Here is my morning routine: when I get out of bed, my feet must touch the edge of the rug, one at a time, while I softly vocalize two magic words that are best described as puffing and plosive sounds. If my feet don’t touch correctly, or if I don’t say the words right, I get back in bed and try again. Once I have properly performed this initial procedure, I again tap my left foot on the carpet while vocalizing the first magic word, and then—while holding my breath and without moving my mouth or tongue one millimeter during the duration—I silently incant a phrase that is far too nonsensical and embarrassing to share publicly, then tap my right foot while vocalizing the second magic word.

This can take anywhere from ten seconds, if I’m lucky, to two or three minutes. Once executed to my satisfaction, I am able to go downstairs, unplug my phone and perform roughly the same procedure on it, with my thumbs instead of my feet, and then I am allowed to use my phone. Likewise, the refrigerator door when I’m making coffee. Likewise, the edges of my laptop when I power it on. With these routines completed, I can start my day, open a Word document, and begin writing.

I realize this sounds bad, but it’s a compromise I’ve reached after decades of managing my obsessive-compulsive disorder. I’ve gone cold turkey before, renouncing all habits and tics, but they eventually creep back in. A therapist once described OCD behaviors as a “blob,” which felt apt; whatever part of it you press down on, another part bulges back up. These little routines are, in a sense, a deal I make with myself, so I don’t have to perform random routines all day long. Not doing them is not an option. If I don’t do them, the world will end.

I can’t remember exactly when it began. As is true of so many disorders, medical literature generally links OCD with the onset of adolescence, and this tracks with my earliest OCD memories: missing the bus to middle school because I had to touch mailboxes and the curb in a certain sequence; playing songs on my cassette deck over and over in order to pause on an exact word or chord; staying up in my teenage basement lair, flicking the lights on and off in patterns that, if my parents had noticed, would have looked like some Morse code call for help, which in a way, it was.

The most vivid memory I have from this era is typing out the final draft of an English paper over and over. I’d written and revised it first by longhand in a notebook, in anticipation of the Sisyphean task to come. The rule I’d set for myself—or rather, the rule that had mercilessly evolved over the course of the school year—was that if I made one error typing, I had to erase the whole thing and start over. When I mistyped in the final paragraph, I deleted all four pages and took a break to cry. I finally pecked the last period when the sun was coming up.

So maybe adolescence is when it started, but who knows? Quite possibly, the first instance was prememory, age three or younger, some toddler urge to touch a chair leg repeatedly. Regardless of when the behavior first manifested, it feels to me that the underlying vulnerability has always been there, if latent. Fundamentally, an unusually—and uselessly—keen sense of my own mortality.

One of my earliest memories is sitting on the carpeted stairs of our home, suddenly aware of my heartbeat. I was perhaps four, and I was convinced that I was having a heart attack. I listened to it thudding away in my chest and expected to die with each little rush. When I was eight or nine, I became terrified by and obsessed with a Time magazine article about something called AIDS. Those famous images of cadaverous men with Kaposi’s sarcoma—I remember staring at them in horror, certain I’d get it, a ludicrous fear for a preteen, presexual child to harbor, but on-brand.

This death awareness is, in my amateur self-diagnosis, at the root of my OCD behaviors and attendant hypochondria, derived from the Greek term hypokhondrios, meaning “of the soft parts between the ribs and navel” from hypo (“under”) and khondros (“cartilage of the sternum”). Ancient physicians believed that this part of the abdomen was the seat of melancholy and morbidity. It makes sense, given that this existential dread often seems to issue from your gut and not from your head, which is usually engaged in the fruitless task of convincing your gut you are not dying. The vague, motivating threat for not touching a curb or counting to a certain number was always an imaginary illness—ironic given the very real illness I actually had. Although it took me decades to realize it, by thirteen, I was suffering from a full-blown mental health crisis.

But strangely, it was also a great time in my life, because at the same time this stuff manifested, I began learning to play music. After school, I would engage in endless attempts to play classic rock songs. The slippery intro to “Sweet Child O’ Mine,” by Guns N’ Roses, was a particular fixation—my poor parents must have heard that riff botched ten thousand times before they heard it played right once. One Christmas, I asked for The Beatles: Complete Scores—still one of my prized possessions—and over the course of the following year, I learned how to play every song. All of them, even minor stuff like “Savoy Truffle.”

Although I never considered it at the time, it is impossible for me now not to frame the intensity of this devotion to music as a counterpart—a harmony—to my OCD. Every moment I was poring over tablature or trying to master a new chord was a moment not spent, say, touching a byzantine pattern of bricks on the fireplace wall. When I was playing, writing, recording music, I was safe.

This obsessive phase lasted through the first half of my twenties, by which point I’d written and recorded three albums and toured the country. At my peak, sometimes to the chagrin of my bandmates, I was writing a new song every day. It was a ten-year stretch of intense focus and fixation on music that, at a certain point, largely evaporated. I think of the exchange between Meryl Streep’s and Chris Cooper’s characters in Spike Jonze’s great Adaptation, talking about why his character—a strange Florida autodidact—one day stops collecting exotic fish:

John Laroche: Then one morning, I woke up and said, Fuck fish. I renounce fish, I will never set foot in that ocean again. That’s how much “fuck fish.” That was seventeen years ago and I have never stuck so much as a toe in that ocean. And I love the ocean.

Susan Orlean: But why?

John Laroche: Done with fish.

I was done with music, I understand now, because it had stopped requiring the deep learning that constructively engages my obsessive side. The thing that does this now is writing. Writing helps with these compulsions better than music ever did. When I finally complete my morning routines and manage to get a Word file open, the whiteness of the page is like white noise, drowning out the most vocal of my anxieties. The blank page unsettles many writers, but to me, it’s a soothing null space that offers the promise of a world I fully control, a placid refuge from the real life uncertainty that motivates my disorder. It’s a paradox of the OCD mind (mine, at any rate) that the same thing that can hamper your movement through the world can be such a huge advantage when focused. My routines and rituals represent a manic and senseless industry that suddenly makes sense when applied to creative work.

Controlling a sentence—controlling this sentence, as I type—is for me the best, most pleasurable work there is. I build the paragraph, tagged by its thematic first word: control. In crafting this sentence, this paragraph, this essay, I get to be both architect and construction worker, and both jobs offer equally pleasing aspects of control. The former involves creative design and abstract thought; the latter brings the visceral, simultaneously logical and intuitive pleasure of finding the right word, moving it around, putting it in just the right place. Having written that sentence, I know I must reverse myself and concede that the idea of there being “just the right place” is illusory—that even this work is, in its essence, as arbitrary as anything else. This is true, but nonetheless as I write, I shut out the world, other responsibilities, Twitter, the news, everything.

Although obsessive-compulsion may offer a special, somewhat unusual version of this kind of relief, I don’t believe I’m that different from most people. Most people in these chaotic times are engaged in some form of obsessive control: sixty-hour work weeks, relentless curation of social media personas, helicopter parenting, and the regulation of mood via opiates, increasingly legal marijuana, and that old standby, alcohol. OCD’s manifestation is aberrant (and often ridiculous) enough that it largely can’t be integrated into normal life, and in some ways this is useful. At the very least, I cannot fool myself into thinking my compulsions are anything other than what they are: a warding away of death via the primitive magic of routine.

As I type these words, it’s around five o’clock in the afternoon. Soon my wife will be home from work. The dog needs walking, dinner needs making. There will be more tasks to complete, more magic words to incant before sleep. But I’ve written some pages, at least, have done my work for the day. That’s something. I will get up tomorrow, and I will do it again. I will do all of it all over again.

Adam O’Fallon Price is a staff writer for The Millions and the author of two novels: The Grand Tour and The Hotel Neversink (Tin House Books, 2019). His short fiction has appeared in The Paris Review, Vice, the Kenyon Review, The Iowa Review, and many other places. His podcast, Fan’s Notes, is an ongoing discussion about books and basketball.