People have been asking on a regular basis how my clients are managing during the pandemic. Their question is usually followed by, “it must be really difficult with all the handwashing and wearing masks.” Their well-meaning but misguided assumption is that my clients must be having a difficult time with COVID-19 because people with OCD worry about germs…right? Yes and no. While some people with OCD worry about contamination, there is a larger proportion of people whose OCD encompasses a broad range of topics. My response has been that my clients are doing well; in fact, many of my clients are handling the uncertainty of the pandemic better than the people I know who don’t have OCD. However, OCD doesn’t always present in an overt manner and instead can manifest in other subtle ways.
Recently, one of the ways I have seen OCD emerge during the pandemic I would describe as a subtle form of perfectionism. I see this manifesting with some of my clients as striving to have the “right” thoughts and feelings about the pandemic, all while seamlessly executing new roles and responsibilities that have emerged as a result of shelter-in-place orders. The overarching theme I have been observing is that there is a right way to feel, think, and behave during the quarantine. Often times it may be compounded by the changing guidelines about how to behave during the pandemic presented by the media, as well as the new expectations of parent involvement in their children’s education. The situation created by COVID-19 can be a breeding ground for OCD.
Was There a Training I Missed?
Like many others, I have been scrambling to figure out how to best navigate the abrupt changes that have taken place as a result of COVID-19 while doing my best to provide consistency to my children. While I have been managing the new roles and responsibilities fairly well, I came to recognize the old familiar voice of OCD suggesting that I was not meeting all of my responsibilities to the utmost best of my ability, primarily with my children. Every morning my son was asking how many clients I had that day and when my breaks were. I felt guilty every time I had to inform him that I had a full work day with few breaks. The thought that I was failing to spend time and not providing enriching activities produced a gnawing feeling of guilt and responsibility, leading me to spend all my time between sessions trying to make up for the fact that I was working. My efforts resulted in more anxiety and guilt. As I began to settle into a new routine working from home, I began to identify the OCD trap I was in. The feeling of urgency was leading me to act like my children’s mental health and education were at stake.
I have seen similar manifestations with some of my clients. Often, the subject matter sounds reasonable in light of the pandemic, but what is different is the marked need to be certain they are performing their responsibilities right, thinking the right thoughts about the gravity of the situation or feeling the right feelings. The idea that there is a particular way one should feel or respond during a pandemic is nothing but tried and true OCD trickery.
Examples of subtle obsessions
- Why am I not more worried about my parents’ health?
- Am I modeling for my children the right response to the pandemic?
- Am I following the CDC guidelines perfectly?
- Am I feeling as upset as I should feel?
- How do I know if my reason for going to the store is a good enough reason?
- My wife is beginning to irritate me, what if I don’t love her as much as I should?
- I am not sure I am spending each minute of my work day “working.”
- What if my children’s education is ruined due to my inability to home school effectively?
Examples of subtle compulsions
- Apologizing for not exhibiting a positive attitude at all times.
- Re-reading the CDC guidelines just to make sure you are doing them exactly as instructed.
- Seeking reassurance from others about how they are doing home school.
- Confessing to your superior that you occasionally take a few minutes off during your work day.
- Reading multiple articles about how to homeschool effectively.
- Asking friends about how worried they are about their parents’ health.
What underpins each example is the belief that one may be falling short of what the “ideal” way to act, think, or feel in relationship to the pandemic. It is easy to get tricked by the feeling of urgency and importance that are really hallmarks of OCD. The reality is that the current situation we are in is uncharted territory. We are all figuring it out as we go. Don’t let OCD bully you into believing you will be graded on your performance. Instead, practice mindfulness, acceptance, and self-kindness.
Anti-Perfectionism? Mindfulness, Acceptance, and Self-Kindness
A few months ago, I was in turmoil over a significant change in my life that left me feeling uneasy and afraid. While I was relating to my husband all the potential outcomes that could happen, he turned to me and said “Molly, this is happening.” Something about his obvious statement really struck me. I was resistant to accepting the fact that the situation was scary, it was new, and I didn’t know what the outcome would be, but it was happening. His comment brought some odd measure of comfort by stating the truth of the situation. His mindful statement of fact allowed me to make room for the feelings I was having, rather than judging myself for having what I thought might be the “wrong” feelings or response. Mindful awareness helped me to end the suffering which resulted from resistance to actually accepting that there was a change happening.
Practicing mindfulness during the quarantine may look different depending on your individual circumstances. Maybe mindfulness to you is meditation, maybe it is walking outside and becoming aware that COVID-19 has not stopped the spring from coming, flowers from blooming, or the birds from chirping. It may be simply acknowledging how surreal the situation feels and that you feel like you are in a science fiction film.
Regardless of how you practice being mindful, the most important thing to be mindful of is how you treat yourself during this time. It may be a good time to spend with your children or learning a new skill, but it also could be the perfect time to slow it down, take a breath, consider what you need at this very moment. There is no training manual or instruction booklet on how to live through a pandemic. There will be no awards given or grades handed out based on how you navigated this historic time.
If you have OCD, it may seem as if you feel more uncertain than those around you when in fact, we are all uncertain about what the outcome will be or what daily life will look like. Now is actually the perfect time to practice sitting with the uncertainty, recognizing that uncertainty about the future is neither good nor bad. Allow yourself to not know how to navigate the situation and to put one foot in front of the other anyway. Practice self-kindness by honoring the fact that the past few weeks have been really hard and really scary. Practice being gentle with how you treat yourself and how you talk to yourself. Tell OCD that you hear its concerns, but you’ve got this. No one expects you to be super-human. After all, it’s a pandemic and OCD doesn’t know anything more about it than you do!
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Molly Schiffer, LCPC
Associate Director, The Center for OCD and AnxietySpecialties:Anxiety Disorders, Cognitive Behavioral Therapy, Obsessive-Compulsive Disorder (OCD)