To Speak or Not to Speak: The Experience of Disclosing and Concealing My Obsessive-compulsive Disorder – a Heuristic Enquiry
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Abstract
There is a tendency among those living with obsessive-compulsive disorder (OCD) and other mental illnesses to conceal their experience and to delay or avoid seeking help, which can lead to negative mental health outcomes. This phenomenon has received very limited attention in the mental health literature, particularly from the perspective of the sufferer. The present heuristic self-search inquiry (HSSI) offers an in-depth exploration of the researcher’s lived experience of concealing and disclosing an OCD diagnosis.
This study offers mental health practitioners augmented insights into the lived experience of OCD, insights that can enhance the clinician’s empathic engagement with their client and strengthen the therapeutic relationship, which is widely understood to be the most crucial healing element of psychotherapy.
Several themes pertaining to concealment are outlined, including fear of reduction, fear of negative judgement, fear of rejection, and negative self-judgement, as are several themes pertaining to disclosure, including being known, the danger of disclosure and the fight inherent in disclosure.
Core psychodynamic elements underpinning the experience of OCD concealment and disclosure are discussed, namely a sense of feeling unworthy and unlovable, but also a sense of relief following disclosure.
Limitations of the heuristic research and implications for psychotherapeutic theory, practice, research and training are highlighted.