Skip to main content

Verified by Psychology Today


A Broken Heart at the Center of OCD

A Personal Perspective: In my view, OCD is as much about feeling as it is about thought.

Source: RDNE Stock project/Pexels
Source: RDNE Stock project/Pexels

When I was in third grade, I was gripped by fear that my mother would be killed if I didn’t follow orders. From whom and where these orders were coming from wasn’t entirely clear, but I quickly learned to obey. Like the main character John Nash in the movie "A Beautiful Mind," I was being watched, and everything I thought was monitored for loyalty to the sinister totalitarian state of which I had now become a new citizen. There was no way out.

Every day at the religious school I attended, this presence whispered in my ear, “She’ll be dead when you arrive home if you think something bad.” Trying to live each day with a pure heart became a curse, a way to trap and punish me in the most painful way imaginable. If I failed, this invisible entity would take away the person I loved and needed most in the world—the single mother who protected me—as well as the flame of sensitivity within me which the world seemed all too eager to snuff out.

When the neighborhood kids dared me to throw away my Winnie the Pooh bear, I foolishly gave in and was heartbroken. The next night, Paddington Bear in his blue duffle coat and red bucket hat appeared on my bed.

When we returned from the movies, my mother asked about the hopes and fears of the characters because she could see them still percolating in me. Like a music conductor, she’d encourage me to allow every section of the orchestra of my mind and heart to play out just a little louder, strengthening a confidence in an invisible capacity I could not yet name.

I adored my mother and knew that without her, my sensitivity would be swept away. So, as Abraham did with God in the story of Sodom and Gomorrah, I negotiated with the amorphous all-powerful entity controlling my fate. If I read every word in the prayer book, it might be appeased. If I had an evil thought, I could cancel it out, and if done right, the entity might be mollified.

But in the end, the charges kept returning. No sooner was I absolved of a crime I didn’t even know I committed than a new trial restarted. The world was full of impossible binds. Death and doubt resurfaced at every turn.

It wasn’t surprising that I developed OCD. My mother had an identical fear of losing her mother at the same age and struggled with contamination OCD, opening doors with tissues, and ever-ready with rubbing alcohol. “It’s just my craziness,” she’d confess.

One day, a red futon tied to the roof of our car fell while driving along the highway. Pulling over to the side of the road, 10-year-old me peered into my mother’s eyes expecting to find terror there.

“Michael, the big stuff doesn’t scare me. It’s the little things that get me, remember?” And with a smile, I helped reattach our precious cargo.

My mother was familiar with an existence as paper-thin as the tissues she carried with her everywhere to ward off germs. Her parents’ marriage fell apart shortly after their arrival in New York from the Middle East via Panama, when her mom—my grandmother—became the main breadwinner and caretaker of the family of four young children. Sensing her fragility, my mother stepped in to minister to her.

A highly educated woman now working behind the counter at a department store to make ends meet, my mother easily noticed the pain—the unspoken sadness, longing, and fear—that others hardly detected. Even my mother’s siblings mistook their mother’s desire to have joyful holiday dinners as just another form of control, instead of what it really was: a cry for help. Please eat and show me, not only that you love me, but that somehow God hasn’t abandoned me like my husband.

My mother stayed close to home, learning to fear rather than crave independence. Without the freedom to disagree or feel anger, her sensitivity became the emotional suture for a constantly bleeding family. In doing so, she lost much of the thread holding herself together.

She doubted her own instincts and confidence, even though she had a sixth sense of empathy that few recognized as her hidden superpower. English professors noticed it and called on her regularly for her insights in class, but in the real world, she felt unmoored.

OCD emerged as an expression of how precarious the world felt to her. It offered her a blameless way of seeking the boundaries and guidance she couldn’t ask for directly. When OCD dictates something—when it says, “Please tell me everything is going to be okay, please wash your hands, please help me right now!”—it allows for an aggressive urgency that’s otherwise forbidden.

Sound and Fury

As a psychologist, I’ve treated individuals struggling with OCD since my graduate school days. Then, you could find me on the streets of Manhattan touching tissues to doors and diluting them before doing exposure exercises with clients. You’d find me in the library turning over every stone in my dissertation research on what did and didn’t work for OCD.

These days, I get calls and emails from clients around the world who fail OCD treatment and say they’re not encouraged to talk—even with their own therapists—about the deep feeling and fire they experience within their OCD. To attribute any meaning to OCD, they’ve been taught, is to enable reassurance. To envision OCD as anything other than a bio-behavioral glitch is dangerous and foolish. They tell me that their therapists say things like: "It takes 17 years on average to arrive at appropriate OCD treatment—why would you jeopardize that?"

My perspective on OCD is likely to be dismissed by some as misguided and anachronistic, even taboo. Many in the OCD community believe that talk therapy is unhelpful at best and regressive at worst. A widely circulating meme in the recovery world echoes the mainstream view, inspired by a passage in Macbeth: OCD is “just sound and fury, signifying nothing.”

But what if the meaning at the heart of OCD is there and we’re just not talking about it? What if these clients aren’t failing treatment but treatment is failing them? What if, instead, we listened to what burns so brightly inside OCD?

In my view, OCD is as much about feeling as it is about thought, as much about meaningful self-expression as distracting noise. Hardwired by nature and stoked by nurture, our brains repeatedly throw an unsolvable dilemma that’s trying to communicate something valuable.

I believe that OCD can be both friend and enemy, but we tend to view it only as an enemy because by the time people get help for it, it’s a five-alarm fire. If you look at it with the right eyes—ones attuned to the sparks of sensitivity within it—you see raw potential in it that’s inspiring, sensible, and bold.

In my next post, I'll delve further into this new take on OCD.

More from Michael Alcee Ph.D.
More from Psychology Today