Friday, March 5, 2010

Skin Checks and OCD: Never Enough

After being diagnosed with squamous cell skin cancer, the dermatologist advised that I have a skin check every six months. At first this sounded wonderful! I thought it would make me feel safe, and because my doctor mandated it, I didn't have to feel the tension of deciding whether or not to go to the doctor.

But OCD had other ideas. I did ok for the first few months and but by the last few weeks, I would be on hyperalert, noticing variation in color or texture on my skin, and in the tug of war about what to point out to my dermatologist. I'd be sitting there in a paper gown, obsessing my brains out, full of pressing dread. My doctor would walk in looking like an astronaut with her special magnifying goggles, and my OCD would go on the loose:
What if she misses something? The nurse told me to leave my underwear on, what if something dangerous is hidden? Should I ask her about the tiny bumps on my hands after a shower? Am I crazy? If I don't ask I will be swamped with anxiety. If I do ask, I will be humiliated, and the reassurance won't last two minutes, and I'll find a new symptom. I must be a bad person to be struggling with this. She's wear magnifying lenses for godsake, how could she miss something? But how do I know she actually saw everything? Why isn't she worried about the underwear? Oh, god, I'm worrying about underwear. I'm a mess.

I felt cursed that my desire to be watched over and taken care of turned into an ever deeper pit of obsessing. As I've been seeing Leonard for ERP therapy, I have learned to have more compassion for myself and how hard it is to actually have something physically wrong related to an old obsession. I've learned that I'm not a bad person for having OCD. I've learned that I can cope with having skin cancer, and that the OCD was more painful than the surgery.

Related Post:
Skin Cancer Anxiety


  1. I understand this completely. I once had a dermatologist who left no stone unturned - between toes, legs, and where the sun don't shine. My current dermatologist isn't so ... aggressive. And I wonder exactly what you wonder, why isn't the underwear a problem? It is hard to let it go. The dermatologists will say silly things like, "Keep an eye on this for changes over the next six months, and we'll see." No. No freaking way. I'll GO MAD. If the mole is suspicious, get rid of that sucker. I'm not staring at it for the next six months and making up changes or not depending on my OCD level for the day. Still, I've also made some progress, myself. I don't self-check moles every day. I wear my sunscreen and my long sleeves then say, "Best I can do" and try to go and live a little. Too bad my OCDs make most sunscreens scary, too ...
    Blue Morpho

  2. That's cool that you aren't checking moles everyday! I think the "Best I can do" and try to live a little is the key. I want to have a life, and since OCD will never be fully satisfied(maybe if I was dead??), I am learning to tolerate the pain of acting against the OCD.

  3. I can really and truly relate to this. I had a basal cell carcinoma removed from the side of my face a few years ago and since then I have been battling a fear of skin cancer every day. Generally I can stay on top of it but at my worst, I am self checking moles and fretting about every blemish or mark. It feels exhausting at times and my biggest dread is that it is only a matter of time before I am diagnosed again with something else - perhaps even more agressive. I like the best I can do approach. It truly is all we can do.

  4. Anon--the problem I had with cognitive therapy was that it seemed to imply the bad thing wasn't going to happen, and yet something I was obsessing about actually happened. Exposure therapy helped a lot because it got to the essence of my dilemma--learning to live with the uncertainty of life, of not knowing. My heart goes out to you--the skin cancer fear stuff sucks. Reading Grayson's Freedom from OCD might be a good place for you to start.