Obsessive-Compulsive

2.3% of the population has obsessive-compulsive disorder, known colloquially as OCD. I had pretty severe OCD for a while from about 2003-2013. I was a door locker. When I left the house in the morning, I would lock the door, walk about 20 steps, turn around to make sure the door was locked, go back and get in the car, drive about 500 yards, turn around and make sure the door was locked, confirm that it was indeed locked, get back in the car, drive about a mile or two, have feelings of crippling anxiety that the door wasn’t locked, go back and check the door, and so forth. On an average day, it would take me a full 45 minutes to go through this process before I could go to work. I got smart and started locking the door in a specific pattern: 2-4, 3-6-3, 7-10, and that worked for a while, but then I didn’t even trust myself to do it correctly. It was a real handicap.

OCD is part of a class of what is known as anxiety disorders. Hoarding, by the way, is also an anxiety disorder. And the problem with anxiety disorders is that they’re basically untreatable with medication. There is medication, and it works—a little—in the best-case scenario, there is a 40% reduction in harmful activity. The best way to get rid of an anxiety disorder is to get rid of the source of anxiety. But that is a lot harder than it sounds. I will say that my OCD got significantly better when I left Lehman in 2008. I would not allow myself to believe that my job was causing me anxiety to that scale. In retrospect, it was obvious. As an ETF trader, I was getting bombs dropped on me on a daily basis, and living in constant fear of compliance and regulation. But it wasn’t just the job—I had anxiety about everything. I have written before about ways to combat anxiety.

I had a psychiatrist appointment recently, and the doc asked me about my OCD. I told him that it was about 98% better, and he said, without medication? And I said, yes, without medication. He said that was exceedingly rare. Basically, I had to come up with some Jedi mind tricks to fight it. After I left the house, I would focus on a problem at work, and I would start thinking about it, which would crowd out any thoughts about whether or not I had locked the door. By the time I remembered the door, I was a half hour away, and it was too late to go back. I would feel anxiety about it, but there was nothing I could do. And I would get home at night, and inevitably, the door would be locked. I have never, not once forgotten to lock the door.

Most people don’t really know what OCD is, and are glib about it. People think it is OCD when you’re at the gas pump and you have to get the dollar amount to a round number. That is not OCD. That is perfectionism, or something else. People confuse the two all the time. Real OCD is not funny, not a joke at all, and people suffer badly from it. There was a guy at Lehman who was a compulsive handwasher. Every time I was in the men’s room, he was in there, washing his hands, in the same repetitive motion. He must have spent two hours a day washing his hands.

Let me tell you how this works, and why obsessions and compulsive behavior exists. You have something that is causing you anxiety, say a lawsuit or something like that. As a defense mechanism, your mind decides to focus on some small thing as a distraction from the bigger thing that you have anxiety about. It is all about control. If you can control how clean your hands are, or whether the door is locked, then you can not think about the lawsuit for a while. It is a distraction technique. So the real way to fight OCD is through talk therapy, and to work through the big things that you actually have anxiety about. I talked about the door-locking with my therapist, and he told me that working at Lehman was the cause, the big anxiety that I was avoiding. I didn’t listen to him. I said, no way, I love my job, that can’t possibly be it. But it was it. Like I said, I am 98% better, and that 2% still gets me. I still check the door—once—when I leave the house. If the compulsion flares up again, I know that there is something bigger that I am worried about, and that I had better do something about it.

There are examples of pediatric OCD. And I had it. When I was five, I had an obsession with how the seam in my sock lined up with my toes. During the school day, in kindergarten, if I felt the seam out of place, I would take my shoes off to fix it, and then I would get in trouble for taking my shoes off in class, which would get me a beating at home, which was obviously the source of the OCD. Pediatric OCD is about 60% less common than adult OCD, but it is usually a harbinger of worse things down the road.

Hoarding, as you know, can be debilitating—and dangerous. People who hoard objects are more than just nostalgic—they have memories associated with objects, and they feel that if they discard the object, then they will lose the memory forever. Of course, over time, this morphs into shopping at yard sales, and acquiring other people’s objects, and co-opting their memories as your own. It’s an anxiety disorder—the purpose is to distract from some larger issue. They made TV shows about this 20 years ago, which were unhelpful, sort of a window into the depths of this mental illness and a contest to see whose house was the grossest. Not much different than a freakshow at a carnival. These people deserve our sympathy, but out of all the manifestations of OCD, hoarding is the most difficult to break. The afflicted individuals generally do not want help, and the worst thing to do to a hoarder is to throw their shit out. Pandemonium.

How do you know if you have OCD? If you’re engaging in compulsive behavior and you want to stop. You know that it’s harmful, you know that it’s impacting your life, and you really wish you could stop checking the door. If you’re engaging in repetitive behaviors and you don’t want to stop, then you have something else. It is possible that you have autism spectrum disorder, for one. People on the autism spectrum arrange objects sequentially, engage in ritualized, repetitive behavior, but crucially, either they aren’t aware that they are doing it, or they believe that the behavior is functional, but if they don’t want to stop, it’s not OCD. By the way, the whole field of psychology is dedicated to helping people with certain behaviors stop doing those behaviors. That’s why it’s called behavioral health. If you’re a PhD or an LCSW and you can’t reliably help people from harming themselves, then you’re just bad at your job. Good therapists can help people with these sorts of things. I will add that addiction and OCD have a lot in common, and these two things naturally co-occur in lots of people.

I will probably never stop checking the doors. There exists that kernel of anxiety that someone my break into my house and steal shit, or my cats might get out. That would be the worst thing in the world, so I take out insurance on the worst thing in the world by checking the door every day. Behind all of these compulsions is a kernel of truth. And also, lots and lots of trauma, as I mentioned earlier. If you have OCD, I’d advise against the medications—they don’t do much anyway—but get a good therapist who specializes in OCD or addictions, or both. And then you actually have to put in the work. The good news: you can beat it if you try! I did. And there is a lot of letting go involved, which is hard to do.