Saturday, June 19, 2010

Nesting Dolls: OCD All the Way Down

Nested secrets
I am not a novice at Exposure Therapy, and expect that I *should* be able to know when something is OCD, and that I must be defective if I don't get it right. The metaphor that helps me sense what's going on more clearly is one of nesting baskets or dolls--the initial obsession is nested inside wanting to figure out if it really is an obsession, nested inside criticizing myself for being stupid, nested inside criticizing myself for criticizing myself, nested inside labeling myself a bad person because I am so critical and slow and imperfect. I practice identifying the nesting pattern to get some distance from it, and to recognize that every doll is part of the "big doll" of OCD.

I am working on accepting that sometimes I won't know if something is an obsession until after I ritualize--that I'm not perfect, that I am not omniscient, and that if I practice tolerating the anxiety I feel when I don't attempt to "undo" this lack of perfection with relentless questioning of my actions and retracing my thoughts, I will get better. The more I try to figure out why I am stuck in a loop and still doing rituals the worse my OCD gets.

I remember my therapist telling me that learning is by "trial and error" and I looked at him in disbelief. I assumed I had to do everything perfectly the first time. I know this sounds irrational, but as much as I might intellectually understand that humans have a learning curve, I feel panic during the process of learning. It's been 3 years since I started ERP, and my ability to tolerate making mistakes and doing things imperfectly has increased dramatically. I had a strong belief since I was little that if I was perfect then my parents would love me and approve of me--the concrete thinking of a child. This belief intertwined with my OCD, and so if I did something I viewed as imperfect, then I would compulsively try to analyze it, undo it,research it or avoid doing anything at all so I wouldn't make a mistake to begin with.

ERP went really slowly until my therapist and I figured out I was trying to do my exposures perfectly, and that my belief was that if I failed that meant I was a worthless human being. I would do the first thing on my hierarchy of exposures, and immediately have the thought that it was inconsequential, inadequate, nested inside the thought of "I should've done this years ago," nested inside of "I'm a failure for moving so slow," nested inside "And this is yet more proof I am a defective human being." Then I would avoid doing any more exposures. It's hard to get motivated to do exposures if I feel both anxious, and in danger of proving I am a bad person. . .I'm learning to take the risk of doing things "wrong" on purpose--that it doesn't determine my worth, and that the ocd is promising something it can't deliver--perfection.


  1. Again, I can relate. I always thought my perfectionist approach to life in general was just the way I liked to do things. Back when I was applying to college, when they inevitably asked "what's are your best and worst qualities?,” I often gave the same answer for both: perfectionism. That trait, I thought, was what allowed me to succeed. It was what made me who I was. At the same time, it often posed a problem. There was the inability to prioritize - everything required the same level of effort no matter its importance, which made me dread doing various mundane tasks more than the average person, I suspect. Then there was the tendency to be slow and late when I couldn't complete something “correctly” fast enough. No one seemed to realize that telling me "to work faster" or "set a time limit" was of little help. I first needed to change the way I approached the tasks (and how I believed my performance on those tasks determined who I was as person) before I could work faster or adhere to time limits. But I couldn't see this at the time, and I guess others didn't either.

    I knew that when I was a kid, I had had episodes that were probably that "OCD thing" but assumed that I had grown out it as the themes of my obsessions changed and faded with time. Little did I know that the element of perfectionism that I had, ironically, been perfecting for years after that was probably just another version of the OCD.

    It wasn't until this past year that I was finally diagnosed with OCD. With that diagnosis, and the epic amounts of reading about OCD that have followed, (as much as I could manage within the bounds of my reading compulsions...another problem I had always had, but didn't know had a name), I suddenly feel like I can look back at a lot of things and explain many of my strange behaviors. There were many that flew under the radar, even mine, especially in the realm of mental compulsions. It’s strange having this new perspective. There are a lot of things I want to work on, but I have to be patient as I first conquer the things that get in my way the most.

    Anyways, discovering I have OCD has been a joy! That probably sounds strange, but realizing why I struggled so much with some things, and learning that there is a way to minimize the effect those struggles have on my life, is such a liberating idea! However, along with that joy comes the fear that perhaps I am exaggerating the extent to which OCD affects me now or did in the past. I fear that I am being overly dramatic, a whiner who complains about normal life requirements. I fear that all those things that I now see as OCD are not OCD at all, but normal challenges we all face on a daily. Perhaps I actually do have to perform this or that perfectly. Perhaps what I have come to expect of myself is nothing out of the ordinary, and my desire to not have to do things "just so" means that I am lazy, defective, or somehow incapable of living up to normal standards.

    And then there is the fear that, if I can eliminate most of my OCD, I will unravel. The concept of who I am seems so intertwined with elements of OCD that I don't know what is what sometimes. Am I a kind, hard-working, ambitious? Or is it merely the OCD that drives me to try to be these things? Has OCD made me who I am?

    I have to remind myself that these fears, too, may be another layer to the OCD. Or maybe not. But as long as I try to reassure myself that what I fear isn't true, the deeper I dig myself into anxiety. I have to remember that, as my therapist has told me, there are very few things in life that I actually "have to" do or a way in which things "must" be done. OCD or not, I can change my old ways, but may have to face the discomfort of wondering what kind of person that makes me.

    Sorry to leave such a long comment! I guess this is probably a sign that I should start my own blog so that I don't flood others’ pages with my very long comments. Sorry!!!

    - Fellow OCD Sufferer

  2. And of course, I am horrified as I read back over my comment and see all the errors that popped up after I pared my comment down to size and failed to read over it again!

    - Fellow Sufferer

  3. Interesting post, thanks.
    Just this morning I was kicking myself for not hugging my dad at our Father's Day breakfast. Despite really upping my exposures lately, I get mad at myself when I don't do more, or slip up on some of them.

  4. Great metaphor! I can definitely relate to that, and the perfectionism. I realized that holding myself to an unreasonably high standard just feeds the OCD. OCD is about an irrational need for certainty, among other things. Give yourself permission to be imperfect. You know, like all the rest of us humans ;)

  5. Fellow Sufferer--Your comment was incredibly resonant with my experience. Thank you for commenting. I would love it if you started your own blog, because I'm sure I would learn a lot from it! One of my biggest fears was that if I got better from ocd, I'd discover that *then* I'd really need to be perfect--I'd have no excuse not to be. . .There is grief in realizing that perfection has been an illusion of protection, but also the beginning of liberation.

  6. You summed it up beautifully! Right now a lot of my most obvious compulsions center around contamination issues...except, until very recently, my apartment has been a mess! People who know about my OCD who discover this about my apartment are always could I live in a dirty apartment if I'm so worried about cleanliness? They don't see that the desire for cleanliness and the need to clean "perfectly" and in the "right" way are really the reason my apartment is so dirty in the first place. I hate having a dirty apartment. But sometimes the idea of doing a cleaning task, and having to do it "correctly" scares me more than just living with the dirtiness. For me that imperfection, that failure to maintain cleanliness, is long as I feel too paralyzed by the OCD to even think of attempting cleaning. As long as I have this disorder as a defense, as well as my resulting inability to do any form of cleaning in an efficient manner, my failure in the form of a dirty apartment is okay. But if I get seems like there will be no such leeway for failure.

  7. I hear you on the needing to do something "perfectly" so not doing it at all! That OCD paralysis is a bizarre thing--you end up with the very thing you were trying to avoid. I was afraid of being incompetent at work and would avoid many tasks, which ultimately eroded my competence. . .and yes, the fear that if I got better, I really would have to be perfectly competent at work. . .

  8. An interesting note on perfectionism that I find lovely is the Native American concept of keeping a mistake in weavings and beadwork to acknowledge human imperfection. It is called a humility stitch. I love that we are not supposed to be perfect or do things perfectly. Just supposed to be human.

    I am a long time sufferer of OCD, now living 99% free thanks to meds and exposure therapy and a lot of willingness to suffer for the sake of getting better.

    All the best,

  9. Julia--thank you for telling me about the humility stitch. I remember reading something about "hozho" in Navajo weaving--the beauty of imperfections, of subtle variations not made by machine but by human hands, and found it very comforting. Your beadwork is absolutely beautiful!