Crazy people don’t know they’re crazy… do they? Wait, am I going crazy? Am I crazy? Nah! People who are crazy don’t know they’re crazy, or going crazy… for the most part. Yep yep yep, there’s that lovey uncertainty again. It is sooooo very common that if you suffer from OCD that you will at some point fear that you are going crazy, that you are crazy, that your diagnosis is wrong, that you’re a lie, that you’re an imposter; yikes! What’s the key ingredient in this line of questioning? Doubt! For example, I have a strong fear that I have schizophrenia. Now there is absolutely nothing wrong with having schizophrenia, nor is it unlikely that schizophrenia won’t present itself comorbidly with my condition. It’s possible… however, perhaps not as probable. So if there is nothing wrong with having schizophrenia, then why are you afraid? Simple, doubt. I doubt my diagnosis, I doubt my symptoms, I doubt myself… I’m afraid of losing control, I’m afraid of having a break with reality, I’m afraid of going crazy. How can you be sure none of that is going to happen? I can’t… no one can ever be sure, and that’s okay.
Like any obsession or fear, you must do the opposite and lean into the unknown. For example, if you think that you’re going crazy, then respond “yep, I’m going crazy”… if you think that you’re going to lose control and go on a psychotic killing spree, then respond “yep, I’m gonna lose control and become a mass murderer”… if you think that you can’t trust reality and your intrusive thoughts are voices and hallucinations, then respond “yep, there are those voices and hallucinations again”… now, I’m not trying to say that it’s that simple and you’ll be cured, but it’s a start and the direction you must head; remember, the only way out is through.
Writing worst case scenarios is such a great way to help tackle these kind of obsessions because they are so cerebral and existential. Sure, there are some in vivo exposures you can do like schizophrenia simulations, acting out scenes from “The Shining” (without the axe of course), but still there is quite a lot of imagination and commitment required. These imaginal exposures, like writing, reading, recording, and listening to worst case scenarios can be extremely effective.
Look, not every fight can be won, but that doesn’t mean you should stop fighting. One must endure and one must always try, that is how your true value will be molded. Death needs win only once, but life must win every time. Everyone will lose more than they will win, and it isn’t how many times you win in your life, but it’s about how you react to the times you lose. Embrace the suck. Lean in to your fears. OCD can be survived and you can live very well with the condition, but it takes work. OCD will always try to find a way to grab your attention, and some of its more existential and abstract lures are sure to ensnare your… that’s okay, just don’t get too tangled. Everyone stumbles, but we must get up and try again. In the end, we will never know anything for sure, but we can be sure to know that we tried our damndest!
“The simple truth is, not every fight can be won.”
– Elyn R. Saks