We may be living in a doughnut. It sounds like Homer Simpson’s fever dream, but that could be the shape of the entire universe – to be exact, a hyperdimensional doughnut that mathematicians call a 3-torus.
This is just one of the many possibilities for the topology of the cosmos. “We’re trying to find the shape of space,” says Yashar Akrami of the Institute for Theoretical Physics in Madrid, a member of an international partnership called Compact (Collaboration for Observations, Models and Predictions of Anomalies and Cosmic Topology). In May, the Compact team explained that the question of the shape of the universe remains wide open and surveyed the future prospects for pinning it down.
“It’s high-risk, high-reward cosmology,” says team member Andrew Jaffe, a cosmologist at Imperial College London. “I would be very surprised if we find anything, but I’ll be extremely happy if we do.”
The topology of an object specifies how its parts are connected. A doughnut has the same topology as a teacup, the hole being equivalent to the handle: you can remould a clay doughnut into a cup shape without tearing it. Similarly, a sphere, cube and banana all have the same topology, with no holes.
The idea that the whole universe can have a shape is hard to picture. In addition to the topology there is another aspect: the curvature. In his theory of general relativity in 1916, Albert Einstein showed that space can be curved by massive objects, creating the force of gravity.
Imagine space as two-dimensional, like a sheet, rather than having all three spatial dimensions. Flat space is like a flat sheet of paper, while curved space could be like the surface of a sphere (positive curvature) or a saddle (negative curvature).
These possibilities can be distinguished by simple geometry. On a flat sheet, the angles of a triangle must add up to 180 degrees. But on a curved surface, that’s no longer so. By comparing the real and apparent size of distant objects such as galaxies, astronomers can see that our universe as a whole seems to be as close to flat as we can measure: it’s like a flat sheet pocked with little dimples where each star deforms the space around it.
“Knowing what the curvature is, you know what kinds of topologies are possible,” says Akrami. Flat space could just go on for ever, like an infinite sheet of paper. That’s the most boring, trivial possibility. But a flat geometry also fits with some topologies that cosmologists euphemistically call “nontrivial”, meaning that they’re far more interesting and can get pretty mind-boggling.
There are, for mathematical reasons, precisely 18 possibilities. In general, they correspond to the universe having a finite volume but no edges: if you travel farther than the scale of the universe, you end up back where you started. It’s like the screen of a video game in which a character exiting on the far right reappears on the far left – as though the screen is twisted into a loop. In three dimensions, the simplest of these topologies is the 3-torus: like a box from which, exiting through any face, you re-enter through the opposite face.
Such a topology has a bizarre implication. If you could look out across all the universe – which would require the speed of light to be infinite – you would see endless copies of yourself in all directions, like a 3D hall of mirrors. Other, more complex topologies are variations on the same theme, where, for example, the images would appear slightly shifted – you re-enter the box in a different place, or perhaps twisted so that right becomes left.
If the universe’s volume is not too big, we may then be able to see such duplicate images – an exact copy, say, of our own galaxy. “People started looking for topology on very small scales by looking for images of the Milky Way,” says Jaffe. But it’s not entirely straightforward because of the finite speed of light – “you have to look for them as they were a long time ago” – and so you may not recognise the duplicate. Also, our galaxy is moving, so the copy won’t be in the same place as we are now. And some of the more exotic topologies would also shift it. In any event, astronomers have seen no such cosmic duplication.
If, on the other hand, the universe is really immense yet not infinite, we may never be able to distinguish between the two, says Akrami. But if the universe is finite, at least along some directions, and not much larger than the farthest we can see, then we should be able to detect its shape.
One of the best ways to do that is to look at the cosmic microwave background (CMB): the very faint glow of heat left over from the big bang itself, which fills the cosmos with microwave radiation. First detected in 1965, the CMB is one of the key pieces of evidence that the big bang happened at all. It is very nearly uniform throughout the cosmos. But as astronomers have developed ever more precise telescopes to detect and map it across the sky, they have found tiny variations in the “temperature” of this microwave sea from place to place. These variations are remnants of random temperature differences in the nascent universe – differences that helped to seed the emergence of structure, so that matter in the universe is not spread evenly throughout the cosmos like butter on bread.
Thus the CMB is a sort of map of what the universe looked like at the earliest stage we can still observe today (about 10bn years ago), imprinted on the sky all around us. If the universe has a nontrivial topology that produces copies in some or all directions, and if its volume is not significantly larger than the sphere on which we see the projection of the CMB, then these copies should leave traces in the temperature variations. Two or more patches will match, like duplicates of fingerprints. But that’s not easy to detect, given that these variations are random and faint and that some topologies would shift the duplicates around. Nonetheless, we can search among the statistics of the tiny temperature variations and see if they are random or not. It’s pattern-seeking, like traders looking for nonrandomness in fluctuations of the stock market.
The Compact team has taken a close look at the chances of finding anything. It showed that, even though no nonrandom patterns have yet been seen in the CMB map, neither have they been ruled out. In other words, many weird cosmic topologies are still entirely consistent with the observed data. “We haven’t ruled out as many interesting topologies as some previously thought,” says Akrami.
Others outside the group agree. “Previous analyses do not rule out there being possibly observable effects due to the universe having a nontrivial topology,” says astrophysicist Neil Cornish of Montana State University in Bozeman, who devised one such analysis 20 years ago. Ralf Aurich, an astronomer at Ulm University in Baden-Württemberg, Germany, also says:“I think that nontrivial topologies are still very much a possibility.”
Isn’t it, though, a little perverse to imagine that the universe may have some twisted-doughnut shape rather than having the simplest possible topology of infinite size? Not necessarily. Going from nothing to infinity in the big bang is quite a step. “It’s easier to create small things than big things,” says Jaffe. “So it’s easier to create a universe that is compact in some way – and a nontrivial topology does that.”
Besides, there are theoretical reasons to suspect that the universe is finite. There is no agreed theory of how the universe originated, but one of the most popular frameworks for thinking about it is string theory. But current versions of string theory predict that the universe shouldn’t have just four dimensions (three of space, plus time) but at least 10.
String theorists argue that maybe all the other dimensions became highly “compactified”: they are so small that we don’t experience them at all. But then why would only six or so have become finite while the others remained infinite? “I would say it is more natural to have a compact universe, rather than four infinite dimensions and the others compact,” says Akrami.
And if the search for cosmic topology showed that at least three of the dimensions are indeed finite, says Aurich, that would rule out many of the possible versions of string theory.
“A detection of a compact universe would be one of the most staggering discoveries in human history,” says cosmologist Janna Levin of Barnard College in New York. That’s why searches like this, “though they threaten to disappoint, are worthwhile.” But if she had to place a bet, she adds: “I would wager against a small universe.”
Will we ever know the answer? “It is quite likely that the universe is finite, but with the topology scale larger than what we can probe with observations,”says Cornish. But he adds that some odd features in the CMB pattern “are exactly the kind you would expect in a finite universe, so it is worth probing further”.
The problem with seeking patterns in the CMB, Cornish says, is given how each of the 18 flat topologies can be varied, “there are an infinite number of possibilities to consider, each with its own unique predictions, so it is impossible to try them all out.” Maybe the best we can do, then, is decide which possibilities seem most probable and see if the data fits those.
Aurich says that a planned improvement of the CMB map in an international project called CMB stage 4, using a dozen telescopes in Chile and Antarctica, should help the hunt. But the Compact researchers suspect that, unless we get lucky, the CMB alone may not allow us to answer the topology question definitively.
However, they say there is plenty of other astronomical data we can use too: not just what’s on the “sphere” of the CMB map but what’s inside it, in the rest of space. “Everything in the universe is affected by the topology,” says Akrami. “The ideal case will be to combine everything that is observable and hopefully that will give us a large signal of the topology.” The team wants either to detect that signal, he says, or show that it’s impossible.
There are several instruments now in use or in construction that will fill in more details of what is inside the volume of observable space, such as the European Space Agency’s Euclid space telescope, launched last year, and the SKA Observatory (formerly the Square Kilometre Array), a system of radio telescopes being built in Australia and South Africa. “We want a census of all the matter in the universe,” says Jaffe, “which will enable us to understand the global structure of space and time.”
If we manage that – and if it turns out that the cosmic topology makes the universe finite – Akrami imagines a day when we have a kind of Google Earth for the entire cosmos: a map of everything.
Readers are advised that this article contains explicit discussion of suicide and suicidal and obsessional thoughts. If you are in need of support, contact details are included at the end of the article.
At the age of 12, “out of nowhere”, Matt says he started having repetitive thoughts concerning whether he wanted to end his life. Every time he saw a knife, he would ask himself: “Am I going to stab myself?” Or, when he was near a ledge: “Am I going to jump?”
Matt had heard a lot about teenage depression, and thought this must be what was going on. But it was confusing, he says: “I didn’t feel suicidal, I really enjoyed my life. I just had an intense fear of doing something to hurt myself.”
Shortly afterwards, pre-empted by hearing about a notorious banned film, Matt began questioning whether he, like the central character, might be a serial killer. These thoughts “kept coming and coming” and he would lie in bed running over scenarios, trying to work out whether he was “going crazy”:
I really needed help. I didn’t know who to talk to. But it wasn’t on my radar to think about this as OCD.
Obsessive-compulsive disorder (OCD) is a significant mental health diagnosis in the 21st century. The World Health Organization (WHO) lists it as one of the ten most disabling illnesses in terms of loss of earning and reduced quality of life, and OCD is frequently cited as the fourth most common mental disorder globally after depression, substance abuse and social phobia (anxiety about social interactions).
Yet everything Matt knew about OCD, he tells me, came from daytime talkshows where “people were washing their hands 1,000 times a day – it was all about external and really extreme behaviours”. And that didn’t feel like what he was going through.
Across the world, we’re seeing unprecedented levels of mental illness at all ages, from children to the very old – with huge costs to families, communities and economies. In this series, we investigate what’s causing this crisis, and report on the latest research to improve people’s mental health at all stages of life.
A similar experience is recounted in the 2011 book Taking Control of OCD by John (not his real name) who, after a colleague had taken their own life, became “inundated with thoughts” about what he might do to himself. Every time he crossed the road, John thought: “What would happen if I stopped moving and was run over by a bus?” He also had thoughts of murdering those he loved. John recalled:
Try as I might, I just couldn’t chase the thoughts out of my head … When I tried to explain what was going on to my girlfriend, I couldn’t find a way of articulating what was happening to me … At the time, I thought OCD was all about triple-checking you had locked the front door and that your drawers were tidy.
Despite the prevalence of OCD in contemporary society, the experiences of Matt and John reflect two important features of this disorder. First, that the stereotype of OCD is one of washing and checking behaviours – the compulsions aspect, defined clinically as “repetitive behaviours that a person feels driven to perform”. And that obsessions – defined as “unwanted, unpleasant thoughts” often of a harmful, sexual or blasphemous nature – are viewed as obscure, confusing and unrecognisable as OCD.
People who experience obsessional thoughts are therefore frequently unable to identify their symptoms as OCD – and neither, very often, are the experts they see in clinical settings. Due to mischaracterisations of the disorder, OCD sufferers with non-typical, less visible presentations usually go undiagnosed for ten or more years.
When John visited his GP, he was diagnosed with depression. He recalled that the GP concentrated more on the visible effects of his distress - a lack of appetite and disrupted sleeping patterns. The thoughts remained invisible. As he put it:
I don’t know how you’re supposed to tell someone you don’t know that you have thoughts about killing people you love.
Even for those with “textbook” OCD such as my friend Abby, “the compulsion is just the tip of the iceberg”. Abby was able to self-diagnose at the age of 12, when she experienced handwashing and locking door compulsions. She says people still think of her as “Abby [who] likes to wash her hands a lot”.
Now, she tells me, “I realise that I have no interest in washing my hands – I’m a pretty messy person, and I don’t mind other people being messy.” Rather than a love of cleaning, her acts were related to the altogether scarier obsessional thought: “What if I am going to hurt other people?”
Clinical guidelines, such as those provided in the UK by the National Institute for Health and Care Excellence, define OCD as being characterised by both compulsions and obsessions. So, why do the difficulties encountered by Matt, John and Abby – of recognising the internal thoughts that dominate their lives – appear to be so common?
OCD is a multifaceted disorder, yet understanding tends to focus on the visual, compulsive aspect.Colored Lights/Shutterstock
My experience of OCD
From the age of 16, I have also suffered with thoughts that I later came to associate with OCD, but which began as invisible and tormenting. An article I wrote in 2014, entitled The Unseen Obsession, described my experience of having left university midway through my studies due to a single thought that gathered “such power that I even ended up attacking my body in an attempt to eliminate its force”. I wrote:
I have suffered with obsessional thoughts for the last four years, and can safely say that [OCD] is far from being about clean hands.
My obsessions have taken many forms since my teenage years. They began with me wondering whether things really existed, whether my parents were really who they said they were, and whether I wanted to harm – and was a risk to – my family, friends, even my dog.
Many of us know what it is like to ruminate about a person, a conflict, or something else we feel anxious about. But for those with obsessional thoughts (diagnosed or otherwise), this is quite different to simply “overthinking”. As I attempted to explain in my article:
Conversations falter as the thought leaps through your mind. Other topics seem less important, and time to yourself provides space to assess, analyse, and look for evidence of the thought being ‘true’ … [Obsessing] is like fighting: you push and shove your thoughts away and they come back with twice as much force. You spend time trying to avoid them and they pop up everywhere, taunting and mocking your failed attempt at running away.
It took me six months of weekly therapy sessions before I felt able to voice my obsessional thought to my therapist – someone I had known for a number of years. My unwillingness to be open about it was not only tied up with feelings of shame about its taboo content, but also my inability to see such thinking as part of a recognised disorder.
In particular, my research shows that there are important insights to be gained from the research decisions made by a group of influential clinical psychologists in south London in the early 1970s – shedding light on why so many people, myself included, still struggle to recognise and make sense of our obsessional thoughts.
The origin of the concepts
Categories of mental illness are not stable across time. As medical, scientific, and public knowledge about an illness changes, so does how it is experienced and diagnosed.
Prior to the 1970s, “obsessions” and “compulsions” did not exist in a unified category – rather, they appeared in an array of psychiatric classifications. At the start of the 20th century, for example, British doctor James Shaw defined verbal obsessions as “a mode of cerebral activity in which a thought – mostly obscene or blasphemous – forces itself into consciousness”.
Such cerebral activity could, according to Shaw, arise in hysteria, neurasthenia, or as a precursor to delusions. One of his patients – a woman who experienced “irresistible, obscene, blasphemous and unutterable thoughts” – was diagnosed with obsessional melancholia, a “form of insanity”.
The symptom arose from what Shaw defined as “nervous weakness”, an explanation that reflected the broader 19th-century view that obsessional thoughts were indicative of a fragile nervous system – either inherited, or weakened through overwork, alcohol or promiscuous behaviour (described as “degeneration theory”). Notably, Shaw did not mention any form of repetitive behaviour in relation to these verbal obsessions.
At a similar time to Shaw’s writings, Sigmund Freud, the Austrian founder of psychoanalysis, developed his psychoanalytic category of “Zwangsneurose – translated in Britain as "obsessional neurosis” and in the US as “compulsion neurosis”. In Freud’s writings, the “Zwang” referred to persistent ideas that emerged from a repressed conflict between unresolved childhood impulses (those of love and hate) and the critical self (ego).
Freud’s most famous case study, published in 1909, featured the “Rat Man”, a former Austrian army officer who possessed a variety of elaborate symptoms. In the first instance, he had become obsessed that he would fall victim to a horrific rat-based punishment that had been recounted to him by a colleague. The patient also expressed that if he had certain desires such as a wish to see a woman naked, his already-deceased father “will be bound to die”.
The Rat Man was described by Freud as engaging in a “system of ceremonial defences” and “elaborate manoeuvres full of contradictions” that have been read by some as the behavioural aspects of what would become OCD. However, there are crucial differences between the “defences” of Freud’s client and the compulsions of OCD, including that the former largely involved thinking rather than acting, and were by no means consistent or stereotyped.
This article is part of Conversation Insights The Insights team generates long-form journalism derived from interdisciplinary research. The team is working with academics from different backgrounds who have been engaged in projects aimed at tackling societal and scientific challenges.
The psychoanalytic category of “obsessional neurosis” was adopted and modified in Britain during the first world war, and became a staple – but inconsistently defined – diagnosis in British psychiatric textbooks of the inter-war period. Up to the 1950s, the terms “obsession” and “compulsion” were being used interchangeably in psychiatric writing. The complexity surrounding their meaning is demonstrated in the writings of Aubrey Lewis, a leading figure in post-war British psychiatry, who referred to “obsessional illnesses” as being made up of “compulsive thoughts” and “compulsive inner speech”.
Like Freud, Lewis mentioned the “complex rituals” of the obsessional – such as the patient “who is perpetually putting himself in the greatest trouble to ensure that he never steps on a worm inadvertently”. But he cautioned against “the dangers of associating any kind of repetitious activity with obsessionality”, writing that “it certainly cannot be judged on behaviourist grounds”.
Defining OCD by visible behaviour
OCD began to emerge in the form we recognise it today from the early 1970s – and was established as a formal psychiatric disorder through its inclusion in the third and fourth editions of the American Psychiatric Association’s Diagnostic and Statistical Manual (commonly known as DSM-III and DSM-IV) in 1980 and 1994.
The centrality of visible and measurable behaviours in the categorisation of OCD – particularly washing and checking – can be traced back to a series of experiments conducted by clinical psychologists in the early 1970s at the Institute of Psychiatry and the Maudsley Hospital in south London.
Under the direction of South African psychologist Stanley Rachman, the complex array of symptoms contained in the categories of obsessional illness and obsessional neurosis were divided into two: “visible” compulsive rituals, and “invisible” obsessional ruminations. While Rachman and his colleagues conducted a large research programme on compulsive behaviours, obsessions were relegated to the backburner.
For example, in their investigation of ten psychiatric inpatients diagnosed with obsessional neurosis, “compulsions had to be present for entry into the trial and patients complaining of ruminations were excluded” – a statement reiterated throughout subsequent experiments.
Indeed, this study did not merely require patients to exhibit some form of visible compulsion. The ten patients included were exclusively those with “visible handwashing” behaviour, which was viewed as the “easiest” symptom to experiment on. Likewise, the second round of studies only included patients who engaged in visible “checking” behaviour, such as whether a door was unlocked.
In a 1971 paper, Rachman offered his rationale for taking this approach, explaining how “obsessional ruminators raise special problems for the clinical psychologist because of their subjective, private nature”. This, he argued, was in contrast with “the other main feature of obsessional neurosis, compulsive behaviour, which can be approached with greater ease. It is visible, has a predictable quality, and many reproducible analogies in animal research”.
Rachman viewed compulsions as “visible” and “predictable” in large part due to the way clinical psychology had developed as a new profession in Britain, at the Maudsley Hospital in particular, in the decades following the second world war. To differentiate their practice from the existing mental health professions of psychiatry (medically trained doctors specialising in mental health) and psychoanalysis (talking therapy derived from Freud), these early clinical psychologists presented themselves as “applied scientists” who brought scientific methods from the laboratory to a clinical setting. Their conception of science was rooted in empiricism – with an emphasis on visibility, measurability and experimentation.
As part of this commitment to empirical science, these clinical psychologists adopted a model of anxiety derived from 20th-century behaviourism. This focus on observable behaviour was viewed as having much greater scientific value than psychoanalysis, which dealt with the “unverifiable” and “unscientific” realm of thoughts and thinking.
So, when obsessional ruminations gained a renewed focus in the mid-1970s, it was through this lens of visible compulsive behaviours. Rachman and his colleagues started talking about “mental compulsions” (such as saying a good thought after a bad thought) as “equivalent to handwashing”- rather than focusing on the importance and content of these thoughts in their own right.
In the early 1980s, clinical psychology came under pressure from cognitive psychologists (those concerned with thinking and language) for its reductive focus on behaviour. But despite this move to include cognitive approaches, the centrality of visible behavioural compulsions has continued to characterise perceptions of OCD in cultural and clinical domains.
This is perhaps most evident in media portrayals of the disorder – a critique taken up by cultural scholars such as Dana Fennell, who look at representations of OCD in TV and film.
The archetypal portrayal of OCD has not been helped by the recent publicity given to David Beckham and his extensive tidying. When I ask Abby what she thought about the attention that Beckham’s OCD was receiving in the media, she replies: “It’s so boring. It’s the same presentation that always gets thought of as OCD.”
Limitations to the ‘gold standard’ treatment
This archetypal portrayal of OCD also relates to how it is treated. The “gold standard” treatment in the UK today is the behavioural technique of exposure and ritual prevention (ERP), either on its own or combined with cognitive therapy. ERP gained acceptance from the experiments of Rachman and colleagues in the early 1970s, when they were exclusively working with patients with observable behaviours.
One of their key studies involved patients from the Maudsley Hospital who repeatedly washed their hands. They were told to touch smears of dog excrement and put hamsters in their bags and in their hair, while being prevented from washing for increased lengths of time.
Such experiments were again governed by observability and measurability. The “success” of ERP treatment – and its perceived superiority over psychiatric and psychoanalytic methods – was demonstrated by a reduction in the patients’ visible handwashing behaviour.
Today, if you are diagnosed with OCD by a psychiatrist and given OCD-specialist treatment via the NHS, you will most likely be told to undergo the same kind of ERP procedure that hospital inpatients were experimentally given in the 1970s: touching a set of items that you fear (exposure) while being prevented from engaging in your usual compulsive behaviour.
An identical method is also used when it comes to obsessional thoughts. Patients are asked to identify their worrying obsession, then either expose themselves to provoking situations or repeat the thought in their mind without engaging in “mental compulsions” – such as counting, replacing a bad thought with a good thought, or trying to “solve” the content of the obsessional thought.
It’s certainly true that this form of behavioural therapy can be hugely helpful in the treatment of OCD symptoms. Abby, after undergoing ERP for 14 years, said she had “developed a lot of practices around not giving into my [washing and checking] compulsions”.
I also found the approach beneficial in reducing the threatening quality of my obsessional thoughts. Repeating “I want to hurt my family” or “I don’t really exist” to myself over and over again, without actually trying to solve these issues, reduced the time I spent ruminating.
However, while being a huge advocate of ERP, Abby also observed that “sometimes when I get rid of a compulsion, it doesn’t mean I just get rid of the obsession.” While the “outward compulsions” disappear, “it doesn’t mean my mind stops cycling and mental questioning”.
Some contemporary clinicians have referred to ERP, designed around visible symptom reduction, as a “whack-a-mole technique” – you get rid one symptom (obsession or compulsion) and another pops up.
ERP is frequently accompanied with cognitive therapy techniques, such as cognitive restructuring (identifying beliefs and providing evidence for and against them), or being told that obsessions are “just thoughts”, that they are meaningless, and that you do not want to enact them.
Despite the success of cognitive-behaviour therapy (CBT) and ERP in scientific trials, a major review of evidence in 2021 questioned whether the effects of the approach in treating OCD had been overstated – reflecting the high proportion of OCD cases that are designated as “treatment resistant”.
I also believe there are some crucial limitations to contemporary treatments for OCD. Exposure (ERP) techniques stem from a period in which thoughts were not being considered at all by clinical psychologists, while CBT designates the content of obsessional thoughts as unimportant. Matt, like me, has found that CBT “can only take you so far”, explaining:
Part of this was that [CBT therapists] are so committed to the idea that thoughts don’t have meaning … [They] treat your symptom and once those are gone, you should get on with your life. I didn’t find that there was a way of thinking about [my] ruminations in the context of my whole life.
Experiences of alternative treatments
So much of my understanding about OCD has changed since I first wrote about it for Rethink Mental Illness almost a decade ago. Thinking about the historical development and categorisation of OCD has, it turns out, given me a greater sense of ease regarding this widely misunderstood condition. I feel less bound by our current conceptual frameworks, and more able to reflect on what I think is helpful in terms of how to successfully manage my obsessional thoughts.
For example, despite being warned away from psychoanalysis from a young age (my mum is a clinical psychologist, and psychologists are often fervently anti-psychoanalytic!), I have found psychoanalysis incredibly helpful in becoming comfortable with my thoughts.
This is because CBT typically focuses on present symptoms without looking into their meaning or how they relate to your personal history, and this comes into tension with my desire, as a historian, to think about the past. In contrast, psychoanalysis locates obsessional thoughts in history – pointing to childhood as a crucial point of psychic development. I have been able to understand my obsessions as the result of a deep childhood fear concerning the death of my loved ones, from which I developed a rigid desire for control.
As a young teenager trying to determine what was going on with him, Matt went to the public library and took out a Freud reader. He describes this as “the worst possible thing for a 14-year-old to read”, as it made him believe “that I did really have all these [murderous suicidal] impulses and all my fears are true”.
Despite this experience, while training to become a social worker, he “got into psychoanalysis as an alternate way to think about therapy and think about my own experience”. For him, psychoanalysis revealed the opposite to the image of “OCD as handwashing”.
Instead, he says, it focused on the aspects of “obsessionality that are internal”, showing him that the “mind is so powerful that it can produce a lot of imaginary fears”. It also allowed him to see “OCD symptoms as wrapped up with my whole life”.
Particularly profound in psychoanalytic thought is the acceptance of the complexity and unknowability at the heart of human experience. As Jaqueline Rose, professor of humanities at Birkbeck, University of London, wrote::
Psychoanalysis begins with a mind in flight, a mind that cannot take the measure of its own pain. It begins, that is, with the recognition that the world – or what Freud sometimes refers to as ‘civilisation’ – makes demands on human subjects that are too much to bear.
This idea of “a mind in flight” has helped me think about my obsessions – whether my parents are really who they say they are; am I going to hurt those I love? – as part of a battle for certainty and control that is both unattainable and understandable, considering the world we live in.
The aim of psychoanalytic treatment is not to eradicate symptoms but to bring to light the difficult knots that humans have to deal with. Matt refers to psychoanalysis as acknowledging “a sort of messiness of the mind … I’ve found the psychoanalytic view of accepting your own messiness extremely helpful”. Rose similarly describes psychoanalysis as “the opposite of housework in how it deals with the mess we make”.
In the UK, psychoanalysis has been rejected within NHS service provision. And I believe this is, at least in part, a result of historical critiques levelled at it by clinical psychologists as they developed behaviour therapies to treat OCD in the late 20th century.
‘A lot of emotion and sadness’
While compulsive behaviour such as handwashing and checking is widely perceived as “representative” of OCD, the tormenting experience of having obsessional thoughts is still rarely acknowledged and discussed. The shame and confusion attached to such thoughts, coupled with the feeling of being misunderstood, make this an important issue to address, particularly when misdiagnosis of OCD is so high.
My PhD on the history of OCD has also showed me the ways in which psychological research shapes how we conceive of diagnostic categories – and consequently, ourselves. While psychology’s commitment to objectivity, empiricism and visibility has provided tools that are tremendously useful in the clinic, my research sheds lights on how the often-exclusive focus on visible symptoms has at times trumped the appreciation of the complex experience of having obsessional thoughts.
I first met Matt in 2019 at the first OCD in Society conference, held at Queen Mary University of London, where he was giving a presentation on the “multiple meanings of OCD”. We discussed our own experiences of the disorder, and what we thought that history, psychoanalysis and anthropology could contribute to understandings of OCD.
Matt was 34, and he told me this was the first time he “had ever voiced the internal stuff out loud, and heard other people talk about it”. Recalling how this made him feel, he continued:
I felt a lot of emotion and sadness. The isolation had been such a big part of my life that I had stopped noticing it. Then being out of the isolation was such a relief, it made me realise how bad it had been.
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Argentina are celebrating their 2026 World Cup qualification with a dazzling 4-1 thrashing of archrivals Brazil in Buenos Aires.
Julian Alvarez, Enzo Fernandez, Alexis Mac Allister and Giuliano Simeone sealed an emphatic win on Tuesday for the world champions, who had been assured of their World Cup berth after Bolivia’s 0-0 draw with Uruguay earlier in the day.
That goalless stalemate ensured a festive atmosphere at the Estadio Monumental before a ball had been kicked, and Argentina kept the party going with a blistering performance.
Brazil, meanwhile, were left issuing apologies via coach Dorival Junior and captain Marquinhos as their hopes of reaching next year’s tournament in the United States, Canada and Mexico were left in the balance.
“What we did here today can’t happen again,” the latter told Brazilian TV Globo.
“It’s hard to talk about it in the heat of the moment. … It’s embarrassing.
“We started the game very badly, far below what we could do, and they’re on a great run of confidence. They knew how to play smart. … I’m sorry for our fans.”
Brazil hit by swift Argentina start
Atletico Madrid forward Alvarez opened the scoring after just six minutes, latching onto Thiago Almada’s through ball and dinking a close-range finish past Brazil goalkeeper Bento.
It got better for Argentina six minutes later when Chelsea’s Fernandez tucked away the hosts’ second goal of the night after Brazil’s back four failed to deal with a low cross.
With Brazil being run ragged by a rampant Argentina, they were thrown a lifeline at 26 minutes after a blunder by Cristian Romero gifted a goal to Matheus Cunha.
Tottenham defender Romero was caught in possession 23 metres (25 yards) from goal, allowing Cunha to steal in and drive a low shot past Emiliano Martinez to make it 2-1.
But any hopes of a Brazilian fightback were snuffed out in the 37th minute with a superb goal from Mac Allister.
Almada was once again the creator, lofting a pass into the area that Mac Allister met with a first-time volley to make it 3-1.
With Argentina in complete control, Simeone then brought the house down with a 71st-minute strike to make it 4-1 – his first international goal.
The 22-year-old son of Argentina legend Diego Simeone somehow blasted into the roof of the net from an acute angle to crown a dominant performance by the hosts.
The win means Argentina have qualified for next year’s finals in North America with four games to spare.
The Argentinians lead the 10-team qualifying group with 31 points from 14 games and are guaranteed one of the six automatic qualifying slots awarded to South America. Brazil are fourth.
Dorival has failed to earn the trust of Brazil’s demanding fans after winning just seven of his 16 games in charge since taking over in early 2024.
“Everything we planned, from the first minute of play, did not happen,” Brazil’s coach said at a news conference. “Argentina was much better in every way. I apologise to Brazil fans. We expected something very different from what we showed. It was a very difficult night for us.”
Marquinhos, who was jeered off with his teammates after November’s 1-1 draw with Uruguay, added that all players should have done better in Buenos Aires.
“It isn’t only about Dorival,” Marquinhos said. “This is not only the coach’s fault. It is the players too. We need to have our heads in the right place. They [Argentina] also had tough times before, and they overcame it. We can do it too.”
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