One person’s experience with a psychopathology view versus a neurodiversity view.

The first mental health condition I was diagnosed with (in my early 20s) was OCD. This was an accurate diagnosis, and typical for America’s MH pathway; I only received help when the suffering had hit a peak that challenged my work. I used an evidence-based framework to manage my OCD, which overall worked. I managed intrusive obsessions and compulsions through exposure response therapy, etc. If something felt potentially intrusive, I managed it with OCD strategies.

I didn’t know I was autistic.

When the Titan Submersible exploded, I had an extreme OCD reaction. Intrusive imagery about the explosion regularly, throughout my waking days, for weeks. I couldn’t focus while people spoke to me. My attention was shot. All I could think about was that damn submarine.

I used exposure to make imagery of the accident bearable, and I controlled obsessive thoughts (as best I could) by not letting myself go down research rabbit holes. Still, the anxiety was pretty high, but it was decreasing.

Now that I know I am autistic, when things like this happen, I treat them as emergent special interests. I know that my brain is capable of tremendous pattern seeking, and here it is trying to pattern seek across something it finds risky to me for some reason I don’t seem to understand.

When I finally allowed myself to become obsessed with the Titan Submersible, to do the hours of research and understand why this was intruding, I was able to get to the root of it: I was afraid I would be on that dang thing — or some stupid risk like it — if I kept my current habits. (At the time, I was taking risky reporting jobs.) Fine, now I could contain it, size it up, analyze it, see if it was true. I could become an expert in the Titan Submersible, how people ended up on it, and why. I still hate that fucking thing, but I know exactly which character I am on it. (Suleman Dawood.) I have given my brain what it wants, and it was the solution after all.

It would be literally wrong to say I didn’t have OCD. I completely “have” OCD when I am under-resourced, and too cramped for time to give my brain the obsessive space it wants. But to see my life only from this angle had become as much a limit as a lens. The neurodiversity framework — the autism diagnosis, the self acceptance — is something new, and better, and true too. That it has always been true, but I didn’t have access, makes me sad for high-masking autistic people everywhere.