Letter to the Ex-Therapist Who Missed My OCD Diagnosis

Dear Ex-Therapist,

It’s been awhile since we’ve spoken. I was last in your office around four years ago as I was about to graduate from college, and we parted at an impasse. It was clear that there was not much more you knew about what to do with me, and I left your office feeling deeply misunderstood and misdiagnosed.

I’ve been doing really well since we worked together, but it took a combination of the proper diagnosis and right type of therapy to get there. Shortly after our last session, I was diagnosed with Obsessive Compulsive Disorder (OCD), and all of my thoughts and behaviors started to make more sense.

I’m not sure if you have much formal training in the disorder or its treatment, but in short, OCD is when a person experiences “repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions)” to mitigate the anxiety that the disturbing thoughts provoke. 

OCD is ego-dystonic and tends to go against a person’s values. Many clinicians don’t realize that OCD can center around different themes, which can include existential thoughts, self-harm, and fear of suicide.

The last type is exactly what my brain grabbed on to when I started coming into your office in fall 2015. I had latched on to a fear of killing myself and engaged in compulsive rituals that took up most of my day in order to rid myself of the anxiety that I had when faced with that thought, including calling my parents for reassurance that they loved me, compulsively researching the “meaning of life” on the internet, and repeating certain phrases to myself to remind myself that my life mattered. 

Ultimately, these behaviors only made the OCD worse, as the only way out is to accept the inherent uncertainty in the questions and fears. Once I started receiving Exposure and Response Prevention (ERP) treatment and facing the thoughts without engaging in compulsions, I began to learn that I could allow the thoughts to be there and didn’t need to do anything to respond to them. 

Why am I writing all of this to you?

On average, it can take an OCD sufferer 14 to 17 years from the time of onset to receive appropriate treatment, often due to a lack of awareness of the signs and symptoms, both amongst the general public and clinicians. Media representations of OCD as a personality quirk or preference for cleanliness and orderliness only perpetuate misunderstanding of this disorder and make it all the more difficult for sufferers to recognize their symptoms. 

I was one of the lucky ones—although you didn’t recognize it as OCD at the time, it took me only a year or so from the onset of symptoms to when I started to receive proper treatment. I am infinitely grateful that I was ultimately able to receive the help I needed, but too many people suffer with OCD for far too long, and when it is not being treated appropriately, the suffering is immense and deep.

For a while, I was bitter because I spent that year in your office suffering right under your nose and you never recognized it. I resented you for touting yourself as an experienced psychologist—you were my first therapist, and I trusted you and the framed Harvard diploma that hung on your office wall.

Most of all, though, I mourned the loss of a year of my life to being stuck in my head. I mourned all of the little moments that I missed out on—in class, at family holidays, at parties with friends, on beautiful hikes in the Shenandoah—millions of moments where my body was there as a representative of me, but I couldn’t have been further from the sights, the sounds, the smells, the love that surrounded me. Now, I try to approach the situation with more gratitude and compassion for my former self that struggled through a dark time. 

I’m in grad school studying to be a social worker now. My dream is to work with youth and support them with mental health challenges in the same way that so many people have supported me throughout my life.

Although I don’t hold any resentment towards you anymore, it is my hope that you learn about this tough and often misunderstood mental health condition so that you can better support your future clients. They shouldn’t have to wait to get the right treatment, because a life with untreated OCD is a waking nightmare, but a life in recovery opens up possibilities and a sense of hope I never would have thought possible.

About the Author

Alexandra is a social work graduate student who is passionate about mental health and social justice, and a human who lives with OCD. She calls the mountains of Colorado her current home.