The perception of OCD – has it changed in the last 20 years?

“I’m a bit OCD” is a phrase I have heard countless times in the last few years, but I think it is actually slightly insulting to people who have the condition of Obsessive Compulsive Disorder. It is interesting that this phrase is frequently used but I have never heard this type of phrase used when talking about other disorders and illnesses. Is this a good or a bad thing? However, it is encouraging that this phrase could actually show how the perception of OCD has changed in the last 20 years, as people now, at least on some level, understand more about what the condition is. It could be viewed that this phrase is at least bringing the disorder into everyday language, however frustrating the phrase potentially is to people who have OCD.

What prompted me to write this article was knowing someone who experienced OCD symptoms as a child, although they have never been diagnosed with having the disorder. Their parents did not understand what was happening to their child and felt as though they could not help the situation. This was in the late 1990s, when mental health as a whole was not widely spoken about, especially not as frequently as it is today. It was only in the years after did celebrities, such as David Beckham, start to talk about OCD and what they go through when dealing with the disorder. This shows that just by talking about something more openly and frequently can make it become more relatable as a topic; people tend not to be as afraid about something they understand at least on some level.

I think it’s important to understand what OCD actually is because in the media especially, the extremes of the disorder are portrayed and that isn’t always the full story of what people go through in their everyday lives. Obsessional Compulsive Disorder (OCD) is serious condition, which is related to anxiety, where a person experiences frequent unwelcome and intrusive obsessional thoughts (obsessions). These obsessions result in a person carrying out repetitive behaviours or rituals in order to prevent a perceived harm. These behaviours include:

  • Avoiding people, places or objects
  • Constantly seeking reassurance
  • Internal mental counting
  • Checking body parts
  • Blinking

These behaviours are referred to as compulsions. Compulsions bring temporary relief to the distress caused by the obsessions, but reoccurs when the obsessional thought is triggered. Interestingly, these compulsions can become more of a habit; the obsessional fear/worry could long have been forgotten, but a person carries out the compulsions to allow them to feel ‘just right’.

One of the main treatments of OCD is psychological therapy, which is usually Cognitive Behavioural Therapy (CBT). CBT is designed to help a person face their fears and obsessive thoughts. Medication can also be used, which is usually an antidepressant that aims to help by altering the chemical balance in the brain.

A lot of the facts I have just stated are ones found on websites, free for anyone to look up if they so wish. But there was a time where information was not available in a few clicks of a mouse, or a couple of taps on a phone. A time where information was obtained from books and from knowledge passed between people or down from generation to generation. Today, if we hear someone talk about a subject we know nothing about we can ‘google it’ and become acquainted with the new subject in seconds. In some ways, it allows people to become more open-minded if they are armed with the facilities to do that so quickly. However, people who grew up with or developed OCD before this may have experienced a society where those around them did not understand what was going on, such as the person I spoke about earlier.

Like many aspects of life, people are commonly frightened of what they don’t know about and/or what they don’t understand. This is completely understandable - people don’t know how to deal with something if they don’t understand what it is they are dealing with. This is where I think the media plays a huge part in allowing people to take the time to understand or at least see what a possibly unknown disorder or illness is all about. The ITV soap ‘Coronation Street’, for example, recently began an OCD storyline with a character called Craig Tinker. Craig is training to become a police officer, and last year he was involved in a case where he had to give evidence in court to help his friend get justice in a child grooming case. When giving evidence in court, Craig said a time in the wrong format (not using the 24 hour clock) so he had to clarify that the time he stated was at night, not in the morning. He felt that he had let his friend down because of this error, and hated that he made that mistake. Over the next few months, he became fixated on the time and would only leave somewhere if the time was on a certain minute. He also began taking all of the plugs out of their sockets and would check that the oven hobs were switched off (compulsions) to ensure that his friend would then be OK (obsession). He tried to hide what he was doing the best he could but it got to a point where it would take over his whole life, making him late for appointments, for example. When his friends and family eventually found out, they were generally supportive, and we as the viewers were told that he was taking medication and seeing a therapist. Having viewed online forums, there were members who made fun of Craig and of what the character was going through, but disrespectful online talk is a matter for another article; at least it is being talked about.

What struck me about this storyline was that it didn’t include anything about hygiene. Over the last ten years, a lot of OCD storylines I have seen on TV are based on hand washing; the BBC soap ‘Doctors’, for example, has a long-standing character called Dr. Jimmi Clay who has OCD. We see his compulsions as frequent hand washing and cleaning, with cleaning being something that is spoken about a lot with his character even outside of it being part of him having OCD. OCD is not just about hygiene, it could be to do with any kind of intrusive thought, such as thinking you are going to hurt someone, even though you would never actually do that, and the compulsions are therefore different. However, I would bet that if you asked someone what OCD is, if they did not have any personal experience with it, hygiene would be spoken about somewhere as an example in their explanation. The question could be asked about whether it is better for something to be misrepresented but known about than being unspoken about at all. I would think the jury is still out on this question, and would depend on what the subject matter is.

I’m not saying that OCD, and mental health overall, is now understood by everyone, but it is a lot better than it was. In the last 20 years, the perception of OCD has changed for the better, but there is still a long way to go, and shows like Coronation Street need to continue to break down the barriers between the researchers/writers/actors and the viewers to enable those viewers who do not have real world experience of OCD to understand the very real world of those who deal with it every day. The perception of OCD could only have changed in the last twenty years due to it being spoken about more in the media, and having celebrities talk more freely about their experiences. But people who do not fully understand the subject need to carry on being focused on in the media’s target audience, especially television, to ensure that the misconceptions that many people have about OCD are deflated and a more represented view of the disorder is portrayed; there is still some way to go until the perception is realistic.

Sarah Keeping MBPsS MSc PgDip GDip BA (Hons)

Follow Sarah on twitter at @keepingapproach