Ask Tracie Ibrahim—or “Taboo Tracie” on Instagram—to tell her OCD story, and you’ll likely walk away angry, sad, and in disbelief that she was treated so horribly as a kid and teen. And, you will be in awe of her. As she explains in more detail below, Tracie’s harm OCD was misdiagnosed, and she was in and out of psychiatric units for nearly a decade. When she finally received the right diagnosis as an adult, she made it her mission to treat kids and teens with OCD and make sure no one else experienced what she did. Tracie is hilarious, and she uses humor to take some of the sting out of taboo intrusive thoughts. Read on to get some of her advice, which I’ve tried myself!
I was lucky enough to hear you speak at an OCD event, and you said something that really stood out to me (though not so much I can remember it word for word, apparently): “If it’s horrific, it must be silly, so I’m going to laugh about it.” First, go ahead and tell us what you actually said. Then, can you tell us more about this strategy for addressing disturbing intrusive thoughts?
I think I said something like this: “If something feels terrifying, it’s likely ridiculous, so I’m just going to laugh about it.”
As someone who has been experiencing very graphic and detailed intrusive harm and sexual thoughts since I was 10 years old, I’ve learned that they are going to occur whether or I like it or not, and there is no way to escape them, but also there is no need to escape them. So much of what keeps OCD fueled up and loud is the many different types of mental and physical compulsions that people do while trying to escape or solve them. After decades of compulsing and living with out-of-control OCD symptoms, I learned that there is nothing to actually escape—there is no actual danger or concern that needs to be addressed at all. So I started thinking about it differently and started reacting differently when the intrusions would come up. I started using humor because I realized how absolutely ridiculous OCD is.
We know that trying to push thoughts away only makes them stronger, but it’s a natural first instinct. If someone isn’t ready to lean into their thoughts like you’re able to, what are some other approaches they can take?
I am a big fan of starting with a goal of identifying, reducing, and delaying compulsions. Maybe you aren’t ready to lean into the intrusive content just yet, but if you can truly commit yourself to focusing on doing some response prevention (reducing/delaying compulsions) then you will start to feel some amount of relief and then can work on doing more over time.
I love that you use humor to take OCD down a notch. There was a time when I thought I’d never find anything funny again, and I certainly didn’t think I’d be able to laugh at my darkest thoughts. Why do you think laughing at OCD is so powerful?
Using humor when it comes to OCD is what is technically called a “cognitive defusion” technique. This helps you observe your thoughts as separate events instead of 100 percent truths or facts, which reduces the power and grip they have on people with OCD. It breaks up the seriousness and helps you see it as ridiculous.
Your harm OCD was misdiagnosed when you were 10 years old, and you spent years in and out of varying levels of hospitalization. Can you walk us through some of that experience?
I recently posted on my Instagram a detailed timeline of events starting with my first misdiagnosis through three decades of absolutely nobody getting it right.
At age 10 I was going through difficult family issues and physical/emotional abuse by my stepfather. A series of events with the abuse led me to being taken in for a psychological evaluation. I was sad, crying, and scared. I never was suicidal or self-harming or anything like that. I was assessed as needing to be placed inpatient “to help ensure my safety and well-being.” Just like that, I was admitted to a children/teen psychiatric unit. I was diagnosed with depression. I was surrounded by teens who had attempted suicide, were self-harming, and had other disturbances. My undiagnosed OCD latched on to the question I was asked at my assessment, “Have you ever had thoughts, plans, or attempts to harm yourself or end your life?,” and then being surrounded by people who did in fact do those things only made it worse. I would meet with the psychiatrist and when asked if I was having any thoughts about harming myself or ending my life, I would answer “yes” because my intrusive thoughts and images were pounding in my brain even though I didn’t actually do anything at all and I never stated that I had a plan or intent to do any of those things. Nonetheless, I was placed on “suicide precautions” and that was the beginning of my decade of hell.
If I heard your story with no context, I’d assume it all happened in the 1950s. But it wasn’t that long ago! Do you think it would be less likely to happen today? What can mental health professionals and parents do to make sure no kid is involuntarily hospitalized like you were?
It is very common that OCD is misdiagnosed, even today, because the vast majority of therapists, psychiatrists, and other healthcare providers are not properly trained in how to assess or treat OCD and are not trained in all of the ways OCD can show up. I see it almost constantly. It’s one of the reasons I went into specializing in assessing and treating OCD in very young kids and teens, because I didn’t want this to keep happening. The best thing parents and caregivers can do is to ensure they are seeking professionals who are properly trained. It’s really difficult because a ton of professionals advertise themselves as “specializing” in OCD and OCD treatment, but they absolutely are out there doing harm, even if they think they know what they are doing. I would recommend only going to valid resources when looking for a care provider. Ensure they can educate you all about the various subtypes of OCD and that they were properly trained to utilize the gold-standard, evidence-based treatment for OCD, exposure and response prevention (ERP) therapy. This is not the same thing as exposure therapy, which actually makes things worse. Most practitioners were trained that regular CBT is how to treat OCD, but it treats OCD as if it is a logic disorder that can be cured with facts. That is simply untrue. OCD is not curable, but it is manageable, and you can live a full and beautiful life with ERP therapy.
After everything you went through as a kid and teen, I wouldn’t blame you if you wanted to get as far away from the mental health field as possible, but you decided you needed to help other kids as a therapist. Can you tell us about going to college after you’d been hospitalized for years?
I was angry, disappointed, damaged, and still improperly diagnosed and treated when I finally got out of the last mental health facility at almost 19 years old. I was still living with undiagnosed harm OCD (both suicidal and homicidal OCD) as well as other themes like contamination and just right OCD. I didn’t know how long I’d be alive, but I knew that I absolutely had to become a therapist who could offer better treatment to kids and teens who were suffering from mental illnesses like I was. So two weeks after I was discharged from the facility, I signed myself up for community college as a psychology major. I didn’t know exactly what was wrong with me or how to deal with it, but I at least wanted to help other kids and teens not have to feel as bad as I did and not have to suffer with incompetent care providers. I would help them feel better; I just needed to learn how to do it.
I finally got the right diagnosis at age 31 because I diagnosed myself with OCD and I found ERP treatment myself as well. That’s when everything changed and started getting better.
If you could give just one piece of advice to someone with OCD, what would it be?
Never ever give up. Don’t expect a treatment to “work for you” because it is you who has to do all of the hard work inside and outside of therapy sessions if you want to get better. There is no quick fix; it takes time and patience and perseverance to get better. OCD recovery is a lifestyle, not a destination.
Alison Dotson 