Relationship OCD Fear of Choosing the Wrong Person or Gender

My 21st anniversary of being with my husband is coming up. I remember our 3rd anniversary, as we sat on the floor of my dorm room, and I struggled to tell him my fears. I had just gone to a presentation by a "feminists against pornography" group, with a slide show of violent images found in magazines, and the images were stuck in my head. I felt a claustrophobic dread that I would always be trapped by these images, a barrier between me and living my life with any peace or joy.

I had been reading a book on women's friendships, and combined with the scary things I had just seen, my OCD went into overdrive trying to figure out if it was safe to be in a relationship with a man, whether I was making a mistake, showing extremely poor judgement. As my anniversary approached, the obsessing intensified, and permeated all my thoughts and feelings. Was I putting myself in danger? Was I stupid? Was I wrong? Would this man betray me or hurt me?

It's hard enough to have these questions as a 20 year old, in any context, but in the context of OCD, I felt crazy. My first date with this man was to hear a feminist folksinger. I had never met anyone who listened to me like this man did, and took my thoughts seriously. He was compassionate. But my OCD wanted absolute certainty that he wouldn't become a monster. My best guess would've been that no, this was unlikely, but the OCD whittled away at this knowledge, kept demanding I figure things out.

Maybe you should be with a woman? That would be safer. If you stay with this man, you are betraying your gender. Are you sure you feel something for him? Keep checking on this. Any sensations? You are so tense when he touches you, obviously this is a sign that you need to be with a woman. So many horrible things have been done to women by men. You'll become part of that. You will be in collusion and contaminated. What if you stay with him, but you are actually a lesbian and you will lose any chance of happiness?

So, there I sat on the floor, on my anniversary barely able to speak, crying, and my love thought I was breaking up with him. This was the essence of OCD--I didn't want to break up with him. I just wanted the anxiety and intrusive thoughts and endless exhausting dialogues in my head to go away, and to know for sure I wasn't making a mistake.

There's a lot this 20 year old didn't know. She didn't know she had OCD. She knew she was anxious, but assumed that was a sign of her own defectiveness. She didn't know that OCD attacks what we hold dearest, what cuts right to the core of our identity and self. She didn't know that if you constantly check to see if you are feeling anything, you will mostly feel anxiety and fear. She didn't know that some things are incomprehensible, like the violent acts done to some women by some men.

I'm glad that somehow I made the decision to stay with the man who is now my husband. That took a lot of courage, since it meant trusting my own judgment and living with the whole host of anxiety-provoking questions, with no support for dealing with my OCD.

15 Minutes at a Time The FlyLady and Exposure Therapy for OCD

In January, faced with increased difficulty finding things in my house, and general chaos, I remembered reading about the FlyLady, and went to her site. Just going there was an exposure for me, since my perfectionism starting raring up, but what I like about the FlyLady is an explicit acknowledgment of how much of the home clutter chaos stems from this very perfectionism. The fear that you have to do it "right" and all at once, and rip apart every closet and scrub every surface.

She advocates doing 15 minutes at a time, and then stopping. That's the hardest part for me. My perfectionism OCD gets entangled in this, and once I start a task, I feel anxiety at the thought of stopping before the task is done, even if there's no clear ending point, and so I keep going until I exhaust myself and it seems preferable to avoid cleaning at all. For someone with contamination OCD the feared consequence may be that nothing is clean enough after only 15 minutes.

The FlyLady is practicing a form of Exposure Therapy. She dares her readers to do housework imperfectly, incompletely, incorrectly. The irony of OCD is that it's all about the anxiety not about reality. Avoiding cleaning altogether is not more "perfect" than doing 15 minutes at a time. A refrain on the FlyLady forums is "I've got so much to clean up that 15 minutes isn't enough time." This kind of thinking is part of why I didn't start actually doing exposures right away when I finally found an Exposure Therapist.

I saw the enormity of my compulsions and anxiety, and I wanted to be better immediately because I was in pain, but also because my perfectionist OCD made it seem dangerous to have a learning curve, to proceed slowly, by trial and error, imperfectly, haltingly, erratically. I needed to do things instantly, the first time, or my feared consequence was that I was a worthless failure. Again, the reality is that avoiding learning or taking small steps serves to give a relief from the anxiety of facing the fear, and yet paradoxically, set me even further behind in getting better from my OCD.

What I have learned in therapy is that anything above zero is good. 30 seconds of resisting compulsions is good. 1 minute. 5 minutes. 15 minutes. It's all good. Exposing myself to something I fear, even if it is the least of my fears, is good. Perfectionism says that you either get better all at once, or you don't get better. This doesn't give me my life back. It keeps me trapped in my compulsions. In 15 minute increments I have cleared through the chaos of my house. The FlyLady motto is that you can do anything for 15 minutes, but for 2011 she's challenging us with a new motto: Let's Go for Seven in 2011

Seven minutes on the timer, because 15 minutes can still be too daunting. The FlyLady says that housework done incorrectly still blesses your family, and in the case of debilitating rituals, this is a powerful statement.

Finding a Good Therapist for OCD In US and Canada

The International OCD Foundation(IOCDF)has an an OCD Treatment Provider List for the United States and Canada. There is a dearth of qualified Exposure and Response Prevention(ERP)/Cognitive Behavioral therapists, and it can be frustrating to find effective therapy, but this is the place to start.

What to look for:

• Behavior Therapy Training Institute(BTTI) faculty
  
• Graduates of BTTI
• If they are a graduate of BTTI and have a website, check to see if they mention ERP at all. Some take the training, but their sites show no trace of it.
  
• Specific mention of ERP in their listing
  
• Cognitive Behavorial Therapy(CBT) in combination with ERP
  

Keep in mind that this list is made up of therapists who requested to be on it, and there is a disclaimer that the IOCDF does not screen or research any of the therapists, but I do think it increases your odds of finding someone who is well versed in current treatment.

Related Link:
Tips on Finding a Therapist from Austin OCD Center
Finding a CBT Therapist

How do I know when Im done OCD and the Desire for Complete Assurance

OCD affects aspects of human experience that most people don't think about, or only fleetingly. It's not that OCD is totally alien, but it is more severe than what people without OCD experience. I have OCD but don't usually check switches and such. But when leaving on vacation, a few years ago, I was halfway out of town and couldn't remember if I locked the door, and went back to check. Everyone has had a day where they aren't sure, and go back to check. Sometimes special circumstances like vacation will make you more aware of the consequences of an unlocked door.

Usually someone without the compulsion to check doesn't need to remember if they locked something or turned off a switch or a knob, because they do it, and move on without even thinking about it. It feels "done" but it's barely conscious, and they flow into the next actions of their day. OCD can disrupt every aspect of the flow of life. Someone with OCD can turn off the light switch, and stand there in the dark and still not be absolutely certain they turned it off, because they get a surge of anxiety that is gut wrenching, and a host of possible feared consequences, ie. "If I don't turn this off, a circuit could short and burn the house down. So I'd better keep checking."

The other day I watched my husband search for a muffin recipe online. He looked at a couple, one fit his ingredient list, and he hit print. He knew he was done. I could even say he "felt" done, but it's so a part of him that he doesn't really feel it as much as keep moving in the momentum of what he wants to get done. Part of my OCD is not feeling finished, not feeling I've fulfilled my goal, and I'm well into page 10 or more on Google when looking for a recipe. It's like I don't have an "off switch," and I am very likely to feel anxious if I don't feel "just right" or "done" and ironically, my OCD pretty much guarantees I won't get that feeling, no matter how much compulsive searching for the perfect thing.

Even when I find something that fits my criteria, I don't believe it, because I want to be certain that it's the right thing, and I'll feel anxious if I take the chance of printing something from page one. OCD isn't about logic. This can frustrate both the person with OCD and their friends and family. There is a tendency to assume if you explain the illogic, that this will solve the problem. "You are standing in the dark. Of course the light switch is off." "You've checked 5 review sites, and they all recommend the same product--why do you have to keep looking?"

I've always been fascinated by phenomenology--the attempt to understand what someone's experience is from the inside, the lived sensations of consciousness. OCD is that moment of wondering if you locked the door, and thinking you probably did, but having dire visions of thieves in your house while on vacation. You feel anxious. You don't want to ruin your vacation worrying about this. You drive back to check the door. But OCD will keep generating those moments of stabbing fear, even after you've checked. Did I really check? How can I be sure? There's no stopping point.

Cognitive Behavioral Therapy can get hung up at this point if the instruction is to guess the probability of something bad happening, and how much of it would be your responsibility--it could be .00001% and the OCD is still going to be clamoring about no risk being acceptable. For me Exposure Therapy has involved choosing something off the first page of Google, even if I break into a cold sweat, to help retrain my brain recognize that I'm done and can move on. I spent years waiting for fanfare and illuminated signs that a decision was right so I wouldn't have to feel anxious, but I am learning that most decisions don't get that kind of certainty, and that I can actually live well in spite of this.

OCD Toolbox Listening to Scripts Imaginal Exposure

My husband had this habit, when records were still current, to play one side over and over, the arm continually lifting up and going back to the beginning. This drove me crazy, but it's the same principle that helped me to deal with my indecision. Jon Grayson discusses this in his book, and once I started writing and recording and listening to scripts as both exposures and support for doing exposures, I was able to give the healthy part of myself more airtime. OCD usually has a monopoly on all channels, and has worn deep paths into my brain, but scripts gave me some alternatives.

Traditionally, tapes were made on the itty bitty cassettes in answering machines that can loop over and over. I used QuickVoice recording software, which is very inexpensive, and fairly straightforward to use, which enabled me to record my scripts sitting at my computer with no additional microphone or device needed.

I then listened to the script continuously on my iPod Nano. I have about 50 scripts that I wrote and recorded. In the case of decision making, when I went grocery shopping, I would listen to a script I wrote about it never being possible to make a "perfect" decision and that OCD will change the criteria of "perfect" the minute I start to reach for an item, and that my life was waiting.

The key was finding what gave me the most unease about an OCD fear, and directly addressing that in the script, putting it out there, rather than running from it. Yeah, I might choose the "wrong" item and feel my face go hot, and a panicky ache in my chest. I might really screw up, and be haunted by regret about my poor decisions and never have any peace from the obsessing about obsessing.

For about a year, I took the shopping script with me almost everywhere I bought things, and listening to it continuously, logging many hours, and gradually, in combination with flipping a coin when I really felt stuck, I freed up a lot of time in my life instead of circling the aisles of the grocery store, looking at every item, reading every label, picking stuff up and putting it down, over and over.

Related Posts:
OCD Toolbox: Flipping a Coin