Author of Pure: Rose Cartwright

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Everyone with OCD has at least one thing in common, and I’ve met a few people with OCD over the years who I’ve really connected with. But I feel like I have a lot in common with Rose Cartwright, at least when it comes to our experiences with OCD. I’m not sure about the rest of our lives—she’s British, for one, and she’s met Jake Gyllenhaal. I haven’t crossed that one off my list yet.

Since I relate to so many of Rose’s obsessions, I applaud her especially for being open about them. It’s not easy to talk about pedophelia obsessions, or HOCD, or any taboo obsessions, but Rose lays it all out in her new book, PureThe subtitle asks, “Have you ever had an inappropriate thought?” Why, yes. Yes, I have. If you have, too, I hope you’ll check out her book as well as her courageous and eye-opening articles in The Guardian, Pure OCD: A rude awakening” and “A moment that changed me: Charlize Theron’s boobs, my boyfriend, and OCD.”

As painful as some of her obsessions were, she can laugh about them now—at least sometimes. Her attitude toward these taboo obsessions is refreshing and could go a long way toward destigmatizing the disorder.

You were diagnosed in your 20s after years of battling unsettling and unwanted obsessions. Why do you think it took so long for you to realize OCD was to blame for your intrusive thoughts?

Because OCD awareness is still very poor. If you’re experiencing disturbing sexual thoughts, and you have no idea that they’re a symptom of OCD, you’re likely to keep them quiet. And sufferers keeping quiet means that awareness remains poor. It’s a very self-defeating illness. Even when I was diagnosed it seemed so ridiculous that I struggled to believe it myself. I hope that kind of incredulity will change over time, as the full spectrum of OCD becomes more widely understood.

Somehow those of us with OCD can hide our torment from even those closest to us, especially when we struggle more with pure O than, say, hand-washing rituals. Were your friends and family members surprised to hear you’d been diagnosed with OCD? How did you tell them?

I’d told a couple of people a sugar-coated version of my story, but saying those things out loud proved extremely difficult. In the end I wrote about it for a UK newspaper, so my family and friends were reading about my experiences at the same time as hundreds of thousands of others. It wasn’t a very intimate way of doing it, but it was easier writing those words than saying them.

Although it took longer than you would have liked to get the proper diagnosis, somehow you were clued in to OCD and diagnosed yourself after conducting some Internet research. Unfortunately, your doctor recommended the wrong treatment first, which you said made your OCD worse. Tell us more. How did you ultimately find effective treatment?

I was prescribed psychodynamic therapy, which encourages a great deal of soul-searching and exploring your past to try and ease your current suffering. Unfortunately that only served to collude in my compulsive behavior—I’d been soul-searching for an answer to my identity for a decade and had only made myself worse. Sadly, I found effective treatment through trial and error over many years, and a lot of research—I knew what hadn’t worked in the past, so I knew what to avoid. In the end it was CBT with exposure and response prevention (ERP) therapy which saved me.

The title of your book, Pure, is perfect. Not only do you have pure O, but you might say some of your intrusive sexual thoughts aren’t exactly considered pure. In fact, they’re considered pretty taboo. How did you decide to disclose these very personal and painful thoughts in a memoir?

I just had this overwhelming feeling that this was a story that needed to be told in a very public way. It seemed scandalously unjust to me that so many people were experiencing this, yet no one felt able to talk about it. So I thought—screw it—let’s do this. If something bad happens, it’s not going to be as bad as a lifetime of keeping secrets. The thoughts themselves didn’t feel too personal, as by then I knew that they didn’t reflect my identity, and that they were being experienced by countless others out there.

You noted in one interview that when you struggled with the pedophilia obsessions you felt like you’d committed an unforgivable sin. How did you realize you had nothing to be sorry for? Was it as simple as being diagnosed with OCD and understanding it was the culprit, the “bad guy,” not you? Or did it take some time to forgive yourself for the thoughts—no matter how unwelcome they had been?

It’s strange. I’m 29 now. Those thoughts started 14 years ago and I think my brain has done a very good job of making me forget just how traumatic that time was. The cognitive knowledge I’ve learned has made me realize that thoughts are just thoughts which don’t necessarily reflect intent. Instead of forgiving myself, I learned that there was nothing to forgive.

You also struggled with another very common sexual obsession, homosexual OCD, or HOCD. How did this affect your relationships with men? Did you avoid dating at all during this time?

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It had a disastrous effect on my relationships with men. I was terrified of commitment. I felt I couldn’t commit to anyone until I was 100% certain that it was the right thing to do. I had this recurring thought—what if I settle down and then years down the line I realize I’ve made a terrible mistake? Ultimately I had to accept that I can never be certain that that won’t happen, and jump in with both feet anyway.

Your boyfriend is very understanding. So many single people with OCD are terrified they’ll never find love, and that someone who doesn’t have OCD couldn’t possibly understand—and I think this is particularly true when they have sexual obsessions. We worry that we’ll be perceived as some sort of sexual deviant. Do you have any advice for my readers who don’t know how to tell a mate what’s going on?

I was lucky with my boyfriend. He totally understands. We live in a very accepting social circle. My thoughts about homosexuality didn’t trouble me because I thought they were deviant, they troubled me because I desperately wanted certainty that I couldn’t get. Advice? I guess having a favorite OCD article or definition which you can place in someone’s hands is a good way of expressing what feels like the “unsayable.”

Do you still consider yourself to have OCD even though you’ve largely conquered it?

Yes. I’ll always have OCD, and I’ve made my peace with that. I’ve been through effective therapy and I know how to manage new obsessions when they arise.

If you could give just one piece of advice to someone else with OCD, what would it be?

Two pieces of advice, if I’m allowed. One: Be cautious whose advice you take. I realize the irony of this sentence as I type it, but OCD is a very complicated illness and non-expert opinions can often be unhelpful. Two: Get a course of ERP combined with CBT—it could turn your life around.