Chronic Urgency Stress Syndrome (CUSS) and That Monster Hiding Under Your Bed

Originally published by: The Healthy Compulsive Project

I remember recognizing, years ago, that I would concoct reasons to surrender to my habitual urgency, and rush to get things done. It wasn’t really necessary to rush, but for some reason I preferred being in a hurry.

This isn’t unusual for people with obsessive-compulsive traits. But it raises the question: are we running toward something, or away from something?

This distinction, known as approach motivation vs. avoidance motivation, determines a lot about the quality of our lives, and it’s important to clear it up. Right away.

A lot of urgency comes from trying to avoid that monster that was chasing you in your dreams and is now hiding under your bed. It might seem like you’re moving toward something positive if you’re always in a rush, but often enough the fantasy of peace and resolution is really just about outrunning the monster of shame. Or fear or sadness or anger. And it can have a huge impact on your life.

But you may not be aware of the connection. Citing the unconscious as a factor in our wellbeing has become passé since we developed cognitive and behavioral techniques over the past 30 years. But, despite exaggerated reports of its death, the unconscious is still alive and kickin'. Current research affirms that much of our behavior is determined by internal processes out of our awareness. (See in particular the work of psychologist John Bargh at Yale.)

Let’s look at how an unconscious effort to avoid disturbing feelings by being urgent affects you in three places: relationships, work and well-being.

Once caveat first. Compulsives may feel at least as much urgency to get things done perfectly as getting them done at all. And, in some cases, since nothing is perfect, nothing gets done. Perfection becomes an enemy of the good. Procrastination becomes the problem and it creates its own sense of powerless urgency. This is true in particular of the Thinking-Planning type of obsessive-compulsive personality.

But for now, let’s focus on the version of urgency that makes you rush through life like they’re giving away a Mercedes-Benz at the finish line. Just one.

Relationships

Most people have no interest in moving as quickly as most compulsives do. That may seem unfortunate, but we have to deal with it.

One common disagreement in couples occurs when the compulsive partner feels urgency to get things done ASAP and the other doesn’t. The compulsive partner may become rigid and demanding about time.

Take out the garbage? 5:42 at the latest.

Grocery shopping? 7 AM. You never know when they’re going to run out of paper towels.

Going to the airport? You must arrive three hours early to make sure you don’t miss that flight to Barbados where you have an urgent appointment to slow down.

But perhaps a worse scenario occurs when your partner is trying to speak with you about scheduling some quality time this weekend, but you’ve got that far away look in your eyes. You’re urgently fine-tuning your strategy for tackling your to do list in the most expedient way possible and you've become totally distracted. Your partner feels alone, and that’s not what they signed up for.

Work

Work, on the other hand, may reward urgency. From McDonalds to JPMorgan, management is happy to see you stretch yourself to a breaking point so that investors can go to Barbados on the dividends you worked so hard to create. So, your urgency and the goals of your employer may fit like a hand in a glove. But not a glove you would really want to wear. It’s too tight, causes a rash, and stinks. Another fitting metaphor is a pair of handcuffs that fit you perfectly.

It is rare, but some managers will notice your urgency and help you moderate it, for the long-term well-being of both employer and employee.

I remember my first job out of graduate school as a psychotherapist in a clinic. It was my first week and I was working late in my office taking notes. My supervisor, warm, wise and wonderful, came by and told me, “Go home. You need to pace yourself.”

My strategy had been, “I’ll get this over with so I can rest.” I saw anything incomplete as a dangerous enemy to be vanquished. A more reasonable strategy, which she encouraged, was to get used to things being incomplete. Coexist with them, and go have some fun. You’ll need that to survive working in a mental health clinic in a poor neighborhood.

Well-Being

And what does urgency do to your well-being? Urgency is a sure bet to create stress, which is a sure bet to create high blood pressure, heart problems, stroke, and inflammation, not to mention depression and anxiety.

Of course you knew all that already, but you’re still hoping to beat the odds.

I suspect that urgency has a few tricks up its sleeve that can lead you to bet against your own long-term interests. One is experiencing the rush when you get something done. Another is what happens when you don’t get the rush: the emotional desert of withdrawal you fall into when you aren’t getting anything done.  No endorphin hit from crossing something else off your list. Urgency has become an addiction and it’s lowering the quality of your life.

And, just as significantly, you hope it will protect you from that monster under the bed.

Tim

Tim was a very decent guy whose urgency and need for perfection sometimes got the best of him. He was experiencing some medical issues and the large practice where he got his care was not as urgent as he was about resolving the problems.

Alarm bells went off in his head whenever he experienced his symptoms. He had somehow missed the Buddha’s memo suggesting that we not get attached to perfect health.  Illness is inevitable.

For Tim, fixing the problem became more problematic than the problem itself. He was 35 and far too young, in his estimation, to have any medical problems. He was afraid his symptoms would get in the way of his exercise, effectiveness, and energy.  He’d be just another schlump.

He’d call the medical office multiple times each day. He’d go there if they didn’t return his call. He had to exercise great restraint not to tell them just what he thought of them. That of course would have been cutting off his nose to spite his pace—point being, it would have taken even longer to get help because then they’d write him off as just another whacko.

His symptoms were disturbingly uncomfortable, but not dangerous. Still, like most compulsives, his drive for resolution took off like a runaway train, a one-track mind oblivious to everything else. Rather than get him where he wanted to go, this urgency caused him to neglect what was most important to him.

Diagnosis can take time at times, and he needed to learn to be patient, not urgent.

He had to sidle up to the monster that had been hiding under his bed. For him it was the fear and shame that he wouldn’t be perfect. And that was what he was running from.

He wanted very much to start a family, and finding a partner was his immediate goal. He had imagined that any imperfection would make him too vulnerable to be attractive--as if all potential partners were perfect themselves. The end goal of starting a family had been lost to the means--perfection, which he had imagined was the fast track to domestic bliss.

As it turned out, his drive for perfection was causing his medical problem: Chronic Urgency Stress Syndrome. Okay, I made that term up. But any physician will tell you: drive yourself that hard and it will take a toll. His situation was just a different version of the too-frequent pattern of compulsive exercising leading to injuries.

Patience

I remember once hearing a suggestion that if we want to achieve better mileage with our cars, we need to drive patiently. I thought at first that was a strange way to describe it, but as I’ve reflected on it, it’s a good way to achieve change. It means not being in a rush to get somewhere, not getting apoplectic when you’re delayed, and, to stretch meaning a bit, being present to where you are. It means hunkering down in the moment—even if it makes you feel uncomfortable.

This also means hunkering down with whatever you've been avoiding, including the monster that’s been hiding under your bed. That monster might be the shame you fear feeling if you’re not perfect, the angst at not getting enough things done, or the discomfort you feel when things are not resolved. The monster under your bed is just a feeling. And you can handle that.

Study it with curiosity. See what it wants from you. Was it originally trying to protect you, but has taken over?

Moving Toward

Just as important as knowing what you’re running from is knowing what you were running to before the urgency took over. What’s truly most important to you? If your well-being is not on that list, I’d suggest you slow down and re-examine your priorities.

At the healthy end of the obsessive-compulsive spectrum we find meaningful urges that were lost when urgency to deal with anxiety and insecurity took over. Creating, producing, and fixing can fulfill our need for purpose if approached mindfully. But too often our urgency leads to an amnesia for meaning.

Don’t forget your original motivations. That unconscious of yours contains not only the things you are avoiding out of fear, but also the neglected passions and drives that will lead you to fulfillment.

References available in original article on The Healthy Compulsive Project.