If you’re familiar with obsessive-compulsive disorder (OCD) and its quirks, you probably know that OCD manifests in various themes, much like different rides at an amusement park. And as one progresses through life with OCD, the specific theme or “ride” that you’re on can change.
For many people, this change is akin to hopping off one terrifying ride only to find the next one even more daunting. The previous ride, once so terrifying, now seems almost laughable in hindsight. And as someone who’s been through numerous OCD theme changes, I can say they’ve certainly felt that way for me. But as difficult as these experiences have been, I can also say they’ve taught me a lot.
How life circumstances and values can affect OCD themes
Before we go any further, I think it’s important to consider the potential reasons why OCD themes can change. Maybe it’s because your values changed, or your perspective on life and what you find important at that moment in time has changed. In my case, having lived with OCD since the age of 9, I’ve dealt with theme changes nearly every year through my development because things were changing so rapidly.
In elementary school, when my relationship with my parents was still strong and I was really starting to get a grasp on my identity, I experienced themes such as harm OCD, which focused on my loved ones and suicidal obsessions about my own personal safety. When puberty entered my life in middle school, so did the themes of SO-OCD and POCD. Then, in high school, there was a massive array of school shootings, which affected what I valued and led to another round of egregious harm OCD. In college, an acute need to attain social approval and a certain physical image brought on intense episodes of body dysmorphic disorder (BDD), a condition that commonly co-occurs with OCD.
The point being, as you change, and as your environment changes, so can your OCD. Broadening your sphere of self-awareness by reflecting on how you have shifted and how your themes have shifted over the years may give you a better grasp on how to handle current or future obsessions. By acknowledging the “nurture”-like effects that your environment and life-position may have had on you, you can become more conscious of specific compulsions you may give in to.
There is a sense of indecisiveness and a cost-benefit analysis involved in nearly every action we take. When faced with a choice, people typically run through a range of potential decisions to determine what best represents their desired outcome. People with OCD are more likely to intensify this process by magnifying the importance of certain decisions. For example, someone who stubs their toe might see the cost-benefit scenario of driving to the doctor as 99/1, so they don’t go. However, someone with OCD will often enhance the importance of the decision, making the situation feel more like 50/50. These constant, seemingly make-or-break situations can significantly increase stress.
What I’ve realized about OCD theme changes
Now that we have a foundation, let’s dive into the specific theme of OCD that I am currently struggling with: Perfectionism OCD. But before we get into what Perfectionism OCD is, I think it’s important to understand what it isn’t.
Perfectionism OCD is often mistaken for cliché misunderstandings of OCD or obsessive-compulsive personality disorder (OCPD), a similarly-named but very different condition.
Perfectionism OCD involves intrusive thoughts about making mistakes or not meeting high standards, leading to repetitive behaviors aimed at achieving perfection or preventing perceived mistakes. Individuals with OCD usually recognize these thoughts and behaviors as irrational and distressing.
On the other hand, OCPD is a personality disorder characterized by a chronic preoccupation with orderliness, perfectionism, and control. Unlike OCD, OCPD does not involve distinct obsessions and compulsions. Instead, individuals with OCPD have a general pattern of striving for flawlessness, rigidity, and a strong need to control their environment, often viewing their perfectionistic behaviors as necessary and justified.
While both conditions involve perfectionism, their underlying mechanisms and impacts on the individual’s life are distinct. Here’s an analogy that might give you a better understanding of what I mean:
Imagine there are three people walking up the same-sized mountain, all trying to reach the top.
The person with OCPD has a motivational coach running next to them, keeping them diligent in their effort to get to the top.
The person without OCD or OCPD is on the mountain by themselves. They may slip and fall, take their time getting up, or even take some much-needed breaks.
The person with OCD has a man right behind them holding a spear. Any time they misstep or try to take a breather, they are met with a knife’s end to the back, forcing them to keep moving.
The reason I paint this picture isn’t to victimize myself or someone with OCD to gain sympathy. No, see, I believe that nothing happens in a vacuum. Everything has a cost-benefit relationship, and it’s up to the individual with OCD and their loved ones to be aware of how OCD operates and make the best decisions for themselves.
Getting back to the value stuff, I am currently a 24-year-old entering young adulthood and facing pressures to establish a career, create long-lasting relationships, achieve financial stability, and lay the groundwork for personal success. What I value is reflected by this snapshot of my current worldview; therefore, in my opinion, it makes total sense that my OCD forces me to engage in compulsions that resemble the advice of any self-development guru: run an extra mile, spend an extra hour at work, read three more chapters, cut out more sugar, stop drinking, enhance my skincare routine—you get the gist.
But hey, that’s me—your experience with OCD will be different, which is why I want to emphasize the importance of subjectivity here.
Once I understand the root of the obsessions, I have to face the contradictory nature of my situation: I know engaging in these compulsions hurts me, strengthens my OCD, and decreases my psychological flexibility. But they also help me get to “the top of the mountain,” so to speak. I live in a culture that values achievement and self-improvement, and I value these things myself, which makes it easy for the line between drive and compulsiveness to become blurred. Ultimately I have to decide which I care about more, even if it’s a tight race.
See what I mean? It’s not easy, but then again, most things aren’t.
The tightrope walk of living with OCD
I’m always talking about walking on this tightrope where my irrational obsessions have such a grip on me that it feels as though they’re propelling me towards whatever goal I’m aiming for. But the reason I call it a tightrope is that when things blow off course even slightly, the distance to the ground isn’t a mere step; rather, it’s a 20-story fall. In essence, the stakes are much higher.
What does it mean for me to walk the line of order and chaos, though? How do I reach what I see as the perfection of getting across that tightrope without the lingering 20-story drop? It’s a situation where you can’t have your cake and eat it too.
Everything I’ve mentioned comes from reflecting on my own personal experience with OCD and what I have learned over the past 15 years, so take it with a grain of salt. But from my perspective, it’s extremely rare that a certain theme park ride will serve as helpful in the long term; eventually, you’re going to want to get off and go home.
So what can you take away from my experiences, if anything? Well, I would hope for an awareness of the individualized nature of this complex and nuanced disorder. I think it’s crucial to understand that what works for you may not work for someone else, and to know that in order to understand what works for you, you have to be willing to take a look at yourself and ask: Why am I even on this ride right now?
Living with OCD and its ever-changing themes can really feel like walking a tightrope, constantly balancing between what you genuinely value and what OCD tries to force on you. That’s where exposure and response prevention (ERP) comes in—it teaches you how to walk the tightrope without letting compulsions knock you off course. By sitting with the discomfort and resisting those urges, you start to separate what truly drives you from what OCD is making you believe. It takes time and effort, but with ERP, you can regain control, walk the line on your terms, and live according to what matters most to you, not your OCD.
If you’re struggling with OCD, NOCD can help. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. They’ll work with you to create a treatment plan personalized to your unique needs and help you regain your life. You can book a free 15-minute call with our team to learn more about getting started with OCD treatment.