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For much of my life, I have been plagued by a terrifying question: "What if nothing is real, and everyone’s in on the joke, apart from me?" I’m talking some kind of Matrix-esque, Truman Show hellscape, where everything I think I experience is some kind virtual reality, or a reality TV show that I’m both the star of and in the dark about.
It is not unusual to wonder about this sort of stuff, and it’s all fun and games over a late-night discussion with friends. Yet, in my experience, the nightmare starts when the feeling that nothing around you is real starts to dictate every waking hour. Your days are consumed with wondering whether your friends and family exist, and how you can be certain that you are not utterly alone, trapped in the screen of an alien’s computer.
I have lived with obsessive-compulsive disorder (OCD) for as long as I can remember. The misconceptions that surround this disorder are so entrenched that many people think OCD is an adjective for someone with a cutesy liking of symmetry and order. In fact, to have OCD, all that is required is that you experience obsessions, which are unwanted thoughts that cause you significant distress, and compulsions, which are the action you then take, whether physical or mental, to neutralise that thought or worry.
Seen in this light, you begin to understand that OCD is a disorder that can literally be about anything. As Patricia Zurita Ona, Psy.D. (known as Dr. Z.), author of Living Beyond OCD Using Acceptance and Commitment Therapy, comments: "obsessions can vary from being regular thoughts that we all experience — 'What if I get cancer?', 'Am I in love?' — to being very nonsensical — 'What if you steal my knowledge when I’m talking to you?” Basically, the ways in which the brain could latch onto obsessions is limitless."
Some people with OCD experience what has been termed "existential OCD." Dr. Z. says that "this theme of obsessions involves philosophical thoughts, existential matters, and reflections about life issues. While they seem like natural reflections that every person has at one time or another, at some point these thoughts arise alongside extreme distress that is hard to let go. Most well-known existential obsessions are about death, life after death, feeling love after death, making the best of life, whether emotions are the right ones in a given situation, immortality, life-after-death experiences, and other similar matters."
For me, the obsessions centered around questions such as “What if I don’t exist?”, “What if nothing is real?” or ‘What if everything is meaningless?" These are interesting philosophical questions, but for the person with OCD, the engagement with them is not academic or curious. It operates in the same way as any other obsessive-compulsive cycle (which is why there is really no "existential OCD" — it’s more a useful way of describing a particular obsessional theme). It’s tedious and debilitating, and less about the actual content than the cyclical process of engaging with compulsions such as rumination — perhaps trying to endlessly "talk yourself out" of the belief that nothing is real or "check" your perception of things is accurate.
Dr. Z. adds that "compulsive behaviours may include scanning memories about life events in which a person experienced particular feelings, replaying emotional experiences (such as falling in love, being excited about life, etc.), dissecting past encounters when having a particular feeling to make sure it was the right one, discussing existential topics or life issues as a form of 'figuring them out' and hoping to find the 'right response,' searching online about existential matters, and reading books about philosophical matters."
At times during my experience of existential obsessions, I even "saw" things, such as snow on a car roof in summer, that I felt confirmed my view nothing could be real. I have since wondered if I was experiencing a period of psychosis, as the feeling I had "seen" those things was so real.
I discussed this with Dr. Z., who felt that what I described were occasional images experienced in the context of severe symptoms of OCD. She explained that "a person dealing with OCD may have random visual errors or — like we all do — but instead of moving on with their day-to-day life, they actually cannot let it go. Instead, they quickly engage in compulsions such as replaying it multiple times over and over to find the truth, to figure out exactly what it is; the challenge is that, the more they mentally review an event, the more uncertain they feel, which in turns, keeps the OCD cycle going."
I recently contributed a short story about my experiences with existential obsessions as both a child and an adult to What Doesn’t Kill You: Fifteen Stories of Survival, published by Unbound, and you can read the first part of it here. I wrote it, and share my experience of existential obsessions in this blog, so you know you are not alone if you experience similar thoughts about reality and existence. I tend not to say that any obsession is "the worst," as they can all be pretty hellish in their own unique ways, but these have certainly been the ones that have made me feel the most alone.
Patricia E. Zurita Ona, Psy.D., is the author of Living Beyond OCD Using Acceptance and Commitment Therapy and The ACT Workbook for Teens: Unhook Your Life and Live to the Full. She is the founder of the online program ACT beyond OCD, the first online program using Acceptance and Commitment and Exposure Response Prevention skills to overcome OCD-related struggles.
