Category Archives: OCD

A Look at Obsessive-Compulsive Personality Disorder

Obsessive-compulsive PD’s are truly awful people, I am sorry. They just are. I knew my father for over 50 years of my life. They’re not ok.

The problem is because of their extreme conformity, workaholism, and morality, a lot of people who know them they are “fine upstanding people.” Only the people who live with them know what monsters they really are. That’s why no one believed my siblings and I when we talked about what a lousy father my Dad was. All the other adults of his generation thought he was the star of the neighborhood – a classic, fine, upstanding, good, hard-working, moral family man. That’s the face they put on to everyone else. They know exactly what they are doing, and they can control themselves most of the time. They just choose not to control themselves around their loved ones because they can get away with treating loved ones like crap.

OCPD often takes the form of hostility, constant criticism, and rages.

They project all the time and go around pointing out everybody else’s faults. Everyone else is lazy, messy, immoral, and incompetent.

They’re prigs. They’re always calling you evil in some way or another because you are probably inherently immoral.

You’re always a slob, no matter what. They love to go through other people’s stuff and clean it up. They often go through other people’s stuff and throw a lot of the other person’s possessions away.

They work constantly and they never have fun. They try to force everyone around them to do this too and if you don’t, you’re evil or sinful.

Having fun is evil or sinful and you need to be ashamed of yourself. They hate parties. You go on vacations with them, and they spend the whole time working, being uptight, and yelling at people. They are like martyr-saints who believe that life is crap, and life is nothing but suffering. Hence, suffering and constant deliberate deprivation are noble things.

They are frustrated all the time.

They are tightwads. They hate spending money except on necessities and paying off debt. Spending money for fun is literally sinful, and you should be ashamed of yourself. They’re stingy with money. If you need money as a college student, they might grudgingly give you five bucks.

They have no insight whatsoever and they have a defensive structure that is so elaborate that it is like an Escher + Goya painting combined with a Rube Goldberg device. The defenses literally have layers upon layers, trap doors, fake entrances, and the craziest fortifications you have ever seen. If you try to point out their OCPD nonsense, they fly into wild rages because it really hits home.

They can’t delegate any responsibility for any job because everyone else is incompetent, so they have to fix everything themselves. Except they don’t know how to fix anything. They try to get you to help them and then scream at everything you do because everything you do is wrong because you are inherently incompetent.

They are masochistic and are always taking on thankless tasks that other “incompetent” people won’t do. They stay late at work fixing the work of the “incompetents.”

They’re never wrong and they’re always right. Everyone else is always wrong and never right. They’re perfect and everyone else isn’t and needs to be constantly criticized for being such screw-ups.

They are always making long lists of things to do, but then they hardly do any of them. They get lost in the endless planning of the project such that the project itself never really gets going. They can’t see the forest for the trees. They can’t see the big picture.

They put everything off to the last minute, and then they run around frantically, hollering in frustration all the time, doing all the tasks that they put off to the end because now they are in a terrible time bind.

They’re control freaks in a covert way that is not obvious.

They hate change. They are some of the most rigid people you will ever meet. They hate anything new.

They are perfectionists and a lot of their own work is never good enough and needs endless revisions.

They’re always tense and uptight and rarely relax.

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Schiz OCD Versus Psychosis: Differences and Interactions

Hassan Herrera: By saying “Anxiety processes can at times escalate all the way to psychosis.” You mean, for example a OCD’er getting through the fear of going psychotic can start experiencing psychotic symptoms coming out of the anxiety process? I catch sight of a post of you setting apart core process and where the symptoms come from. I hope i got myself across.

Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of go together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it.

I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case. Never seen a case of Schiz OCD going all the way to psychosis, although I know a woman with schizophrenia and Schiz OCD in which the two sort of went together but not completely. She still has delusions that she does not doubt. She also hides symptoms a lot, which is very hard to figure out, though I can sometimes do it. I don’t think the Schiz OCD went into the Schizophrenia, but the Schizophrenia dx obviously played into the Schiz OCD. It’s an extremely complex case.

There is a Psychotic OCD but I have never seen a single case of it, and I have seen more OCD’ers than 95% of clinicians will ever see. I have seen cases that I worried were Psychotic OCD, but when you got it all untangled, they still had reality testing intact more or less, at least in terms of overvalued ideas. There is a sub-diagnosis of OCD with Overvalued Ideas.

The OCD symptoms in this case were extremely bizarre, and phenomenologically, they looked a lot like the sort of thing you see in Psychotic OCD. His symptoms appeared so psychotic that when I mentioned them to a retired clinician, she insisted that this person was psychotic and would not accept that they were not. Unfortunately I am not allowed to share the very interesting symptoms on here.

Psychotic OCD has a sort of a “look” to it along with typical delusions that are present in a lot of cases – it is a syndrome, in other words.

A classic case of Psychotic OCD would be a case where the obsessions have escalated into delusions. The people are typically not dangerous, as fear is a freezing agent, and OCD’ers tend to be shy or very shy, passive, introverted, and remarkably nonviolent. A classic case is a man sitting in a chair all day shaking like a leaf and going on about his obsessions, which have now reached delusional intensity. The old view was that Psychotic OCD’ers never got too far gone psychosis-wise, and it was quite easy to pull them out of the psychosis. A typical case might last three weeks.

However, we now have recent cases of Psychotic OCD going on for years that did not respond to treatment. Some responded to ERP oddly enough. Some of these people are so ill that they have become the homeless mentally ill like a lot of schizophrenics, carting their belongings around in a suitcase.

The main thing to note is that Psychotic OCD is rarely seen. However, when OCD is very bad, they can appear psychotic. Hence, OCD’ers are often misdiagnosed with psychosis of one form or another and put on antipsychotic drugs, which generally do not help them. I get clients all the time coming to me with a diagnosis of some form of psychosis. Once I figure out they are not psychotic and are usually instead Schiz OCD’ers with what I call fake delusions and fake hallucinations, I tell them to fire their psychiatrist and go doctor shopping until you find an MD who understands that you have OCD and not psychosis.

A lot of psychiatrists continue to misdiagnose OCD’ers with psychosis. The phenomenology of OCD is not understood well by many clinicians, and the fact that OCD when severe looks like psychosis but is not results in  a lot of misdiagnosis.

I think a Schiz OCD’er would be the last person to go psychotic, as the condition is predicated on continuous worry and doubt that they are going psychotic. If you have spent any time around psychotic people, that’s clearly not what’s going on. In psychosis the person never worries whether they are psychotic, nor are they are aware they are psychotic.

If you are worried about or are aware of being psychotic, then you cannot possibly be psychotic. That’s a rule out for psychosis right there. This is exactly what is going on in Schiz OCD, hence Schiz OCD is never psychotic by definition.

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What Makes an OCD Thought More Rooted in the Mind and Makes It Even More Difficult to be Removed?

I understand exactly what you are talking about. OCD thoughts or obsessions have some peculiar power to them. Something “sticks” about them. I call them Super-thoughts and believe that they are much more powerful than regular thoughts. They seem to have some odd “pull” to them that seems to almost force you to think about them.

I have had clients who have told me that they feel that they have to think these thoughts. Unfortunately, I felt that way somewhat myself at one point. Keep in mind that OCD’ers often feel that they “have” to do all sorts of things. This is the compulsive nature of the illness, but the broken record nature of the obsessions also looks compulsive or habitual. If OCD is a disease of doubting, as the French say, it is also a disease of repetition.

To determine if something is an obsession or not, the great psychiatrist George Winokur told his med school students, “Look at how hard the patient resists the thought. The harder they resist and fight the thought, the more likely it is to be an obsession.”

I will take it even further. “If you try to stop it, it’s an obsession.” That’s not literally true, but it’s pretty much true.

The thoughts also become your friend in a sense because they are with you most of the time. In counseling, I sometimes tell my clients to think of the thoughts as your best friend. After all, they are always with you, and they will never leave you, right? Just like your best friend.

The thoughts also seem to be “alive” in a sense, and it seems like they do not want to die.

Before I realized I had OCD, I just thought I was going insane in my head. For some reason, this was projected out at the world, and everyone seemed to think there was something wrong with me.

The OCD had set up bizarre rules that I had to live my life by, mostly designed to make my life as miserable as possible. I was terrified to break the rules. Finally I had had it with these stupid and frankly masochistic rules, that I started to stand up and fight them. I remember every time I did that, the OCD would stand up and fight and “try to stay alive.” Finally, I would beat the OCD and the the OCD would back down, cower, and say, “Ok, you win.” But then it would come up with a new rule that was often not quite as bad as the previous rule.

In my opinion, it is almost as if these thoughts are living beings. Living beings do not wish to die, so neither do these thoughts.

This ties in with the bizarre nature of the illness where the sufferer himself thinks the thoughts are stupid or absurd, but they still can’t stop thinking them.

Many times I have heard, “Why in the Hell am I even thinking about this?…This is something I would like to think of as infrequently as possible, or never if I could…Of all the thoughts I could think, this is the worst one of them all…Please give me a new thought to think, OCD!”

So the person feels that the thoughts are preposterous, idiotic, and senseless, nevertheless the thoughts have this bizarre pull or stickiness to them as if they are almost demanding that you think about them.

People get so used to their obsessions because they think them all the time that some OCD’ers say, “There is a part of me that wants to stay ill for some reason…I’m afraid to kill the thoughts for some reason…as much as I hate them, the thoughts seem like my friend, and it feels sad to kill them.”

Now why obsessions have this bizarre stickiness, power, or pull to them, I still have no idea. I can’t even come up with a theory. But it’s definitely a part of this very strange illness.

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Does Borderline Personality Disorder Cause Obsessive Behavior?

Answered on Quora.

If by obsessive behavior you mean OCD-type behavior, there is no connection at all other than perhaps the coincidental incidence of both illnesses in some individuals.

However, the presence of BPD in an individual with OCD greatly complicates the OCD and makes much harder to treat than without the BPD.

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Does Fearing Homosexuality Make Someone Gay?

Answered on Quora.

No. I believe most straight men find the thought of being gay to be frightening if not terrifying. A number of straight men told me that they would rather get shot in the head then have sex with a man. Fear of being gay is fairly normal for straight men. There is even a type of OCD called Gay OCD in which straight people fear that they are gay. 0% of these people are actually gay.

There has been an attempt by PC types to conflate fear of homosexuality with hatred of homosexuals, but they seem to be very different things. Yes, there are a few closeted gay or (usually somewhat bi) men who overcompensate and engage in reaction formation or projective self-hatred by hating gays, but that’s not common.

Most gay haters are not gay at all; in fact, they are quite the opposite. I have known many homophobes in my life. In fact, I know some at this very moment.

Generally it is associated with masculinity. The more masculine the man is, often the more homophobic he is. Most of the strong homophobes I have known were extremely masculine men, I mean some of the most masculine men I have ever known. They were also probably some of the least gay men I have ever known. All were aggressively heterosexual and some had had sex with many women.

I would say that homophobia or hatred of gays is associated with masculinity, particularly hypermasculinity, extreme masculinity or as they call it toxic masculinity more than anything else.

I doubt if most homophobes really fear homosexuality all that much. Instead they just hate gay people for some reason or another. Gay people need to wake up and figure out that the “homophobes are all closet cases” is a big fat lie. There are a lot of people out there who are just assholes and openly hate gay people simply because of what they are.

They really ought to come up with another word. Gayhaters pretty much sums it up.

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Borderlands: Obsession, Delusion and Their Differential Diagnosis

The Borderland between Obsession and Delusion

Anxiety processes can at times escalate all the way to psychosis. I have had some OCD clients who I had a very hard time figuring out if they were psychotic or not. With one, I told a retired therapist of their symptoms, and the therapist immediately said, “Well, they’re psychotic. That’s a delusion.” The things that they believed or almost believed did look like psychotic delusions. However, they did not entirely believe them. OCD with Overvalued Ideas was probably a better diagnosis. There are a few cases of Psychotic OCD. I have never seen one though, although this case was getting close.

When OCD gets very bad, they appear psychotic. However, they generally are not, and in 95% of cases, I can figure out that they are not psychotic. That is because Severe OCD That Looks Psychotic has this particular look, feel, or vibe (gestalt) about it where the cases all give off this particular vibe. It’s like they are all reading off the same script in a sense.

The Problem of Psychotic People Hiding Symptoms

You get a different look, feel, or vibe (gestalt) with an actively psychotic individual, but they can be hard to figure out too because sometimes they lie about their delusions.

I have caught them hiding symptoms from me.

Some people with psychoses learn to hide symptoms because they figure out that every time they say “The FBI is after me,” someone grabs them and hauls them off to the hospital. So they continue to believe the FBI is after them, but they learn to shut up about it.

You look at what the person is doing in reaction to the thoughts. They thought the neighbors were hacking into their computer so they disconnected their computer from the Internet? Delusion. A person who just had the fear or obsession that the neighbors were hacking in would not disconnect the computer, and their description of the fear would be full of all of these strange doubts and uncertainties.

The Difficulty of Differentiating between Thoughts and Voices

Psychotic people sometimes refer to thoughts as voices. I had one client who referred to thoughts telling him to do bad things, in this case, to kill animals. He had recently killed five puppies in response to these thoughts ordering him to kill these animals. I suspected these were more than thoughts, so I had him describe them, and he said, “It’s a thought, you know. You hear it like someone standing next to you and talking.” Ok if you hear it outside your body like that, it’s not a thought, it’s a voice.

Some people with schizophrenia hear their thoughts spoken out loud in the environment, and they fear or believe that others can hear their thoughts being broadcast out there. However, if you corner them on it, some will try to deny it by saying that they just have very loud thoughts in their heads, and the thoughts are so loud that they worry or fear that maybe others can hear them. That’s not quite precisely a delusion, and it’s not a hallucination like the thought broadcasting. It’s off into the obsession/delusion borderland.

Schiz OCD – OCD with the Fear of Psychosis Theme

There is a type of OCD where the person fears that they are going psychotic. OCD’ers have made up a term called Schiz OCD for this illness, which is really OCD with the Fear of Psychosis as the theme. Some clinicians have complained to me about these “hokey names” for the different OCD types and accused me of making them up. I didn’t make up any of them.

The sufferers make up these names for the different themes that they have. I feel that the sufferers have a right to own their symptoms and illnesses and call them whatever they want to call them. That’s their right as sufferers.

Who are we to tell them that their name for their symptoms is the wrong name? Do we have a better name? Of course not. “We” are just arrogant clinicians who think we know these illnesses better than the sufferers themselves know them. I realize Schiz OCD is a confusing name, but it’s the name they picked, and we don’t have a better one, so let’s go with it.

They develop all sorts of “psychotic” symptoms, including fake delusions, fake hallucinations, and even perceptual disturbances. Once again the Schiz OCD symptoms have a completely different quality – look, feel, vibe or gestalt – than you get with someone who has actual delusions and real hallucinations. In addition, all of the Schiz OCD symptoms have a very similar quality across many different people – once again, it’s like they are all reading off the same script.

The Problem of Misdiagnosis in Schiz OCD

I have now seen more people like this than I can count, and I’m an expert on this illness. But I still get people with this type of OCD coming to me all the time with diagnoses of various types of psychoses, schizophrenia, psychotic depression, etc. They received these diagnoses from qualified clinicians such as psychiatrists and clinical psychologists. They were misdiagnosed in 95% of cases, so you see even skilled clinicians can’t tell this OCD type from a psychosis in a lot of cases.

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A Few Words About Schizophrenia and Psychosis in General

I do not know much about schizophrenia. I have met two people who were schizophrenic who discussed their symptoms with me.

The young man was medicated but he was still too ill to work and lived off disability. The woman may also have been medicated and she also lived off disability. This is a typical outcome for this illness, sadly.

Her diagnosis was a true grab bag, and she had been diagnosed with everything in the book, including OCD and frequently Borderline Personality Disorder. I was not sure what her complete picture was, but in adolescence and early adulthood, she underwent what looked like a classic schizophrenic prodrome process. There’s nothing else that looks like that. Afterwards a lot of psychotic symptoms developed including visual hallucinations. Also she did not believe she was ill, which is typical of these folks.

I could not really see the Borderline PD. The problem with these schizophrenics is that the schizophrenic process is so complete and totalizing that it essentially swamps over all sorts of other or lesser symptoms.

 

 

The man also had an OCD process going on, and he denied his symptoms were caused by mental illness. He was also trying to hide symptoms from me, which they do sometimes after the illness goes on for a while. It’s not that they believe the symptoms are crazy – they think it is actually true that the man in the TV said, “It’s going to rain today” and that really is a secret message to them telling them to go to the store and buy a pack of cigarettes. Incidentally that is a common type of psychotic symptom and they are called delusions of reference and they are common in schizophrenia. I have someone close to me who had Bipolar 1 Disorder with prominent psychotic (schizophrenic-like) features who had symptoms exactly like that.

The thing is that even chronic psychotics are not stupid and are driven by the pleasure principle to avoid pain. Eventually these people often figure out that when they say certain things like that the CIA is after them, people tend to get alarmed, call the police and they get hospitalized. Being more rational than you would think, they learn to keep some of these symptoms to themselves if only to stay out of the hospital.

He had a lot more insight than a typical schizophrenic which may be due to the OCD, which would introduce a chronic doubting nature into the psychosis, which would be good for any psychosis, as they are based on hard belief. There are new theories about an illness called Schizo-obsessive Disorder which looked a lot like what this man had. Paranoia, Shneiderian symptoms, and a better prognosis are among the features. To give you an example of the Shneiderian features, for instance, this man heard his own thoughts spoken out loud in the exact same way as if you were to speak your thoughts out loud – how creepy! He was afraid to ride the buses as he feared that the others on the bus could hear his thoughts as he thought them as they sounded as loud and clear as if there were someone talking right next to you.

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Differential Diagnosis in Psychiatry – Separating “Symptomatic” Processes from “Core” Processes

In an anxiety disorder, the main thing you see or the “meat” of the illness is the anxiety – I call it an “anxiety process.” In this sense, even some anxiety disorders that have gone psychotic, say Psychotic OCD or Body Dysmorphic Disorder, are still basically anxiety disorders at their core and not psychotic disorders.

The primary disturbance or process if you will is anxiety and the psychosis is just growing out of that process.

What we are doing here is looking for the core essence of the problem – the Gestalt if you will. We are ignoring symptomatic features on the outside and looking underneath them to see what the core or basic process is underneath.

In the same sense, mood disorders that have gone psychotic or even resemble schizophrenia are better seen as mood processes. In Bipolar Disorder, the primary disturbance is one of mood. The psychotic features, if any, are only present during the mood disturbance – the depression or mania. The psychotic features are flowing out of the mood issue and not the other way around as in the case of some schizophrenic persons who get depressed due to the depressing nature of their illness.

If you clear up the mood process and the psychosis is still there, it tends to go over to Schizoaffective Disorder. This is a controversial category, but it is valid. No one quite knows what it is, but I believe the best explanation is that this is simply Schizophrenia and a mood disorder – Major Depression or Bipolar Disorder – occurring in the same person. Persons with Schizoaffective Disorder tend to be heavily loaded genetically for both mood disorders and schizophrenia, whereas someone with a core mood disorder will tend to have mood disorders in their family history and someone with schizophrenia will tend to have relatives with schizophrenia.

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What Is the Most Misdiagnosed Mental Illness?

Answered on Quora. A lot of the other answers are also very good if you are interested in psychiatry.

I work for the most part only with persons with OCD. I don’t even claim to be able to treat any other mental disorders. When I get people with other disorders, I refer them out, especially if they badly need help.

OCD seems to be poorly diagnosed. I get people who obviously have OCD who have been misdiagnosed as something other than OCD all the time. A lot of the time, the clinician simply does not know what is wrong with the person. At other times, they diagnosis is simply something like “anxiety,” which is not very helpful, as there is a lot more to OCD than just anxiety. The people given a diagnosis of “anxiety” in general were not being properly treated.

The second one I get a lot of is some form of psychosis. It is very common for people with OCD to get a misdiagnosis of some form of psychosis. I see a lot of “psychosis”, “mild psychosis”, “mild schizophrenia”, “psychotic depression”, “schizophrenia”, “manic psychosis”.

Almost all of these people are being treated with antipsychotic drugs, and in almost all cases, the drugs are not working or are even making them worse. I simply tell them that they are not psychotic, the diagnosis is in error, please fire your psychiatrist, and look around for another one until you find one who figures out that this is OCD.

The problem is that people with OCD quite commonly appear psychotic when the illness is bad. They “appear” psychotic, but if you examine them very closely, it becomes glaringly obviously that they are in fact not psychotic at all!

In addition there is a form of OCD called by its sufferers “Schiz OCD” in which the person worries and obsesses that they are going psychotic. They often worry that they are developing schizophrenia. I have seen more people with this problem than I can count. Some of them were properly diagnosed, especially by clinical psychologists, but many others were not.

The condition is further muddled by the fact that the person will start to develop a number of “psychotic-like” symptoms that can even include perceptual alterations. They develop “fake auditory hallucinations” where they think they are hearing voices but actually they are not. They are just misinterpreting ordinary sounds in the environment as hallucinations. They also develop “fake delusions” in which they worry that they believe crazy things when in fact they do not.

I am now very good at differentiating fake hallucinations from real ones and fake delusions from real ones and worrying that someone is psychotic from actually being psychotic. But it took me a long time to figure it out, and it’s not clear or obvious at all unless you are very good at diagnosing this particular condition.

Also the obsessions themselves or the illness itself can simply look like a psychosis. I could give you some examples, but space is limited here. Suffice to say that OCD can be a very strange, weird illness and the obsessions can look like delusions. You have to be good at differentiating between an obsession and a delusion, and the distinction is not clear at all.

However, an obsession that looks like a delusion has a particular “feel” about it that an actual delusion simply does not have. It’s more of a Gestalt, intuitive or impressionistic conclusion than a logical one.

Suffice to say that people with OCD often have a certain sameness about them. I like to say “they are all reading off the same script.” After you have seen enough of them, you can practically spot them 1/2 a mile away blindfolded at night, but few clinicians see that many people with OCD.

When OCD is extremely bad, it does indeed look like a psychosis, and the difference between severe OCD and “psychotic OCD” (which actually exists) is not clear at all. I had people who I mulled over for months whether they were actually psychotic. However out there they are though, generally reality testing is still somewhat intact.

You can start getting into the territory of some truly bizarre symptoms. I remember describing one girl’s symptoms to a retired LCSW with decades of experience. She said, “Well, this person is psychotic. That’s all there is to it.” I actually now believe that she was not, but if I told you the very weird ideas going through her head, you would probably immediately say psychosis too.

The problem is that in order to get good at this sort of micro-diagnosis, you have to see a lot of people with the disorder. After a while, you start seeing a common syndrome and a diagnostic picture develops. But a clinician who only sees people with those symptoms rarely if at all has little opportunity to hone his diagnostic skills.

If any clinicians are reading this, you can see that I am complaining that many clinicians do not understand this condition well, hence it is often poorly diagnosed and treated. I believe it is important for clinicians to understand this poorly understood disorder better. How to go about doing that, I do not know. That is for you to decide.

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Do People with OCD Enjoy Thinking about Their Obsessions, or Is It Always an Involuntary/Unpleasant Experience?

Answered on Quora:

Do people with OCD enjoy thinking about their obsessions, or is it always an involuntary/unpleasant experience?

Actually enjoying your obsessions (or repetitive thoughts) is a rule-out for OCD. If you enjoy your repetitive thoughts, OCD is literally ruled out. I sometimes come across people who enjoy their repetitive thoughts and think they had OCD. I told them that they did not.

Most common differential diagnoses were Prodromal Psychopathy (person is developing psychopathy but does not yet have it), Pedophilia, GAD and Obsessive Compulsive Personality Disorder. Also things like Homosexuality which are not even illnesses. None of them are common. The only one I have seen more than once was Pedophilia.

But by and large, people who come to me suspecting they have OCD are correct almost all (98%) of the time. Clinicians despise self-diagnosis and say it has no credibility, but with OCD at least, many persons are quite certain that they have it, and they are correct in their self-diagnosis.

Usually what happens is they get symptoms and cannot figure out what is wrong with them, so they start doing research. They come across articles that describe OCD in great detail or are case histories of OCD’ers. They read that, and something instantly clicks. They say, “That’s me exactly! The person who wrote that could have been crawling around in my brain reading my thoughts.”

Pure O OCD symptoms are remarkably similar. I also like to say I can spot Pure O OCD symptoms half a mile away, blindfolded, at night. That’s not true, but you get the picture. It’s like they are all “reading off the same script.”

The symptoms are so clockwork-like that it has led me to think there is something wrong with a person’s brain who has OCD. The symptoms are classic, almost all of them display the same core symptoms and you can go down a checklist to figure out who has it, or just recognize it by sheer intuition. In that sense it is very much like how physician diagnoses a physical illness he is familiar with quite quickly via sheer intuition. In that sense, OCD resembles a typical physical illness very much.

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