Anxiety in the mind: obsessions and obsessional tension

ANXIETY IN THE MIND: OBSESSIONS AND OBSESSIONAL TENSION
We all evolve our own particular ways of coping with tension. Some people relieve it by "blowing their top" and ventilating their emotion, and in this way they dissipate their anxiety; some develop a studied calm in their approach to things; while with others the anxiety is concentrated in one particular limb or organ, so that the rest of the body is free. Other people cope with inner tension by making sure that they have everything just right. They feel that if everything is right there can be nothing to worry about. These are the perfectionists. They like everything neat and tidy and in order. This is likely to become an obsession with them so that they become preoccupied with it and spend much of their time checking things over time and again. In this way they are inclined to fuss over every minor detail. It soon comes about that there is no time for the really important things, for with all their attention focused on the details they lose sight of the main issues. There is a tendency for the mind to keep churning over some particular subject and be unable to make the normal transition to other subjects of thought. At the same time the need to have things just right leads to doubts about whether things are right or not. In this way the obsessive is continually in doubt, so that he becomes a constant worrier and has such difficulty in making up his mind that even trivial decisions may become a matter of great effort. He seems to see two sides to every question; and when it comes to some important matter, such as marriage or choice of occupation, he simply dithers and is unable to come to any decision.
Nevertheless, the perfectionist way of avoiding inner tensions works reasonably well in some circumstances. It is effective if the person is able to live a methodical routine way of life that allows everything to be neat and tidy and in its right place. But if something happens to change this way of life so that he can no longer follow set routines, then he becomes tense and anxious because his way of preventing tension does not work in the new set of circumstances.
This was the case with a young woman whom I have recently seen. She had been a very good nurse, in fact she had been top of her year because she was so neat and thorough that she always had everything in order. She liked her work and was free of tension as she was able to avoid worry by having everything in order. However she married, and quickly had two children. In the new circumstances with two babies to care for she was no longer able to have everything around her in perfect order. She could no longer cope with her inner tensions and broke down with severe anxiety.
Another perfectionist woman was successful in running a milk bar with her husband in a country town. Then they went to live on a dairy farm, but the presence of the mud and dirt from the cows so conflicted with her perfectionistic tendencies that she broke down with severe tension and anxiety.

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