When most people imagine someone with OCD carrying out a ritual, they probably picture them visually carrying the ritual out in the “real world”. Maybe some will picture a person repeatedly tapping a light switch, arranging books or washing their hands, but it is unlikely that the person pictured will simply be standing there with no obvious signs of ritualistic activity.
However, many people with OCD actually have rituals that can be carried out invisibly, and this is a side to OCD that I feel needs more discussion/awareness raised, partly to help others understand the condition better, but partly to help sufferers who do not realise that what they are experiencing is actually a form of OCD that can be treated.

Now I have started to write this blog post I have realised just how hard trying to explain a mental ritual is to people who may not have had them themselves (damn it past Katie why did you have this as an idea for a blog).
If trying to give a rough idea in terms of my OCD though, my personal thought rituals generally involve things like compulsively picturing certain events or people, thinking the same words a certain number of times, having to remember something in exact detail or ritualistic blinking (which I suppose isn’t really a thought ritual as if you know what I am doing you can physically see it, but in most circumstances people don’t notice and thus I count it as one of the lesser known invisible sides to the illness. Even when people do notice I am fairly good at covering it up anyway. You would not believe the number of times people have asked if I am ok because I am flapping my eyelids like the wings of a hummingbird and I have had to pretend I had an eyelash. I used to feel very bad saying this as I don’t like lying, but recently the guilt has gone as I realised that it isn’t actually a lie. It is indeed a true fact that I have eyelashes…just not in the specific eye location implied by my blinking…God this is a long set of brackets…sorry about that…I will close them now…actually wait…no it is ok that was all I had to say about blinking…today at least).

Some of these thought rituals mentioned above are fairly straightforward, as in the “repeating a certain thought over and over”. Okay it can take a long time but it is easy to understand and explain to professionals as a symptom. This is not however the case with all thought rituals, and in order to give some impression of just how complex they can become, I thought I would explain a specifically long and complicated one of mine (if you are able to follow this next bit and gain any sense from it then congratulations, you are a genius, please apply to Mensa immediately).

So, probably the most complex of my rituals is one that I carry out every night before I go to sleep in order to “keep my friends and family safe” (though I am of course aware that rationally there is no way that my thoughts prior to the land of nod are capable of such safeguarding. Nevertheless I still carry them out every evening without fail…GAH!)

The start of the ritual involves picturing a long mantlepiece (it is made of high quality mahogany in case you are interested), and it is lined with photo frames, each one containing the face of a loved one that I wish to protect. Over the years the photos of the people in these frames have changed as people have come and gone from my life, but it is rare that a picture is removed and more common for an extra one to randomly appear when someone becomes particularly special to me (bear in mind this is a very long mantlepiece that can hold an infinite number of frames. It is a nightmare to dust.)
Once all the pictures are imagined in their neat little line, the next step is to imagine a paintbrush with green paint on the end drawing a tick over the face of each person to confirm them as safe, much like an attendance sheet register thing that you have in school. What must not happen is that I picture a red cross being painted over each face. It sounds easy enough, after all they are my thoughts so surely I can think what I want (ha!), but it is very much like that trick when people ask you to imagine a scenario and not to imagine a white elephant, a statement after which you can think of little other than a trunked creature looming in the forefront of your mind. Once the green tick is imagined on the person’s face I then have to move on to the next picture and so on until all of the faces are adorned with a flourish of bright jade acrylic. However, if during this process one of the pictures goes wrong (aka they get a red cross), then I have to start the entire thing again from photo one. Even if I finally manage a line of perfect ticks though, the ritual is not over, as then I have to imagine staring at all these approved photographs for 100 counts without imagining a gust of wind blowing any of the pictures over which is incredibly stressful as if such a wind occurs I have to whip out the paint brush and start all over again. That little explanation from the painting of the green ticks is step ONE of this thought ritual.
There are ten steps overall. TEN.

Rest assured, I will not elaborate on the next nine steps as I fear I would be here all day. No matter what step I get to however, if there are any mistakes I am sent back to step one and hopefully this explains somewhat the difficulty, complexity and time consuming nature of rituals that may not be visible like those in which I wash my hands multiple times. I realise it probably sounds a bit weird to say that I get stressed and upset over imaginary breezes blowing imaginary photo frames off an imaginary mantlepiece, but if those breezes come and if those pictures fall then I fear I will put everyone I have ever loved in danger due to my negligence, an understandably scary thought for anyone.

You are probably wondering how on earth I concocted such ridiculously long mental routines, yet if you were to ask me how they appeared I honestly couldn’t tell you. They didn’t exactly appear overnight, rather they developed over time in a gradual process I cannot remember the beginning of. That said, if I had to pin the origin of my mental rituals it would probably be my first hospital admission to a psychiatric unit over ten years ago. With most people, OCD tends to evolve and morph over time as the person’s life and situation changes and it is often a dramatic change in environment or situation (like suddenly being inpatient in hospital), that can cause rituals to flick on stealth mode and turn invisible. Before my first hospital admission, all of my rituals were visible and involved things like showering for hours on end or repeatedly washing my hands. In hospital however, none of these rituals were possible as I was physically locked out of my bathroom and had to ask for permission each time I needed to use it, at which point I would be supervised and stopped from engaging in any behaviours. Now, on the surface, you would think this cured the problem. True, I was no longer showering for hours every day, but that wasn’t because I didn’t have OCD anymore, it was because I was physically incapable of getting to the shower despite best efforts (turns out I am rubbish at picking locks/kicking down doors of psychiatric unit shower rooms. I would make a poor criminal.)
By being physically locked away from the equipment needed to do my usual rituals then, my rituals changed and adapted. The OCD was too strong to just disappear at the first hurdle in the road and instead my compulsive behaviours became located in areas nobody could lock me out of, areas nobody could bar my access too, those areas being found in my own head (just left of imagination next to the frontal lobe to be specific).

The reason this invisible kind of thought ritual OCD is less talked about than its more apparent variants is probably because of how difficult it is to explain (let alone understand…seriously if you are following this get on that Mensa thing). Nevertheless, difficult or not I think it is a really important topic to raise awareness of as like I said near the start, some people may be suffering from OCD in this way and not really aware of it. I have been in treatment for years so when aspects of my OCD became internal I knew immediately what it was, yet I am sure there will be people out there struggling who never knew that this was a thing. Perhaps there are people out there silently suffering, in distress as they find themselves having to paint ticks and avoid imaginary gales without having any idea of why or how to stop it. Had I no knowledge of OCD and were I experiencing such things there is a good chance I wouldn’t tell anyone because even I can admit that thought rituals sound a bit “crazy” and are not something you would want to bring up voluntarily or admit to, especially if you didn’t know anyone else felt the same. Maybe people with thought rituals don’t even realise it is OCD because they think OCD is washing, and it is for those people (as well as any other lovely people reading this of course) that I have written this post.

If you are struggling with compulsively carrying out intricate thought patterns that cause distress if not performed correctly, you certainly are not alone and it doesn’t mean you are crazy. Obviously I cannot diagnose anyone online, but if you relate to this post there is a good chance that what you are struggling with is an invisible form of OCD. That probably sounds scary if you haven’t ever considered yourself as a person with mental illness in need of therapy, but hopefully it will provide some comfort knowing that your struggles are part of an illness that can be treated. It is not something to be suffered in silence even if your routines are performed in such a manner and I would urge anyone out there relating to this to go to the GP and ask for help. If they have any awareness of mental health issues they will NOT think you are “weird”, they will understand that this is a common issue for OCD sufferers and hopefully by speaking out you will be able to get the help you need. Also if there are any GPs out there or students training in medicine, maybe this post could help you identify these symptoms and help someone in the future. Either way I really think invisible thought OCD rituals need more discussion. The more we are aware of OCD, the more we can understand and most importantly of all, defeat it.

Take care everyone x