Therapy Jealousy

I sometimes get jealous of my friends who actually talk to their therapists about things. Like they have some problem in their life and they go talk to their therapists about it. And their therapists listen and give them advice and they feel better. Or maybe their therapists just give them some things to think over that will help point them in the right direction.

My therapy sessions are nothing like this. My therapist does not know anything about my day-to-day problems. He knows nothing about my relationship or the dynamics at my job. I don't talk to him about sex. He doesn't know what I value in life and what I don't give a shit about.

The thing is, this is okay. I think my therapist is very good, in part because he is so direct and to the point. We work on a specific issue I'm having and don't dabble into anything else.

I have no problem with talk therapy--it's been shown to work just fine for a number of things. However, I don't think it would be good for me unless perhaps I had a talk therapist who could tell me when my talking starting sounding like obsessing.

Nonetheless, part of the reason I went into therapy was that I needed more support in my life. I get support in the sense that my OCD and skin-picking symptoms are lessened, but not really any emotional support outside of these limited topics. I'm kind of jealous that I don't have an impartial person to talk to about my problems. 

More than that, a few of my friends can casually mention, "my therapist said such and such" or "I'm going to talk to my therapist about that." I never say these things, not because I'm a closed person, but because there never is a good way to drop into a conversation what my therapist says or what I'm planning to talk to my therapist about. I suppose I worry that I come off as more closed than I really am.

An Over the Weekend Obsession

I had an obsession over the weekend. It was bad and it reminded me of what it feels like to be fully immersed in one: really shitty.

The situation was that something shitty happened at work Friday. I was able to let it go for the day, but when my partner got home from work, I launched into the whole story. I found myself getting angry and I couldn't let it go. I exercised and still couldn't let it go. I tried to sleep and still couldn't let it go. I eventually fell asleep, but Saturday morning I woke up early and it was there. I cried about it Saturday afternoon while trying to enjoy myself on a hike. Saturday night I told my friend about it and she recommended I take action. Sunday morning it was still there and I decided to write an email about the situation to my boss. It took me forever, I wrote it, and after some deliberation I sent it. I was anxious after sending it, but I definitely experienced significant relief. I was able to move on to other things.

The thing is, I didn't regret sending the email. I didn't see it as a pointless compulsion, like driving home to find that the door is already locked. At the same time, I know I was having an obsession. I wanted to write the email because I knew it would provide relief.

So, the question I have for myself is can I make difficult decisions without obsessing? I ultimately think it was a really good decision. But I just don't know how to come to those sorts of decisions without obsessing. Ack. I don't know how to live my life.

More on BFRBs

I just took a bath and thought about my last post.

My therapist says that perfectionism is what ties OCD and BFRBs together--a sort of perfectionism. I had never thought of my behaviors in this context. My desire to pick and pull stems from a desire to make things smooth, look better, and be more perfect. I would have said relief-seeking was what tied them together, but perhaps relief-seeking is considered to be symptomatic of perfectionism.

In any case, I was thinking about the whole ramblely paragraph in my last post regarding my unwillingness to think things that I don't believe to be true. I just realized that this is symptomatic of a sort of perfectionism: "my thoughts must be logically consistent at all times." Now what do I do with that?

I guess I want to know more about behavioral therapy at this point. Maybe perfectionism isn't something I can easily address directly. Maybe I can only address the problematic behaviors that stem from it--i.e. BFRBs and OCD.

Body-Focused Repetitive Behaviors

Therapy was hard yesterday. I suppose I was already having a hard day, but there's something particularly hard about talking about my body-focused repetitive behaviors--skin picking, hair pulling, etc. I'm just so ashamed or embarrassed I guess.

It's weird, because talking about my OCD is also embarrassing. You have to say that you're incredibly anxious about something that doesn't make sense to be anxious about. Or something that doesn't even make sense at all. But there's something worse about BFRBs. I don't know if anyone uses that acronym. I just made it up, I guess.

Last session, I said that I thought my BFRBs were weird and gross. My therapist said I needed to have more compassion for myself and stop being ashamed. He said he could think of at least ten things that people did that were weirder and grosser than my BFRBs. He said that he wished people were more ashamed of some of these things. I suppose he's right. I have exceptionally little compassion for myself, which paradoxically enough exacerbates the behaviors I'm trying to stop.

So, I guess the question is how do I cultivate compassion for myself? My therapist was particularly interested in me reevaluating idea that my BFRBs are weird and gross. He told me he thought I was smart and asked me why I think that if I knew it wasn't serving me. I didn't get an opportunity at the time, but for me thinking things is about whether or not I believe them to be true, not whether or not they serve me. It seems intellectually dishonest to change what I believe to be true based on what will serve me best. I can understand not dwelling on things that I believe to be true if it serves me not to dwell on them, but I can't understand not believing them. The thing is, I do think my BFRBs are weird and gross. I can agree that there are weirder and grosser things that people do, and I suppose that helps me cultivate at least some compassion for myself.

Emma Pillsbury on Glee

The sort of odd thing about OCD is that everyone is familiar with it, but no one seems to have any idea what it actually is. It's entered the vernacular as a description of someone who is overly meticulous and perfectionistic, which doesn't match the clinical definition at all. I think there are a lot of potential reasons for this. For one, it's relatively uncommon affecting only 2-3% of the population. That said, diabetes affects around the same percentage of the population, though, and everyone knows what it is.

I think the bigger reason is that it's never portrayed particularly clearly or accurately in the media. To be sure, this is a difficult task, because so much, if not all, of OCD, happens in the sufferer's head. A couple of common mistakes are made. The first is to confuse OCPD (obsessive-compulsive personality disorder) with OCD. Outwardly OCPD and OCD can appear similar, but the main difference is that OCPD sufferers don't realize that their behaviors are odd and don't make sense. It's much easier to portray OCPD since it isn't something the sufferer is ashamed of and tries to hide. The second mistake--or perhaps omission--is is to focus solely on overt compulsions, usually cleaning and washing compulsions. In reality, OCDers actually perform from a much wider variety of compulsions: praying, tapping, checking, hoarding, counting, as well as a host of mental compulsions.

I've been watching Emma Pillsbury on Glee with some interest for a while. She has OCD, which has for the most part been disappointing. She obsessively cleans to get rid of germs and doesn't seem to understand it's weird until late in second season. In second season she goes to a psychiatrist who tells her if she takes a low dose of an SSRI her symptoms will get better. Two weeks later, she tells Will that she's better and that her SSRI worked. At this point, I was pretty disappointed. First of all, it wasn't really clear she had OCD in the first place. Second of all SSRIs are not magic, particularly not at low doses when treating OCD.

The most recent episode, "Asian F," however was a little bit more accurate. Emma experiences a relapse after a stressful dinner with her parents. Also, Emma tells Will that one of her compulsions is praying in her head all the time and when that doesn't work, she prays out loud. Indeed, stress triggers OCD and mental compulsions, including praying, are a very real and common symptom of OCD. The only disappointing bit was Will offered to pray with Emma. I suppose this makes sense, but hopefully at least of of their characters will figure out that performing compulsions (or assisting in the performance of compulsions) only makes OCD worse.

Therapy Yesterday

I shared with my therapist the thought that I was having that my anxiety levels were meaningful and indicative that something in my life wasn't working. He seemed to think this was an OCD situation and then I felt embarrassed. I think I even started to blush. God.

I don't know what to think now. I think that my anxiety is meaningful, but I'm starting to doubt my doubts that my life isn't working. I don't think my obsessions point me towards what isn't working, but I think there existence is an indication of something. And I think I know what that something is: work is a bit of a mess right now for various reasons and I don't handle work stress well.  

Then we ran out of OCD things to talk about, so we talked about skin picking. Ug. I know I brought it up two weeks ago and I know I want to stop doing it, but it's probably the most embarrassing thing to talk about in any detail. It doesn't feel so bad to say I skin pick, but if you actually want me to get into the details of it, I will get embarrassed and have trouble telling my therapist all the details. I don't even know that my partner knows all the details. I mean, he knows that I do it, finds it gross, and for God knows what reason accepts me despite this, but I don't know if he understands the urges and perverted and bizarre thought processes that lead me to do it.

From what I've read about skin picking, like OCD, it comes down to sitting with discomfort. With OCD, that discomfort tends to be anxiety (but it can be guilt or other unpleasant emotions). With skin picking, the discomfort comes from an urge unsatisfied. It's sort of depressing for me to feel that all my issues stem from an unwillingness or inability to sit with discomfort. So, I obsess more, perform compulsions, and skin pick. It makes me feel like a bit of a wimp. I wonder, am I a wimp? Or do other people not experience discomfort at the same levels I do? I suppose I can never really know the answers to these questions.

Stress and OCD

I think OCD is my perverted way of dealing with stress and burnout. It's sort of irritating that this is how I deal with these things. It'd be much better if my mind said, "Hey! I think you're getting a bit stressed. Maybe you need to address the stress in your life, do less, and take better care of yourself." Instead, my mind says bizarre perverted things like, "you must ruminate NOW on the nature of death and time" or, more mundanely, "maybe you left the stove on."

The thing is, I think my mind does tell me I'm stressed and on the path to burnout but I don't listen. So, I just keep on going. Eventually, my mind makes me listen by either causing a stress related injury or OCD. Both of these things make me slow down, but have the unfortunate side effect of fucking up my life making me wish I had listened and slowed down sooner.

I had a long conversation with a kind-of coworker today. He told me about how a number of my predecessors had epically and suddenly burned out. I knew that two of my predecessors had, but there apparently were a few before that that did too. I had an odd emotional reaction to this. On the one hand, it felt relieving to know that my bizarre and perverted obsessive-compulsive reaction to work stress wasn't unusual or unexpected. Not that my predecessors were OCD, but one of them apparently was a big drinker who was stealing alcohol from work. It apparently was a bit of a mystery where the red wine was going. We all express our issues in uniquely self-destructive ways, I suppose.

On the other hand, I had already been wondering about whether or how to continue at my job. My predecessors, I suppose, uncomfortably reminded me that I need to continue exploring this issue.  A number of books I have on anxiety say that a lot of anxiety disorders don't go into remission until you are doing something that makes you feel passionate and excited. It's clear to me that my job causes me undue stress and that a change is needed. I don't know whether all I need an attitude change. Given my predecessors, is such a change possible? Or do I need to do something more drastic... like quit?