Thursday, March 19, 2009

Am I Too Perfect?

Am I too Perfect?
Jonathan Schwartz, PsyD1
  • Have you ever been told that you spend too much time making lists and schedules? Do you think you do?
  • Have you been so involved in the small details of what you were doing that you lost sight of the main thing you were involved in?
  • Would you describe yourself as perfectionistic? Would others?
  • Do you have difficulty making decisions because no side of a particular issue is 100% correct?
  • Have you ever failed to complete a project on time because of your attention to organizing or your high standards for that project?
  • Would you call yourself a workaholic? Would others? If so, do you spend so much time working that you have little time for family, friends, or entertainment?
  • Do you do jobs yourself because no one else will do them to your satisfaction?
  • Do you take over other people's responsibilities to make sure things are done right?
  • Do people describe you as stubborn?
If you have answered “yes” to most of these questions you might want to consider if you meet the diagnosis for OCPD. You see, Obsessive Compulsive Personality Disorder (OCPD) is a pervasive disturbance involving one's generalized style and beliefs in the way one relates to themselves and the world. The behavior style is often characterized with a preoccupation with details, rules, lists, & order, a perfectionism that interferes with task completion, an excessive devotion to work and productivity, an overconscientiousness and inflexibility about matters of morality, ethics, or values, excessive interpersonal control and rigidity and stubbornness. People with OCPD are usually so typically deeply entrenched in thinking that their way of functioning is the only "correct" way, they hold family and friends to their own strict (often errant) standards. While people with this style of thinking will tell you that "all is not well," they tend to be deeply committed to their own beliefs and patterns. It is the belief that "my way is the correct way" that makes them resistant to changing one’s life. Yet, letting go of this rigidity is paramount in their recovery.
At this point, you might still be asking, “Wait a minute, now ambition and striving for perfection are also psychological disorders?” You might even be wondering how psychologists reconcile this diagnosis with a healthy Hashkafas HaTorah. After all, who among us hasn’t noted the concept of Shleimus – of perfection, as a primary goal of Yahadus? Why be concerned with a pervasive preoccupation with perfection?

The Malbim (HaCarmel) distinguishes between two similar Torah concepts – Temimus and Sheleimus. While on the surface these two concepts seem similar, Temimus refers to perfection. It is a notation that implies no blemish whatsoever. Sheleimus, refers to a complete achievement – doing the best that is possible for the particular type. Rav Hirsch (Berashis 33:18) adds that this concept of Sheleimus must involve a certain internal harmony within the individual striving for it. To the person with OCPD, these stages are never possible.

Perfectionism as expressed by the OCPD is not the admirable quality often sought by the world at large. The OCPD perfectionism entails checking and rechecking "completed" tasks to be absolutely sure that there are no imperfections. It could literally take upwards of 10 to 20 minutes to fill out a check or mail an envelope due to a rigid need to ensure that there are absolutely no mistakes. It is as if, to make a mistake which might be noticed would ruin ones reputation for life. Perfectionism could also take the form of a need for over completeness -- reading and rereading material until a sense of absolute clarity exists. Not only is it extremely time consuming but the overall content of the story is lost. The forest is missed while examining each leaf, of each branch, of each tree. This disposition can also have an adverse impact on one's conversational style. In the course of a conversation sometimes information is sought which involves such minutiae that the questioned person becomes lost and frustrated. Slight inconsistencies or mistakes, within another's conversation, are often perceived by the OCPD sufferer. These details, no matter how peripheral to the conversation, must be brought out into the open and clarity must be achieved.
Dovid, a 20 year old Yeshiva bochur, was suddenly faced with a dilemma. While in High School he was a genius, completing Bekius Mesechtos and acing exams both in Limudei Kodesh and secular studies. Now involved in full time learning, he couldn’t concentrate on the text of the Gemara if he couldn’t visualize every word. The Gemara’s concepts he got but his Chavrusos complained to him that he was spending too much time “visualizing” trivializations like what Rava or Abaye looked like or intoned when they made a particular statement.
These issues can create problems at school and in the workplace. From early adolescence, through college, perfectionism can take an otherwise straight "A" student and bring him to the brink of failure due to incomplete assignments. Having to get the term paper exactly correct is an almost impossible task. At work too, perfectionism and a need to repetitively check minor details for errors can prevent OCPD employees from finishing projects by their deadlines. Additionally, an insistence on observing even the most insignificant regulations, the need to micromanage projects, and obvious criticism and contempt for subordinates, can lead to conflict with, and alienation from others.
Menachem’s hard work finally paid off. He was hired by a major accounting firm to work – where else – in the auditing division. His boss asked for a quick assessment on a particular assignment that he was working on. After two days, the boss complained to him that the assessment was long overdue. Menachem noted that he had done the assignment within the first 2 hours of its request but was reluctant to call it “complete” until he had reviewed it to his own satisfaction. That satisfaction, he told the frustrated superior, was still forthcoming.
Even home relationships suffer from one’s OCPD. One’s behavior with significant others is likely to be disrespectful and even domineering. The goal is not necessarily to behave negatively, but rather to get the entire family to a pattern of orderliness, discipline, and safety. In addition, their “no nonsense” rigidity make them unlikely to “let the hair down.” Even vacations become times of intense stress to “guarantee” that they are resting and vacationing “correctly.”
Shani, a 25 year old recently married Kalla returned from her first vacation with her husband in tears. “This is not how vacation was supposed to be,” she noted. The major difficulty of the vacation was that “nothing ran according to my plan.” Therefore, it was not “perfect” but “ruined.”
When events stray from what a person's sense of how things "should be," bouts of intense anger and emotional discord are characteristic. But Shani’s case highlights yet another aspect of OCPD- dichotomous thinking. Dichotomous thinking is the tendency to categorize all aspects of life into one of two perspectives -- "All good" or "All bad." It can take only one stain or blemish to have the person completely find justification in discarding anything which evidences a flaw. With such high consequences at stake, the desire to maintain “perfection” is evident. At the same time, the tension of maintaining that perfection is anything but Shaleim.

Indecisiveness: Another critical aspect of the OCPD thinking style is indecisiveness. When almost all decisions seem to take on the same paramount importance and being correct is imperative, making even simple choices can become a nightmare. Persons with OCPD can become stymied in life due to an inability to establish with certainty which choice is the correct one. Not unusual would be for someone to spend over ten minutes attempting to choose the correct pair of socks which best matches their tie. They tend to place a great deal of pressure on themselves and on others to not make mistakes. Within OCPD the driving force is to avoid being wrong. Since continuously making the correct choices in life, seems to be an impossible task for us humans, there is a regular source of discontent available for OCPD sufferers.
Malki’s parents were exasperated. A bright, beautiful girl of 26, Malki had been “on the market” looking for a Shidduch for 6 years. In Malki’s case, the same pattern seemed to repeat itself constantly. First she would be interested in a guy. Then they would date and become somewhat serious. However, Malki would “hold back” when the proposal of marriage would come. Each time she would find something apparently trivial that would “bother” her and slow her down. “I don’t know” she would say, “I can’t decide if he is THE ONE.” She would seek advice from anyone who would listen but then reject it for one reason or another. Eventually, the guys would end the relationship. She had been “serious” with 5 great guys already.
Treatment options: The treatment of OCPD is incredibly complex and thus beyond the scope of this article. Generally speaking the focus of Cognitive-Behavioral treatment for OCPD entails helping these individuals develop a greater tolerance to the notion that the world is exclusively made up of navigational gray, not the clearly defined black and white lines of rigidly held beliefs. Having someone identify that these thinking styles are a handicap at all is a monumental achievement. The treatment would most likely focus on breaking down and intervening on specific individual aspects within the spectrum of OCPD. Social skills training and role-playing might help facilitate a more effective style in relationships. Assertiveness training would facilitate one's ability to make requests or provide feedback such that the receiver of the information not be alienated. Overriding all of the specific interventions would be a sensitivity to helping the sufferer relinquish their dogmatic belief system. Letting go of “perfection” is a tremendous ambition. The dividend it pays is incomprehensible.
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