Friday, August 06, 2010

The Dishwasher, Marriage, and Obsessive Compulsive Disorder

Caveat:

Before we begin, please do not consider the following post an exhaustive treatment on how to treat Obsessive Compulsive Disorder. The intervention I discuss is only one strategy, and treating OCD can be quite long-term, begs different methods. It is never a simple behavioral therapy. I'm only suggesting that without a behavioral approach, the therapy is remiss.

Nor am I making fun of people who have the disorder or dismissing them as silly. That's the farthest thing in my mind. It's a very serious, painful disorder.


The Post

Many couples argue about the right and the wrong way to stack a dishwasher. There is, apparently, a right and a wrong way, depending upon the direction of the jets. You knew about the jets, right? So couples argue about this one quite a bit, and it's not an Obsessive-Compulsive Disorder thing, not even a control thing, so much as an
Are the dishes getting clean?
thing.

So we could talk about that, for sure, but let's talk about me.

I’ve become one of those people who washes the dishes 100% before stacking them in the dishwasher. I never thought it would happen. There's no need to do this. This particular Whirlpool sounds like an airplane, but the dishes come out clean when the war is over.

So FD comes home and eats breakfast, wants to stack his plate of crusted bagel crumbs and butter in the dishwasher. He sees the clean dishes and asks me, “Are these clean? I just emptied this thing.” His tone is upset, confused.

“Yes, they’re clean. I’m using the rack to let them air dry.”

“Well, how am I supposed to know what’s clean and what isn’t?”

He has a point.

You're all thinking, I know you are, this is so obsessive-compulsive, washing before a wash. But the difference is that there is no second wash.

Another example of mythological OCD:

My mother, 84.5, lives independently but won’t cook for herself anymore. Or bake. She is a fabulous cook, a wonderful baker, and although I’ve tried to fill in, I’m too impatient for real baking; you know what I mean. She won’t cook because it’s too messy. Does she have Obsessive Compulsive Disorder?

She might, is the truth, but in this case, her behavior isn’t a function of her OCD; it’s a vestige of self-esteem. Why should she have to clean up for herself at her age? She's done enough of that, cleaning up for herself, for others. It's time to call it quits.

So we don’t have to treat Mom. But when should we treat compulsions? (Obsessions are the thoughts, compulsions the behavior). And when should we leave symptomatic behavior alone?

We might suggest that if a younger person refuses to cook for herself because a splat of omelet on the range causes her too much distress, then that might be something to treat, depending upon a host of other variables.

And how would we do that, treat it?

It’s not necessary to talk about toilet training as a child, although a therapist could make decent money off this approach. And it’s fun to talk about early childhood, for we do establish much of our irrational tendencies as children just coping with life stress. Life, if you're a kid, has inherent stressors, mainly having to do with weird rules and the behaviors of large people.

But far more elegant than talking about childhood is a behavioral approach. You start (I do) with something that’s upsetting to the patient, like a spill. A therapist like me might pour grape juice into a pitcher and leave it close to the edge of my desk for an entire visit to see how long it takes for the patient to say,
“Could you please move it? It’s going to fall.”
Ridiculous, right? It’s not going to fall. It is a full pitcher. It isn't going anywhere. I move it an inch away from the edge.
“Good enough?”
Of course not.
“Does this make sense?” I ask.
Well yes, it does. We could have an earthquake. Anything could happen. We talk about the concept of stressing the mental set, making the brain grapple with the thought that it could fall, all kind of bad things can happen. But it won't. I won't let it. The thought is irrational and dysfunctional.

Dysfunctional because while under the influence of an obsessive thought, or a compulsive behavior, whatever else is going on in our lives, whatever else is important, is taking a second to something as small as a pitcher of grape juice. And we make other people miserable, waiting for us.

Sure, caution is a good thing, and most of us avoid precarious situations like spills, but when the caution is obligatory, rigid, symbolic for everything, somehow, then we have to tickle many sources, not only a difficult childhood. Pick a trigger, any cause for anxiety, then another, and play with it, talk about it, test it.

Try syrup, working with a spill phobe. No one with this set of compulsions (the cleaning set) is comfortable with spilled syrup.

Hold a spoonful of syrup over the floor, make like you’re going to spill it, but don’t. Get very close to spilling it, but definitely don't. This requires some coordination, but repeat the near accident over and over, each time measuring the length of time the patient is holding his or her breath. (Not literally, just look for any change in expression).

A little anxiety is what we’re shooting for, not too much, and a gradual magnification of the stimulus. This teaches the patient to manage his or her anxiety some other way, and hopefully you're familiar with relaxation techniques and have passed them on, or cognitive strategies, like the rational thinking we discussed above.

The technique of gradually increasing the stress of a feared stimulus is called desensitization. Gradual is key. No need to give anyone a heart attack with spilled grape juice of syrup. Not until you're sure that spilling won't cause a heart attack.

The therapy really can take years. There's always another trigger to desensitize the patient who has this disorder. Medication is helpful, and surely a couple's therapy is always in order, psycho-education for the spouse, and coaching, even shadowing.

So what about me and FD? With the dishwasher. We could dedicate one side of the dishwasher to clean dishes, another to dirty. But I feel this contaminates the clean ones that are minding their own business, just resting across from the dirty ones.

Maybe someone can think of a better idea. I’m not sure I want to quit washing the dishes 100%. It feels good, hot soapy water on skin (I never thought of it this way until a friend mentioned it to me). And it seems like something that should become a permanent bit of the home’s personality, saving counter space, like we're heading in a new direction.

And FD could actually look at a dish to see if the dish is clean. Would that be so bad?

therapydoc

22 comments:

moviedoc said...

There's also the wasted water. I fill a gallon jug (in the summer) and still let water go down the drain just so it will get hot enough to do the hand washing. If I'm going to run the dishwasher anyway, I let it start first to get to the hot water. (I use the jug full to water plants in the yard.) Using the dishwasher as a drying rack only may save water, but I suspect dishwashers waste less water than washing by hand, not to mention your valuable time.

The Treatment: Is what you describe desensitization or exposure and response prevention?

Ella said...

For us, the arrangement of the dishes in the racks IS about control. My way is right, his way is right. I have to give up my way being right if I want him to do this chore.

But he's also a bit OCD. And I know not to mess with that - did it while we were dating, moved the salt and pepper and sugar dish around on the restaurant table, moved them from the spot where they must be. He moved it back. I moved it away. He moved it back. He threatened me with bodily harm if I moved it again. I walked out the door, walked back to my office down the road.
We each learned about the boundaries that day.

Brian said...

If you like the warm and the soap, I'd put the dirty dishes in the dishwasher and then take a shower..
You'd be saving time and water and still getting all of the benefits!!

Anonymous said...

My husband does the same thing, washes the dishes and uses the dishwasher as a dryer. I have suggested we get a counter dish dryer so he can enjoy himself and he says no, that's just clutter. I'm with FD on this one, sometimes it's hard to tell what is "dirty." And dishwashers are for dirty dishes, not clean ones, after all.

I have to say, nothing personal about you, this is an annoying habit. And my husband doesn't like the way I load the dishwasher. But he gets annoyed when he finds a load of dirty dishes in the sink and keeps trying to "instruct" me.

I am in a no win situation with the dishes here.

Syd said...

A dishwasher by name is for washing. If something needs soaking first, we put it in soak and then in with the other dirty dishes in the washer. It works for us without any fuss. I guess we aren't OCD. Yea!!

Sandy Cooper said...

The pitcher of grape juice on the edge of the desk would drive me completely bonkers. I wouldn't even ASK you to move it. I would get up from my seat and do it myself.

That doesn't make me OCD. It makes me a mom of three little kids.

Blessings,
Sandy

ladykay said...

Two suggestions: A dish drainer for the counter and/or one of those clean/dirty magnets for the dishwasher.

Kerro said...

I'm reminded of the time I got anxious because my therapist tied her hair with a rubber band. The kind that goes around mail. Seriously. How could she? All those broken hairs nearly did me in. I nearly bought her proper hair elastics, but I resisted.

As for the syrup... I'm already running from the room... aaarrrggghhh!!!

The Rebbetzin's Husband said...

This is really helpful; thank you very much. I especially like the beginning segments, about what is and is not OCD, and what does and does not require treatment.

moviedoc said...

For DSM-V:

Dishwasher Dysphoric Disorder
Dishwasher Derrangement Disorder

Isle Dance said...

I can relate a little all of this. Or a lot. "Contaminates" is a word in my head. I like things clean, but I tire of doing it over and over. It's just easier to not get things so dirty in the first place. Or to do it in a way that keeps some kind of order to it all. I know I need to work on this. Gah.

Anonymous said...

One of the things I thought about when I read this was that just recently I'd seen an article that stated that pre-washing is not necessary and that in fact, the current brands of automatic dishwashing soaps are designed to work when there is the presence of food. In the absence of food particles, apparently the detergent munches on the plates themselves, causing them to become pitted.

Anonymous said...

My husband doesn't like the way I arrange the dishwasher and takes things OUT that I have put IN. Drives me crazy. No reason for it except for his OCD.

Tzipporah said...

Clean/Dirty magnet. Easy as pie. And cheap.

Donna B. said...

Dishwashers drive me crazy. There, I said it. It feels wrong to run it unless it's full, but we can't really get it full because we use more items that need to go in the top rack than in the bottom.

On top of that, there are items that can't or shouldn't go in the dishwasher at all. Or, at least I think there are.

So many things for a married couple to disagree about concerning the dishwasher.

And then there are my visits to my daughters' houses and trying to learn their (and their spouses') rules about what goes in the dishwasher and where.

Throw in some baby/toddler items, an expensive knife or pots and pans, a concern for the environment or toxins, and the entire kitchen clean-up is rife with possibilities for grief and conflict.

Suggestion for next topic: how to handle leftovers and how to determine if they are safe to eat.

Anonymous said...

My brother was surprised that I wash sponges in the dishwasher. So when he was staying with me for an extended period, and was very sweetly cleaning up the kitchen, he came to me with a used tea bag and said he wasn't trying to be facetious but did I wash tea bags. I thought that was terribly funny. But I could see why he wasn't sure, too.

Peter said...
This comment has been removed by a blog administrator.
Tzipporah said...

Something you haven't touched on much here, but our community's been struggling with it in the last couple months.

Yes, Virginia, moms do kill themselves

Michal Ann said...

I love Donna's comments about some of the many potential kitchen clean up challenges. BTW, microwaving a dampened sponge or cloth is proven to kill 99% of ecoli and other bad bugs. Just give it a minute or two at full power and it's sanitized. This is much better than giving it a ride in the dishwasher (with the tea bags?? Hilarious!)

I'm not sure where you're going with using the DW for a drying rack. You told your husband that they're "dirty" but they're not. I like to hand wash dishes as well but I compromise by thoroughly rinsing items because they'll have to sit for a couple days til I get a full load. I can hand wash stuff that is delicate, doesn't really fit in the dishwasher as well as my reusable water bottles, etc.

I'm with your mother-in-law; there's ALWAYS stuff to wash and wipe up. Time for a break! Why not?

Michal Ann said...

I love Donna's comments about some of the many potential kitchen clean up challenges. BTW, microwaving a dampened sponge or cloth is proven to kill 99% of ecoli and other bad bugs. Just give it a minute or two at full power and it's sanitized. This is much better than giving it a ride in the dishwasher (with the tea bags?? Hilarious!)

I'm not sure where you're going with using the DW for a drying rack. You told your husband that they're "dirty" but they're not. I like to hand wash dishes as well but I compromise by thoroughly rinsing items because they'll have to sit for a couple days til I get a full load. I can hand wash stuff that is delicate, doesn't really fit in the dishwasher as well as my reusable water bottles, etc.

I'm with your mother-in-law; there's ALWAYS stuff to wash and wipe up. Time for a break! Why not?

therapydoc said...

My readers are way funnier than me. Thanks all for the insight. Things aren't any better around here, but nobody cares.

EN said...

Haha, hand washing dishes - in a tub with used water anyway - is something I can't do. And forget about sponges. If it is to be done, any cleaning usually requires steeling myself with thoughts of a shower immediately after. Rubber gloves help, though there will be hand scrubbing.

I don't get it, am I the only germophobe who prefers personal cleanliness to environmental cleanliness? And does disgust even qualify as an obsession when you don't think anything actually bad will result?