Posted by: Jess Riley | January 25, 2009

Roleplaying Disorders: Obsessive-Compulsive Disorder

This is apparently the week for revisiting older columns and adding to them again. It occurred to me that I hadn’t shared my wisdom on roleplaying psychological disorders for some time, not least of all because I couldn’t think of many disorders that people often try (and, sometimes, fail) to write about.

For those of you who are interested, please check out the past posts I’ve done on this topic.

Obsessive-Compulsive Disorder is a bit of an outside favourite in fiction; it notably appears on the TV show Monk (the titular character), the film The Aviator (Howard Hughes), and in webcomic Questionable Content (Hannelore Ellicot-Chatham). Obsessive-Compulsive Disorder also appears in the subtext, and fan theories, of TV show Friends (Monica Geller), and has been mentioned at least once in webcomic Penny Arcade.

This leads to two things. One, Obsessive-Compulsive Disorder is a very popular disorder to write about – and why not, when it’s so frequently seen as little more than an extreme form of normal human behaviour? Two, a lot of people unfortunately think of media portrayals of Obsessive-Compulsive Disorder as being accurate, and so derive their own characters more from these examples than from the truth of the disorder.

Now, of course, that’s not necessarily bad; like all disorders that frequently appear in fiction, Obsessive-Compulsive Disorder has some examples that are terrific and realistic, with others that are quite poor. However, even deriving a character concept from a mostly-realistic portrayal of Obsessive-Compulsive Disorder in another media carries the risk of getting a ‘Telephone game’ version of the disorder – each successive portrayal is one more step removed from the original source, and so is increasingly garbled.

In real life, Obsessive-Compulsive Disorder is characterised by a person experiencing obsessions and/or compulsions. I am sure you are surprised by this. Obsessions are defined as recurrent thoughts, impulses or images that are intrusive or inappropriate, not simply excessive worries about real world problems, recognisably from one’s own mind, and which are suppressed or neutralised only through concerted effort. Compulsions, on the other hand, are repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession or in accordance with rigidly applied ‘rules’, and which are designed to prevent or reduce distress or suffering, but which are clearly excessive or not connected with what they are designed to prevent.

The typical example of an ‘obsession’ is the individual who is constantly anxious about germs or a lack of cleanliness, or who has recurrent thoughts of the house catching fire, someone breaking in, or similar. The corresponding ‘compulsions’ that we tend to see in media are repeated hand-washing or cleaning, checking the oven to ensure it is turned off, and repeatedly checking a door to ensure that it is locked.

However, not everyone experiences the obsessions and compulsions in the same way – for example, a person with the disorder may feel compelled to poke people in the shoulder three times, for no discernible reason, leading to situations wherein they would stare intently at someone for several minutes, trying not to poke them, then poking them once, unable to resist, then twice more after a short pause, to make it ‘right’. Another person may so fear hitting someone with their car that they drive around each block several times, keeping a eye out for pedestrians they may have hit on the previous drive.

Unusually, perhaps, for a psychological disorder, the other primary defining feature of Obsessive-Compulsive Disorder is that the person in question must recognise that the obsessions or compulsions are unreasonable or excessive. It also has a prevalence rate of around 0.5 – 2% – meaning up to 2 in every 100 people will have Obsessive-Compulsive Disorder in some way (to greater or lesser extent – there is a discernible spectrum of intensity).

In terms of how to actually roleplay, here are some basic pieces of advice on the subject:

  • First and foremost, it must be noted that virtually everyone who wants to write about Obsessive-Compulsive Disorder makes some reference to repetitive hand-washing, even though not everyone with the disorder shows this symptom. It is rather tired and overused, so personally I would steer clear of this one.
  • Don’t be afraid to be creative with their symptoms! Most people with Obsessive-Compulsive Disorder have certain ‘types’ of obsessions/compulsions, and not everyone has both noticable obsessions and compulsions. Someone who repetitively circles the block many times to ensure they have not hit a pedestrian could have Obsessive-Compulsive Disorder to the same degree as the archetypal hand-washer, even though these are obviously very different examples of compulsions. Consider a warrior who will only use a blade a set number of times, or a mage who will not cast a Fire Blast unless they have already cast Fireball twice. That could be just as interesting!
  • Don’t fall into the trap of using as many different obsessions or compulsions as occur to you. Most people with Obsessive-Compulsive Disorder will have obsessions/compulsions about only one kind of thing – there are plenty of people who will compulsively count every step they take out loud, but who don’t spare a thought for hand-washing or whether their stove is on, and vice versa. Limit yourself to only one or two key things – or, if there are more, show how they are related.
  • Don’t confuse fictional co-morbidity* with other disorders, or exaggerations of unrelated personality traits, for symptoms of Obsessive-Compulsive Disorder. Possibly the most common example of this is people confusing Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder. For the record, Obsessive-Compulsive Personality Disorder is characterised by perfectionism, details, rules, lists, organization and mental/interpersonal control – the archetypal ‘control freak’. (Monica from Friends probably has Obsessive-Compulsive Personality Disorder, if anything). Obsessive-Compulsive Personality Disorder can be a great jumping off point for a character, and I heartily endorse using it – but don’t confuse it with Obsessive-Compulsive Disorder.

Similar to other examples of mental illness or character traits that may offend, I will warn you to exercise caution – playing a character with Obsessive-Compulsive Disorder realistically and straight is very different to playing it mockingly or exaggeratedly, and I’m sure you can all see how some people may find it offensive or off-putting to push it that way, or to misrepresent it.

However, it is something you can explore and make an interesting character out of so, keeping this in mind – have fun with your character!

*Co-morbidity refers to two or more disorders appearing in the same person – for instance, Obsessive-Compulsive Disorder is frequently co-morbid with General Anxiety Disorder.

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Responses

  1. Thanks for covering this in such detail, and with a commendable eye for accuracy.

    Having been through two extensive battles with OCD myself – once after my father was treated for Non-Hodgkin’s Lymphoma and once following a massive car accident – I can definitely testify, as you have already, that the way this particular disorder is depicted in the media is not 100% accurate by any means.

    Actually, on that note: For anyone who might consider applying this concept to an RP character, it’s good to note that Obsessive-Compulsive “episodes” are sometimes spurred on by incidental stressors (e.g. car accidents) that compel the individual in question to *overcompensate* for a lack of control. This often manifests itself in seemingly unrelated behaviors that are immediately easier to control (e.g. locking and re-locking doors a specific number of times).

    In-game, the Scourge of Lordaeron or the crash of the Exodar are two perfect examples of accidents that would compel characters to start overcompensating in this manner.

  2. In terms of my ‘commendable eye for accuracy’, thanks for the compliment, but it may be worth noting that I am a Psychology student. I’m no expert, not by the wildest stretch of the imagination, but I have had some education in the area, and access to some good resources on the subject.

    As for your second point, from what I’ve learned, there’s a couple of different ‘types’ of Obsessive-Compulsive Disorder – beyond the spectrum of intensity, there are people who experience chronic Obsessive-Compulsive Disorder, which has no real ‘trigger’, and episodic Obsessive-Compulsive Disorder, which you have spoken about. Both groups of people, technically speaking, have Obsessive-Compulsive Disorder the whole time, but some have spurts that last a lot longer and aren’t sparked by much, whereas others have episodes linked to triggering events.

  3. Ah, I gotcha. Good points.

    Ironically, I was a Psych student, too. šŸ™‚


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