhere to the treatment, your brain will adapt in its own time. Motivation for me is knowing that even though something is hard, I can get through it and it will not always be this way. I have recaptured so much of what I once enjoyed in life through ERP. While I still have a long road ahead, a year ago I would never have thought this moment would be possible. 

I no longer lie in bed all day long. I attend college and am not a victim of my emotions. I still struggle, but I am in the driver’s seat, not the OCD. I can sit with anxious feelings, and be willing to let them be present while still moving forward. The mindset that I need to get rid of anxious feelings largely shifted. My feelings no longer stop me from doing what I want to do, unless I let them.

I make the choice. I do not allow OCD to choose for me. At the end of the day, I am in control. I decide what I do with my life.

I still struggle. I still have to push myself to do the hard things. It is not easy to live with OCD. Sometimes the thoughts creep up that I might stop feeling altogether. I worry that doing ERP may make me numb to my emotions and without them that I could lose my morals. But I also have learned that this a familiar trick OCD likes to play. I just need to remind myself that this is a very cunning disorder. Certain themes carry with them more shame and guilt, so these are harder to work through. Themes like somatic and real events are so difficult to overcome, and I still struggle regularly with my most longstanding theme of moral scrupulosity. However, I also know I’m not alone. I have the support of an OCD community that understands the scope of the difficulty of this treatment. I have a therapist who gets it and who knows how to help me move forward. I understand, now, more than ever, what OCD is. I choose to use mindfulness to confront OCD daily. Living an unaltered path is the most profound way you and I can communicate to our OCD just how irrelevant its antics are. At the end of the day, you as the gatekeeper, are in charge. 

Today I enjoy investing, making music, playing the piano, basketball, and video games. I am capable of enjoying these things because of my dedication to the unaltered life path. You can achieve these wonderful goals for yourself as well. Get out there and show OCD who’s boss! 

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