How OCD Is Portrayed In Movies & TV Shows

There are a variety of reasons OCD misconceptions run so rampant. Everyday conversation, social media, and self-diagnosis by those who don’t truly possess the disorder all play a part. They’re not the only guilty parties, though.

Movies and television shows contribute to the above by perpetuating stereotypes and painting OCD as a condition that is funny, quirky, and entertaining enough to make waves in the Nielsen ratings.

Hooray for Hollywood? Not in this case.

But hang on just a sec…..

To be fair, we can’t throw Hollywood under the tour bus entirely because it’s not always off the mark in its portrayal of OCD. One of the most accurate accounts comes from the movie The Aviator, a biographical drama directed by Martin Scorsese.

In the film, Leonardo DiCaprio plays Howard Hughes, the aviation pioneer and film producer who was widely considered “eccentric” because of the compulsions he performed on a regular basis.

In the course of the film, we see Hughes spiral into the depths of his disorder and engage in the following:

• Scouring his hands so hard and for so long that they bleed
• Refusing to touch objects that other people have touched (such as glasses)
• Consuming milk only after performing a complicated and specific ritual
• Requesting unopened bottles
• Eating the same meal night after night
• Carrying his own soap to wash his hands
• Wrapping steering wheels in cellophane
• Engaging in complicated routines in order to complete everyday tasks
• Becoming so afraid of germs that he cannot leave his home
• Growing worse until he’s entirely reclusive

The movie wasn’t really marketed as being about OCD and, even now, it’s fair to argue that many people likely saw it without being able to identify Hughes’s exact affliction (chalking it up, once again, to him simply being “eccentric”).

Still, the movie itself does portray the heartbreak of compulsions, how time-consuming they are, the irrationality and anxiety involved, and how – in the moment – they feel like the most important thing in the world. Perhaps the portrayal is so accurate because the film, unlike most films, is about a real person and real life circumstances. DiCaprio in the lead role certainly doesn’t hurt.

There are other examples of movies where the time-consuming and irrationality of compulsions are portrayed reasonably. One of these is As Good as it Gets, a film that stars Jack Nicholson as Melvin Udall, an author dealing with OCD.

The movie successfully demonstrates how some people struggle with OCD as Melvin is shown turning lights on and off a specific number of times, flipping the lock on the door a specific number of times, avoiding cracks in the sidewalk, hoarding soap (and using fresh bars), and washing his hands in scalding water.

But it paints Melvin as an ass as well – rigid, entitled, rude, and, at times, downright mean. Though the movie might not explicitly link these traits to OCD, audience members may infer a relation. In reality, Melvin’s self-importance is aligned with narcissism as his “ass-like” traits are not reflective of someone suffering from a life riddled by obsessions and compulsions.

For example, at one part in the film, Melvin barges into his therapist’s office unannounced and uninvited. He then asks, “How can you diagnose someone with an obsessive compulsive disorder and then act as if I had some choice about barging in?”

In general, people with OCD don’t behave in this manner. In fact, people with OCD are not rigid, pushy, or inflexible unless they’re trying to perform a ritual (people with Obsessive Compulsive Personality Disorder (OCPD), however, may be extremely inflexible).

If Melvin needed to wash his hands and his therapist’s office held the only working sink in the building, the portrayal would have been more accurate. Otherwise, someone with OCD who barges into their therapist’s office is far more likely to spend hours obsessing about having offended their therapist than they are to simply excuse their behavior dismissively (that is, if they even barged in in the first place).

The film is far from alone in its failure to demonstrate what OCD isn’t.

The Big Bang Theory is another example that causes audiences to mix up OCD with other disorders (commonly, Hollywood and laypeople mistake OCPD for OCD). While OCD is based on anxiety, OCPD is a personality disorder where sufferers believe their way of doing things is the right way.

Sheldon, one of the main characters in The Big Bang Theory, is largely believed by laypeople to suffer from OCD, though he’s more of a poster child for OCPD. He’s rigid, uncompromising, and believes his way of doing things is the right way of doing things. These characteristics are different than the ones omnipresent in OCD.

Friends similarly plays on misconceptions as the behavior of Monica Gellar, the resident neat freak, has led many people to believe she has OCD. In fairness, the show never says this (or addresses it in any way), so people are jumping to the conclusion on their own. But it seems like an erroneous conclusion, nonetheless.

Monica – by and large – enjoys cleaning, loves organizing, and gets such a thrill out of order that she has a drawer dedicated to ribbons in addition to 11 different categories for towels (such as “fancy,” “guest”, and “fancy guest”). Nevertheless, Monica doesn’t appear to be driven by anxiety or intrusive thoughts, which is why people with OCD have OCD in the first place. Thus, it’s less likely that she has OCD and far more likely that she is a perfectionist who enjoys tidiness (perfectionism is present in OCD but it’s present in the general population as well with about 1 in 3 or 4 people describing themselves as “perfectionistic”).

Khloe Kardashian, one of the Kardashian sisters, takes another misstep, though the error is again not in the writer’s room but instead with Khloe herself (well, maybe – who knows how set in “reality” Reality TV truly is).

Khloe claims to have OCD but describes it in a positive light, referring to it as “a blessing” because it keeps her house so tidy.

It’s hard to imagine any actual OCD sufferers describing OCD as anything other than torture. Even in those whose OCD offers some practical benefit (their house is always clean, for instance), most sufferers will gladly take a messy home and quiet mind over order and anxiety.

Khloe went as far to market a video series as “Khloe-C-D” (something else it’s hard to imagine anyone with OCD doing). In it, she offers tips and tricks buoyed by her love for home organizing. And herein lies a very important deviation: She, herself, admits that she enjoys sorting, cleaning, and organizing (just like Monica on Friends).

People with OCD, true OCD, do not “love” to clean or organize and do so because of anxiety, fear, and overwhelm. They get no joy out of performing their compulsions (though they do get temporary relief from anxiety) and perform them only to reassure themselves that something bad won’t happen. OCD is not marked by personal preference and, instead, is driven by fear, plain and simple.

Now, it’s possible that someone somewhere with OCD does indeed enjoy cleaning but, in this case, their enjoyment likely reflects their natural personality and has nothing to do with their OCD. For instance, someone might have Relationship OCD and constantly fear that their spouse will leave them. They might also enjoy cleaning and organizing (or soccer or backgammon or watching murder shows on ID Discovery). The latter is a reflection of who they are; it’s not a reflection of their OCD. Compulsively cleaning and organizing for pleasure are two entirely different things.

There is an episode of Keeping up with the Kardashians where Khloe goes to an OCD therapist and acknowledges that she feels anxiety if she doesn’t clean (which is along the lines of OCD). Yet the episode didn’t align with OCD in a way that really gelled with sufferers.

For instance, at one point Khloe says, “I’m willing to talk to a therapist because I’m polite but I just don’t think I have a problem.” The vast majority of people with OCD recognize they have a problem, know they’re acting irrational, and want to regain their lives (those with OCPD, on the other hand, usually don’t recognize that they have a problem and don’t believe they need to change nor do they have any desire to change).

Later in the episode, Khloe states, “I’m actually proud of myself. I feel like I’ve got it together. I’m not as crazy about things. I’m better, I let it ride a little more.”

In real life, OCD is not cured in a few sessions with a therapist (or a 30-minute TV show). It takes months and months (or years and years) of hard work to get symptoms under control (and often medication, too). Even then, it’s not curable and requires vigilance to avoid a relapse. Any type of insinuation that OCD goes away with a quick fix is an insinuation not based in reality.

It’s always possible that Khloe does have OCD but, if so, her experience is not representative of how the disorder most typically presents. Since it’s being promoted as if it is, that, in itself, is problematic.

On the other hand, the Keeping up with the Kardashians episode that discussed Khloe’s OCD aired in late 2019, well after she received plenty of backlash from the OCD community for her tone deafness and insensitivity regarding the seriousness of the disorder. That, to play Devil’s advocate, is suspect: Like the series itself, it’s hard to know what’s real and what’s not.

Obsessions versus Compulsions

OCD involves a complicated dance between obsessions and compulsions. Technically, not both are needed for a diagnosis but they almost always present as a pair. Even in Pure O, sufferers tend to engage in invisible compulsions (such as mentally praying, counting, or thinking of “good’ words to counter the “bad” ones).

Obsessions present as intrusive, terrifying, and ego-dystonic thoughts that go against the sufferer’s true values (for example, someone who loves their mom may have an intrusive OCD thought about killing their mom or her dying in a car accident). Compulsions are the routines and rituals (either physical or mental) that sufferers engage in as they attempt to modulate their anxiety. Sufferers perform compulsions either to assure that their intrusive thought isn’t true or to make sure that it won’t come true.

In movies and TV, the intrusive thoughts (i.e., the obsessions) rarely get any mention. But there is no chicken or egg argument with OCD: The obsessions come before the compulsions. The obsessions are the entire reason compulsions exist at all.

When Hollywood fails to address the intrusive thoughts that act as hallmarks of the disorder, they paint OCD as something it’s not: Someone performing quirky rituals for no clear reason other than perhaps they’re superstitious or, more inaccurately, because they want to.

For instance, a movie might show someone with OCD walking through a doorway 18 times until it feels right but it doesn’t show that the person doing this is doing it to keep a plane from crashing or to prevent their child from getting kidnapped. In real life, sufferers engage in this type of thing because OCD tells them, “If you don’t walk through this door until it feels right, a plane will crash over Toledo and it’ll be your fault.” Or, “If you don’t walk through this door exactly 18 times, your child will be kidnapped tomorrow while they’re shopping at the mall.”

Hollywood omits this important key, which prevents people from truly understanding what the disorder involves. In short, portraying the compulsions (the what) without portraying the obsessions (the why) leaves a piece of the puzzle in the box, ultimately resulting in an incomplete picture.

Contamination: We’ve Seen This One Already

Hollywood largely ignores this and fails to focus on any story of OCD that involves obsessions and compulsions around relationships, homicidal harm, sexual harm, maternal harm, self-harm, existentialism, sexual orientation, scrupulosity, or any of the other topics that plague OCD sufferers.

The failure to look at OCD outside of its stereotypical lens perpetuates the misconceptions about OCD by suggesting that it always involves contamination or tidiness and that sufferers are always stocking up on Lysol or loofahs. This damages sufferers a few different ways.

For one thing, it plays into the “I’m soooo OCD” misconception, reinforcing the incorrect belief that people who have a personal preference for order have OCD. Perhaps more damaging, it sidesteps representation for a group of people who need it desperately.

As of now, OCD subtypes outside of contamination essentially don’t exist in Hollywood. And this tells those who suffer from Harm OCD, Pedophilia OCD, Scrupulosity OCD, and other lesser known types that they’re alone, something many already feel so potently.

What’s more, the idea that OCD solely involves contamination risks leaving undiagnosed sufferers in the dark. Because those with OCD are perpetuated so dramatically as being “germaphobes” or “neat freaks,” those who suffer from less traditional flavors don’t always recognize that they have a mental illness.

Someone with Harm OCD, for example, may erroneously assume that they’re a psychopath. Someone with Pedophilia OCD may erroneously assume that they’re a child molester. Someone with Scrupulosity OCD may erroneously assume they hate Jesus. This lack of awareness can have tragic consequences for OCD sufferers who don’t yet know they’re OCD sufferers.

Minimizing a Major Disorder

But when cinema portrays OCD (or any illnesses) in a manner that intends to take a realistic tone, the producers best portray it realistically. If they don’t, it’s the sufferers who get hurt.

To demonstrate, let’s look at the TV show Monk, a crime series about a detective with OCD that was widely-acclaimed by seemingly everyone except those with OCD.

Monk’s OCD began to dramatically interfere with his life after his wife was murdered. This isn’t completely unrealistic as times of stress and trauma can certainly worsen the disorder. But it’s a tired ploy in Hollywood regarding mental illness: There always has to be a reason why, according to the movies. In real life, many people become mentally ill for no reason other than their brain betrays them (more on this below).

Monk, per usual in Hollywood, has the stereotypical OCD: He’s consumed with organization, order, and a fear of germs. He is also afraid of some not-so-stereotypical things (like frogs and milk) but the former is what dictates his disorder. And, as typical in Hollywood, the series focuses mainly on the compulsions without diving in (at least not often) to the obsessions and anxiety that cause the compulsions to begin with.

One of the most pressing issues with Monk is the way the series portrays therapy. Monk is shown engaging in talk therapy, a type that does not treat OCD (you can’t talk it away, no matter how hard you try and instead must engage in Cognitive Behavioral Therapy with Exposure and Response Prevention). While this was likely done as a way to fit more narrative into the story and infuse dialogue into the show, the fallout is an inaccurate portrayal of how OCD is truly managed.

Medication is another area where Monk walks a dangerous line. In Season 3, in an episode titled, “Mr. Monk Takes his Medicine,” Monk begins taking a new experimental drug. The next day, he turns into a completely changed man; his compulsions are gone but so is his innate personality. He becomes reckless, engaging in impulsive and strange behavior. He’s no longer able to solve crimes, either. He eventually decides he dislikes the “new him” and stops taking his pills so he can go back to being himself.

There are a few issues here. First of all, the idea that an OCD drug would work overnight is highly unlikely as most take several weeks before they kick in at all (antidepressants, the drugs most often used in OCD, can take up to four weeks before their effects are felt). OCD is notoriously well known for not being something that involves any kind of quick fix (via medicine or therapy).

Second of all, OCD medications don’t entirely change personality traits and turn someone into a completely different person; instead, they help sufferers recognize their thoughts as irrational by lessening the power of those thoughts and moderating anxiety. Sure, the drug used on Monk (Dioxynyl) is fictional so it theoretically can affect people however the writers want. But the insinuation that OCD drugs dramatically influence personality, stripping people of their innate core and talents, risks sending a dangerous message and may deter people from taking meds that could help give them back their lives.

To its credit, the show does demonstrate how life-interfering OCD can be, but it minimizes the disorder when it uses phobias and compulsions as entertainment. It reinforces the idea that OCD is cute and quirky.

It would be wildly inappropriate to poke fun at many other diseases like this but OCD is fair game in Hollywood and elsewhere. And part of the reason is because people don’t understand its severity, don’t comprehend its heartbreak, and don’t recognize that people with OCD are ten times more likely to commit suicide than those in the general population.

On another bright side, Monk did seem to have some positive influence over how people perceive mental illness in others. So, we’ll give recognition where it’s due.

How Mental Illness on the Whole is Portrayed in Hollywood

Hollywood does move past from their standard operating procedure at times as demonstrated by movies like Ron Howard’s A Beautiful Mind. In this film, the screenwriter went so far to put Russel Crowe’s character on medication when the real life John Nash wasn’t taking anything. He did this because he was afraid a movie that failed to mention meds could sway people with schizophrenia away from their prescriptions.

But a few diamonds in the rough aside, Hollywood routinely gets several things wrong about mental illness, including:

It’s always borne out of tragedy: From Jason getting picked on, chased, and tossed into Crystal Lake to drown in Friday the 13th to Freddy Krueger getting bullied as a child in Nightmare on Elm Street to Hannibal Lector’s family getting murdered by the Nazis, trauma appears to be the main catalyst for mental illness when it comes to cinema. It’s so prevalent that it’s a wonder they didn’t give the shark in Jaws mommy issues.

This is present more subtly too, even when the movie doesn’t focus on a deranged killer. In The Fisher King, for example, Robin William’s character develops mental illness after witnessing his wife’s murder. While it would make absolute sense for him to suffer for PTSD, he demonstrates symptoms more along the lines of schizophrenia. It’s possible that a traumatic experience could trigger dormant illness in someone but it’s far more likely for someone to have a preexisting illness made worse by the trauma.

When it comes down to it, Hollywood appears to believe that mental illness must come with a backstory when, in reality, many of those diagnosed don’t need trauma to act as the predecessor. Environment may play some role, but many people develop mental illness because they’re born with it (or born predisposed to it). They have genes, structural abnormalities in the brain, and functional abnormalities in the brain that provide causation (or at least put them at increased risk). But none of that is as entertaining as someone spiraling into a dark depression because they witnessed a dramatic event complete with plenty of special effects and an ominous soundtrack.

OCD, in particular, is not usually trauma-based (in terms of causation). In other words, trauma is highly unlikely to cause the disorder to develop out of the blue. Even kids who grow up with abusive parents who focused on hygiene or organization don’t develop OCD unless other factors are at play. Previously, it was believed that parents were a huge cause of OCD (an idea perpetuated by Sigmund Freud) but now it’s largely accepted that moms and dads don’t cause OCD outside of the genes they pass down to their children.

True love conquers all: Movies tend to have happy endings (well, not you, Old Yeller). And the ones that involve mental illness don’t always deviate away from this concept. True love, the apex of many films, seems to conquer all….including a chemical imbalance in the brain.

Deep down inside, we know this isn’t realistic and it’s not intended to be. Cinema is frequently designed to serve as an escape, which is why movies leave us with all the feels. But it does walk a fine line in regard to mental illness, tiptoeing between the heartwarming and the socially irresponsible.

In OCD, true love might help but only if it comes with a heavy dose of Exposure and Response Prevention therapy.

Mentally ill means violent: Possibly the most damaging and dangerous stereotype perpetuated by Hollywood is that mental illness translates to violence (The Joker is a good example of this as well as being another good example of Hollywood’s propensity for linking mental illness to trauma). It’s not just TV or movies that are responsible for this violent misconception but the news media too.

Mental illness is largely ignored by mainstream media until something tragic happens (most often a mass shooting). Only then, only after an act of unspeakable violence, does the media routinely address mental illness, ultimately giving off the impression that the two are linked.

In reality, the vast, vast majority of people who are mentally ill are not violent and the vast, vast majority of violence is committed by people who are not mentally ill. According to the US Department of Human Services, only between 3%-5% of violent acts are due to mental illness and those with mental illness are far more likely to be victims of violence than causes of it (ten times more likely when compared to the general population).

The incidence of violence among the mentally ill is so low that experts agree that mental illness isn’t really a factor when it comes to crime. Some food for thought includes the differences between women and men. Women are more likely to be diagnosed with a serious mental illness (5.7% of females are diagnosed compared to 3.3% of men) yet they’re far less likely to commit violent crimes. Even exposure to violence doesn’t make women violent; it makes them depressed.

OCD is not a disorder linked to violence and Hollywood doesn’t insinuate that it is (it typically paints schizophrenia in this unfair light). But habitually linking mental illness, any mental illness, to violence, homicide, mass murder, rape, or the killing of children does a disservice to anyone struggling with their mental health (and it may act as a trigger to those with Harm OCD, worsening their anxiety). It might be entertainment to some but only at the risk of stigmatizing people who are already stigmatized enough. It perpetuates shame, secrecy, and ultimately sways people away from getting help.

In the end, representation matters. Whether it comes in the form of race or religion or sexuality, people need and deserve to see others who they can relate to, who walk in their shoes, who remind them that they’re not alone, and who grant them the most fundamental human right: To know that they matter.

Representation for OCD and mental illness is no different but that representation must be accurate. When it’s not, it misses the mark and creates plenty of collateral damage in the process.