From Living with OCD to Working with it

The author Natalia Aniela Aíza

My journey as an OCD therapist (and what I have yet to learn).

Compulsions are some of my earliest childhood memories. I was the only daughter of a single mother, a political refugee from Poland, and a Mexican father that I didn’t know. I locked and relocked the front door, then picked up the landline to make sure there was a dial tone, then looked out the back window to see if there was a car in the alley. I was six years old when I started spending every afternoon, and many weekends alone on the top floor of a duplex in downtown Milwaukee. 

In late elementary, I started feeling the urge to cut my arm. It was pre-internet, and I had no idea that anyone else did this too. I always cut in the same spot on the same arm, and then spent the next week compulsively dousing the wound with rubbing alcohol. The skin would bubble and puss, and I would focus all my anxiety on that searing pain. I distinctly remember that queasy feeling of being both powerful and powerless – what I now understand to be the dichotomy of having a control disorder that is out of control. I literally could not stop hurting myself. 

By middle school, my compulsive cutting had morphed into stealing. I was easily the best student in my classes, but was pathologically quiet. When other students went to recess, I would sneak back into the teacher’s supply room and take folders and binders. I never used any of these items, but I created a little collection in my bedroom that felt sacred to me. 6th grade summer, I began to slip single sleeves of stickers into my pants at the local Kohl’s grocery store (a staple of 1990s Wisconsin). My OCD version of shoplifting – the same item from the same store at the same time of day, every day – obviously got me caught. I actually got handcuffed as a 75 pound little girl, taken to the police station, and fingerprinted. 

My stealing abruptly stopped after this scared straight moment, and my OCD morphed once again into the place where it happily stayed for the coming decades: perfectionism. 

Of course some part of me is grateful that my compulsivity settled into a safer landing spot than self-harm or theft, but now that I am a therapist, I appreciate how much harder it is to heal from perfectionism OCD. Pushing myself to achieve that “just right” feeling, and overachieving until I literally cannot keep my eyes open anymore, has propelled most aspects of my life. It has brought pride and achievement, but also loss and disconnection. I anchor myself so loyally to perfection, I am not sure who Natalia is outside of it. 

Natalia with her team at Kairos Wellness Collective.

I realize the irony of trying to compose this very essay. My center is thriving, my life is full: and yet I wake up early Sunday morning to search for the consummate words to describe perfectionism. I am no longer that frightened and lonely little girl in Wisconsin, but somehow I am still driven by an intangible sense of danger. Being less-than feels unsafe.

If I put my therapist hat on, I am able to identify my current OCD as “ego-syntonic.” This means that my core self and my OCD are in line. Even if I recognize how my happiness is limited by my need for excellence, I will still willingly make this trade. 

As a mental health practitioner, I have a belief (perhaps superstitious) that the universe pairs you with the clients that you need to fully see yourself.  I began my career with two jobs: as an expat therapist in a ritzy neighborhood of Shanghai and as a child therapist at a local orphanage.  I spent the year toggling back and forth between these very different workplaces, struggling with the duality of working with children with abandonment wounds and over-achieving adults. It was only in retrospect that I started connecting these two client bases as aspects of my own self. 

From a very early age, I accepted that I wasn’t good enough to keep my father. I knew nothing of the circumstances of my parent’s rupture, but I formed a core belief that I was not worthy of love.  My attachment style, unsurprisingly, has been anxious for my whole life. I fear that love will crumble if it is imperfect, and I am hypervigilant of my partner’s reactions to me.  My anxious brain can ruminate on something as benign as a sour look in my direction. 

In Cognitive Behavioral Therapy, we teach our clients that most negative perceptions can be traced back to one of three core beliefs: I am unworthy, I am unsafe, and I am unloved.  My perfectionism has been so treatment-resistant because it was my salve for all three of these fundamental fears. 

Perfectionism is my brain’s effort to give me a sense of control; if I am measured, perhaps I will be safe. If I am tireless, perhaps I will be worthy. If I am flawless, then perhaps I will be loved. 

However, as an OCD specialist, I know that we have to let go of the compulsion in order to heal the obsession. Consistently meeting your own outsized standards reinforces that you must always do so, no matter what. I will never feel loved, worthy, and safe, until I am truly able to lean into the discomfort of imperfection.

Even as I sit here trying to type out my “perfectionism story,” overthinking and judgment lingers around this very text.  My perception of my business is warped by self-criticism.  Every piece of negative feedback fully eclipses all the positives.  Sometimes I even feel nostalgia for the self-destructive little girl that I once was. This adult version of me must continuously self-construct. If I slow down, or do just good enough, I do so with a chorus of intrusive thoughts that I might fail. 

I long to break step with this pattern. I have been marching forward for so long that I don’t know how to dance. I see the harm of perfectionism in my clients, but also how dearly they cling to it. I have to be honest with them – this compulsion still shadows me now.  Committing these words to the page signifies a pact with myself to finally, completely let go of perfectionism. 

I tell my clients: let’s try this new dance together.

Natalia Aniela Aíza, LPC, is the founder of Kairos Wellness Collective, an OCD clinic in Boulder, Colorado.  Her maladaptive perfectionism drove her out of a difficult childhood to Harvard College, then Harvard Law, before she found her true calling as a mother and an OCD specialist. She is passionate about mental health advocacy, and honesty from healers about our own (ongoing) struggles. You can follow her center on Instagram.