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One among many OCD topics - perfectionism


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Hi,

I (50) haven't been in this forum for almost 6 years. As mentioned in the title I have got several topics with respect to OCD. However, I have been doing rather ok over the years applying Acceptance Commitment Therapy exercises and taking Sertraline (currently upped to 150mg). The topic I'd like to get your opinions about is my quirky perfectionism OCD:
Personal "things" that are very meaningful/important to me have to be almost perfect or if I discover imperfections my thoughts revolving around questions if and how to fix these and why it is like it is and I have to check them oftentimes. And when I actually fix an issue on such a "thing" I can only stop when it feels right, which is very time consuming. Afterwards I ruminate over the fix resulting being unsatisfied. Sometimes I try to improve the fix. This all creates or amplifies a negative attitude towards such "things" and as a consequence I'm not really able to enjoy them. As a consequence this undermines my joy of life and depresses me.

BTW: Things that don't mean much to me couldn't care me less. I'm not really orderly - my wife regularly complains about this. Normally, my job doesn't bother me, too. So I'm not a perfectionist in every aspect of my life.

Regards

Oliver

 

 

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3 hours ago, KaKop said:

I have been doing rather ok over the years applying Acceptance Commitment Therapy exercises

Interesting--I've never heard of that...is it similar to CBT? I guess I can google that later.

What sort of successes have you been having with regards to other topics of OCD?

For the perfectionism one it sounds like you would apply the same methods as for anything else, but because I'm not familiar with the therapy you've done, I wonder if cbt is a different approach?

3 hours ago, KaKop said:

And when I actually fix an issue on such a "thing" I can only stop when it feels right, which is very time consuming. Afterwards I ruminate over the fix resulting being unsatisfied. Sometimes I try to improve the fix. This all creates or amplifies a negative attitude towards such "things" and as a consequence I'm not really able to enjoy them. As a consequence this undermines my joy of life and depresses me.

This sounds like just the typical ocd cycle where normally one would aim just to put an end to the compulsion of "fixing"  and ruminating about it...don't do any fixing at all...

 

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3 hours ago, KaKop said:

Personal "things" that are very meaningful/important to me have to be almost perfect or if I discover imperfections my thoughts revolving around questions if and how to fix these and why it is like it is and I have to check them oftentimes. And when I actually fix an issue on such a "thing" I can only stop when it feels right, which is very time consuming. Afterwards I ruminate over the fix resulting being unsatisfied. Sometimes I try to improve the fix. This all creates or amplifies a negative attitude towards such "things" and as a consequence I'm not really able to enjoy them. As a consequence this undermines my joy of life and depresses me.

Hi Oliver.

OCD works in similar fashion whatever the subject matter of the obsession, which can be literally anything - not always mainstream things.As it happens perfectionism in some form is not uncommon.

It looks like the OCD core belief underlying your problem here is " if it's important to me it has to be perfect".

We have to challenge these core beliefs. So I am going to say, why does it have to be perfect? Because something less than perfection works perfectly well for everyone else. Why is that? Because the extra time spent between creating something that is good enough, and something that borders upon perfect is wasted. E.g.clients/customers/friends don't have to have perfect propositions - they want one which is viable and meets their brief.

E.g. Our bedroom doesn't have to be perfectly clean and tidy. The cooker need not always be spotless to cook dinner. This post I am making does not have to be grammatically and spelling-wise perfect for me to be happy with it.It will do with my best first-time effort, with an edir for anything glaringly wrong. 

It's quite usual for there to be an alleged  consequence if we don't meet the certainty O C D demands in line with its core belief. So, what is the consequence of non-perfection for you? You need to establish that, then challenge its reality against the standards of others.

In ERP you are going to need to deliberately produce things that aren't "perfect" and sit out the resultant anxiety, telling yourself the consequence is not rational, not as others operate. 

And resist carrying out compulsions to put it right, or worry about it in rumination.

When you feel the urge to carry out compulsions, deliberately shift focus away to something else, and keep doing this. 

The therapy will be tough and you will have failures and successes. But as your successes approach then cross the gain line between failure and success, gradually the urge to perfection, and to carry out compulsions, will ease away.

  

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My last therapy was 6 years ago. It was ACT based but didn't comprise ERP. I practice meditation almost every day to train mindfulness in order to realize as soon as possible when OCD thoughts appear. The longer they are present and I'm not aware of them the more it gets possible that ruminating continues for hours and compulsions (mental or physical checking) occur.

I identified the missing ERP as the crucial part and my intention last fall was to develop my own ERP program. I was very reluctant to tackle this out of fear of worsening my mood. But after reading "Everyday Mindfulness for OCD", which also emphasizes ERP (beside Mindfulness) I started my first tentative ERP trials according to this book. You may be asking why not with a therapist? Well, it is not easy to find a suitable one here in Germany and you have to be patient until you will be able to start because of their waiting list - mostly several months.

The ultimate ERP treatment I devised for myself looks as follows:

I take pictures of those things that have caused OCD thoughts and compulsions (and there are at least 50 around at home - my major OCD battle field) and compile a slide show that I then watch in my ERP session. Actually, I thought about playing a curious boulevard journalist who investigates a person's OCD triggers when tacking the picture with the goal to identify as many as possible for his new headline and to become a Purlitzer Price nominee :) - not to get caught in OCD thoughts during this activity, which I really fear and which prevented me from doing it.

After the ERP session I perform sports trying to concentrate on the exercises.

As far as I have read it is normal to feel uncomfortable/anxious or an impulse to do compulsions during ERP. To those of you with ERP experience, did your OCD and/or depressive mood increase in the beginning phase of ERP? As mentioned in my initial posting I increased my Sertraline. This was because I felt more depressed and ruminating more, which I attributed at least partially to my initial ERP experiments.

 

Oliver

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It's normal to feel worse at the beginning of ERP because you are challenging OCD's worst fears upon you, and suggesting they are NOT true - when your brain is still trying to tell you they are. 

MIndfulness I have also found to be great in steering us away from that part of the brain where we obsess and compulse (the active "doing" part, so said my therapist), and refocusing into the benign "just being" part, where we simply focus our mind into the present in the moment. Teaming it with CBT as you are doing is good. Do spot which pattern the obsessions fall into - falsehood/lies, exaggeration of nil or minimum risk, or revulsion - and bring that to mind for each obsession's ERP sessions.Maybe also group them into similar types of theme. 

As you do this, and work the exposure in short repeating sessions, you should find the anxiety reducing then fading away . 

To get the best out of what you are doing maybe try working on several only at time - and until you feel the anxieties going then gone on each, before moving on to another/others; a blanket ERP exercise is doubtful  to be effective.

All the best

Roy

N.b. I worked in Bremen for 3 months after finishing my business studies course at college back in 1970. MIght have stayed on if I hadn't got really homesick, as I actually liked the way of life in Germany and the language wasn't a problem as I had studied it through A-level and into the business studies course. And the Werder Bremen Bundesliga team was pretty good then, and I was working with the father of the right back :football:

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Roy,

thanks for your opinion. The idea of grouping is interesting and I’m thinking about modifying my idea of using one slide show to one per group. As mentioned there are so many things at home that can cause OCD thoughts and compulsions that using one or two of them per ERP session would take a very long time to be done with all of them. 

 

Regards

Oliver

 

 

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