OCD perfectionism & social anxiety treatment: Tweet your way to greater health

Posted by in Obsessive-compulsive disorder (OCD), Perfectionism, Social Anxiety Looking for ways to overcome social anxiety or OCD-related perfectionism?  At the end of this post, you’ll find some strategies I use to help individuals in South Florida (Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami) overcome their anxiety.  These exercises are examples of “Intentional Mistake Practice”, a CBT-based technique that can be used to challenge some of the problematic perfectionistic beliefs that are central to social anxiety and OCD. First, though, what do social anxiety and OCD-related perfectionism have in common?  Although on the surface, these anxiety disorders are quite different, individuals with social phobia and OCD often share many perfectionistic beliefs about the world.  Social anxiety (or “social phobia”) is characterized by excessive worry about being perceived negatively by others.  Individuals with social phobia often have perfectionistic expectations about their own behavior and question their social competence.  They fear potential shame, embarrassment, or rejection in social settings. In OCD, perfectionistic cognitions may also involve “performing” in front of others but more often involve personal perfectionistic standards.  These individuals often feel a moral imperative to live up to their true potential.  They often seek to give nothing but their best (100% of the time) and fear making mistakes because of what this might imply about their value as a person. Many research studies have found that the most effective treatment for OCD-related perfectionism and social anxiety is cognitive behavioral therapy (CBT).  If you have one of these conditions, find a therapist who uses exposure and response prevention (ERP), a specific form of CBT that will be an important part of your recovery.  ERP will help you challenge your perfectionistic beliefs, which will reduce your symptoms and make you less vulnerable to future relapse.  I should note that although ERP is commonly thought of as an OCD-specific intervention, its principles apply readily to social anxiety treatment. As I have discussed earlier, ERP has two main components: exposure – purposely doing activities that are designed to elicit your anxiety response prevention – actively resisting the urge to complete a ritual You should only complete exposures if you are able to maintain good response prevention while doing so.  This applies both to external/behavioral rituals, as well as mental rituals.  Even the most challenging, high-level exposures will be ineffective if you are not maintaining good response prevention.  Moreover, ritualizing during your exposures will actually strengthen your anxiety in the long run.  In some cases, acting in a self-deprecating...
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Perfectionism in OCD: When the pursuit of success turns toxic

Posted by in Obsessive-compulsive disorder (OCD), Perfectionism There is more than one type of perfectionist. First, there is the adaptive perfectionist.  This perfectionist is the prototypical workaholic student/employee who goes above and beyond expectations.  This person is intelligent, hard-working, dependable, and passionate about meeting or beating deadlines.  He or she sets high personal standards of performance and has an attention to detail that is appreciated by (and often draws accolades from) others. However, not every perfectionist resembles this prototype.  There is another type of perfectionism that might be affecting you or someone you know.  This perfectionist doesn’t quite look like the adaptive perfectionist, and based on his or her observable behavior, their perfectionism might not even be readily apparent. Nevertheless, the maladaptive perfectionist shares many features in common with the adaptive perfectionist.   Similar to the adaptive perfectionist, the maladaptive perfectionist is likely to be intelligent and articulate.  He or she has very high standards and feels passionately about the importance of hard work.  Yet in contrast to the adaptive perfectionist, the maladaptive perfectionist often misses deadlines and fails to deliver an exceptional work product (or, in some cases, any work at all).  He or she might even be considered lazy or irresponsible by others.  However, the maladaptive perfectionist is usually far from lazy; despite a lack of tangible output, he or she often spends an overabundance of time and effort working. How is this possible?  The maladaptive perfectionist often gets stuck in repeating tasks and has difficulty finishing projects.  He or she may repeatedly recheck or revise their work.  However, despite these efforts, the product never quite feels “good enough.”  The ideas are nearly there, but they never feel fleshed out or polished in a way that gives the individual enough internal satisfaction to achieve closure and bring the project to completion.  Alternatively, the person may suffer from intellectual paralysis due to an over-concern with living up to their own potential, fear of failure, or a fear of disappointing others (e.g., teachers, parents, loved ones).  This intellectual paralysis may lead to complete avoidance, and this avoidance often becomes chronic and difficult to change. For some individuals, maladaptive perfectionism is actually obsessive-compulsive disorder (OCD).  This type of OCD is tricky because it can be more subtle than other types of OCD.  Because it doesn’t resemble many of the other types of OCD with which people are commonly acquainted (hand-washing, checking locks, etc.), it often goes undetected and untreated.  This can be frustrating and depressing for sufferers....
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