Often mischaracterised solely as a fixation on cleanliness and order, obsessive compulsive disorder (OCD) is far more complex than the stereotypes suggest. For writer Shaun Flores, it left him feeling suicidal. He explains why the narrative needs to change.

My OCD began with a fixation on my health. I was terrified of catching an STI and developed a fear that I was constantly ill, which persisted despite repeated clear tests. Over time, this fear morphed into a deep anxiety about HIV – a concern that would temporarily subside only to resurface again, leading me to overspend on private tests.

The disorder then shifted focus towards my sexuality, following a dream I had about a man, which spiralled into overwhelming anxiety about the idea that I might be gay – despite having no evidence to support this.

Later, I began to experience frightening intrusive thoughts about committing sexual assault or other violent acts, as well as suicide. I envisioned myself jumping off a bridge. These thoughts were so against who I was, but I felt hijacked with anxiety. I realised that I needed professional help.

By some miracle, the Instagram algorithm pointed me towards Emma Garrick, aka ‘The Anxiety Whisperer’, a psychotherapist and coach. I messaged her and pleaded with her to help me. ‘Why am I having these thoughts?’ I asked. ‘I don’t want to hurt people.’ Emma explained I was experiencing ‘Pure O’ OCD – a type of OCD in which a person experiences obsessive thoughts without visible compulsions or rituals. She saved my life.

Until I spoke to my therapist, I held a deep belief that I was the only one suffering with this type of OCD. For several therapy sessions, I did nothing but cry. I felt hopeless. But, over time, I learned my fears wouldn’t materialise just by me thinking about them. OCD thoughts are ego-dystonic thoughts – those that do not align with who we are and what we believe.

These obsessions and compulsions can be invisible, meaning that you might not be able to see the suffering from the outside. Or they can have physical manifestations. Mainstream narratives often misrepresent OCD. TV shows such as Obsessive Compulsive Cleaners, which first aired in 2013, have contributed to this by portraying OCD in a humorous light. Similarly, popular characters, such as Sheldon Cooper from The Big Bang Theory and Monica Geller from Friends, perpetuate a narrow, often incorrect view of OCD that focuses solely on quirks related to cleanliness and order.

Stigma, shame, and hopelessness can prevent people from seeking help. There’s an average delay of 12 years between the onset of OCD and treatment being received, according to the UK charity OCD Action. At the moment, the illness is severely underfunded and under-researched, with 89p spent on research for every person affected by OCD – despite the fact that an estimated 1% to 2% of the UK population is living with the illness. According to a 2023 analysis, OCD currently costs the NHS £378m every year.

I’ve made it my life’s work to challenge this stigma. OCD was the worst thing to happen to me, but I’m determined to be the worst thing to happen to OCD. In the same breath, sometimes with mental illness, we embody the identity of the disease and it’s easy to forget that we are so much more. I refuse to do that. I am more than a diagnosis, and there is no way that my life can be summarised through my diagnosis alone.

Shaun Flores is a mental health advocate, educator and public speaker living with OCD
and ADHD

The Expert View

Psychotherapist Joshua Fletcher answers your OCD questions.

What is OCD?

Obsessive compulsive disorder is a mental health condition marked by distressing obsessions and compulsions. These obsessions often include intrusive thoughts that sharply contrast with an individual’s values or self-perception.

At the core of many OCD experiences is an overwhelming need for absolute certainty. This isa response to the anxiety triggered by intrusive thoughts, which causes individuals to engage in compulsive behaviours in an attempt to alleviate distress. Among the most common compulsions are rumination – repetitive thinking, analysing or problem-solving – and reassurance-seeking, where individuals repeatedly seek confirmation to mitigate fears.

Some of the most prevalent subtypes include:

Relationship OCD

In which doubts surrounding emotional commitment or the partner’s feelings lead to constant questioning.

Harm OCD

Characterised by the fear of causing harm to oneself or others, often accompanied by a relentless mental review of past actions.

Contamination OCD

Which involves an exaggerated fear of germs or dirt, in turn leading to excessive cleaning or the avoidance of perceived contaminants.

Checking OCD

Which drives people to repeatedly check appliances, locks or other items to prevent disaster.

Sexuality OCD

Marked by persistent doubts about one’s sexual orientation.

Gender OCD

Where individuals obsessively question their gender identity, despite having a clear understanding of it.

Taboo sexual thoughts OCD

Which involves distressing thoughts or mental images regarding socially inappropriate or forbidden sexual scenarios.

Is There a Cure For OCD?

The leading treatment for OCD is exposure and response prevention (ERP) therapy, a specialised form of cognitive behavioural therapy (CBT). ERP involves gradually exposing individuals to the thoughts and situations that trigger their obsessions while coaching them to refrain from performing their usual compulsive behaviours.

Recently, inference-based CBT (I-CBT) has also gained prominence as an effective treatment. This targets the flawed reasoning patterns in OCD. I-CBT teaches individuals to challenge these misinterpretations and base their responses on factual evidence.

For anyone suspecting they might have OCD, the first step is to consult a doctor, followed by seeking a therapist specialised in OCD – ideally someone trained in ERP and accredited in CBT. Properly addressing OCD with a knowledgeable professional can significantly improve outcomes and help individuals to regain a measure of control over their thoughts and actions.

Joshua Fletcher (@anxietyjosh) is a psychotherapist with an MSc in counselling psychology. He is also the author of And How Does That Make You Feel?