Sunday, August 8, 2010

Seeing the OCD as the Problem

There is a blog about eating disorders that I like to read which I have referred to here before.  I like reading this blog because a) I can relate in the sense that, for a brief stint in my life, I suffered from an eating disorder in addition to OCD, and because b) the author has a wonderful writing style an ability to capture her thoughts and feelings in a way that draws many parallels with my OCD way of thinking.

I was reading some of her past posts today and found one titled "Seeing the ED as the Problem."  In this post she discusses how she had to fight to identify the ED, the eating disorder, as the issue, and not the various things that got in the way of her desire to exercise and restrict.  Her behavior and attitude towards the eating disorder were described as being "ego-syntonic" or basically in line with her self-image.  It wasn't something she shuddered at and wanted banished from her life completely (in which case the ED would have been ego-dystonic), rather, she believed that her weight really was the problem and welcomed the opportunity to exercise and limit what she ate to remedy the perceived problem.

And this is where I get confused...oh so confused.  I have often read that OCD and eating disorders differ in that OCD is, by definition, ego-dystonic, and eating disorders are generally ego-syntonic.  If you were to ask someone with OCD if they would like to banish the thoughts and horrible feelings they cause, they are supposed say, "YES!  Take this terrible disorder away from me!"  Even the author of this blog, who also has experience with OCD, said that, when she was a teen and was suffering from both OCD and the eating disorder, she would have gladly gotten rid of the OCD stuff but wasn't really hoping that someone could magically free her from her ED-related thoughts and her desire to engage in ED behavior.

So then, people often draw a line between EDs and OCD because, technically, one is supposed to be ego-syntonic and the other, ego-dystonic.  But in my mind, and in thinking about my experience with both disorders, the lines aren't nearly so clear.  I really feel like my ED was just an extension of my OC thinking - it was just directed at my body image and weight instead of other common OCD targets.

I am not really educated in psychology.  I haven't studied these things and maybe I am interpreting them incorrectly.   And I am still sorting out my own OCD thinking and even a little bit of ED thinking, as well, so perhaps I am not really in a position to clearly see and judge these things because I am still in the midst of them.  But right now, the boundary between OCD and EDs seems somewhat artificial.  And just like the author of the ED blog sometimes struggles to see the ED as the problem, I still struggle with seeing my OCD as the problem.

No, this is not completely and 100% true in all circumstances.  I do recognize that my behaviors are probably exaggerated relative to the degree of risk they are designed to eliminate. But I still cling to such behaviors with tenacity, because, on some level, I still believe they are necessary.  To a certain extent, I still believe that the behaviors aren't the problem; instead, it's my inability to always do things the "right way" that I see as being problematic.

Perhaps the difference is the level of "insight."  I mean, isn't that, to some degree, what makes the difference between ego-syntonic and ego-dystonic behaviors?  If both are generally seen as being destructive to living a healthy and fulfilling life, isn't the ability to recognize that such behaviors are in fact destructive, what makes something ego-dystonic instead of ego-syntonic?  Doesn't the individual with an ego-syntonic view of his behavior cling to his way of doing things even if they are maladaptive and interfere with living a fulfilling life, while the individual with an ego-dystonic view of his symptoms wishes that he could stop the behaviors but can't figure out how to without experiencing crippling anxiety?

The reason I get way too wrapped up in all this and go around and around in circles in my head with this question is that I often struggle to see OCD as the actual problem.  I, in a very sick and twisted way, feel like I want my OCD.  Instead of seeing my OCD strategies for fighting anxiety as the issue, I see my inability to do things "correctly" as the real problem at hand.  So for example, instead of seeing my rigid and exacting rules for cleaning as the problem, I see my reluctance to engage in cleaning when there are such rigorous demands and my resulting to failure to keep things clean as further proof that I am inherently "defective" and thus, need to force myself to adhere to such rigorous cleaning guidelines.  OCD, as I sometimes see it, is really the thing that protects me from becoming a slob, a heathen living in filth, when, in reality, OCD makes it harder for me to do any sort of cleaning in the first place because of the all-or-nothing demands it thrives on.  How is this different from seeing my ED as something that I had to endure, the thing that protected me from swelling up into an immensely overweight individual, rather than the thing that constantly made me feel fat in the first place?

So to me, the line between OCD and eating disorders isn't always that clear.  In particular, the way my eating disorder presented itself just made it seem like another manifestation of my OCD.  I'm not trying to suggest that all cases of EDs and OCD are one in the same.  Some people, like the author of the ED blog, seem to experience these two disorders very differently.  But for me, drawing such a line between the two seems artificial and counterproductive, because I think the way I approach one is also indicative of the way I approach the other, at least to a certain extent, anyway.

Sometimes I wonder if this is why I struggle so much in fighting the OCD.  Rationally, I know that OCD is a problem.  Living my life this way isn't going to work out forever.  As I listed in a previous post, there is a lot I would like to be able to do now and in the future that OCD could keep me from doing if I don't fight it.  But, at the same time, I cling to my OCD.  I want it.  I feel like it keeps me from turning into a slob with sub-par standards in many different areas of life.  Since I am fairly convinced that it has played a not-so-minor role throughout much of my life, I am afraid of what I might become without my obsessions and compulsions.  Sometimes I cling with fervor to my OCD way of thinking and behaving because I think it keeps me safe.  I think it makes me an "acceptable" person.

So I have to remember that OCD is the problem.  OCD is what leads me to believe that I need the compulsions just to be who I am, to be acceptable, in the first place.  OCD is not keeping me safe.  It is hurting me.  It is taking time and the chance to enjoy my life freely as it happens away from me.  OCD isn't saving me from myself.  It is planting the idea that I need to be saved from myself in the first place.

It may not always be easy to remember but, OCD, without a doubt, is the problem!

3 comments:

  1. I get tripped up on the ego syntonic and ego dystonic distinction too--I've had ocd so long that it really has felt like "me." It has often been a compensatory strategy when I feel defective or worthless--"I'll just try harder and be perfect." But I am learning that to determine with precision what feels like "me" and what doesn't is another ocd trap. And also that I do not need my compulsions to be acceptable--that one is so hard to comprehend and yet the one that offers the most hope of freedom.

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  2. Oh I most definitely agree! Since like you, I've had OCD most of my life, I always just thought it was "me," as well. But since being diagnosed, realizing that I DON'T have to do all sorts of little things I've always felt I had to do is such a liberating concept! Now I just have to get myself there so I can enjoy living that freedom rather than just thinking about it! :)

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  3. I just started a new blog for my journey with ocd and depression. Thank you for your blog:) God bless
    Jennifer

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