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I see a client with obsessive compulsive disorder. She has a tendency to pick at her fur and skin, some troubles with physical affection that make her feel 'gross', a fear of driving that leads her to worry that someone has been struck by the car, and a sort of external claustrophobia that leads her to struggle with the idea of closed-in spaces such as cabinets and cupboards, which we suspect stems from some early childhood abuse.
She also struggles with relationship-rightness with her husband. She worries constantly that he might not be, in some way, okay. It's not particularly that she thinks he might not love her, or that she might not be good for him, but that if there is anything wrong in his life in any way, that she must address it. It goes beyond simply needing to comfort him, and well into the territory of her world falling apart should anything be wrong that she cannot address.
(I suspect that their relationship is codependent, as I think that her husband gets as much out of taking care of her as she gets out of him taking the lead. However, I don't think that it's abusive or manipulative in anyway, simply that this is the way that their relationship works.)
When I brought this up with Jeremy during one of our sessions a few months ago, speaking specifically to the stress that I felt in masking around someone who existed in such a high state of activation at all times, he asked if I had greater trouble masking around those who experienced strong egodystonic symptoms and feelings than those who experienced strong egosyntonic symptoms.
Att the time, I explained it thus. Those egodystonic disorders, the ones that impede upon the patient's life, brushing their fur the wrong way and leaving them in discomfort or pain, often lead to high-stress situations where I find myself struggling with the task of expressing appropriate emotions, engaging that visible sort of empathy that helps so much with patients and which I feel I must practice. I find myself wanting to disengage in order to protect myself. Avert my eyes. Cross my arms. Close myself off from the stressors before me.
Egosyntonic symptoms, where detrimental feelings, symptoms, or thoughts do not disturb the patient's sense of identity, are far easier for me to mask around. It feels much more natural for me to try and engage with a patient with visible empathy if my goal is to try and help them understand that a behavior might be damaging to themselves or others. At that point, masking is a tool in my kit.
I suspect that this habit may stem from my connection with my faith. If an individual sins, knows that it is a sin, and struggles with that, it is far more uncomfortable than if an individual sins, does not consider it a sin, and cannot see the spiritual consequences that they might thus face. With the former, I struggle to mask because it is their goal, their work, their job to find their way back to the path, but with the latter, with the sinner from outside the church, they must be met with empathy, for they know not what they do.
This ties in quite neatly with my reasons for steering away from ministry: my instincts were in direct opposition to much of my training. Parishioners were to be treated with the greatest empathy while the sinners from outside were to be shunned and set aside.
Yet are not parishioners blessed with the knowledge of the path that is before them? And are not the sinners ignorant of the path all the more deserving of our attention and care for that?
Ah well.
All this to say that I am starting to come to the conclusion that limerence is the egodystonic form of attraction.