What Turtles All the Way Down gets right about OCD

I was diagnosed with OCD three years before I read “Turtles All the Way Down,” John Green’s 2017 novel, which has just been adapted into a movie. I had recently entered my second major mental health crisis and found solace in the news that one of my favorite authors was publishing a novel that would be inspired by her own experience with OCD.

This book served as a vital part of my support system during my treatment and recovery for me, it felt as important and life saving as it did my friends and family.

“Turtles All the Way Down” helped me feel seen during my early battles with OCD. Although the main character experienced a different subtype of OCD than mine, her overall experience with the disorder accurately reflected my struggles at the time.

When I heard about the film adaptation, I was anxious to see how the book’s depiction of OCD translated to the screen, but also a little anxious to revisit some of my most difficult moments. My hope was that the movie would do as good a job as the book of showing what OCD was really like.

Often, media depictions of OCD end up being based on stereotypes or misconceptions about the disease. We often see OCD delicately portrayed by Monica Geller: excessive meticulousness that makes her the perfect party host, or a fixation on having things a certain way.

Instead, OCD is rooted in intrusive thoughts about things like pollution, harm, and profanity. An OCD spiral begins with an unwanted, distressing thought that a non-OCD brain would likely recognize and ignore, but an OCD brain clings to. The intrusive thought leads to a spiral of doubt about its origin, purpose and truth, a spiral so stressful and upsetting that it often convinces a person with OCD that certain rituals, often counterintuitive, are the only way to find relief.

I now know that the lack of media representation of mental health disorder contributed to my confusion about what was happening to me before I was diagnosed. Accurate depictions of the complexities of OCD like the one I read in “TATWD” might have helped me recognize that my spiraling doubt was more than just an anxiety attack, without feeling like I was losing my mind. all. And I hoped that the movie “TATWD” would become that for others who were currently experiencing what I had gone through, all those years earlier.

OCD is known as the disease of doubt because of the way it envelops a person in doubt about who they even are or, in the case of “TATWD” protagonist Aza, Yes even they are. In this film, Aza spends much of her day in the service of her thoughts. The experience of being held hostage by your own mind is one that I think will resonate with many OCD sufferers and the hold these thoughts seem to have on Aza sometimes sends her into a spiral of thoughts about how it can even be real : shine a rar. light on existential OCD.

I broke down how OCD is portrayed in “TATWD” and the good news is that the movie gets it pretty much right.

What OCD really feels like

“TATWD” uses audio and visual effects to replicate the sensory experience of a thought spiral, and does so more authentically than I’ve ever seen.

In one scene, Aza, the 16-year-old protagonist of “TATWD,” is sitting with her friends when her intrusive thoughts about contracting a disease intrude. Soon she’s disconnected from her surroundings: piercing static drowns out the voices of her friends and we see a mini-movie of her obsessive thoughts another version of her, sweating in bed with a fever, ending up in a hospital bed .

As she walks to the bathroom to compulsion to clean an obsession-related finger wound, she argues with herself the entire time, unsuccessfully trying to rationalize her OCD thoughts.

This scene so accurately captured the “logic” of the funhouse mirror that OCD creates to keep you locked away. Ever the defense attorney, OCD always has a “What if” or “Are you sure” to get you stuck in the spiral again.

What is OCD treatment like?

Aza is in therapy but is resistant to both medication and exposure response prevention therapy, a type of cognitive-behavioral therapy considered the most effective treatment for OCD, as supported by a 2021 review of 24 randomized controlled trials published in the Journal of Obsessive- Compulsive and Related Disorders. While her disheartened participation was frustrating to me, as someone who has been in OCD treatment for 10 years and knows how effective it can be, it was also deeply relatable.

When I was recently diagnosed, I was also reluctant to engage in treatment when I knew the evidence-based options would be deeply frightening and uncomfortable at times.

I appreciate the way the film accurately depicts the path to treatment and symptom management, which is not always a straight line. And I hope that naming the type of therapy that has helped so many people with OCD raises awareness, encourages empathy, and guides those in need to the right resources.

“TATWD” also portrayed the tools that people with OCD often rely on well. In an early scene, Aza’s best friend Daisy begins to tell an interesting story when she suspects that Aza is starting to spiral. We see how it helps Aza detach from her thoughts and redirect her attention to the present moment. We also see Daisy use humor to break some of Aza’s spirals, which is often an effective tool for people with OCD. It was nice to see these small, but powerful demonstrations of a strong support system in a way that showed how Daisy has tried to understand how to be there for her friend.

What the symptoms of OCD can look like

The climax of the film shows Aza’s worst nightmare: being admitted to a hospital, which in her mind represents a cesspool of disease. The film portrayed the raw terror that underlies OCD’s obsessions and fuels its compulsions so accurately that I found it both cathartic and provocative. If I had to highlight what I think this film did to help the layman understand OCD, it would be this portrayal of fear.

I also appreciated that at no point did the film imply that Aza had the option to simply “control her thoughts,” a trap that other media portrayals of anxiety disorders often fall into. People with OCD cannot push their fears away if they are right enough; in fact, trying to suppress an OCD thought will only make the symptoms worse. Aza had to struggle with her obsessions throughout the film, which felt true to life.

That said, the film is not without hope. I think the scene of Aza leaving the hospital after navigating her crisis is one of the most powerful. As the film reminds us: she was not her forever now.

What OCD Recovery Can Look Like

The film shows Aza reintegrating into her life after recovering. Towards the end, viewers are treated to a flashback to the future, where we see Aza living life to the fullest, doing things the 16-year-old can’t imagine she’d be capable of.

But even in this happy future, we see Aza re-applying a bandage to her finger, a reminder of the lasting presence OCD will have in her life. Mental illness is not cured by proper treatment; is managed

I think this movie did an amazing job of also showing the dichotomy of living with deep fear, but still wanting to chase big dreams and go beyond the expectations of what is comfortable. OCD can be self-doubt, but it’s only uncomfortable because it doesn’t fit the person’s values. They tell Aza that her doubts make her real. Maybe I interpreted it differently than intended, but I think the discomfort that the doubts create almost shows that deep down the person beyond OCD is fighting the fight.

In a Vanity Fair interview about the film, John Green explains why he ended Aza’s story with a time jump: It was a way to send a note to his younger self, who also had OCD; a way of saying that he was so sorry for the pain he had to go through, but that he was going to be okay.

Watching “TATWD” allowed me to do just that. As I cried next to Aza, it was with a different perspective than I had when I read the book version of her story. Seven years later, the movie gave me a chance to feel sad about what she and I shared, but knowing that I was going to be okay, to feel proud of my own strength.

I believe this story will serve as a reminder of resilience for those who have overcome moments of crisis with their mental illness, as well as a glimmer of hope for those currently in crisis that their now is not theirs forever.

Amanda Holtzman has a master’s degree in experimental psychology and over six years of research experience, with a focus on cognitive resilience, psychological stress, and mindfulness. He also has a career in stage direction for professional theater productions in the United States.