Defining obsessive-compulsive disorder is tricky. Redefining it against the grain of near-universal misunderstanding is trickier. For decades, OCD has been conflated with perfectionism, rigidity, neatness, cleanliness. I hope that Pure – the Channel 4 TV drama series based on my book of the same name about living with intrusive sexual thoughts – has gone some way towards addressing these misconceptions.
What I didn’t want to do with Pure was replace one reductive definition with another. OCD is no more about sex than it is about tidiness. The object of the obsessions is actually irrelevant when defining the mechanics of the condition and how it affects your brain. Someone with OCD experiences repetitive unwanted thoughts, fears, doubts or images. Everyone is familiar with such intrusions. But not everyone is rendered intensely anxious by them, or feels compelled to spend hours every day trying to resolve, escape or explain them. It’s this compulsive reactivity that marks out OCD. The compulsions make the obsessions worse and sufferers get stuck in a debilitating loop: a vicious cycle.
I falter when asked to describe my OCD succinctly, because it can’t be distilled from the context of my life. Mental health is always refracted through individual stories, and I find it no easier to summarise my mind in a few hundred words than I do in a seven-minute doctor’s appointment. When asked “What’s it like to have OCD?” there’s an underlying question: “Who are you?”
I am not the girl who thinks only about sex. Yes, my thoughts have often dwelled in that ballpark, but my OCD is far from one-track-minded. Aged five, I’d climb the walls, terrified the Bosnian conflict would come for my family. In pre-adolescence I feared “bad things” would happen if I told even the smallest white lie. At 15 I started having horrific unwanted thoughts about child abuse – a common OCD theme. In my late teens I was engulfed by the sexual images which you see in Pure. By 25, I was self-harming and suicidal.What causes OCD? We don’t know. The most we can say is that in some people, an intangible interplay of environment, character, biology and genetics flare up as OCD. Unsatisfyingly vague, but true.
Can you be “a little bit OCD”? Well, despite the way our culture attempts to categorise mental health into discrete labels, there are no bright lines in the mind between diagnosed and undiagnosed, or between diagnoses themselves. Nobody owns the objective truth of this condition, so everybody’s free to identify on a spectrum. I’d encourage anyone contemplating how “OCD” they are to think carefully about the “D”, the disorder, which can leave people agonised, ostracised, impoverished and dead. In my early 30s, my sexual thoughts are complemented by more existential obsessions – worries about the structural integrity of buildings and of my own bones. My footsteps trigger thoughts about my ankles crumbling. Can you imagine what it’d be like to stop trusting your own mind, or the universe? Sometimes I worry that gravity won’t hold up the Earth.
We’re excellent mythmakers where our own selves are concerned, so I try not to cling too tightly to any one analysis. But looking back, I wonder if my obsessions fit a pattern: “my world might implode, I must stop that happening.” The foundations of love, home and body feel imperilled. We try to impose structure on these threats of chaos. Maybe it’s the same need for structure that made me a writer – or maybe that’s just mythmaking.
Since writing Pure, I’ve been messaged by hundreds of people, including a mother whose 12-year-old daughter saw me on Channel 4 News and said, “That’s me”. Messages like this give me purpose – more healing than any pill.
Am I better? I’m reluctant to use the word (too fixed), but I’m happy, secure, empowered. I got here in no small part through therapy, which I’ve written about in this paper before. Since then, it’s been interventions of a less clinical nature – mindfulness and storytelling – which have finally taught me to love myself.
When the Channel 4 series was commissioned, I left London to do 10 days’ silent meditation. I wanted to stare down the contents of my thoughts before viewers did. Gradually, I began to witness something I’d only ever known on an intellectual level – that thoughts enter and leave the mind of their own accord, passing through consciousness like weather through the sky, or images on TV. I was not the author of them, I was the observer. For someone once so convinced they’d perpetrated their thoughts that they wanted to die to stop them, this was no small thing.
We dream ourselves into existence every day, making ourselves the heroes of our own mythologies. We each have an endless showreel in the theatre of our minds, that feels so incredibly real, we forget it has an audience of only one. It’s been strange to fictionalise my story, and to physically walk through that fiction on set. But what’s been stranger is realising that I’d been telling stories about myself in my mind my entire life. And that I could let those stories go.
Rose Cartwright is the author of Pure. Its Channel 4 adaptation is available to view on All 4
If you’re a young person in the UK who needs to talk to someone about mental health, Childline can be reached on 0800 1111, or by confidential email via its website at childline.org.uk. Young Minds also offer a service at youngminds.org.uk/find-help. For help outside the UK, see childhelplineinternational.org/child-helplines/child-helpline-network
In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.