I was never diagnosed with OCD. I hid it very well. I was once described as suffering “anxiety and duress”. I verged briefly on anorexia. For a long while, I behaved like the alcoholic I believed myself to be. But at the beating heart of my difficulties, howsoever manifested, it was always OCD in truth. It changed me from a zesty, confident and healthily developing child, up to the age of 13, into an ineffectual, unbalanced, introspective, increasingly shy, wraith-like inspiral void. My previous place as an active, flourishing member of the human race was no more. It seemed to me that the world had changed forever. Inside, I grew to hate and berate myself. Outlandishly alien demands for ugly, stupid ritual performances were suddenly heaped upon me. These requirements spread until there was no aspect of my life unaffected. Surely and progressively, like rank fungal rot, OCD seeped decay from somewhere deep inside me, permeating my every fibre of being.

I remember taking myself to my GP and suggesting that he place me on tranquillisers. I had read that drugs might be a way to break a cycle of anxiety. He declined my request, instead referring me on to a psychiatrist at the local hospital. I recall an excruciating interview with this man, although lasting only 15 minutes or so. His gaze squewered through me like a fishing lure. My evident embarrassment when asked how I felt about masturbation was a source of much note taking on his part. But he found me sufficiently sane to send me on my way. No drugs from him either. And under a shield of shyness, my OCD went undetected.

From this brush with the psychiatric services, I was offered a course of brief counselling and a place on a day scheme for young people recovering from mental health problems. I found the counselling entirely unhelpful, my defences proving impenetrable. But I gained something immediately from the warm friendship I found by associating with other young people at the day centre. In a rattling Health Service van, this seedy crew sailed out daily, like bleary press-ganged pirates, desperately seeking little shared escapes from our individual chaos. I was then in my early twenties and had never heard the term ‘OCD’. In fact, I did not discover how commonplace my plight was until several years later. Until then, I continued to believe I was a freak.

Obsessive Compulsive Disorder (OCD) is not difficult to define. There seems fairly widespread agreement on the presenting symptoms. Obsessive thoughts, typically experienced as disturbing or bizarre, intrude unbidden into consciousness, persisting there against all efforts of will to the contrary. Compulsive behaviour describes ritualised or stereotypical actions, often performed as a charm against calamity, such as may be threatened by intrusive thoughts, or as a means to otherwise mitigate anxiety. It is possible to be troubled by obsessions only, or by compulsions only. But full blown OCD tends to be a combination of interlinking thoughts and actions. Typically, sufferers are painfully aware of the nonsensical nature of their OCD behaviour, but nevertheless feel compelled to endure all that is required of them.

In psychiatric terms, OCD is an anxiety disorder, classified alongside phobias and depression. Indeed, many OCD sufferers will additionally develop clinical depression, being a direct reaction to the trials of OCD itself. For this reason, mis-diagnosis is an error easily made by GP’s, a likelihood further compounded by the intense secrecy typically inbuilt into OCD. Reluctance to admit to the buzzing manifestation of illogical impulses that seethe and plague throughout the day is understandable. Sufferers often fear that normal people (i.e. everyone else!) would think them crazy, were they to describe the contents of these most private thoughts. The broad sub-text of this book is that it is my strong belief that OCD sufferers are neither crazy nor incurable.

Common forms that OCD symptoms assume include: a need for a symmetrical arrangement of objects, such as tying shoelaces ‘just so’; perfectionism; excessive tidiness; ritualised cleanliness, particularly hand washing; acquisitive hoarding or stockpiling of clutter; an unusual slowness of movement, although this may belie much whirring mental activity required to complete a particular action; indecisiveness and procrastination; endless ruminations on insolvable problems (the philosophical chestnut of ‘freewill’ versus ‘determinism’ used to occupy me a great deal); performing actions a set number of times, or else repetitively until it ‘feels right’ to stop (but with recommencement often essential should further intrusive thoughts or external forces interrupt completion of the ritual); the counting of objects, even the number of letters in this sentence; checking, re-checking and worrying still about whether a task has been safely completed, such as that doors are locked against burglars, or if the gas has been turned off; exaggerated concerns about dirt, contamination or infection, with asbestos poisoning a once fashionable fear, now overtaken by HIV/AIDS; intrusive thoughts of transgressing personal moral codes, such as the urge to yell blasphemy in church, or the recurrence of sexual fantasies of an unwelcome, ‘perverse’ nature; threats of death, injury or illness to family members or friends. All these, plus doubtless many more, are common themes of OCD, but the precise content of each personal version will be as distinct as the individual sufferer, offering a near infinity of variation.

Such themes are consistent across cultures, across gender, plus across the span of age. OCD, it would appear, represents an elemental force of the human psyche. Current estimates suggest that between 2-3% of the population will suffer OCD during their lifetime. Onset usually occurs in youth, with 33% of cases beginning by the age of 15, with fewer than 15% developing after the age of 35. Average age of onset is 6-15 for men and 20-29 for women. Famous historical sufferers often cited may include: John Bunyan (who had to resist strong urges to shout obscenities in church), Dr. Samuel Johnson (who was described as having elaborate rituals for leaping in and out of doorways), Howard Hughes (who kept his urine in specimen jars), and Shakespeare’s Lady Macbeth (who could not – “out, damned spot!”- free her hands of an imaginary scent of blood however long she washed them).

Some of these OCD characteristics might, if properly channelled, seem laudable rather than objectionable. For a master craftsman, a degree of perfectionism is prerequisite. And the brooding urge to ruminate may prove productive in a philosopher. Indeed, none of the listed characteristics of OCD are intrinsically problematic, not unless they are so inhibiting to an individual’s daily life that they themselves feel it unbearable. Minor quirks, personal foibles and superstitious behaviour are so commonplace they are, in general terms, only human. Peculiar habits and magic rituals are adaptive or comforting to children and form a part of normal human development. None of these things are unusual or strange. Only when such thoughts or behaviour intolerably impede an individual’s life, with high levels of anxiety invariably attached, is the psychiatric diagnostic criteria for OCD fulfilled.