At university, it felt like every noticeboard, laptop case and Facebook status displayed one Roald Dahl quotation: "A person who has good thoughts cannot ever be ugly. You can have a wonky nose and a crooked mouth and a double chin and stick-out teeth, but if you have good thoughts they will shine out of your face like sunbeams and you will always look lovely." Of course I understand the sentiment, but it never quite resonated. Unbeknownst to the status-writers, my brain was being attacked by a swarm of disturbing sexual intrusive thoughts that were not – probably by anyone's standards, let alone my own – "good".
More recently, I was terrorised for a few months by a new fear. I couldn’t shake the sense that I had to end my happy, functional long-term relationship, for reasons so multifarious that now I can’t remember the deciding factor. One day I reached breaking point. I knew I didn’t want the relationship to end, and yet I didn’t know. No matter how many times I checked or speculated, I couldn’t figure out which side I was on. I couldn’t trust my own mind – nothing felt real.
I left the office sobbing down the phone to my dad, screen smeared with a film of tears and foundation, fingertips blanching in the cold. This isn’t anxiety, this is how people feel when they want to break up, my brain said, as more waves of panic descended. A woman with a baby strapped to her front stopped and asked if I was OK. I couldn’t speak, so half-nodded and gestured to the phone. I thought about how she must have presumed something bad had happened, and would never know that actually I was slowly driving myself insane. She handed me a tissue, which I took, feeling fresh horror and shame at her kindness as she mouthed, "Are you sure?"
I’m not sure about anything. Every new thought can create a plethora of doubts. The more doubt, the more unwanted thoughts, and the more unwanted thoughts, the more being in your own head becomes an inescapable, disorientating living nightmare. This is obsessive compulsive disorder in one of its lesser known guises, finally held up for the world to see in Channel 4's new series Pure, written by Kirstie Swain and based on Rose Cartwright’s memoir. Pure’s 24-year-old protagonist Marnie (played by the brilliant Charly Clive) is plagued by graphic sexual intrusive thoughts. The more she tries to push them away, the thicker and faster they come. She’s convinced she’s some sort of pervert or deviant, and reaches breaking point at a family event, when she imagines snogging her own mother.
The show follows Marnie on her quest to find out what’s going on in her brain and, by extension, who she really is. It’s the first TV show to broach this particular type of OCD in such searing detail. And this is vastly important. Though OCD’s perceived affiliations with cleanliness, locked doors and orderly pencil cases do represent ways in which compulsions can manifest (and be extremely debilitating), this is by no means the disorder’s full extent. In fact, the subject matter can be anything uncertain or disturbing, often sex as we see here, but also violence and harm. In Pure, Marnie herself initially dismisses the idea that she could have OCD because she doesn’t identify with the cliched characteristics, before hearing the full story and rejoicing in relief.
Pure’s title is not only an ironic nod to the distinctly impure content of Marnie’s mind. It’s a reference to so-called "pure OCD", a term some use to refer to this particular type. Pure O can be a helpful way to categorise obsessional rumination and intrusive thoughts, but it’s actually a misnomer. Pure O is not, as it might imply, compulsion-free: it simply means that the compulsions – rituals developed to feel less threatened by unwanted thoughts or feelings – are generally performed mentally rather than physically. Just as somebody with a contamination fear might have to wash their hands, somebody with "pure O" might have to analyse what their intrusive thought means. And so in Pure we see Marnie try to "unthink" things, repeating mantras like "it's not me, it’s my OCD". These are ways for Marnie to escape the anxiety and doubt that her thoughts induce by trying to find certainty (then not finding it, feeling more doubt and starting the cycle all over again).
In between flashes of tits, incest and orgies in tube carriages – which the viewer also sees – Marnie’s life changes. Though the OCD is a specific type of distress, her soul-searching is something almost all of us can relate to. The show offers a gently realistic view of your twenties, with awkward train goodbyes, cringe one-night-stands and disastrous, Bridget Jones-esque office mishaps. Marnie’s budding friendship with Charlie (played by Joe Cole, of Peaky Blinders) is a joy to watch as they bond over their brokenness. Her flatmate Shereen (Kiran Sonia Sawar) provides a sort of normie benchmark, a caricature of that enviably fine friend with the straightforward life. Of course, we know that’s an illusion, both in life and in the show: Shereen reflects our fantastical presumptions about our own "normal" friends and acquaintances.
Lena Dunham’s Girls also depicts OCD, most memorably in the grisly season two episode where Hannah’s counting compulsion leads her to try to poke a Q-tip at her ear eight times. She stabs it all the way in by mistake. Her distress allows us to observe the physical and practical effects of mental illness in gory detail, and more rapid deterioration. But Pure – narrated in both anecdotal first person and internal monologue – lets you experience the sensations with the sufferer, to begin to understand how it feels to try to live while unwanted images flood your mind. Similarly, in season four of Bojack Horseman, a constant internal monologue in one episode helps us understand Bojack’s depressive thoughts. It’s not an uncommon narrative device in TV, but becomes particularly poignant when the audience sees what a character with mental ill-health sees. OCD can be an incredibly isolating disorder, especially when the thoughts feel too shameful or disturbing to share. It is crucial that people begin to feel better understood in their experience of it.
The treatment for OCD is CBT (cognitive behavioural therapy) and ERP (exposure response prevention therapy). At Marnie’s visit to the doctor, before she has any idea what might be wrong with her, the doctor suggests her "explicit sexual thoughts about women" indicate she could be gay. This serves to demonstrate a chronic unawareness of this type of OCD and how to deal with it. It reflects some of my own (and doubtless many others’) experiences with doctors and therapists who have unknowingly indulged obsessions and made things worse by unearthing more to obsess over. Crucially, dissolving the compulsions is at the centre of "pure OCD" recovery, not trying to find out if the obsessions are true. Also: having OCD is not just "being a worrier", just as clinical anxiety isn’t. OCD is a specific kind of snowballing, metamorphous horror that infects everything around you and the things you value most.
Pure is infused with a beautiful wit, lifted from Cartwright’s memoir and given a new flavour in Swain’s script, that can only come with the power of hindsight after years of suffering. Its delicate and honest treatment of the subject will break taboos, but also provides a perspective we could all learn from. Humans like to fit things into neat little boxes, to tie up loose ends and create narratives. We like posting on social media, for example, because we have a contained space to create something that is quintessentially "us", a completed product accompanied by a pithy caption demonstrating just how aware we are of our postmodern personal brand. We like certainty, and especially certainty about who we are. But real lives and real minds do not have these kinds of boundaries. Nothing is ever quite sure. Pure shows us that, OCD or not, we must learn to accept life in all its sprawling uncertainty, warts – or, in Marnie's case, tits – and all.