my detailed answers to the yale-brown obsessive compulsive scale, copying questions from https://embrace-autism.com/yale-brown-obsessive-compulsive-scale/ date: may 28 2024 # Obsessions ## Aggressive obsessions 1. I fear I might harm myself EXAMPLES: Fear of eating with a knife or fork, fear of handling sharp objects, fear of walking near glass windows Answer: past and current - very careful when using knives for cooking - overly precautious about putting them away and making sure i dont accidently cut myself - extreme care when using power tools or sharp objects or dangerous in general - this is omnipresent and makes me very careful at all times - whenever i handle anything that might be dangerous in any way i always have to be thinking about safety 2. I fear I might harm other people EXAMPLES: Fear of poisoning other people’s food, fear of harming babies, fear of pushing someone in front of a train, fear of hurting someone’s feelings, fear of being responsible by not providing assistance for some imagined catastrophe, fear of causing harm by giving bad advice Answer: past and current - fear of touching food and causing other people to get sick - fear of hurting someones feelings is something constant - fear of accidently kicking a kid or a dog - fear of causing harm by giving bad advice makes me always preface my advice with "this is what works for me" 3. I have violent or horrific images in my mind EXAMPLES: Images of murder, dismembered bodies, or other disgusting scenes Answer: past and current, happens semi regularly 4. I fear I will blurt out obscenities EXAMPLES: Fear of shouting obscenities in public situations like church or class, fear of writing obscenities Answer: past and current - fear of blurting out something bad or that im not supposed to say - accidently saying slurs at people is a big current one - accidently swearing at school was a big past one - causes me quite a bit of anxiety, especially recently 5. I fear doing something embarrassing EXAMPLES: Fear of appearing foolish in social situations Answer: past and current, literally in all social situations, makes me very socially anxious 6. I fear I will act on an unwanted impulse EXAMPLES: Fear of driving a car into a tree, fear of running someone over, fear of stabbing a friend Answer: past and current, lots of random impulses that im afraid ill act out on and cause damage (like the ones related to 2, or throwing my phone off a high place and hitting someone with it) 7. I fear I will steal things EXAMPLES: Fear of “cheating” a cashier, fear of shoplifting inexpensive items Answer: past and current - accidently leaving things in the cart - stealing something by putting it in my backpack and forgetting about it - fear that i mightve stolen something by accident and not realized 8. I fear that I’ll harm others because I’m not careful enough EXAMPLES: Fear of causing an accident without being aware of it (such as a hit-and-run accident) Answer: past and current - specific example: fear that me crossing the street will cause a car accident, or fear that me walking around someone on the subway platform will cause someone to fall onto the tracks 9. I fear I’ll be responsible for something else terrible happening EXAMPLES: Fear of causing a fire or burglary because of not being careful enough in checking the house before leaving Answer: past and current - fire because i didnt turn the burners off or didnt clean the lint or my computer is broken or an extension cable is frayed or a battery is failing or because i overcharged a device - burglary because i forgot to lock my doors - my cat escaping or getting hurt because i left something out or didnt close the door or didnt close a window - this one causes me a LOT of distress ### Aggressive obsessions subscore: 18/18 ## Contamination obsessions 10. I am concerned or disgusted with bodily waste or secretions EXAMPLES: Fear of contracting AIDS, cancer, or other diseases from public rest rooms; fear of your own saliva, urine, feces, semen, or vaginal secretions Answer: past and current - very careful around washing my hands after potentially touching any of my own bodily wastes - fear of something getting on my hands and then spreading onto the "safe" parts of my apartment 11. I am concerned with dirt or germs EXAMPLES: Fear of picking up germs from sitting in certain chairs, shaking hands, or touching door handles Answer: past and current - this permeates almost everything in my apartment - everything in my apartment is ranked on a scale of "clean" to "unclean", with anything that touches an unclean surface becoming that level of contamination - i stress a lot about making sure that the important things to keep "clean" remain clean - specifically my bed and face must be kept to the upmost quality of clean or else i freak out - something important being contaminated is EXTREMELY distressing and will result in me cleaning it at the earliest convenience - i purposefully try to not think about the contamination because if i start thinking about it itll spiral and ill go insane trying to make everything clean - because something being "clean" relies on only touching things that are "clean" and being able to be "reset" to a "clean" state by washing it somehow - if i overthink things, i can convince myself that a washing machine doesnt clean something enough, at which point i would probably go insane - i can do this fairly well on a day to day basis, just maintaining the "bare minimum" of contamination management 12. I am excessively concerned with environmental contaminants EXAMPLES: Fear of being contaminated by asbestos or radon, fear of radioactive substances, fear of things associated with towns containing toxic waste sites Answer: past and current - huge spikes of obsession/anxiety around both radon and asbestos at my old house in canada - big spike of anxiety recently with regards to lead in the new york city water (got a free lead test, started filtering all my water) 13. I am excessively concerned with certain household cleansers EXAMPLES: Fear of poisonous kitchen or bathroom cleansers, solvents, insect spray or turpentine Answer: past and current - as a kid i could never touch bottles of bleach or drain cleaner without anxiety - currently, i can use drain cleaner but i wash my hands many times afterwards to make sure it isnt going to burn my hands off 14. I am excessively concerned with animals EXAMPLES: Fear of being contaminated by touching an insect, dog, cat, or other animal Answer: past and current - cats are good/ok (i will wash my hands after petting skipper), dogs are extremely borderline (i will try to wash my hands asap) - bugs are BAD (i will try to not touch a bug at all costs and then wash my hands afterwards anyway) 15. I am bothered by sticky substances or residues EXAMPLES: Fear of adhesive tape or other sticky substances that may trap contaminants Answer: neither 16. I am concerned that I will get ill because of contamination EXAMPLES: Fear of getting ill as a direct result of being contaminated (beliefs vary about how long the disease will take to appear) Answer: past and present - asbestos, radon, lead all led to big health anxiety (i was convinced i was going to get lung cancer and die) - bugs getting me sick 17. I am concerned that I will contaminate others EXAMPLES: Fear of touching other people or preparing their food after you touch poisonous substances (like gasoline) or after you touch your own body Answer: past and present - the example is very apt is something i experience - huge fear that food that i cook for others will be undercooked and ill poison them - or that my hands were dirty because i touched a dirty dishcloth and it was on my hands which got on the food which was cooked but might still have the contamination ### Contamination obsessions subscore: 14/16 ## Sexual obsessions 18. I have forbidden or perverse sexual thoughts, images, or impulses EXAMPLES: Unwanted sexual thoughts about strangers, family, or friends Answer: past and present, unwanted thoughts about family, very distressing 19. I have sexual obsessions that involve children or incest EXAMPLES: Unwanted thoughts about sexually molesting either your own children or other children Answer: past and present, very distressing 20. I have obsessions about homosexuality EXAMPLES: Worries like “Am I a homosexual?” or “What if I suddenly become gay?” when there is no basis for these thoughts Answer: neither - im a trans lesbian so im not sure how this question would apply to me - i do sometimes worry about being straight and 'what if i suddenly become straight and want to have sex with men' i guess? 21. I have obsessions about aggressive sexual behavior toward other people EXAMPLES: Unwanted images of violent sexual behavior toward adult strangers, friends, or family members Answer: neither - though i do experience non-violent unwanted images as per 18 ### Sexual obsessions subscore: 4/8 ## Hoarding obsessions 22. I have obsessions about hoarding or saving things EXAMPLES: Worries about throwing away seemingly unimportant things that you might need in the future, urges to pick up and collect useless things Answer: past and present - in the past id have stacks of papers from a year of school that id only be able to throw out at the end of the year (or sometimes even after that) - i currently have a stack of random papers and reciepts and letters behind me sitting on the floor, which i cant throw away - whenever i have to throw out garbage i get the intrusive thought of "what if there's something important in there that i accidently threw in that ill need in the future" ### Hoarding/saving obsessions subscore: 2/2 ## Religious obsessions 23. I am concerned with sacrilege and blasphemy EXAMPLES: Worries about having blasphemous thoughts, saying blasphemous things, or being punished for such things Answer: neither - i was never particularly religious 24. I am excessively concerned with morality EXAMPLES: Worries about always doing “the right thing,” having told a lie, or having cheated someone Answer: past and current - constantly anxious about having done the right thing ### Religious obsessions subscore: 2/4 ## Symmetry obsessions 25. I have obsessions about symmetry or exactness EXAMPLES: Worries about papers and books being properly aligned, worries about calculations or handwriting being perfect Answer: neither ### Symmetry subscore: 0/2 ## Miscellaneous obsessions 26. I feel that I need to know or remember certain things EXAMPLES: Belief that you need to remember insignificant things like license plate numbers, the names of actors on television shows, old telephone numbers, bumper stickers or t-shirt slogans Answer: neither (?) - i feel unsure about this because i do end up memorizing random insignificant things, but just because i want to 27. I fear saying certain things EXAMPLES: Fear of saying certain words (such as “thirteen”) because of superstitions, fear of saying something that might be disrespectful to a dead person, fear of using words with an apostrophe (because this denotes possession) Answer: neither 28. I fear not saying just the right thing EXAMPLES: Fear of having said the wrong thing, fear of not using the “perfect” word Answer: past and present - causes a lot of social struggles - lots of anxiety around wording myself properly and properly conveying the idea i have in my brain 29. I fear losing things EXAMPLES: Worries about losing a wallet or other unimportant objects, like a scrap of note paper Answer: past and present - im not sure why it says "wallet or other unimportant objects" because a wallet is a very important object no? - but yes i am generally very fearful of losing my posessions and have to compulsively check that i have everything (either by touch or visually, sometimes resulting in me opening my backpack many times over to make sure that i take something out and lose it) 30. I am bothered by intrusive (neutral) mental images EXAMPLES: Random, unwanted images in your mind Answer: neither - im not sure what this means honestly, neutral mental images that are bothersome? i dont think so? 31. I am bothered by intrusive mental nonsense sounds, words or music EXAMPLES: Words, songs, or music in your mind that you can’t stop Answer: neither (?) - maybe at a sub-clinical level where i usually have a song playing in my brain on repeat, though it isnt particularly bothersome 32. I am bothered by certain sounds or noises EXAMPLES: Worries about the sounds of clocks ticking loudly or voices in another room that may interfere with sleeping Answer: past and present - all noise bothers me, though this is comorbid with my autism related sensory sensitivities - voices in another room bothering me with sleeping is a very specific problem that plagues me deeply though 33. I have lucky and unlucky numbers EXAMPLES: Worries about common numbers (like thirteen) that may cause you to perform activities a certain number of times or to postpone an action until a certain lucky hour of the day Answer: neither 34. Certain colors have special significance to me EXAMPLES: Fear of using objects of certain colors (e.g. black may be associated with death, red with blood or injury) Answer: neither 35. I have superstitious fears EXAMPLES: Fear of passing a cemetery, hearse, or black cat; fear of omens associated with death Answer: neither ### misc obsessions subscore: 6/20 ## Somatic obsessions 36. I am concerned with illness or disease EXAMPLES: Worries that you have an illness like cancer, heart disease or AIDS, despite reassurance from doctors that you do not Answer: past and present - exactly as written - be unable to sleep at night because id be worried about illnesses - checking symptoms and diagnosis methods over and over again on different sites trying to figure out if i have something 37. I am excessively concerned with a part of my body or an aspect of my appearance (dysmorphophobia) EXAMPLES: Worries that your face, ears, nose, eyes, or another part of your body is hideous, ugly, despite reassurances to the contrary Answer: past - as a part of transitioning and trying to come to terms with my body and enjoy it for what it is, this has greatly diminished ### somatic obsessions subscore: 3/4 # Compulsions ## Cleaning/washing compulsions 38. I wash my hands excessively or in a ritualized way EXAMPLES: Washing your hands many times a day or for long periods of time after touching, or thinking that you have touched, a contaminated object.This may include washing the entire length of your arms Answer: past and present - as mentioned earlier, i have to wash my hands after i touch something i perceive as contaminated 39. I have excessive or ritualized showering, bathing, tooth brushing, grooming, or toilet routines EXAMPLES: Taking showers or baths or performing other bathroom routines that may last for several hours. If the sequence is interrupted, the entire process may have to be restarted Answer: neither 40. I have compulsions that involve cleaning household items or other inanimate objects EXAMPLES: Excessive cleaning of faucets, toilets, floors, kitchen counters, or kitchen utensils Answer: neither (?) - I keep my cleaning tools clean but im not sure what the boundary between compulsion and "i just want to be clean" is - If the boundary is "i do this because of my contamination/being afraid of getting sick" obsession, then the answer is past and present - I must clean everything related to cooking to a satisfactory level (no longer 'contaminated') before im able to cook (or touch my food with it at all) 41. I do other things to prevent or remove contact with contaminants EXAMPLES: Asking family members to handle or remove insecticides, garbage, gasoline cans, raw meat, paints, varnish, drugs in the medicine cabinet, or kitty litter. If you can’t avoid these things, you may wear gloves to handle them, such as when using a self-service gas pump Answer: past and present - not touching things, using paper towels to boundary my hands from them, trying to avoid touching them at all costs or at least in limited areas (like the tips of my toes or the tips of my fingers) ### Cleaning compulsions subtotal: 4/8 (or 6/8?) ## Checking compulsions 42. I check that I did not harm others EXAMPLES: Checking that you haven’t hurt someone without knowing it. You may ask others for reassurance or call or text someone to make sure everything is all right Answer: past and present - i constantly feel the need to ask my friends to make sure i didnt say something wrong or that they dont hate me etc etc - huge compulsion in the past, more controlled nowadays but still present - more controlled for people im close to, still not very controlled for coworkers and acquaintances - i almost always after social interactions feel the compulsion to review what i said to make sure that i was behaving normally and didnt say anything wrong and that they didnt display signs of being upset or unhappy - thinking more deeply, this is a pretty serious compulsion that i cant really control, it just runs its course in less time than it used to 43. I fear saying certain things EXAMPLES: Fear of saying certain words (such as “thirteen”) because of superstitions, fear of saying something that might be disrespectful to a dead person, fear of using words with an apostrophe (because this denotes possession) Answer: neither 44. I check that nothing terrible happened EXAMPLES: Searching the newspaper or listening to the radio or television for news about some catastrophe that you believe you caused. You may also ask people for reassurance that you didn’t cause an accident Answer: past - I used to do this a lot, checking the university/airport/mall news expecting to find news that I had caused a major incident 45. I check that I did not make a mistake EXAMPLES: Repeated checking of door locks, stoves, electrical outlets, before leaving home; repeated checking while reading, writing, or doing simple calculations to make sure that you didn’t make a mistake (you can’t be certain that you didn’t) Answer: past and present - I do all of the examples - Daily life: checking locks, stoves, taps are closed - School/work: checking i didnt make mistakes, checking wording, checking for errors 46. I check some aspect of my physical condition tied to my obsessions about my body EXAMPLES: Seeking reassurance from friends or doctors that you aren’t having a heart attack or getting cancer; repeatedly taking pulse, blood pressure, or temperature; checking your appearance in a mirror, looking for ugly features Answer: past and present - most relevant example thats been going on for the last few years since transition: staring at myself in the mirror seeing if i have visible facial hair, shaving myself even when its barely visible or just a shadow, irritating my skin by shaving too often, putting on concealer - my obsession with fearing being sick conflicts with my executive dysfunction and often times means i cant manage to book a doctors appointment because im too anxious - so i just sink into a deep pit of anxiety - this feels like a very specific intersectional experience of autism and ocd, and is something i really struggle with - if i was more capable of booking appointments and making phone calls, i would have a ton more doctors appointments and checkups ### checking compulsions subtotal: 7/10 ## Repeating rituals 47. I reread or rewrite things EXAMPLES: Taking hours to read a few pages in a book or to write a short letter because you get caught in a cycle of reading and rereading; worrying that you didn’t understand something you just read; searching for a “perfect” word or phrase; having obsessive thoughts about the shape of certain printed letters in a book Answer: past - In the past I would reread and rewrite emails or messages for a long time before feeling comfortable with sending it - Nowadays I still am worried and have the same compulsion to do so, but am much better about controlling it, to the point where it doesnt affect me at all now (I can overcome the compulsion fairly trivially, unless the message is very important) 48. I need to repeat routine activities EXAMPLES: Repeating activities like turning appliances on and off, combing your hair, going in and out of a doorway, or looking in a particular direction; not feeling comfortable unless you do these things the “right” way or the “right” number of times Answer: neither ### repeating rituals subscore: 1/4 ## Counting compulsions 49. I have counting compulsions EXAMPLES: Counting objects like ceiling or floor tiles, books in a bookcase, nails in a wall, or even grains of sand on a beach; counting when you repeat certain activities, like washing Answer: neither ### counting compulsions subscore: 0/2 ## Ordering compulsions 50. I have ordering or arranging compulsions EXAMPLES: Straightening paper and pens on a desktop or books in a bookcase, wasting hours arranging things in your house in “order” and then becoming very upset if this order is disturbed Answer: neither ### ordering compulsions subscore: 0/2 ## Hoarding compulsions 51. I have compulsions to hoard or collect things EXAMPLES: Saving old newspapers, notes, cans, paper towels, wrappers and empty bottles for fear that if you throw them away you may need them; picking up useless objects from the street or from garbage cans Answer: past and present - as mentioned with the hoarding obsession, i hold onto a lot of old papers/reciepts/documents/instruction manuals in case i need them in the future - throwing them out is actively difficult ## Miscellaneous compulsions 52. I have mental rituals (other than checking/counting) EXAMPLES: Performing rituals in your head, like saying prayers or thinking a “good” thought to undo a “bad” thought. These are different from obsessions, because you perform these rituals intentionally to reduce anxiety or feel better Answer: past and present - imagining a scenario in my head and how i would handle it and rehearsing what i would say and how i would handle it - im not sure if this is specifically used to cope with the above obsessions though, ill have to think about it more - but this does happen very often and takes up a lot of time and is very hard to resist doing 53. I need to tell, ask, or confess EXAMPLES: Asking other people to reassure you, confessing to wrong behaviors you never even did, believing that you have to tell other people certain words to feel better Answer: past and present - A lot of asking people to reassure me 54. I need to touch, tap, or rub things EXAMPLES: Giving in to the urge to touch rough surfaces, like wood, or hot surfaces, like a stove top; giving in to the urge to lightly touch other people; believing you need to touch an object like a telephone to prevent an illness in your family Answer: neither 55. I take measures (other than checking) to prevent harm or terrible consequences to myself or family EXAMPLES: Staying away from sharp or breakable objects, such as knives, scissors, and fragile glass Answer: neither (?) - this feels very broad and non-specific and the examples dont particularly help - taking safety measures is a normal and good thing to do, but to what extent does it become a compulsion? 56. I have ritualized eating behaviors EXAMPLES: Arranging your food, knife, and fork in a particular order before being able to eat, eating according to a strict ritual, not being able to eat until the hands of a clock point exactly at a certain time Answer: neither 57. I have superstitious behaviors EXAMPLES: Not taking a bus or train if its number contains an “unlucky” number (like thirteen), staying in your house on the thirteenth of the month, throwing away clothes you wore while passing a funeral home or cemetery Answer: neither 58. I pull my hair out (trichotillomania) EXAMPLES: Pulling hair from your scalp, eyelids, eyelashes, or pubic areas, using your fingers or tweezers. You may produce bald spots that require you to wear a wig, or you may pluck your eyebrows or eyelids smooth Answer: neither # Scaling ## Obsessive thoughts Review the obsessions you checked on the Y-BOCS Symptom Checklist to help you answer the first five questions. Please think about the times when these symptoms were at their worst in the last 3-6 months (including today), and check one answer for each question. 1. Time occupied by obsessive thoughts How much of your time is occupied by obsessive thoughts? **Answer: 1 to 3 hrs/day or frequent** - This answer feels the most correct? - My obsessive thoughts occur very very frequently, but often dont last for very long - At their worst, they could easily take up an hour or more of obsessing over - But in general nowadays im quite good at recognizing an obsessive anxious thought as something that i should not dwell on - It helps that quite a few of my obsessions are not directly linked to compulsive behaviors - Contamination -> cleaning - Hoarding - Causing accidents -> checking - The other obsessions (violent, sexual, moral, interpersonal) did not develop with a corresponding compulsion beyond asking for reassurance - Over time ive taught myself that even if i dont do anything, nothing bad will happen, so these categories of obsessive thoughts are much easier to quell and thus dont take up a lot of my time - They do happen quite frequently (violent and sexual happen almost daily when I walk around outside) - The best way to describe how I feel about those two kinds of obsessive thoughts occurring is somewhere between disturbing and annoying - However the obsessions that are linked to compulsive behaviors, those i cant stop from starting and taking over my brain unless i perform the compulsive behavior 2. Interference due to obsessive thoughts How much do your obsessive thoughts interfere with your work, school, social, or other important role functioning? Is there anything that you don’t do because of them? **Answer: Slight interference with social or other activities, but overall performance not impaired** - Sometimes I get stressed out at social activities, sometimes i have to check in with people too many times, sometimes i have to stop and open my backpack over and over to make sure i havent lost my keys - But overall, my ability to do social and work and life tasks is not imparied - cooking is hard with the contamination obsessions, but not impossible - social interaction is hard with the fears of saying the wrong thing or blurting out a slur, but once i get going its not that bad - though the obsession with fearing that i said something wrong or hurt someone is pretty difficult to deal with - Maybe `Definite interference with social or occupational performance, but still manageable` is more appropriate 3. Distress associated with obsessive thoughts How much distress do your obsessive thoughts cause you? **Answer: Disturbing, but still manageable** 4. Resistance against obsessions How much of an effort do you make to resist the obsessive thoughts? How often do you try to disregard or turn your attention away from these thoughts as they enter your mind? **Answer: Make some effort to resist** - This varies wildly between obsessions - Zero resistance: contamination, saying something wrong, making mistakes, losing things, fear of illness, fear of forgetting to lock the door or turn off the burners or being responsible for a fire - actually I do have some contamination resistance (I will do my best to keep things clean and that'll be enough). Maybe all of these are actually somewhere between zero and some resistance - autism/bocchi as coping for saying something wrong - [[lily lin, junior engineer]] as coping for making mistakes - losing things, fear of illness, fear of causing a fire are close to zero resistance - Some resistance: Hoarding, fear of accidently harming myself - Fairly good resistance: reread/rewrite, unwanted sexual thoughts, most aggressive obsessions - Maybe **Try to resist most of the time** is more appropriate? im not sure because there are a lot of zero resistance obsessions that take up a lot of time 5. Degree of control over obsessive thoughts How much control do you have over your obsessive thoughts? How successful are you in stopping or diverting your obsessive thinking? Can you dismiss them? **Answer: Sometimes able to stop or divert obsessions** - The ability to stop/divert is mostly the same as the ability to resist - In my mind, to resist is to divert and stop the anxiety, so im not sure what the difference between these two are ## Compulsive behaviors Review the compulsions you checked on theY-BOCS Symptom Checklist to help you answer these five questions. Please think about the times when these symptoms were at their worst in the last 3-6 months (including today), and check one answer for each question. 6. Time spent performing compulsive behaviors How much time do you spend performing compulsive behaviors? How much longer than most people does it take to complete routine activities because of your rituals? How frequently do you do rituals? **Answer: Less than 1 hr/day, or occasional performance of compulsive behaviors** - The most accurate answer would probably be, <1 hr/day, but frequent performance of compulsive behaviors - They just don't take a lot of time 7. Interference due to compulsive behaviors How much do your compulsive behaviors interfere with your work, school, social, or other important role functioning? Is there anything that you don’t do because of the compulsions? **Answer: Slight interference with social or other activities, but overall performance not impaired** - Contamination: I just have to change clothes more often, but as long as I follow my set of rules then the obsession isn't set off - Checking: I just have to make sure I follow a strict routine with turning off burners and closing the door - My new apartment has a heavy door that closes on its own and is nearly impossible to not close - Cook -> turn off burners -> turn off ventilation fans -> check that burners are off - Worst case, I run back upstairs to check my door is closed or I get up and make sure that my burners are off - So generally, does not take a lot of time or interfere a lot - Rehearsing scenarios - I end up stuck in my own head rehearsing these scenarios and when I'm not feeling well they can easily eat up a lot of my time spent alone - This category is probably the most interruptive to my life, since it eats up my ability to relax and exist alone with an empty mind 8. Distress associated with compulsive behavior How would you feel if prevented from performing your compulsion(s)? How anxious would you become? **Answer: Prominent and very disturbing increase in anxiety if compulsions interrupted** - Mostly directed at my contamination or checking behaviors being interrupted - Unable to check = prominent anxiety - Something being contaminated = freak out until I can clean it - In my past experience, prominent anxiety is often the result - Relatedly, in my answer to 46, my executive dysfunction often gets in the way of me getting reassurance from doctors, which causes **immense** distress 9. Resistance against compulsions How much of an effort do you make to resist the compulsions? **Answer: Completely and willingly yield to all compulsions** - This feels like the most reasonable answer with regards to the contamination and checking compulsions - Rehearsing: I try to resist most of the time - Reassurance: I yield, but with some reluctance, sometimes I try to resist but the anxiety is very very bad 10. Degree of control over compulsive behavior How strong is the drive to perform the compulsive behavior? How much control do you have over the compulsions? **Answer: Very strong drive to perform behavior, must be carried to completion, can only delay with difficulty** - Contamination: overpowering and involuntary - Checking: Very strong drive - Rehearsing: involuntary, but I try to resist - Reassurance: Very strong drive ### Scoring: Somewhere around 23, depending on interpretation of the answers - Interpretation: moderate/severe OCD Extra question thats on the pdf version for some reason ![[Pasted image 20240528231840.png]] I think my answer is 3, I think that the reassurance/rehearsing may be a little unreasonable, but I think that my contamination and checking related obsessions and compulsions are relatively reasonable and only sometimes a little excessive # Thoughts My thoughts on my experiences Of obsessive thoughts - I get a lot of unwelcome disturbing thoughts (violent, sexual) - This feels pretty clearly like obsessive thoughts to me, but oddly enough they're also the category of thoughts that don't have corresponding compulsions - My autistic brain is just able to filter them out and ignore them and pretend they dont exist fairly easily? So I never developed a compulsion to help deal with them - I get anxieties around things that I need to check (causing a fire or losing something) - To me, this feels like an anxiety and less like the above category of unwelcome disturbing thought - I feel the need to keep things to the correct level of cleanliness - To me, this feels like a comfort requirement. If it isn't met then my entire body is deemed unclean and I feel uncomfortable - Are these even obsessive thoughts at all?? rgrgergfdgdfg Of compulsive behaviors - I don't see my behaviors as senseless or excessive, which is probably why I didn't think of my behaviors as OCD related until now - I think that I do things for good logical reasons, though sometimes excessive - I think my home cleanliness behaviors are excessive in how strict I make it, but the idea of making sure pants that sat down outside or on the subway or whatever don't end up on my bed is fairly normal and logical I think - I think making sure that my burners are off and my door is locked is a reasonable behavior to make - Balancing risk of not checking with the cost of checking, it always makes sense for me to check - There are times where my brain tries to tell me to check again and again, but I try to resist those the best I can by convincing it that checking once is fine - In the past I was less able to manage this and would check burners and door locks multiple times before I would feel comfortable - I think checking to make sure my keys or wallet aren't gone is reasonable since it only takes a second and is very useful - Though sometimes I do this excessively - In general: all the things that I do are logical and not senseless, but sometimes pretty excessive - In my mind, ocd revolved around things that were senseless - Is this true? Or is it the fact that its "compulsive" and unable to be stopped what defines a "compulsive behavior" in ocd? ### A specific note relevant for therapy I have an obsessive fear of lying to mental health professionals - im afraid that im a bad person and lying to get accomodations and time off work etc etc The corresponding compulsive behavior is to never lead questioning in any way, to always answer fully and honestly, and to hrm how do i explain this i always try to just explain my current situation fully and completely, and try to let the mental health professional come to their own conclusions because im afraid of me influencing their judgement in any way shape or form you can partially see that in play with this document itself, see how i annotate every answer with an explanation and my reasoning its because i dont trust myself and fear that im lying im afraid that im lying to convince myself that i have ocd to get accomodations that i dont deserve so the compulsive behavior was to write out this giant document to try to convince myself that im not just lying and to be able to present my thoughts fully to a mental health professional and have them evaluate it themselves see the two sections directly above this, where i doubt that what my experiences are count as OCD, despite the results of the screening ironically enough, this in and of itself is probably one of the more damning pieces of evidence that i have ocd, the fact that im struggling so much with this right now and that i even admitting that this fear of lying is something that i experience feels deeply **wrong** and **not allowed** this fear of lying to both myself and mental health professionals about the struggles that i experience has persisted through the last 5 or so years, since i first started experiencing depression and gender dysphoria i dont think ive ever consciously lied to any health professional about anything, ever i dont know why i would ever do that yet i am obsessed with the thought so yeah, maybe this explains some of my weird behaviors ## an unmentioned obsession that gives me a lot of trouble Obsession: I fear that there is a burglar or stranger or rapist who has broken into my house/apartment and is hiding somewhere waiting to assault me Compulsion: turn on all the lights, check every corner of the area I'm in, close myself off into a smaller area. For example, close my bedroom door, lock it, and check all areas of my room (closet, under the bed) Big problem in the past, unsure if it's less of a problem now because I resist the obsession or because I live in a studio. On particularly bad days when I wake up in the night I get this obsession and compulsion to turn on the lights and check everything. Seemingly triggered by horror imagery and ideas ![[Screenshot_20240529-110154.png]]