Sometimes I am burdened by the thought that I do not love my mother. This thought can persist in the back of my head for up to a week, saying, “You think you love her because she is useful to you. You do not love her. You love having someone else make breakfast.”
I would rather cry in my room alone than tell my mother this secret.
I love my mother. I know this is SickBrain triggering my Relationship Obsessive Compulsive Disorder.
. . .
Harvard Medical School estimates that 2.3% of adults in the United States have a lifetime prevalence of Obsessive Compulsive Disorder. It is the fourth most common mental disorder. OCD is often shown in TV shows like “Monk” as a disorder associated with cleanliness and organization. It can be, but it is not just that. OCD relates to the relationship between “obsessions” (recurring unwanted and distressing thoughts) and “compulsions” (a behavior that brings relief from these thoughts). OCD is not just, “I like my desk tidy,” but rather a variation of, “If my desk is untidy, my dog will die, therefore, I must clean my desk to prevent my dog from dying,” on a loop.
On average, it takes 17 years for a person with OCD to receive treatment. I was diagnosed with anxiety and depression in my teenage years, and with OCD in the last five.
My obsessions mostly relate to hurt and violence. In a 2023 survey, 31.8% of OCD patients had Hurt OCD (the subtype of OCD related to hurt and violence). Stairs, cars, planes, and knives will hurt me. Ceramic dishware will break. My family and friends will die before I see them again. If I see a group of people walking down the street, and they are split by a pole, I must whisper “peanut butter and jelly” to keep them safe.
Sometimes I get the intrusive thought to hurt someone, although I do not want to.
The main compulsion that relieves my OCD stress is knocking my head three times with my top knuckles. Always three times and always with my right hand and always on the right side. Sometimes I have to redo the tapping if the first time did not feel right. Knocking on my head keeps my bad thoughts from coming true. This is known as Magical Thinking. According to the Anxiety & Depression Association of America, “Magical thinking is the belief that your thoughts or actions can cause real-life consequences, with no direct logical connection between them.” In a 2023 survey, 26% of OCD patients had magical thinking.
When I was young, I would knock on wood to keep the bad thoughts from coming true (a common superstition), but if I had no access to wood, I had to repeat the words “knock on wood, knock on wood, knock on wood” until I could knock on wood. Sometimes I had to do this, white knuckled and teeth clenched in distress, for 20-plus minutes. This compulsion got better in college when I once had a meltdown with no access to wood and a friend said, “Hey, calm down, your head is made of wood. You can always knock on wood.” She was referencing a common idiom used to describe someone who is considered foolish. And she was right. I always have access to my knuckles and my head, and this small accommodation of having a wooden head has made my life much easier. I always have access to three discrete head taps: knock-on-wood/god-for-bid.
The downside of magical thinking is that it can backfire. Last Thanksgiving, a friend of mine casually said, “Bad things come in threes,” and I had to pause everyone’s dinner, teary-eyed, to research if this was true.
It is not — the rationale is, if three soldiers are smoking cigarettes, the third soldier will get shot. The first match will signal their location to the enemy. The second match will let the enemy aim. The third match is the cue to shoot.
The heaviest part of my OCD is my subclinical delusion. Subclinical delusions are hallucinations and delusions that do not meet the criteria for a psychotic disorder. I am haunted by a series of human-ish figures that mean to hurt me, kind of like ghosts. I do not see or hear them, but I know what they look like, what they want to say to me, and where they are waiting for me. These delusions are not real, so they cannot interact with the physical world or touch me … which is why I panic with unidentifiable sounds or when a door or a shower curtain moves on its own.
These are moments where the material world inadvertently feeds the delusion, and SickBrain gets to say, “This movement is confirmation that they are physically here with you and can physically hurt you.”
But wait, who is SickBrain? SickBrain is my OCD. It is common for therapists to personify OCD thoughts as a separate entity from the patient to mitigate guilt, confusion, and create an emotional distance to challenge unwanted beliefs. The premise is that it is easier to say no to a “bad friend” with “bad advice” that you “do not truly believe in” or “actually want to follow” than saying no to oneself. Naming your OCD dispels its power — either by humiliating it with a silly nickname, intellectualizing its traits (like with the word sick), or giving it a common person’s name to equalize its status. My therapist and I literally talk about SickBrain as if it were a sentient other. My most common phrase in therapy is, “I know SickBrain is lying to me.”
ROCD is an abbreviation for Relationship OCD. ROCD is a sub-category of OCD that specifically relates to obsessive thoughts about a relationship. About 51.3% of OCD patients have ROCD. ROCD thoughts can sound like, “I do not love this person” or, “This person hates me.” ROCD can look like obsessively self-checking if you are thinking “enough” about a partner at work, self-checking if you feel comfortable around a friend (with no reason to doubt your safety), or being unable to stop worrying about a partner’s past sexual experiences. These examples do not scratch the surface of ROCD variations.
My ROCD most acutely presents itself as the fear that I am pretending to love my mother. These episodes are relatively temporary and spaced out, but they bring me the most agony. They falsely reduce my mother to a transactional relationship where my love is tied to the quality of her service. Disgusting. My mother is a selfless, caring woman who does so much for me out of her love for me, and her commitment to being a good mother. My dark thoughts make me feel like I am betraying that trust by using her.
But these thoughts are not me. It’s SickBrain lying to me. I love my mother.
ROCD can also look like an obsessive, unfounded mistrust of a romantic/sexual partner’s intentions or words.
As an undergraduate, I constantly feared my then-boyfriend enjoyed sex with his “ex” more than with me. In reality, they had just been friends with benefits, and she had moved to a different state two months before I met him. But this boyfriend was my first sexual partner, and in the normal process of learning how to have sex, I could not shake off the thought that he liked her more. He never gave me a reason to believe this. He never complained about our sex life. He rarely mentioned her. When I called her his “ex,” he promptly said she wasn’t his ex. I once asked him to list what I did better in bed than she would, and he did — with patience — so that I could feel some form of pride and security in our relationship.
My ROCD with another partner was the fear that he secretly found me ugly. He told me almost every day that I was pretty. He said I had pretty eyes and pretty lips. He liked my smooth, soft skin. He liked my ass. He liked my tits. He said I was the perfect height to fit within his arms. He liked my waist. He liked me naked. He liked my outfits. He said he especially liked me in my puffy, white winter coat and my earmuffs. He liked my eyeliner. He once said he liked my nose and my jawline (but he only said that once). And, appropriately aligned with a sex column, he also said he liked my … lady parts. He never gave me a reason to believe otherwise. He never recoiled from my touch. He never looked away.
Even with this constant, undeniable proof he found me attractive, I couldn’t escape that irrational, delusional doubt that he was insincere. I was ashamed of my face around him. I was ashamed of what was between my legs. I withheld from opportunities I knew would bring me pleasure because SickBrain held me under such deprecation — even in small moments, like overanalyzing if there was a hidden undertone in how he enunciated the word “delicious” in a sentence.
Why? He was genuinely praising me.
— Or not? Does he find me disgusting? Yes. No. Yes. No. I can’t ask. If I ask him if he lied to me about liking my body, then him saying, “No, I was not lying,” could be a lie in itself. There is no way to get to the truth when SickBrain sees facts and taints them with unfounded feelings.
I deliberately use the word “fear.” ROCD thoughts are not your average, normal passing doubts that everyone sometimes has about their partner or their body. ROCD thoughts are deep-entrenched, unwelcome recurring anxieties that texture relationships. It dyes my date night. It sours my sex. My ROCD actively makes me a worse partner.
What about the other half of OCD patients without ROCD? Do they have average love lives? Non-ROCD subtypes of OCD can also trigger behaviors that fracture relationships. If a person fears contamination, they might be unwilling to touch a partner — and this would be a problem for a partner who needs kissing, cuddling, or sex as an important part of the relationship. If a person is concerned with checking behaviors, they might spend hours of their day repeatedly checking if the stove is off — and this would be a problem for a partner who hates being late to restaurants or doctor appointments because their beloved spent twenty minutes repeatedly checking if the door was locked.
My parents know that big, sharp knives upset me. It is under rare circumstances that I will use a kitchen knife. My parents are generous with their time and regularly chop all the ingredients I need for a recipe. This would be a problem with a partner who does not have the bandwidth to cook for or with me.
Despite the obvious challenges, it is not impossible to find romance, friendship, or a fulfilling sex life as a person with OCD and ROCD. People with mental disorders deserve as much joy and love as everyone else.
Again, despite the challenges, I am happy with my relationship with my mother, and I was happy with those previous partners. The people who have been in long-term relationships with me are saints. I am lucky to have loved so many kind people willing to create accommodations for roadblocks towards intimacy or my self-sufficient living.
The secret formula that has brought me success in my ROCD is a loved one’s patience to reaffirm their genuine interest in me as many times as my insecurities need it; my commitment to be vulnerable and to communicate when SickBrain is talking to me; a carefully discussed blanket-consent under which my loved ones can insist and encourage me; and a united readiness to assess new OCD and ROCD challenges as they worsen or alleviate throughout my life.
And I know this advice won’t work for everyone with a sexual ROCD, but a firm and direct “sit on my face” or “touch yourself for me” is enough guidance to override any hesitation and agency that SickBrain has in the bedroom.
