Having OCD When You’re Autistic

About the Author

Bob Waters (he/him) is an AANE employee and Autistic advocate with a strong background in Neurodiversity. At AANE, he leads support groups, assists with individual case management in LifeNet, and engages in public speaking. Bob supports newcomers to diagnosis and those exploring their Neurodivergence and unlearning unhelpful beliefs. Bob is passionate about mental health and has lived experience with anxiety, outplacement and public schooling, and attending college. He enjoys theater, history, educational videos, and silliness.

It is well understood that Autistic people experience anxiety disorders at a significantly higher rate than the general population. One study puts the prevalence at about 50% and anecdotally, this checks out amongst my peers and clients. 

OCD is one of the 6 major anxiety disorders, and it sucks. I have been on my recovery journey from OCD for the last 8 years, and while it remains a struggle, my life has become much more accessible and freeing since I began using the skills of Acceptance and Commitment Therapy to improve the quality of my life. 

I use the term “recovery journey” to describe my OCD because OCD behaves, at its core, like a substance use issue. Instead of alcohol or opiates, it’s your own neurotransmitters and your own emotions. Having OCD or any other anxiety disorder is fundamentally about not having access to the skills to feel your feelings, and attempting to push them away with ritualized thought patterns the same way someone with a substance use issue attempts to push away their feelings with substances.  

One of my mentors in recovering from OCD is a mental health coach named Mark Freeman. In the early days of my journey, when I was reading the same secretive, terrified Reddit posts over and over again, or when I was googling the subjects of my obsessions until 50 plus pages of links were purple, coming across his warm and friendly channel where I could laugh at my brain opened a window into peace. One of the most important things I took away from his work was that, to paraphrase, anxiety is the practice of trying to not feel things, while mental health is the practice of learning how to feel things. 

As Autistic people, we feel a lot. We feel the effects of trauma from a misaligned childhood and a misaligned world. We feel the fear of what others think of us, we feel the drumbeat of self-criticism disguised as self-protection. We feel things like regret, failure, and confusion. We feel pain and longing and grief. We feel joy and comfort and playfulness that arouses intense feelings of suspicion. 

These are allowed to be there. They’re allowed to exist as a flowing river of experience in the scaffolding of our bodies and lives. One of my spiritual mentors, Thich Nhat Hanh, talks about how we can learn that the groundedness of our nature is like a tree firmly planted. When a tree is firmly rooted, wind blows it around, but does not knock it down. When we can see our rootedness, the presence or absence of a storm or a strong wind is not determinative to our peace. Learning to see that is the practice and the journey. 

Autistic people are taught since childhood not to feel rooted. We are taught that what we naturally are, without work, is deficient and “not our best self.” Who wouldn’t feel anxious when the threat of dignity deletion is so close? Who wouldn’t check Facebook 100 times a day to see if their friends had unfriended them if they’d been taught that safety and worth was how palatable you were to the largest number of people? 

I’m very grateful that the work I do here at AANE is, in its strongest and most fundamental way, teaching my clients that their basic presence is already acceptable. That anchoring breaks the OCD cycle of fear, checking, and more fear. 

When fear of loss runs up against unshakeable presence and unshakable worth, the fear simply becomes another bodily sensation to take with you as you go through the world, like a full stomach, or sunlight on your skin, or the feeling of weight in your feet when you pace and jump and laugh and sing. We’re in a mental health crisis here in our society, and while more hospital beds and more therapists are a good start, the real change will come when we teach our children that they can feel whatever they feel, and that they are acceptable just the way they are regardless. We’re closer to that than ever before, and I’m glad to see the work continuing.