Many people have problems that occur repetitively, disrupt their lives and seem completely out of control. Sometimes we’re asked if these problems are examples of obsessive compulsive disorder (OCD). And indeed, there are some similarities to OCD. Nevertheless, these problems are not considered to be in the same category. So what are we talking about here?
Specifically, we’re referring to the category of emotional disorders known as Impulse Control Disorders. The similarity to OCD is seen in the fact that impulse control disorders, like OCD, are repetitive and very difficult for the person to bring under control. Furthermore, like OCD, they greatly disrupt and impair the sufferers’ lives.
Most people can find one thing or another that they don’t like about their bodies. For example, maybe you feel you have a few unwanted pounds, perhaps you don’t like the size or the shape of your nose, or maybe you struggle to deal with your complexion. If so, your concerns fall within a normal range.
There’s no reason to think you have a serious problem. In fact, if you saw your face and body as totally, wonderfully, gorgeous and without flaws, many people would think you were narcissistic.
But there’s a problem called Body Dysmorphic Disorder (BDD) that takes normal, minor dissatisfactions to a level that lies far outside the range of normal. People with BDD have heart-rending distortions of their own bodies. They obsess and feel anguish about one or more perceived bodily flaws.
For example, a man with OCD might have an obsessive thought that a doorknob is contaminated and the thought of touching the doorknob causes him great anxiety. He takes a spray bottle of disinfectant and sprays the doorknob, which decreases his decreases. Then he reaches for a Kleenex to give him a barrier from any possible remaining germs. He feels relieved. And that momentary relief feels pretty good; well, that is until the next doorknob appears.
The pattern repeats: an obsessive thought, an overestimation of danger or risk, increased anxiety, a compulsive action, and then feelings of relief provided by the compulsive action.
About ten days ago, Laura and I came down with the plague. Well, OK, not the plague. More like the flu actually. We experienced energy draining fatigue, headaches, fever, chills, a constant cough and even back pain. We spent close to two days in bed and have just now overcome our symptoms with the sole exception of a lingering, but dissipating cough.
Of course we wondered if we could have done something to prevent this malady from occurring. When we saw our doctor, he suggested that we might have gotten our flu shots too early this year (apparently, they reformulate the shots as the year goes on). Of course, he said we had no way of knowing that and, no, he wasn’t recommending that we start getting two flu shots a year.
Maybe we didn’t wash our hands often enough. Or maybe we weren’t sufficiently attentive to getting enough sleep every night. Or maybe we spent too much time around crowds at the mall. Maybe…YIKES! Stop it!
Many of the clients I see express the need to be perfect. They fear making mistakes and feel horrible when they mess up. Some of these folks even berate themselves for making trivial, largely inconsequential mistakes like parking a few inches over the line of a parking space or making a few typoss on a blog (NOTE TO EDITOR: please don’t correct my typos in today’s blog!).
Some clients with sever obsessive compulsive disorder rachet this concern up to the point that they spend hours reviewing everything they right to insure a complete absence of errors. Others re-read passages from books over and over again to be sure that they remember every single detail. Still others consume large blocks of time arranging everything in their closets in perfect alignment with identical spacing between each item.
If you’re a perfectionist, I strongly recommend that you get a grip! Stop viewing all mistakes as terrible. I can guarantee you that I’ve learned more from making mistakes than I ever would have if I didn’t make them.
Laura and I sometimes amuse ourselves by noticing how language and expressions gradually morph over time. For example, have you ever taken note of how often people preface something they’re about to say with the single word, “Look!”? I think in the past, folks used to call attention to what they were about to say with “Listen.” Why the change? Go figure (another one of my favorite phrases).
And then there’s the ever popular “Seriously?…Really?” I like that one a lot. Why? I really don’t know. It just conveys a tone that I like. Perhaps it’s my sarcastic streak. At any rate, I find myself wanting to say “Seriously?….Really?” pretty often when I confront the thoughts that constantly bombard the minds of people who have obsessive compulsive disorder (OCD).
People with OCD often hold beliefs that are, well, believable. For example, who doesn’t worry about blurting out something inappropriate (or hitting the send button) without thinking? That’s a typical OCD worry, but it’s also a worry that most people have.
In fact, just today I was quickly doing some email and not paying a lot of attention and ended up sending someone a note with the wrong name. Now, as a perfectionist, I’ll be thinking about that mistake around 3 in the morning.
My email gaff might lead me to change my routine. I might start making sure that when I do email I’m not at the same time thinking about the blog I have to write, or the statement I have to send, or the reservation for the dog groomer I have to make, or the dry cleaning I need to pick up, or the checkbook I need to balance—you see what I mean. To change my routine, I might have to come up with changing the way I do email.
I’ve been thinking I should anyway. Maybe I should start with clearing off my desk before I do email. Then perhaps I should vow to read my email twice before I send it.
What happens to those who have OCD is that their normal, believable thoughts grow. So let’s say I am coming down with a case of OCD. I find that I’m still pretty obsessed with my email mistake. Now, thoughts of not only sending out emails with the wrong name but thoughts of sending inappropriate email are flooding my brain.
A couple of days ago, we wrote about exposure. The opposite of exposure is avoidance. We touch on the topic of avoidance fairly often in this blog, but it’s been years since we focused on the topic exclusively.
That’s too long because avoidance is arguably the most important thing for you to understand in order to successfully battle anxiety and OCD, or for that matter, most types of emotional disorders. Humans have an understandable desire to avoid feeling distress, anxiety, sadness, and upsets of all kinds. If you’re like most people, when you experience these feelings, you’ll do almost anything to get rid of them. Common strategies include:
We have been writing this blog for a few years. When we started, we decided to call the blog Anxiety and OCD Exposed. It’s been a long time since we have discussed why we decided on that title so we thought that new readers might want some explanation.
The term “exposed” may bring up a lot of different thoughts such as:
• Finding out that a politician was cheating on his wife
• Discovering a dumping ground of toxic waste
• The feeling of your hands when you forget to wear gloves in cold weather
• A politician taking opposite positions in the same campaign
• Not noticing the piece of toilet paper stuck to your shoe
• The most effective treatment for anxiety and OCD
Research says that overall the best treatment for anxiety and OCD is a method called exposure. When people are afraid or anxious about something, they tend to avoid it. The more they avoid what they fear, the more fearful they become.
Exposure helps people face their fears in a gradual way. Most people find that after being exposed to their fear or OCD triggers, over a period of time, their anxiety decreases. The goal of exposure is not to eliminate all anxiety, but to make anxiety manageable.
When people you care about or love have problems with anxiety, the most natural thing in the world is to help. You may find yourself wanting to reassure them that everything will be OK. That sounds good, but in other blogs, we’ve discussed how reassurance can boomerang and easily make things worse. No doubt, we’ll write about how reassurance works in more blogs down the road because people fall into that trap all of the time.
Alternatively, you may want to coach your loved one through the problem. That strategy actually works sometimes, but it’s very tricky and we recommend professional guidance for both yourself and your loved ones if you want to become their coach.
Coaching, like reassurance, can easily backfire, cause arguments, or be perceived as criticism by people you’re trying to help.