The universe of a patient with OCD is different from that of someone without it. Especially when the disorder has its claws on that person for a long time, that is a great burden and exhaustive. I think that personal presentation and language play a great role in the ‘otherness’ of that universe. Patients have a hard time admitting to strangers that they are suffering from a disease those others in all probability won’t understand at all. Iris, the medical student in my hypothetical story about contamination obsessions and washing compulsions, was ‘found out’ to be suffering from her illness early enough to make a fresh start. Unfortunately, many patients aren’t, especially when they are past the usual education trajectories, and even more so if they lead a life in solitude. Also, I know of very sad cases where family members have become co-patients in such a serious way, that the family conspires: the patients has told the few contacts that remain in his life that he/she has a job. He/she can leave the house in the morning (and stealthily return via the back door). Family members lie on a continuous basis to neighbours. The family may respond to the door bell, not by opening the front door, but by diving for the ground, to create the impression that nobody’s at home.
Shame, fear, guilt, and also ignorance about the illness and about treatment options are central and vicious factors. Perhaps these examples illustrate how families can be brought to their very knees by OCD; and perhaps it has become a bit understandable how patients live in an entirely different universe, separated from non-patients. Lastly, I’d find it a good thing if readers would be able to empathize with the children of OCD patients; they may be subjected to a type of upbringing that is unfit to make them deal with many, many social issues later in their lives, develop severe personality disorders themselves (in a sense in which genetics don’t necessarily have to play a part), and finally never be able to have a intimate and trustful, loving relationship.