This is a guest blog for The Secret Illness written by Christopher J. Falvey.
I’ve struggled with anxiety issues for my entire life. Over time it has been bad enough to have been hospitalized, and it has subsided enough to give me a chance to step back and reflect on my phobias and fears. I also have OCD. These two things are indeed interconnected. I often don’t know which is an offshoot of which. Does my anxiety stem from my OCD, or is my OCD a reaction to anxiety?
While those questions will remain unanswered for now, I felt it would be good to explore the differences between OCD and phobias and fears. Because “anxiety” is such an amorphous concept, I am narrowing it down to the concepts of “phobia” and “fear.”
The purpose of this article is not to downplay one or the other or to compare which is worse or… well, better. Neither is better, they are just different, and it is worth exploring because exploration is how I learn about myself. I am often wrong, but I can only speak from my own experience, an experience I have a lot of.
I battle with OCD taking over my mind. I also battle with fears and phobias taking over my mind. So let’s dig into the details of each and see how they differ. We’re going to stick with the term “fear” for the sake of brevity, but that includes the concepts of phobia and anxiety and everything that relates to that area of mental illness.
When it comes to fear, we’re often talking about a singular mechanism. That is to say, the brain is focused on one thing potentially causing another. If I have a fear of heights, it is pretty much focused on… heights. Being way up there untethered. The fear, often irrational (we’ll get to that in a bit) is that I will fall. And the brain may even believe that falling can lead to death.
With OCD, a much more multi-faceted universe is concocted, which is equally irrational. However, the key here is the “universe.” OCD comes with a narrative that ends in fear and avoidance of said fear. To expand, when I am in an OCD episode, I do not just fear one thing resulting in one horrible conclusion. Rather, I have built (I hesitate to use the phrase “made up” because of the somewhat offensive connotations, but it can work here) a set of circumstances that have caused things to not be right, and I need to act on this not-rightness.
For example, I’ve built up the idea that leftovers—which my rational brain knows to a 90% surety are not spoiled—are indeed spoiled food. The seal on the container must not have been tight enough. I have no evidence of this, yet I think there’s at least enough of a chance. There is air trapped in the container, which is akin to leaving it unsealed anyway. This isn’t how things work, at least not fully, but this is the scenario my mind creates
This is OCD. It is irrational in a slightly different way. I’ve built a narrative from the past, and that narrative is driven by things that could be true to a rather minuscule percentage. In this example, there is probably a 1% chance the food is spoiled. Probably less. Damn near 0%. Yet, the thought is there for reasons I’ve come up with. I cannot stop these reasons. I know they are wrong, but I cannot stop them. Thus, I cannot be swayed in my fear. And I must take the action (compulsion) of throwing out what is most likely good food but is absolutely contaminated to me. “Absolutely” is a strong word for something I know is irrational. But it is absolute. My brain has been convinced by my OCD telling it a story.
Now is fear more rational than OCD? It may or may not be. For one, if one is to climb 13 feet (or 50 feet!) into the air on a ladder, they have very much increased their chances of falling. Now the likelihood of that happening can’t really be measured. But there is no real narrative surrounding such fear. It is just fear because the percentages of failure (falling) are not known fully, but rationally are certainly not bordering on 0%. People fall off ladders all the time. You probably won’t, but if there are enough people reading this… one of you probably will.
If all of you had the same food in your fridge that I just threw out (sorry!)… my rational brain is certain that zero of you would get sick because of contamination and spoilage. But my OCD tells me the food is spoiled for… reasons. OCD involves magical thinking, where pure fear does not.
My brain, when my OCD is high, believes in omens. If you talk about a car accident while driving, I believe you have literally increased the chances of it happening. I will often (yes, rudely) shush you. Ok, I’ll try to be nice about it, but this is beyond fear. It is a way of thinking that is very near 100% irrational. Now, I’ve actually thought about the probabilities of an accident a lot and it all becomes murky. Is there a chance that one increases their potential for an accident just by thinking about accidents while driving? I haven’t looked up the science, but again—we’re probably not at 0% but damn close.
The OCD in me does not want any talk of accidents while driving—not because the discussion is abhorrent to me—but because I truly believe (with part of my brain) that this increases the chances. On the other hand, I do have an extreme phobia of driving, to the point where I will not and have not driven in years. The fear part is much more rooted in reality. I don’t have magical thinking when driving; I just don’t want to risk an accident and all the problems that will cause. Accidents are common. They’re not so tremendously common that the media is calling for all of us to stop driving. But we anecdotally know from seeing accidents that have happened every few months or weeks (depending on where you live!) that accidents happen.
This is my experience with OCD vs. fear and phobia. They’re alike in many respects. I’m not even positive how they interact fully, but I do know they are separate entities in many respects, enough to detail them as such here. Neither is better or worse. I don’t want my OCD as much as I don’t want my anxiety issues. I just happen to tackle them differently. Because they are different.
Christopher J. Falvey
Christopher runs the site/blog Yeah OCD (https://yeahocd.com). Diagnosed with Generalized Anxiety Disorder for years, he worked with doctors to uncover his very atypical OCD, which he explores on his site. As well, he is an advocate for mental health issues and writes frequently about the world of mental illness.
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