0CD Perfectionism

What’s so wrong with striving to do your very best? Without high expectations, what would motivate you to accomplish your goals and aspirations?

There is nothing wrong with working hard and and setting certain standards for yourself. However, if you live with anxiety because you are terrified you may make a mistake or a wrong decision, you may be suffering from OCD perfectionism.

OCD perfectionism should not be confused with obsessive-compulsive personality disorder, or OCPD. The latter is not an anxiety disorder; it is a personality trait which initiates behaviors that demand rigidity and inflexibility. Conversely, OCD perfectionism is a symptom of an anxiety disorder, and may include a constellation of behaviors and symptoms.

The individual with this diagnosis is often in extreme distress due to their unrealistic expectations, which leads to procrastination, indecisiveness, self-reproach, anxiety and depression. OCD perfectionism has far-reaching effects, and contributes to skin-picking (dermatillamania), eating disorders, social anxiety disorder, dirt contamination, phobias, and body dysmorphic disorder, just to name a few.

When an individual suffers from OCD perfectionism, nearly every action is viewed from the perspective that there is a right way and a wrong way: there is no gray area. This simplistic view can cause a person to procrastinate endlessly for fear of making a wrong decision. Relationships, jobs, or anything that requires some small degree of risk-taking can therefore be crippling.

It can afflict an individual with regard to their own need to be perfect; and it may also affect their need for others to comply with their perfectionistic standards. They can be so controlling and demanding that their relationships buckle under the stress, and the resultant rifts are sometimes irreparable. Imagine living with someone who insists you do everything in a particular way or he or she becomes angry and critical. The OCD perfectionist often does not have the insight to recognize just how controlling their behavior can be — and how precarious their careers, academic life and relationships are becoming as a result.

The treatment for OCD perfectionism is to teach the individual how to tolerate the discomfort of relinquishing the need to be perfect. For example, I have encouraged clients to leave home with their socks mismatched, without makeup, and dressed in clothing that is not coordinated well. I may suggest that they limit their time at any particular store while shopping, especially if they have had a pattern of spending excessive amounts of time struggling with choices about their purchases.

OCD perfectionism is pervasive, and usually worsens over time unless it is treated. The prognosis, like most anxiety disorders, is excellent with the proper treatment.

Overcoming Health Anxiety: (formally called Hypochondriais)

For Most people, a recently-appeared skin blemish or a headache is nothing to be alarmed about. But if you suffer from health anxiety, formally known as “hypochondriasis,” symptoms such as these could easily be interpreted as a life-threatening disease. You may visit your doctor excessively, or avoid going to the doctor altogether for fear that you will be diagnosed with something terrible. If you do see your physician, and he or she runs some tests, you are likely to assume the worst — and the waiting period can be agonizing.

Health anxiety can be a central feature of many different diagnoses, including depression, somatoform disorder, adjustment disorder and others. It can also be a central feature of certain anxiety disorders, such as generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), and panic disorder. Individuals suffering from GAD are most likely fear malignancies, while individuals with OCD most commonly worry about infectious diseases. Panic disorder sufferers often worry that they are going to have a heart attack, and/or fear a catastrophic reaction to a medication resulting in “medication phobia.”

Health anxiety is influenced by a number of other factors as well, such as the media reporting — in an often sensationalized manner — the risk factors for various diseases.  In such reportage, the risk factor of “stress” is invariably over-emphasized, which can create an even worse scenario: stressing about the effects of stress on your body! Television dramas such as Grey’s Anatomy or House depict individuals with mysterious (and often fatal) diagnoses. The Internet, of course, is rife with information that is frequently unreliable, and suggestible individuals can spend hours researching just one symptom. These cyberchondriacas are on a desperate search for some reassurance, but more often than not find their anxiety is only exacerbated by the ambiguity of their symptoms.

Two other contributing factors  are age and life events. Generally speaking, the older you are, the more vulnerable you feel to developing illness. You may have friends or relatives around your age that have succumbed to a major illness, or died. Health anxiety is, at its very core, a fear of dying. The reality that you cannot control what is imminent forces you to confront your own mortality. And the older you get, the worse your health anxiety will be.

There is effective treatment for health anxiety. However, the treatment of choice for all anxiety involves confronting your fears. Avoiding thinking about it, or trying to stop the thoughts, is not effective. It may help temporarily, but eventually your anxiety will return, because you can’t help but be aware that sickness and death are fundamentally inevitable at some point. In my practice of specializing in anxiety and chronic illness, I have observed that those clients who already have a serious illness usually do not fear falling ill; they’ve already adapted to it and, for the most part, have developed strategies to live within its limitations. Those clients who have had the fortune of being healthy are more likely to fear being diagnosed with a disease. They have not had the opportunity to learn that there are choices and resources available with many illnesses. It is no surprise, then, that the treatment of choice for health anxiety is a combination of cognitive therapy and imaginal exposure therapy. As threatening as these therapies may sound, they are time-limited, and initiate recovery.