Schoolwork, itself, can be enough of a challenge for many kids and young adults. Especially given the recent disruption of normal school activities. Having to perform at the levels of expectation that parents and school personnel place upon them is never easy and can be quite stressful for some. This does not begin to compare, however, to what happens when OCD enters the picture. Three well-known hallmarks of OCD are doubt, guilt, and perfectionism. We also observe that OCD has an insidious way of attaching itself to things that individuals seem to care about the most. For those students who are already concerned with doing well and achieving high grades in school, having OCD involve itself in this can be an exquisite form of torture. One of the more common forms it seems to take in school settings is obsessive perfectionism.
This should be recognized as an entirely different creature and distinct from a student who simply wants to do their best and is motivated to achieve. There are many students out there who study intensively and work extremely hard, but not to the point where they become unwell and dysfunctional. There is a line that should not be crossed.
Obsessive perfectionism can be severe to the point of seriously interfering with school performance or even being able to attend school at all. The accompanying anxiety and depressed moods resulting from not being able to achieve this perfection can be both excruciating and paralyzing.
Some signs of this problem that are frequently seen in this form of OCD would include:
· Experiencing high anxiety before having to leave for school or on Sunday nights, (or other nights) even to the point of refusing to go to school at all
· Studying for excessive amounts of time to the point of cutting out many other important life activities, such as not socializing with family and peers, skipping meals, neglecting personal hygiene, and even becoming sleep deprived
· Constantly doubting being prepared enough for exams, despite over-extensive studying
· Not being able to get started on assignments or to finish them out of fear of not being able to do them perfectly enough
· Having to repeatedly re-do assignments that do not seem perfect enough
· Getting upset at receiving less-than-perfect grades, even though they may still be more than adequate
· Asking an excessive number of questions in class to make certain they understood everything perfectly
· Going for extra help even though it is unnecessary
· Not being able to finish tests and quizzes on time due to having to answer each question perfectly
· Frequently erasing and rewriting letters and words until they look perfect (even to the point of making holes in their papers)
· Excessively underlining or highlighting information in study materials and textbooks to the point where it becomes meaningless
· Extreme notetaking in class where every word the instructor says must be written down exactly, word-for-word
· Rewriting or typing up notes after class to ensure that they are perfectly clear
· Rereading study materials over-and-over to make certain that nothing could have been missed or was misunderstood
· The need for the highest grades comes to outweigh the value of learning itself, and the real point of getting an education is lost along with great upset if the highest grade is not achieved consistently
· If grades have been posted online, checking them repeatedly
· Checking and rechecking homework and study materials to bring to school from home or vice versa
· Asking family members to repeatedly check their homework for errors
As can be seen, any student suffering from this form of the disorder is not going to have a good school experience and will certainly not be able to do their best work. This is not something that will simply be grown out of, nor can they just be talked out of it. It requires serious treatment, and fortunately can be helped with the right kind of intervention.
Proper understanding of, and treatment for OCD has been around for decades, although it has not been as widely known or practiced as it should have been. At the heart of OCD is unrelenting doubt and uncertainty. The doubt can be so great that only ‘perfect certainty’ will satisfy a sufferer. This often drives students with OCD to try to over-control themselves and others as they try to be certain that they will achieve perfect grades. Therefore, in school-related OCD we see students driving themselves to the point of exhaustion, high anxiety, and depression as they try to do the impossible.
So, what can be done about this? I believe that to be successful, change has to take place on two levels – the philosophical level and the behavioral level. Philosophically speaking, the idea of achieving perfection can be extremely detrimental to a person’s performance at just about anything. I have always held with the old saying, “The perfect is the enemy of the good.” I also like the saying, “Perfection is a standard, not a goal,” meaning that it is something we measure against, but do not realistically expect to achieve. Perfectionism ends up being paradoxical. The pressure resulting from the perfectionism that people place on themselves, and the accompanying anxiety can easily put a damper on anyone’s ability to focus and concentrate on whatever they are doing, and to therefore, do good work. This is all compounded by high parental expectations of “doing your best,” societal pressure to be achieving, and in addition, OCD’s tendency to pick on whatever seems to be most important to a person.
Students can be encouraged to try to do good work without being pushed over their limits. This should be true of both those with or without OCD. Moderation and balance in most things are usually the best approach. Healthy high achievers know this. A child burning themselves out, becoming depressed, and giving up will not result in high achievement. Good therapy can help establish better standards and expectations on the part of students and their families. Behavioral change alone will not get the job done if the underlying beliefs aren’t improved. This can be done via cognitive therapy, which can teach students to challenge their beliefs about achievement and learning on a regular basis and to see what is illogical and unhelpful about them.
On the behavioral side, getting students with OCD to confront their fears of imperfection and failure can help them learn to approach their work in more realistic and moderate ways, and to actually see what happens when they give up their perfectionistic approach. This can be accomplished through the creative use of what is known as Exposure & Response Prevention (E&RP), the best evidence-based behavioral treatment for OCD. Using daily homework assignments that students follow at home, they can gradually help themselves to overcome their fears of failure and train themselves out of their perfectionistic ways. The main goals are to be able to build up tolerance so they can coexist with their fearful thoughts and at the same time, resist doing the compulsions that can end up controlling their lives. These assignments could include such things as:
· Not recopying notes
· Resisting rewriting letters and numbers to make them perfect
· Refraining from highlighting or underlining study materials
· Resisting asking excessive questions in class
· Limiting study hours and taking regular breaks from studying
· Not skipping meals or sleep time to do schoolwork
· Limiting the checking of completed homework or answers on tests and quizzes to only one time
· Not going for unnecessary extra help sessions
· Keeping assignments within their limits and not doing unnecessary extra work
· Deliberately agreeing with thoughts of failing (as a way of building up the ability to tolerate these ideas without having to do things perfectly as compulsions)
· Not continually re-reading textbooks and other material
· Spending more time socializing with friends and family instead of continually studying
· Not checking grades repeatedly online
· Not involving others in checking their work for them
· Doing directed readings on the disadvantages of perfectionism
· Turning in work on paper with small tears or folds, or with typos deliberately left in
This list is by no means complete, and only represents a selection of typical therapy assignments. Therapy sessions are generally held weekly with homework in between. Plain talk therapy will not get the job done, and sessions are best conducted by someone with adequate training and experience in treating OCD.
A question that is often asked is, “How long will therapy take?” There is no simple answer to this. There are many factors that can affect the process. A student’s level of maturity and insight are important, and the better these are, the faster the process can go. So is their level of motivation to overcome the problem. Many kids have been so caught up in their perfectionism that it takes time simply to ‘deprogram’ them to get them to see that they will never succeed at what they are trying to accomplish, and that there are better ways to be successful. Even while working on their issues in therapy, they will still be tempted, at times, to fall back on their old ways of approaching schoolwork. Good therapy allows for this and anticipates it. Parents, too, will sometimes need to revise their thinking about their child’s achievement, as they learn to not pressure or hover in the case of doing schoolwork or therapy.
One other question I frequently get from parents is whether or not to involve the school. I would answer that if the problem has become very visible, then it may be necessary. It can also help to get understanding from the school staff, providing they do not take it upon themselves to conduct their own idea of therapy. Special accommodations can sometimes be a help but only if they do not make it easier for the student to be perfectionistic. The school psychologist can be a valuable ally, especially if they have a good understanding of OCD. It can often be useful to get educational materials about OCD to help educate school staff.
OCD can be overcome if everyone does their part, sees therapy as a process, and exercises patience and persistence. Getting recovered takes hard and consistent work, but in the end, is worth it.