#some therapists have this tendency to like. focus on the Standard Depression Shit and try to treat that

[yardsards]

my hobbies include watching the sheer horror on new therapists' faces when i tell them about my childhood

[veryvincible]

If tony meets the criteria for ocd, why do you still say he doesn't have it? Not disagreeing just curious

Disclaimer again: I am not a mental health professional, I am simply a mental health advocate with many years of research under my belt, as well as lots of firsthand experience with the diagnostic process and other mental health-related incidences with the medical field (in America specifically). So, as always, feel free to look into it yourself if you’re interested in it, because there’s always discourse in the (very messy) field of psychology. Anyway, on we go.

The thing to remember here is that, with fictional characters, we don’t get to delve into their minds as much as we’d like to; internal monologue, as deep and complex and beautiful as it can be, is still a collection of words to define a mass of feelings, and these masses of feelings can be attributed to so, so many things. When a therapist diagnoses you, they get to ask funky questions like, “Do you feel like your thoughts and concerns spiral, and you’re helpless to stop them?” “Thinking back to your childhood, do you think you exhibited similar symptoms that you’re experiencing currently?” “Do you, personally, have an opinion about what may have been a catalytic event for you adopting this state of mind?” and all sorts of things. Though those are much more formally put than most questions I’ve been asked by therapists, the gist is basically the same-- they get to deep dive into your history, your mind, your self-awareness, your body language, your feelings... and you’re one cohesive person with a cohesive story. 

For comic book characters, we don’t get to delve into that. We don’t get to go, “Well, his childhood was like this, and that explains these behaviors! We can assume his panic response is Like This, and we can assume his attachment style is Like This, and we can assume his symptoms are Like This, and we can assume he feels Like This,” but those are all assumptions, and we can’t probe further. On top of that, most of them aren’t even intentional-- sure, yes, Tony Stark is a very sad man, and most writers make him this very sad man, but I can guarantee that most writers aren’t specifically looking into MDD and writing Tony accordingly. Some may be drawing from personal experience, others may be drawing from assumptions, etc. Whatever the case, Tony is not a cohesive man with a psychological timeline wherein one event leads to a developed response, consistently.

Above all else, diagnosis is a tool for treatment-- yes, it is excellent to be able to better understand yourself and feel the relief that comes along with this, but diagnosis came into being for the sake of medical professionals being able to say, “Hm, you’ve got [whatever]. I will go tell the other doctor you’ve got [whatever], so that guy can help you, because he specializes in [whatever], or you can try these home remedies for [whatever], or we can delve into [whatever] emotionally with talk therapy.”

Because diagnosis is a tool for treatment, you get these funky little footnotes in the DSM (which, again, is not the end-all, be-all, but when it comes to fictional characters, it’s totally fine) and other diagnostic tools that tell you “Even if you meet all these criteria, this diagnosis isn’t necessary if these symptoms would be better explained by something else!” because treating you for every psychological condition you qualify for could be rough on your body, it could end up with conflicting treatments (especially if you make incorrect assumptions, or if certain symptoms are stemming from different physiological factors despite appearing the same externally), and it’s just kind of tedious.

Like, you could potentially exhibit every symptom under the diagnosis of Generalized Anxiety, but if you have severe PTSD from long-term trauma that’s made you super jittery, it might be accepted that Generalized Anxiety wouldn’t be the best diagnosis for you, because ideally the treatment you’d receive for PTSD (trauma counseling, medication, etc.) would help with that.

I will say here that having an “umbrella diagnosis” under which other potential diagnoses could fall is not the same thing as having comorbid disorders; you probably know that already, but I’m going to say it anyway, just in case. Comorbidity involves overlap but separation of diagnoses, whereas the whole “Don’t diagnose your patient with [whatever disorder] if these symptoms are better explained by another thing!” happens more often when the entirety of one potential diagnosis fits under a section of another, more fitting diagnosis. So, if you see anyone with very long lists of diagnoses (probably don’t put big lists like that in your bios, though, please-- that seems kind of dangerous), that’s not a sign that they’re, like, mental illness-hoarding or whatever the fuck, despite that being a very common assumption that a lot of neurotypical people (and honestly, other mentally ill people) can have. Bodies like to be balanced. When one thing falls out of place, a lot of other things might follow. Just a disclaimer for you here, because I feel it’s important to say.

So, that covers... most of the reason why I don’t personally like to point to Tony as a character with OCD. First of all, sure, he has what could be considered obsessions and what could be considered compulsions, but we can’t actually ask him, “Hey, do you think these thoughts are obsessive? Are these potential compulsions things you perform ritualistically in order to make the obsessive thoughts go away?”

And... I don’t know. I think OCD (for me, specifically-- I know there are others with OCD whose opinions differ, and more power to them) is something that has to be written more intentionally for it to read as representation. Sure, they might have what could be intrusive thoughts... but my intrusive thoughts don’t just feel like thoughts that “could” be intrusive. They are intrusive, unmistakably. My compulsions don’t just feel like solutions to the problems I’ve made up or exaggerated in my head; they’re irrational, fear-based, anxiety-inducing. It’s the way you make sure every upstairs door is closed before heading downstairs, because otherwise you get a tightness in your chest and you can’t focus or breathe quite right; or the way you get up out of bed to make sure your door is locked multiple times just in case you forgot; or the way you develop avoidant tendencies or overly communicative tendencies because if you don’t, the ramifications within your relationships could be unbearable. It’s having a voice inside your head that’s not just telling you you’re a monster, the perfect antithesis to everything you’ve ever held dear; it’s a voice inside your head that is the monster, a voice that sounds the same as your own, simultaneously overprotective of your well-being and overly interested in the total destruction of your person.

And... I’m not saying Tony doesn’t experience that. He clearly has this feeling of “I am a monster” inside of him. He clearly has that feeling due to what he perceives as his own shortcomings. But these are comic books, and though there are many ways you could introduce intrusive thoughts in an internal monologue, we don’t really get that with Tony as much as I’d need to in order to feel represented by him. We don’t get him thinking shit like, “You could abandon this all, you could leave this shit to the rest of the team, you could fuck off and live on an island somewhere else, you could hole yourself up in a room and never leave, you could kill them, you could kill him, you could kill everyone, you know for a fact you have the resources to kill everyone, don’t you want to make sure? What if your tech fails? What if you do kill everyone? What would happen, huh? How would that look? How would that feel? What do you think it would feel like to pick up their bodies, to look in their eyes and have nothing staring back at you? You could tell him you hate him. Not to save him from you, no-- you could just do it because you’re able to do it, because you’ve cultivated these relationships and you’ve fooled everyone into loving you despite knowing you don’t deserve it. You’ve tricked them, and every day you continue on like this you’re manipulating them, and you’ve taken so much from them-- they’ve put so much of themselves in your hand that you could so, so easily crush if you just took a second and did it.”

... And we don’t get the accompanying monologue of, “No, god no, what the fuck, that’s not who I am, that’s not who I want, I’m not like that, I love them, that can’t be who I am, if that’s who I am then what does that say about me, what does that say about the space I take up, what does that make me?”

Which is where the OCD version of “I am a monster” tends to originate-- the inherent inability to separate oneself from the illness, the difficulty in coping with an overactive survival mechanism ready to ensure you’re prepared for every single thing that could go wrong, very specifically the things you’re most worried about, because that’s what matters, right? The things you’re worried most about. And Tony’s most worried about love, about his loved ones, about the planet, about life.

But “I am a monster” doesn’t imply that internal monologue. “I am a monster” could be a legitimate analysis of what he’s been through and what he’s done, clouded by self-loathing instilled in him by his father. “I am a monster” could be something he’s thought since he was younger, not because of any specific symptoms he developed, but because of what he was told-- because he was told he was wrong, bad, unlovable.

I think Tony could get there. I think I honestly may have written Tony there at some point, just because it’s easy to write for me. But if we’re following standard diagnostic procedures with a man on a page who really hasn’t been written intentionally with anything other than substance abuse, symptoms of PTSD, and depression... I don’t know. It doesn’t read like OCD to me. It doesn’t feel like OCD to me, and if at any point it did, I think that would be more of me filling in blanks with my own experiences than it would be anything else.

(There is one canonical instance of “I could kill this person right now if I wanted to!” level intrusive-ish thoughts I can think of off the top of my head, and that is in the most recent Iron Man run, and that also doesn’t read like OCD to me because, honestly, nothing Cantwell writes with regards to mental health seems natural or authentic or accurate. Also, I don’t know if it really qualifies as an intrusive thought if it feels more like a justified outburst of rage to the character thinking it, so, uh. Hmm.)