Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Dealing with Doubt

By Stacy Quick, LPC

Feb 22, 20226 minute read

One of the hallmark symptoms of OCD is doubt: calling into question something’s certainty, and believing something is unlikely or questionable. Often dubbed the “doubting disorder,” individuals who experience OCD are often plagued by the idea that they cannot trust their own memories or own self. 

These feelings of doubt can be strong and chronic, often leading a person to continually check or repeat things to ensure they were done. Someone with OCD may be able to recognize when feelings and thoughts are illogical, but the intensity of the doubt can override that knowledge. 

The reality is that “certainty” is a facade, and true certainty doesn’t exist. We live in a world full of uncertainty. But the good news is that you can learn to accept uncertainty and live a full life without ever having 100% certainty about the things that OCD wants you to question. 

Mistrust of one’s perception and self

As someone with OCD and a therapist trained to treat OCD, my experience has been that those who struggle with OCD often doubt themselves on a deep level. They doubt who they are and what they may be capable of. Fear and doubt overrule the logical part of them that knows what their values are, and understands that the thoughts they are experiencing don’t align with their beliefs. 

Doubt can be seen through rituals where people with OCD ask others for reassurance, valuing their opinions over one’s own. It can include seeking answers online from strangers who aren’t necessarily qualified to help them. It’s as if there is an unyielding mistrust of one’s own judgment, and that other people’s opinions are somehow more accurate. 

Doubt can also be seen through the need for many to “confess” to someone else the things they’ve thought, said or done in an effort to be told that it was okay. As if they themselves do not know right from wrong, even when they do. The irony is that the people struggling may often be profoundly conscientious and considerate, which is why their doubts are so powerful. OCD makes them feel a need to be certain, when building confidence is actually what they may need. 

That is to say that there is a difference between feeling confident that something may or may not take place and feeling certain. For example, we know with confidence that the grass is green. One may argue they are certain of this. But it is not so simple – someone who experiences color blindness may see a different color, or maybe someone else’s grass is dying and appears brown. Maybe there is a chemical reaction that takes place and changes the color of the grass. Regardless, you can still proclaim with confidence that grass is green, and people will likely accept that answer. But the truth is that we can not be 100% sure that all grass is indeed green. Yet we still move forward with the belief that grass is green because we have a high level of confidence in that. 

“But my thoughts are bad or dangerous thoughts”

The people I have met over the years who struggle most with the concept of accepting uncertainty and sitting with anxiety are those who feel that their thoughts, images, urges, or feelings are too bad to be ignored, or too dangerous to just accept and move on from. 

For those who may experience fears of being a pedophile or a murderer, tolerating uncertainty can be terrifying. It is difficult to imagine a life in which they face the outcomes of this being true. It is nearly impossible for them to picture this ever being something they could cope with. There are a few problems with these scenarios however. The first, as I’ve mentioned, is that certainty is an illusion, and that there is only confidence. Confidence that you will or will not do something, or confidence that something is or isn’t true. 

Although these thoughts are scary and these ideas can cause distress, it still doesn’t mean that you need to pay attention to intrusive thoughts.The fact is that we cannot control what pops into our brains. It may feel like you need to engage in answering with certainty because it feels irresponsible not to. It feels irresponsible to say “this intrusive thought about killing someone doesn’t mean anything.” At the same time, I can be extremely confident that I will never kill anyone based on my beliefs and my values. 

This is not to suggest that you say there is a fifty/fifty chance that you will kill a loved one or that you will push someone into ongoing traffic. The idea is that you accept that these are possibilities. Possibilities do not equal probabilities. This is a very important concept: just because it could happen doesn’t mean it will. 

Possibilities do not equal probability

OCD doesn’t like this and always demands a definitive answer, even though it knows that there is no such thing. So instead, OCD wants you to believe the lie that if you do compulsions, such as reassurance-seeking and confessing, you will obtain a certain answer to your thought. 

That is false. Will you ever be certain enough for OCD, or will it just come back around again? It’s a cycle: the only way to break it is to learn to accept uncertainty and stop engaging in compulsions. Instead of chasing certainty, you can accept that you are confident that you will not do something, and that is enough. 

There is always a chance that something could happen, but you can be confident, based on your own beliefs and values, that it will not happen. I hope you will learn to live your life in the here and now, in the unknown, even when it’s uncomfortable. 

Although it might seem hard right now, you can learn to sit with the discomfort of not knowing. By practicing exposure and response prevention (ERP), you will find that eventually those feelings dissipate and happen less frequently. ERP teaches you to tolerate these difficult feelings and learn that you do not have to do rituals. You will see that anxiety, like any other feeling, eventually passes, and you don’t have to do anything to make this happen.

With time, an ERP-trained therapist will ask you to sit with the possibilities of even your scariest thoughts. Through ERP, you can learn to accept uncertainty around them and move forward with your life. You’ll learn to accept that, despite what OCD is telling you, we cannot know with 100% certainty what tomorrow holds and we cannot control everything that happens. Again, possibilities do not equal probability. 

Learn to sit with uncertainty and doubt

If you are struggling with doubt and the need to feel certain, the best way to overcome it is to practice ERP with a specialty-trained therapist. At NOCD, our therapists specialize in OCD and ERP, and they will provide you with a personalized treatment plan designed to meet your unique needs. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.

Our team of therapists at NOCD are passionate about the treatment of this debilitating disorder and are trained by world-renowned experts. To learn more about working with an NOCD therapist, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with our care team.

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