Book Review: Because We Are Bad by Lily Bailey

Introduction

“Because We Are Bad: OCD and a Girl Lost in Thought” (Bailey, 2016) is more than just a memoir; it is an unflinching exploration of the inner workings of Obsessive-Compulsive Disorder (OCD) from the perspective of someone who has lived it. Written by Lily Bailey, a British journalist and mental health advocate, this book delves deep into the mind of a young girl whose world is shaped and, at times, dominated by her struggle with OCD. With stark honesty and vivid storytelling, Bailey takes readers on a journey from her childhood—marked by an unrelenting inner voice that both terrifies and demands obedience—through to her young adulthood, where the battle against OCD becomes both more intense and more conscious.

Bailey’s narrative is raw and compelling, presenting a layered portrayal of the psychological, emotional, and social impacts of OCD. She provides an insider’s view of the constant mental negotiations, the fear of causing harm, and the compulsive rituals that come to define her everyday life. The memoir not only sheds light on how OCD manifests in thoughts and behaviours but also explores the profound effects it has on one’s sense of identity, relationships, and overall well-being. Through her story, readers gain a nuanced understanding of how OCD is much more than a desire for cleanliness or orderliness—common misconceptions that often overshadow the reality of the disorder.

This review aims to dissect the key concepts covered in Bailey’s work, such as intrusive thoughts, the compulsion to check and repeat, and the impact of OCD on personal and social development. It will highlight how Bailey’s memoir distinguishes itself in the crowded field of mental health literature by providing a voice that is both vulnerable and powerful. Additionally, the review will offer practical insights for therapists, mental health practitioners, and individuals who are either directly or indirectly affected by OCD, making it an invaluable resource for understanding this complex condition.

For readers in Canada, particularly those within Two Spirit, trans, nonbinary, and queer communities, Bailey’s journey of self-awareness and acceptance may resonate deeply. Her candid reflections on mental health struggles serve as a reminder that while OCD can be an isolating experience, there is value in finding and creating supportive spaces where these stories can be shared and understood. Bailey’s memoir is not just a book; it’s a call to see, hear, and understand the hidden battles many face daily.

This review will cover the memoir’s key themes, discuss its standout elements, and encourage readers to engage with this significant work, whether they are seeking therapeutic resources, personal growth, or a deeper understanding of OCD.

Overview of the Book

The memoir opens with a vivid portrayal of Lily’s early life and the onset of her struggles with an unrelenting internal voice, referred to as “She.” This voice is more than a mere thought; it is a commanding presence that insists on perfection, setting impossibly high standards and creating an omnipresent sense of anxiety and guilt. From the beginning, Bailey makes it clear that “She” is not a comforting imaginary friend but rather a tormentor who pushes her to perform rituals and compulsions, making her believe that failing to do so would lead to disastrous consequences. This relationship with “She” forms the core of Bailey’s experience with OCD, illustrating how the disorder can hijack one’s thoughts and shape one’s reality (Bailey, 2016, pp. 3-7).

Bailey’s narrative is structured to move fluidly between different stages of her life, illustrating how her OCD manifests and evolves over time. She takes readers through her childhood, adolescence, and young adulthood, detailing the shifting nature of her obsessions, compulsions, intrusive thoughts, and rituals. Her account is both immersive and unsettling; it effectively conveys the endless mental loops and exhausting rituals that characterize OCD. Bailey’s ability to articulate her internal world with raw honesty and clarity helps demystify the disorder for readers, revealing a mind filled with an ever-present fear of causing harm, pervasive self-doubt, and a relentless need to perform compulsive behaviours aimed at preventing imagined catastrophes (Bailey, 2016, pp. 8-14).

The memoir does not shy away from illustrating the psychological toll these compulsions take. For instance, Lily describes hours spent checking, counting, and performing intricate mental rituals to ensure safety or prevent harm to loved ones. These rituals, while sometimes providing temporary relief, often lead to more anxiety and a heightened sense of dread when they are not perfectly executed. The stakes always feel impossibly high—if she doesn’t complete a ritual correctly, something terrible might happen, reinforcing a vicious cycle that is both mentally and physically exhausting. Bailey uses her experiences to shed light on how OCD can distort reality, creating a distorted logic that feels irrefutably real to those affected by it (Bailey, 2016, pp. 32-40).

Her story is a courageous exploration of the complexities of OCD, highlighting the mental gymnastics required to navigate daily life while feeling constantly under siege by her own mind. She details the feelings of isolation and shame that often accompany OCD, as well as the difficulty of explaining these experiences to others who may not understand. This sense of isolation is further compounded by the stigma surrounding mental illness, which Bailey tackles head-on by describing her encounters with judgment, both from others and from herself.

Lily’s experiences of multiple psychiatric hospitalisations, various therapies, and the impact of OCD on her relationships are woven throughout the memoir, providing a comprehensive picture of how OCD affects all aspects of life. These experiences underscore the challenges many face in seeking appropriate care, particularly when the disorder is not well understood by healthcare professionals. Bailey discusses the trial and error of different treatment approaches, including Cognitive Behavioural Therapy (CBT), exposure and response prevention, and medications, offering insight into what it means to seek help and find the right kind of support (Bailey, 2016, pp. 102-110).

Through her unflinching recounting of these experiences, Bailey reveals the far-reaching implications of OCD, not just for the individual but also for those around them. She describes how the disorder infiltrates her relationships with friends, family, and partners, often making it difficult to connect or feel understood. This part of the memoir is particularly powerful, as it brings to light the social and emotional costs of living with a condition that is frequently misunderstood and trivialized. By providing this detailed and personal account, Bailey’s memoir becomes an essential resource for anyone seeking to understand the lived experience of OCD beyond stereotypes and simplified portrayals (Bailey, 2016, pp. 15-22).

This holistic view of OCD, as both a deeply personal struggle and a broader social issue, is what makes “Because We Are Bad” such a significant contribution to mental health literature. It invites readers to confront their own assumptions about OCD and challenges the stigma that surrounds it, all while fostering empathy and a deeper understanding of what it means to live with this condition.

Key Concepts Covered in the Book

1. The Nature of OCD: Intrusive Thoughts and Compulsions

Bailey’s memoir provides an invaluable inside look at the experience of living with OCD. She vividly describes the intrusive thoughts that plagued her from a young age—thoughts that she might cause harm to others or that she was inherently “bad.” To counter these thoughts, she engaged in compulsive behaviours, such as checking, counting, and mental rituals, to neutralise perceived dangers (Bailey, 2016, pp. 32-35). This portrayal challenges common misconceptions about OCD, showing that it is far more than just being overly tidy or liking things in a certain order.

2. The Impact on Personal Identity and Relationships

Bailey poignantly illustrates how OCD influences one’s sense of self and interpersonal relationships. Her account reveals how the disorder made her question her reality, her morality, and even her own memories. The memoir details the strain OCD placed on her friendships and family dynamics, showing how it can isolate those who suffer from it (Bailey, 2016, pp. 58-63). This aspect of the memoir is particularly relevant for therapists working with clients who may feel misunderstood or isolated due to their mental health struggles.

3. The Journey through Different Treatment Modalities

Throughout the memoir, Bailey discusses her encounters with various mental health professionals and treatment approaches, including Cognitive Behavioural Therapy (CBT), medication, and inpatient care (Bailey, 2016, pp. 102-110). Her experiences highlight the challenges of finding the right treatment and the importance of understanding OCD from a compassionate and knowledgeable perspective. This part of the memoir could be especially useful for therapists looking to gain insights into their clients’ experiences with the mental health care system.

4. The Role of Self-Acceptance and Advocacy

As Bailey grows older, her narrative shifts towards self-acceptance and advocacy. She begins to see her OCD as a part of her, not a definition of her entire being. The book ends on a hopeful note, emphasizing the importance of speaking out about mental health struggles to reduce stigma and foster a more inclusive and understanding society (Bailey, 2016, pp. 185-190). This message is vital for Canadian readers, particularly those involved in mental health advocacy and support for marginalized communities.

5. The Intersection of Mental Health and Everyday Life

Bailey’s memoir also delves deeply into how OCD pervades every aspect of daily life, affecting even the most mundane tasks. Her account makes it clear that OCD is not just a condition that surfaces during moments of stress or anxiety; it is a constant presence that influences decisions, behaviours, and interactions. Bailey describes her exhausting routines and the never-ending cycle of repetitive actions meant to mitigate perceived dangers—whether it’s checking if her family is safe, organizing her environment to prevent imagined harm, or rehearsing conversations to avoid offending others (Bailey, 2016, pp. 74-80). This aspect of the memoir is essential for both therapists and clients, as it highlights the pervasive nature of OCD and the energy it requires to manage such a condition on a daily basis.

6. The Role of Shame and Guilt in OCD

Another critical concept in Bailey’s memoir is the role of shame and guilt in perpetuating the cycle of OCD. She vividly describes how her intrusive thoughts often led to feelings of deep shame—feeling “bad” or inherently flawed—and how these emotions fueled her compulsions. The sense of responsibility she feels for preventing imagined catastrophes creates a burdensome and continuous cycle of guilt and anxiety. Bailey’s reflections provide insight into how shame can prevent people from seeking help, as they might fear being judged or misunderstood by others (Bailey, 2016, pp. 50-55). This theme is particularly important for therapists to recognize, as addressing shame and fostering self-compassion can be a key component of effective OCD treatment.

7. The Impact of Societal Expectations and Misconceptions

Bailey also addresses the broader societal misconceptions about OCD, challenging the stereotype that the disorder is simply about being overly tidy or wanting things to be “just so.” Through her detailed and raw narrative, she illustrates how these misconceptions can minimize the severity of OCD and the suffering it causes. Bailey discusses how the trivialization of OCD in popular culture and everyday language often leads to misunderstandings and lack of proper support (Bailey, 2016, pp. 88-92). This discussion can be particularly useful for mental health professionals and advocates who are looking to educate others and foster a more accurate understanding of OCD.

8. Navigating the Mental Health System and Self-Advocacy

A crucial part of Bailey’s story is her experience navigating the mental health care system and learning to advocate for herself. She discusses her interactions with various healthcare providers, both helpful and unhelpful, and how she had to learn to speak up about her needs. This part of the memoir highlights the importance of being an informed and assertive participant in one’s own care, especially when dealing with a complex and often misunderstood condition like OCD (Bailey, 2016, pp. 112-118). For Canadian readers, especially those within marginalized communities who may face additional barriers to accessing mental health care, Bailey’s experiences can serve as both a cautionary tale and an empowering example of self-advocacy.

9. The Importance of Community and Connection

Finally, Bailey’s journey underscores the importance of community and connection in the recovery process. While OCD can be deeply isolating, her memoir illustrates how connecting with others who understand her experience, whether through friends, support groups, or therapists, can be healing. Her advocacy for greater openness and dialogue around mental health challenges is a call to action for creating supportive communities that can help break down the walls of stigma and isolation (Bailey, 2016, pp. 160-165). This concept resonates strongly with the values of inclusivity and support, which are particularly relevant to queer and trans communities in Canada and beyond.

How This Book Stands Out

“Because We Are Bad” distinguishes itself within the mental health memoir genre for several compelling reasons. First and foremost, Bailey’s narrative style is both engaging and immersive, immediately capturing the reader’s attention from the very first page. She writes with a raw honesty that pulls readers into her world, making them feel the weight of her compulsions and the relentless grip of intrusive thoughts. Her vivid descriptions provide a window into the mind of someone grappling with OCD, demystifying the condition for those who are unfamiliar while also offering a deep, authentic resonance for those who have experienced it. Bailey’s ability to articulate the complexities of OCD with such clarity and empathy is what makes her memoir not only educational but also profoundly moving. Readers are invited to see the world through her eyes, where every interaction, thought, and emotion is filtered through the lens of her disorder, which helps to break down the stigma and misconceptions surrounding OCD.

Secondly, Bailey’s openness about her ongoing struggles and the non-linear nature of recovery offers a realistic portrayal of living with a chronic mental health condition. Unlike narratives that may present a linear path to recovery, Bailey’s story is more reflective of the reality faced by many people living with OCD: progress is often followed by setbacks, and healing is an ongoing, evolving process. This honesty is refreshing and valuable, as it highlights that recovery is not about “curing” the disorder but rather about learning to live with it in a way that allows for a fuller, more meaningful life. Her depiction of this journey can be a crucial resource for therapists and clients alike, providing both hope and validation for the challenges associated with managing OCD. It helps to dispel the myth that recovery is a straightforward process, underscoring the importance of patience, persistence, and personalized care.

Bailey’s memoir also stands out for its emphasis on the need for tailored, patient-centred approaches in mental health care, which is particularly crucial for therapists working within diverse communities, including queer and trans populations. Her narrative underscores that what works for one person may not work for another and that understanding the individual’s unique experiences, challenges, and identities is essential in developing effective treatment strategies. By sharing her experiences with different treatment modalities—ranging from Cognitive Behavioural Therapy (CBT) to medications and inpatient care—Bailey sheds light on the importance of finding a therapeutic approach that aligns with the individual’s needs and circumstances. Her insights are particularly valuable for mental health professionals who serve communities with unique experiences and vulnerabilities, as they emphasize the necessity of flexibility, cultural competence, and deep empathy in therapeutic practice.

Moreover, “Because We Are Bad” is remarkable for its exploration of the societal and cultural dimensions of living with OCD. Bailey’s reflections on how OCD is often trivialized or misunderstood in popular culture and everyday language challenge readers to reconsider their own perceptions of mental illness. She draws attention to the damaging impact of phrases like “I’m so OCD” used casually to describe being organized or particular, revealing how such language can minimize the severity and reality of the disorder. This critical examination of societal attitudes towards OCD not only educates readers but also encourages them to be more mindful and compassionate in their understanding and discussion of mental health. This perspective is particularly relevant for readers in Canada, where diverse cultural narratives around mental health intersect, and where fostering an inclusive and supportive dialogue is vital.

Another aspect that makes Bailey’s memoir unique is her focus on the intersectionality of mental health experiences. She does not isolate her struggle with OCD from the rest of her life; rather, she presents it as interwoven with her identity, her relationships, and her personal growth. This holistic portrayal makes her story particularly relevant to readers from marginalized communities who may face additional layers of complexity when dealing with mental health issues. For instance, Two Spirit, trans, nonbinary, and queer individuals may resonate with Bailey’s narrative of feeling different, misunderstood, or alienated. Her emphasis on the importance of community and connection in her healing process also aligns with the values of these communities, where support networks often play a crucial role in mental health and well-being.

Finally, “Because We Are Bad” is compelling because it moves beyond personal narrative to advocacy. Bailey’s memoir is not just a recounting of her experiences; it is a call to action for greater openness, understanding, and support for those with OCD and other mental health conditions. Her advocacy for reducing stigma and fostering a more inclusive and compassionate mental health discourse is particularly significant for readers who are themselves advocates, mental health professionals, or those looking to support loved ones with OCD. She challenges the reader to think critically about how society treats mental health, the support structures available, and the importance of listening to and believing people who share their experiences.

By combining a deeply personal narrative with broader societal insights, Bailey has created a memoir that is both a compelling read and a valuable tool for education and advocacy. Her story serves as a reminder that while OCD and other mental health conditions can be profoundly isolating, sharing these experiences and fostering understanding can help break down barriers and create more supportive and inclusive communities.

Conclusion

Lily Bailey’s “Because We Are Bad” is an essential read for anyone looking to gain a deeper understanding of OCD. It is a powerful reminder that mental health disorders are not just a set of symptoms to be treated but experiences to be understood in the context of a person’s life. For therapists in Canada and those working with diverse populations, Bailey’s insights provide valuable lessons in empathy, patience, and the importance of listening to the lived experiences of those they serve.

To experience the full benefit of this resource, you can borrow the book from your local library using the BC government website or purchase it from local bookshops like Cross and Crows Books, Little Sisters in Vancouver, Glad Day Bookshop in Toronto, or Halifax Bookmark in Halifax, NS. While I am not an affiliate of these bookstores, I believe in supporting local, queer-inclusive bookstores across Canada. By purchasing from these independent shops, you not only support community-focused businesses but also help foster a more diverse and inclusive literary landscape.

If Bailey’s story resonates with you and you would like support navigating your own mental health journey, consider scheduling a free 15-minute consult with Audrey Wolfe, RCC (she/they) or joining the waitlist to work with me, Clayre Sessoms, RP, RCT, RCC, RCAT, CCC, ATR-BC (she/they). You can book a consult with Audrey here or join my waitlist here.

Reference

Bailey, L. (2016). Because We Are Bad: OCD and a Girl Lost in Thought. HarperCollins.