In the past year, thanks to the proliferation of skin-care recommendations via social media, I’ve become unexpectedly preoccupied with what I’m putting on my face.
For years, I was content to lazily rinse with water in the morning or apply years-old drugstore exfoliator. Then I learned about toner, and from there my skin-care education expanded to expensive Sunday Riley purchases and in-depth micellar water comparisons. I have put on more sunscreen in the past year than all of my teen years combined. My group texts are now peppered with earnest discussions of 10-step regimens, hyaluronic acid, and snail mucus face masks.
Skin care has been a nice investment. I can’t fight the aging process, but my skin looks better. And it’s more gratifying to spend $25 on comically tiny bottles of Good Genes and Ceramic Slip Cleanser than the indulgences of my early 20s.
But skin-care routines are a slippery slope for someone with my mental makeup.
For the past 15 years, my life has been dictated by routines ranging from quirky to self-destructive, all part and parcel of my obsessive-compulsive disorder (OCD). This presents a challenge: How do I engage in skin-care routines—a self-care practice that benefits my body and saturates my social media feeds—without it triggering my OCD?
“The worst thing for people with OCD is to have rituals and routines,” Jenny Yip, Psy.D., a clinical psychologist and institutional member of the International OCD Foundation, tells SELF. “It’s easy for us to replace one compulsion with a new compulsion—and you don’t want to replace one compulsion with another.”
OCD begins with obsessions—unwanted thoughts repeating in your mind—which trigger anxiety and discomfort, she explains. In order to reduce the negative impact of the obsessions, an individual engages in compulsions, which are behaviors that provide relief by allowing you to feel safer or escape the compulsions.
For someone to be diagnosed with OCD, their obsessions and compulsions must interfere with their normal daily functioning, Yip says, such as their ability to handle responsibilities at school or work or interactions with family, friends, or romantic partners.
Sticking to a routine because it brings positive physical results isn’t inherently the same thing as engaging in compulsive behavior, but it can quickly veer into that territory for some. For instance, I’m a very nervous flier, and for years, I’ve relied on rituals to subdue intrusive thoughts of crashes. If, for example, the morning of a flight, I’m methodically repeating my ritual of cleanse, tone, and moisturize until it “feels right” or I reach one of my “good” numbers, then I’m using my skincare routine to quiet my obsessive thoughts about flying.
Magical thinking—an aspect of my OCD that leads me to believe that my thoughts or actions can influence the external world—tells me that messing up my routine before I go to the airport might lead to a plane crash.
When your mind gets into that sort of obsessive tailspin (one you can objectively identify from afar as nonsensical, but still can’t seem to escape) compulsions can give you a sense of relief or temporary freedom from obsessive thoughts, Yip says.
“That relief is reinforcing,” she adds. “So when your thought comes back, what are you likely to do? Whatever you did previously.”
If I get too stuck in that thought loop—I have to do this just so, or this plane will crash—I can end up repeating my routine to the point that it interferes with my daily functioning. I might miss my flight or upset a person I’m traveling with, for instance.
If a skin-care routine begins to interfere with your social life or sleep, or you have to repeat it any time you mess up or according to specific rules, those are signs that it might be eliciting some OCD-related behaviors, Yip says.
More and more people have been getting interested in skin care over the past few years, likely due to “empowerment and education via social media,” Evan Rieder, M.D., assistant professor in the Ronald O. Perelman department of dermatology at NYU Langone Health and board-certified psychiatrist, tells SELF. But for individuals with OCD, moderation is key.
“There can be [a] great benefit to a skin-care regimen with respect to self-care,” he says. Some people find that sticking to a routine like this is relaxing or that a Sunday night mask helps them mentally prepare for the week ahead.
But, Dr. Rieder says, if a regimen starts to move away from being psychologically beneficial towards something that interferes with work or social activities, then it might be time for a change. “Often, limiting the time spent on a regimen and number of times per day dedicated to self-care can be the key difference between helpful and maladaptive behaviors,” he says.
I’ve been living with my OCD long enough that I have a good sense of which rituals can become compulsions and of when my stress level might exacerbate my symptoms. I’ve found that when it comes to skin care, it’s important for me to mix it up—skip the toner or moisturizer occasionally, for instance.
Breaking your “OCD rules” like this is part of a strategy called exposure therapy, Yip says. You can completely ignore the rules, or your “OCD monster,” which is usually a tough first step for people if they’ve never attempted exposure therapy.
Another strategy is to complete the routine in the opposite direction or order: If it’s important to someone that they apply toner in the evening top to bottom, they are urged to apply it bottom to top. Or you can engage in the routine differently, with different quantities attached to each step. For instance, if a ritual requires you to apply three pumps of sunscreen and then rinse your hands with hot water, an alternative might be to apply two pumps and rinse with cold water, or another combination.
The good news is that skin-care regimens can differ by personal preference and individual skin needs, Dr. Rieder says, so not everyone needs to invest in the Soko Glam routine. Many of us really don’t need any more than a gentle cleanser, moisturizer, and sunscreen during the day. And, yes, for some people a skin-care regimen can be both physically and mentally beneficial. If managed properly, a skin-care routine can be just that for someone with OCD—a healthy, beneficial habit without spiraling into compulsions.
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