6 things employers should know about OCD
Obsessive-Compulsive Disorder (OCD) is a debilitating, incurable, anxiety-related condition.
It’s crucial to understand that the way OCD manifests is not set in stone. So, the following list gives you an idea of common ‘types’ of OCD but it is in no way a checklist to be used to decide if someone does or does not have OCD.
Common subtypes identified by OCDuk include
Checking
Contamination / Mental Contamination
Symmetry and ordering
Ruminations / Intrusive Thoughts
Hoarding
OCD is a complex disorder, throughout the article are some links to further reliable resources that can help you understand more about OCD. As someone with OCD, there are many things I wish others knew. Here are a few things I think are particularly valuable for employers
1. OCD is extremely misunderstood.
This misunderstanding leads to misrepresentation.
Pop Culture
Within pop culture, OCD is often presented as a condition synonymous with germaphobia and organisation. The classic example of this is the character Monica Gellar in FRIENDS who constantly cleans and readjusts items around her house until they are perfectly ordered. This portrayal is the punchline of many jokes.
For someone whose OCD centres around ordering and contamination, their experience is much more complex and distressing than this.
Another trope of OCD is that it gives someone some kind of superpower. Characters with OCD are often portrayed as detectives who have super-human abilities in detecting tiny details and using logic. At the same time, this person is portrayed as being somewhat insane or abnormal.
This idea is extremely damaging as it incorrectly alienates people with OCD from everyone else.
Medically
In terms of medical conceptions, OCD has a history of misunderstanding. Nowadays, we struggle to get a diagnosis as our symptoms are poorly understood.
Socially
OCD also tends to be associated with enjoyment. People use OCD as an adjective to describe themselves when they are fond of cleaning and orderliness. This is one of the worst misrepresentations of OCD. People with OCD do not enjoy it. We do not want to engage in compulsions and we do not choose to engage with obsessions over and over. Intrusive thoughts are extremely distressing and we do not control their occurrence.
2. Just because you can’t see OCD, doesn’t mean it’s not there!
Every person with OCD has a different experience and this is largely due to the fluctuating nature of the condition. Not all obsessions or compulsions are visible, but that doesn't mean they aren't there.
Compulsions that we can see are usually what people associate with OCD. This can include things like tapping, turning switches on and off, cleaning surfaces, and checking locks.
However, many compulsions can be hidden such as counting in your head, subtly adjusting body language, and rumination (which is revisiting an interaction in your head for hours on end).
Some also blend into everyday life. For example checking emails repeatedly, asking for reassurance that you’ve completed a task correctly, or rewriting and editing a piece of work until it is perfect.
All of the compulsions mentioned above take up hours of the day for a person with OCD and take a mental toll that is extremely difficult to explain to someone without OCD.
What I wish employers understood is just because someone’s OCD isn’t immediately obvious when you look at them, that doesn’t mean it isn’t impacting them constantly. Importantly, there is not a list of obsessions and compulsions that you can memorise. Obsessions and compulsions can take any form, last any amount of time, and are all equally debilitating for the person who experiences them.
3. Traditional indicators of professionalism in the workplace create a barrier to success for people with OCD.
The notion of professionalism contains rules that are difficult for people with OCD to adhere to. Employers should always make the effort to regularly check in with their employees about what might be a barrier for them as well as how to overcome it. These are just a few that I have found go easily neglected:
Composure
Restricted physical movement can become a challenge for someone whose compulsions are physical. A compulsion might be to tap on a desk, stand up and spin 360 degrees, readjust a chair, walk around the table, engage in checking behaviours, or anything else that involves exiting from a seated and composed position.
In an overly professional setting, I always feel an immense amount of pressure to sit relatively still at my desk. As a result, I might suppress a compulsion to tap each of my fingers together 5 times. The social pressure to look professional at work by not fidgeting is an impossible struggle that I share with many people who have OCD.
In a more relaxed environment, an employee with OCD can spend more time working and less time worrying about if their compulsions will be taken as unprofessionalism which could hinder their ability to progress in their career.
Dress Code
In many workplaces, dress codes are strict and are used to reflect the supposed professionalism of a workplace. People with OCD are often hypersensitive to external stimuli and have difficulty blocking out stimuli that trouble them. This can come into play with any of the senses but one that is often not considered is how this might affect the wardrobe of someone with OCD. Form-fitting, coarse, or restrictive clothing could be very stressful to wear for extended periods.
Allowing employees with OCD to be more relaxed and wear less formal clothing or alternatively ensuring there is a changing room where people can change their clothes could make the difference between a day of spiralling compulsions and a day of relative calm and productivity.
Headphones
Often, in order to maintain focus on the task at hand, people with OCD use distractions to ensure that they are not consumed by obsessions that hinder their ability to work. Using headphones to listen to music or using noise-cancelling features is a classic example of a distraction that can help manage OCD.
Personally, when I am given the opportunity to wear headphones I always will as I know it will increase my productivity and reduce stress levels. However, I have been denied this opportunity in many professional settings because it looks too casual.
Food
Eating lunch at work can be a significant trigger for someone with contamination fears. Although contamination OCD is frequently associated with general cleanliness, food can be equally if not more frightening for someone with OCD. As a general rule, I do not socialise with co-workers when they or I am eating, unless it is someone who I have developed a strong relationship with and the specific food item being consumed is a milder trigger.
Something I would strongly advise employers to do is remove any requirements around when, where, and with whom employees should eat. Instead, giving flexible lunch breaks that can be taken within or outside the workplace will ensure that someone with OCD who fears food contamination does not spend unnecessary hours of their day worrying about, avoiding and obsessing over eating. By introducing flexibility, you can reduce undue stress on an employee with OCD.
Flawed notions of professionalism can hurt the mental state of an employee with OCD and stop them from fulfilling their day-to-day tasks with maximum effectiveness.
4. Pressuring employees at work can worsen OCD
Traditional notions of professionalism are slowly being exposed as counterproductive in the workplace. When it comes to OCD, many existing rules of professionalism fuel anxiety and procrastination.
In my own experience, the two most positive changes an employer can make are removing the expectation of strict deadlines and introducing flexible hours.
Strict deadlines on projects and pieces of work can create enormous amounts of stress for someone with OCD. For example, strict deadlines can lead to someone with perfectionism OCD obsessing over getting something done ‘just right’ and compulsively rewriting the same piece of work over and over again. In this instance, allowing flexibility can help with relieving stress that fuels the cycle of repetition. This can both dampen the likelihood of burnout due to OCD and boost productivity.
When it comes to flexible hours, the reason they can be so valuable for an employee with OCD is that OCD can worsen at any time. So although I always emphasise that OCD is always there, 24/7, no matter what someone's doing, episodes of severe symptoms can often occur unexpectedly.
Consider someone with rumination OCD, they can easily be debilitated by compulsively replaying stressful scenarios over and over in their head. This can then trigger another compulsion like checking that they turned off all the lights in the house. Before you know it, they could have spent 5 or 6 hours engaging in compulsions to try to relieve themselves of the experience of obsessional intrusive thoughts.
Now, if this were to happen on a Monday morning when they were contractually obliged to be in their office from 8 am onwards then they could easily lose their job. Alternatively, if they were given flexible hours then they would be secure in knowing that they would be entirely capable of making up those hours later on in the same day or week.
5. ‘Aren’t we all a little bit OCD…?’
No.
OCD is not an adjective. You are not ‘a little OCD’ because you like organisation, you are not ‘a little OCD’ because you love to clean your house every day, you are not ‘a little OCD’ because you colour coordinate your desk.
To have OCD is not a personality quirk, it's to have a widely misunderstood neurological disorder that impacts every moment of your life.
Trivialising OCD and suggesting that you understand my experience as someone with OCD because you are very organised is deeply harmful. It invalidates my experience and minimises OCD.
OCD is a medical condition that forces its way into every moment of my life.
Although it often comes from a place of compassion or attempted understanding, trying to relate to someone with OCD is often not helpful. By doing this you are reinforcing the incorrect notion that OCD is a funny personality quirk that you can draw upon to be relatable. OCD is constantly being misunderstood, minimised, and mocked throughout society and when you try to suggest that you are also ‘a little OCD’ you are making light of the suffering we experience and minimising the reality of life for every single person who has OCD.
6. OCD is extremely personal
The obsessive intrusive thoughts that characterise OCD attack your greatest fears and the things you hold dearest. As a result, OCD is complicated to explain to another person and many elements of it are tied to the core of who you are as a person and/or are centred around things that hold a lot of stigma.
This is important for 2 reasons:
Firstly, you don’t have the right to ask what someone's obsession is. As an employer, you should discuss reasonable adjustments that we may need without forcing someone to reveal the complexities of their OCD. Asking questions relating to what obsessional thoughts relate to compulsions is extremely inappropriate.
It is essential to realise that there is a difference between asking an employee to explain what OCD is and how this can translate into what they need from you, and sensationalising someone's OCD.
Secondly, the personal nature of OCD means that people often do not want to talk about it with any specificity because it can be highly triggering.
Intrusive thoughts can be about extremely uncomfortable, sensitive or taboo topics. If you force someone to talk about them then you can easily make their symptoms worse or begin an OCD spiral.
Written by Natasha Branicki-Tolchard