Freud even struggled to decipher OCD – it was a problem that had “not yet been mastered,” with Freud confessing that “if we endeavour to penetrate more deeply into its nature, we still have to rely upon doubtful assumptions and unconfirmed suppositions.” He did nevertheless contribute the term “zwangsneurose,” translated as “obsessive neurosis”: what he saw as the maladaptive response of the brain to “conflicts between unacceptable, unconscious sexual or aggressive id impulses and the demands of conscience and reality.” The energy of these repressed impulses would later be released “through pathological attachment to various thoughts and behaviours, turning them into obsessions and compulsions.” This hypothesis, as will be later discussed, misses the mark. OCD is now recognised across the board as an unmistakeably neurobiological illness, one that “is caused not by vague conflicts in the unconscious but rather by measurable chemical abnormalities that occur in specific regions of the brain.” But Freud’s theory is nevertheless an important one, for it demonstrates not just the elusory nature of OCD and the long struggle to understand a disorder characterised by ritualised magical thinking and a battle for control, but – perhaps more pertinently if also abstractly – because it gives some indication towards the rising popularity of the disorder as a cultural phenomenon and widely-claimed socio-psychological conflict (that is, it could be argued that Freud inadvertently cleared the way for a non-medical and purely-behavioural perception of OCD).
It is a challenge, of course, to address a mental disorder – experienced entirely internally, as much as popular culture’s favourite exhibitions of its behaviour may be external – from a perspective that is neither altogether scientifically informed, nor of the confessional-journalistic genre. That it has “not yet been mastered,” still now, both more than a century after Freud and with an increased understanding of neuropsychiatry, does however open a space for a hybridised theoretical-personal account. If we understand OCD to be chemical, a hyperactivity of the cortico-striatal-thalamic-cortical loop, and/or a lack of serotonin, what we don’t know is why obsessive thoughts take the forms that they do. It is also unknown to most – to a full extent, at least – what a sufferer’s moment-by-moment experience is. Further yet, OCD is also an intellectual disorder, a disease of thinking and overthinking. On the one hand, the subject of an OCD thought is dispensable insofar as it is not any more interesting than the fact that it exists in the first place (each new thought quickly supplants an old one, the previous thought being quickly forgotten). On the other hand, however, obsessional thinking typically appropriates those subjects most important to the sufferer, and so the subjects one becomes obsessive about provide a window into one’s conscience.
And so I set out to obsessively theorise on what it means to obsess. I do not intend to propose a new theory of OCD’s causes – chemical, genetic, psychoanalytical or otherwise. There is a gap, however, for an experiential review of existing hypotheses that surveys psychoanalytical, neurobiological and cultural perspectives that come, largely, from the outside (e.g. of the therapist analysing a patient, or the television writer developing an obsessive character). If obsession is having its cultural moment, it is worth asking not simply why this is the case, but what obsessional thinking is and how it is experienced. This piece thus takes the following structure: a discussion of the origins of obsessive thoughts and Freud’s hypothesis; an overview of the labyrinthine experience of obsession; a wider consideration of OCD’s position within popular culture; and a view to the future: both a concession of defeat and a mind-affirming victory.
OCD, Depression, Desire
Writing recently on the various “waves” or “phases” of the Coronavirus pandemic, Slavoj Zizek suggested that the pandemic-fatigued public had transitioned from fear to depression: in learning to live with the virus – and in being no longer primarily focused on not becoming infected – we lost the fear of a “clear threat” that characterised the initial wave of infections. We are thus left with “no clear perspective,” having learned to live with a state of uncertainty but accepting the apparent endlessness of this ‘state of emergency’. “We feel fear when there is a clear threat,” he writes “and we feel frustration when obstacles emerge again and again which prevent us from reaching what we strive for. But depression signals that our desire itself is vanishing.” This final sentence is particularly interesting and worth disambiguating from its specific context. One can find a clear delineation between mental states caused by OCD and depression in that the former is characterised by an excess of stimulation and the latter by an excessive lack of stimulation. With depression, as Zizek writes, desire vanishes. One might then say, in the case of anxiety or obsession, that desire doesn’t vanish but remains in sight. But the distance created between what one desires and what one experiences increases so as to create a distance filled by caricature and fantasy. As such, obsession is much like how Zizek describes frustration – “when obstacles emerge again and again which prevent us from reaching what we strive for” – but with one important distinction: despite what we may think, what we strive for is always unattainable, always out of our control. If we were to rewrite Zizek’s analysis but with obsessive thinking in place of depression, we might suggest the following: fear passes into obsession and one comes to believe that they can not only see a way out (“if I do x I can control y”) but that one can reach that goal by ritualistic compulsion (typically purely by thinking). So unlike the depressive, who loses desire (or that which we “strive for”), the obsessive maintains their desire but it is this that becomes overexcited and warped in a continuously shifting process to the extent that it is worse than vanished: I can see it, but the rational perspective on what I can see has gone.
Whilst OCD may be a neurobiological illness, it is of course necessary to investigate the mechanisms – or origins – or thoughts. Repression of or conflict with id impulses may not provide a suitable explanation, but it is nevertheless the case that people have certain thoughts for a reason. So, I would suggest the above discussion of desire speaks to Freud’s idea of conflicts between ego and id, “the demands of conscience” and unacceptable impulses, but with one clear reversal: into this formulation of a conflict we can replace unconscious desires (i.e. sexual deviances, aggression, and so on) with a hyper-stimulation of conscience – or, in Freudian terms, superego (that is to say, the intrusive presence of thoughts antithetical to my desire and antagonistic to my conscience). So it is not id versus ego, or latent desire versus conscience, but rather the heightened, excited product of that which my conscience and desire is not versus that which my conscience or desire is or should be.
This can be illustrated in the example of what some may call pOCD (paedophilia OCD). The sufferer has the intrusive thought that they are a paedophile – this might be through a false memory of an interaction with a child, or the intrusion of a sexual thought when interacting with a child. This thought will, understandably, evoke panic: one is not a paedophile, one does not want to cause harm to a child. So why am I having that thought? Asks the sufferer. The more that this intrusive thought receives validation – the more value is added to it through resistance, panic or contemplation – the more convincing it becomes. Thus, it is not the emergence of an “unconscious sexual or aggressive id impulse” (i.e. one is actually a paedophile or wishes suffering upon a child) that the sufferer is in conflict with, so much as the opposite: if anything, the over-stimulated conscience, prone to sabotage, is subverted so that a new reality is created in which that which one doesn’t desire eclipses that which one does. A list of common subjects of obsessive anxiety demonstrates this: the death of family members; the sexual past of a partner; the blaspheming of a religious figure.
Psychotherapist Michael Alcee suggests that “individuals with OCD are empaths – highly tuned in to the feelings of others – and this allows them to connect deeply, sometimes almost telepathically with others. Is it any surprise that they worry about the magic of their thoughts harming people…?” If we disregard the mimetic connotations of “empath” and the generalisation explicit in the “are” that precedes it, this description does actually strike an important chord. “Magic,” here, isn’t merely a sensationalised description of the experience of perceived augmented responsibility felt by OCD sufferers but, rather, an affirmation of what I earlier called the “hyper-stimulation of conscience.” The “magic” property of a thought can be translated as the excessive burden of conscience (“I can and must make this right”) and it is the inability to fulfil this magical promise that causes distress. In this, we might say magical thinking acts as an extension of the superego demand that one feel guilt or regret for negative behaviours. So, one tries to correct or control a thought or fear by thinking it away – and yet, if we return to the above list of common obsessive thoughts, one obviously cannot control the death of a family member or sexual history of partner by thinking. The point here is that obsessional thoughts (and their accompanying compulsions) are not the enactment of unconscious desires, “id impulses,” that are always-already present (if repressed) but rather a construct of the conscious mind – unrelated to that which “knows no judgements of value: no good and evil, no morality” – and precisely what it fears.
Crabs In A Bucket
And so one is tormented by the inability to make right that which feels wrong. But it is an awareness of this process – the intellectual and emotional understanding that I am suffering – that can cause further distress and ensure that one doesn’t escape obsession’s trap. Constant anxious thoughts generate a constant fear that becomes obsessive in itself. Each new thought feeds into this self-perpetuating fear: if I am having this new thought, it must mean I still have OCD and therefore I have not and cannot overcome it. Each new thought is a reminder of the subject’s own failing or disorder, and they must act on that failing. The solution, so they think, is the momentarily soothing remedy of reassurance. I can overcome it, and this is how. That reassurance, however, in serving only to scratch an itch that exists by virtue of obsessive fantasy (that is to say, it is merely an extension of the previous anxiety), then becomes obsessive. One might reassure themselves that they are not a paedophile, to return to the previous example, but this reassurance only further validates the thought for it confirms its very existence and plays into the fantasy that that anxiety might be true. OCD thoughts thus function much like crabs in a bucket: no one crab can allow another crab to escape the bucket; even if one crab’s freedom can be guaranteed, the other crabs pull it down to instead assure a collective confinement and, eventually, death. In the obsessive mind, each thought is committed to a ritual of sabotage, and new thoughts will generate to prevent the painless procession of another.
A single obsessive thought, then, generates a shopping list of infinite other thoughts. In an ordinary trip to the supermarket my attention is caught by a promotional poster advertising chocolate cake. If I am making cake, I need flour, eggs, sugar. Actually I need cocoa too. But what about the icing? And I need fruit – candles, a sparkler, even. If I am having cake, I will need napkins, and cake forks. And so on. The trouble is, it is not cake that I am cooking tonight. The obsessive subject loses sight of the object of concern. It is useful here to turn to Zygmunt Bauman, who wrote on the compulsion of consumption and that unending search for “examples and recipes for life:” “There is no end to the shopping list. Yet however long the list, the way to opt out of shopping is not on it.” The same applies to OCD: the solution to the original obsessive thought – to simply not think – is the only essential item missing from the shopping list. So we shop forever, looking for whatever it is that will satisfy our urge, but we only perpetuate the cycle and shop, so they say, ‘til we drop. Of course, to quote Brecht’s In Praise of Communism: es ist das einfache / das schwer zu machen ist, it is the simple thing / that’s hard to do. While it is not the prospect of implementing Communism that is of concern to me (here, at least), the principle remains the same: the right or simple thing to do can appear the most complex (coincidentally, Brecht did also supposedly suffer from OCD). Take that typical example of an OCD ritual: my hands are dirty, I need to wash them until they are clean. The simple thing to do (washing your hands once) is not sufficient; the difficult thing (washing your hands infinitely because they can never be clean) appears to the sufferer as the best solution.
33 Meticulous Cleaning Tricks
Alas, the image of the perennial hand-washer remains prominent in the popular imagination. The original compulsion to, say, clean one’s hands ad infinitum to achieve an unattainable control is replaced by a simple and incorrect formulation: OCD is about wanting to be clean and orderly. The sufferer washes their hands simply because they are a clean freak. As such, people describe themselves as “a little OCD” (it is passé to even mention Buzzfeed but, sadly, an exemplar usage is that website’s insistence on publishing articles like ‘33 Meticulous Cleaning Tricks For The OCD Person Inside You’). To borrow again from Zizek, this is a decaffeinated OCD, a disorder without its malignant property, like a non-alcoholic beer, say, which one can enjoy without the threat of drunkenness or liver damage. So, the popular image of OCD is one of a compulsion (washing hands, etc.) without an obsession and – importantly – without the threat of genuine distress. Such descriptions of being “a little OCD” would require the illness to be not a neurobiological one but a cultural one. The commonly self-diagnosed decaffeinated OCD is not a physical problem but one that relates to some wider cultural trend in desiring control, perfection or order.
“Unlike other mental disorders, which are rarely addressed publicly, OCD has entered popular culture and colloquial conversation.” So, it is reasonable to suggest that OCD has become “trendy” – not just in the vernacular but in song lyrics and television shows. The risible character of Sheldon Cooper on television’s ‘The Big Bang Theory’ is a leading proponent in OCD-mythmaking. An exemplar scene depicting his apparently obsessive-compulsive tendencies sees him declare in a moment of frustration that he wants to “peel off [his] own face” after a game of tic-tac-toe (which can only end in a win, loss or draw, he says) is left incomplete, rubbed off a whiteboard before he can place his final o. Again we see the decaffeinated OCD in action, with Sheldon’s frustration a totally normal response to a game being abruptly ended. There is no obsession mentioned, nor is there even a compulsive act. His discomfort is that which accompanies the suspension of gratification (the “hey I was about to win!” that might be heard throughout childhood) not that which stems from obsessional thinking or neurological abnormality. One online article even suggests that his “emotional disconnect” is a symptom of his obsessive-thinking, seemingly confusing OCD with autism.
But why and when did a serious disorder become a popular trope, stripped of its horrors and inserted with comedy? Fifteen years ago Jennifer Fleissner considered the cultural interest in this previously marginal mental disorder, wondering whether “something in the very organisation of the external world itself answered to the obsessional perspective?” One metanarrative might point to the jarring developments that accompanied (or accompanies, still) the turn from modernism to whatever came next; that is, a turn marked by the rise in digital technologies, the threat of nuclear war (now, perhaps, an outdated or updated concern) and the “intoxicating delirium of ‘the new beginning’”… the result of “tearing up the old local/communal bonds, declaring war on habitual ways and customary laws, shredding and pulverising les pouvoirs intermédiaires” as Bauman put it elsewhere. So attempts at controlling thoughts might be traced to that desire to control what cannot be controlled: “habitual ways and customary laws” would, in fact, be an accurate characterisation of OCD thoughts, and control of such ways and laws might compensate for the lack felt in a broader, material sense, namely that of a hopelessness amid drastically uncertain times.
We can also certainly suggest that most people in developed capitalist economies live at odds with their occupation or means of income and find themselves working for or within forces that can never truly be known. A lack of control is constituent of most working situations – be that in the outsourcing of labour, ever-declining union membership, the rise of zero-hour contracts, and so on. Further, the coronavirus pandemic that halted much of the world in 2020 perhaps also contributed to OCD mythology, with an endless media stream of catastrophising germaphobia creating a culture ripe for self-diagnosis. So perhaps the cultural interest in OCD does find its origins in the “organisation of the external world” – but it is the mistaken attribution of this organisation as a cause or, even, diagnostic tool for OCD that causes problems.
To The End
The critique of a Freudian or socio-cultural perspective on OCD does not necessarily lead to the conclusion that OCD can and must only be treated with drugs or – at an extreme – brain surgery. In fact, it is essential that one does not become stuck on the centricity of a medicalised account, nor hold as gospel the designations of the DSM-5 and its predecessors. Medication – typically SSRIs – can only go so far to alleviate the symptoms of OCD; talk therapy, be it cognitive behavioural therapy or psychoanalysis, or any other means of communicating and exploring one’s thoughts, remains the clearest and most viable option. If obsessional thinking stems from neurobiological malfunction or abnormality it is still nevertheless experienced intellectually and through patterns of thought, and so the management of these thoughts and their mechanisms remains paramount. To be clear, one's repetitive thoughts, the ritualistic hammering of obsessions, strengthen the "neuro-pathways" of one's cognitive processes. Sufferers commonly speak of becoming "stuck" or suffering from "brain lock." That is to say, the attention one gives to a particular line of thought can lead to a rewiring of the brain: there is a dangerous symbiosis between one's biology and the specific thoughts that one becomes fixated on.
So, the wish of this piece is more to avoid OCD becoming “the label to designate the suffering felt by a new generation” as Darian Leader suggested had become of depression and bipolar before it. We also cannot allow obsessional thinking to be reduced to a banal trope or a rigidity of thinking, as is the current pathway paved by cultural representations (not least because obsessional thinking can be intensely creative, with patterned or ruminative thoughts sometimes perhaps perversely amounting to fantastical world-building that can be harnessed for positive use). Perhaps, then, the lack of mastery over the subject reveals some of its beauty: might we instead resist both the misinformed cultural representation and the medicalised inflexibility that kills “the ambiguity of great drama”? The whys of OCD may remain uncertain but the whats and hows of the daily experience can and must be elevated to public concern. Each sufferer of OCD – and only a sufferer of OCD – has the power to characterise its strange horrors as they see fit. Atop the foundation of neurobiology, within and without the speculation of psychoanalysis, popular culture, self-diagnosis or psychiatric insistence, one’s obsessional thinking remains an alchemic ritual experienced internally, in and of the self.