Taking the Shame out of OCD Behaviours

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Kashfi felt ashamed, so ashamed that she had never previously been able to seek help. A bright, lively, attractive young woman, she was single, was active socially, and enjoyed her work in a film production company. What blighted her life was her driving compulsion to check, check, check—and to keep it a secret.

Before going to bed or leaving her top-floor flat, she went around it ensuring that all electric appliances were turned off and unplugged, gas taps were off, bathroom taps and shower hose were not dripping, counting to 100 for each check and repeating the sequence eight times. At work, she made sure all cupboard doors or filing cabinet drawers were shut, so that no one could hurt themselves, and avoided using the communal kitchen area, in case she left some appliance on. She was often dehydrated, as she wanted to cut down on her need to use the toilet. Just as exhausting was keeping all this secret. She couldn’t bear for anyone to know.

“I’m terrified that I am going to harm someone by being careless. I’m fine if others are around—I trust others to get it right. It’s just me. Why am I such a freak?” She burst into tears.

Ritual

As shame was the strongest emotion she was feeling, I reframed what she was doing by telling her about the fascinating work of anthropologist Dimitris Xygalatas, who has made an extensive study of ritual and published a book of that name.¹

Whereas routines such as getting up at the right time or planning how to complete tasks may help us organise our lives and meet goals, rituals, by their very nature, have to be meticulously executed and yet have no observable effects. Instead, as some anthropologists suggest, they help meet innate needs for sense of meaning, security and control—and connection, if carried out in groups. Extreme obsessive-compulsive behaviour (often known as OCD), as suffered by Kashfi, is just a version of this drive gone awry, giving rise not to peace but to continued anxiety.

We are all familiar with the pull of ritual. Children commonly develop routines that they must follow to the letter—sitting cuddly toys in a particular order on the sofa or kissing family goodnight in a set sequence. Such actions give them a sense of agency, that doing this will make everything all right. Ditto for those who indulge in superstitions, such as not walking on cracks in the pavement. In many societies, says Xygalatas, complex community rituals may be carried out to ensure a good crop or weather conditions—but only happen in places where plant disease may be rife or weather unreliable. The aim of the ritual is to create hope and a sense of control where there is none, even though any connection between the ritual and outcome is illusory.

In a fascinating example of the power of ritual, Xygalatas describes how hundreds of people were shown a film of a man pouring two drinks from a pitcher. In the first case, he picked up the glass, cleaned it with a cloth, poured the drink, and set it down; in the other, he waved the cloth at the glass without touching it, before going on to clean it, raised the glass high before pouring the drink into it, and bowed to the glass once full, before setting it down. Questioned afterward, the viewers agreed that there was nothing physically different about the two drinks but, when asked if one was more special, they indicated the ritual drink. When ritual is performed (as at weddings, funerals, and so on), it is for us a marker of something of value.

Innate Needs

It helped Kashfi enormously to understand that her obsessive behaviour derived from innate needs and expectations but with one huge, disabling difference—it did not bring security and so it had to be repeated, again and again.

Human givens practitioners will always ask when such behaviour started. Kashfi had no idea. “It feels as if it has always been like this,” she said. However, we were gradually able to drill deeper and identify that, as she was starting to explore independence as a child, she did not feel trusted by her mother. It was a collection of small things—her mother always double-checking whether she had put the correct school books in her bag, not letting her take her younger cousin down the road to the local shop, and once getting terrifyingly furious when Kashfi accidentally shut them out of the house without a key.

Once Kashfi had stopped beating herself up about having the behaviour, she was able to calm down and think more clearly. We detraumatised the still panic-inducing memory of the key incident and, by looking for examples, were able to identify Kashfi’s very evident ability to keep herself and others safe. She learned to recognise the "ritual-awry" thoughts and not listen to them, while introducing, through breathing and focus and different expectations, the peace and hope that ritual is truly meant to convey.