There is no such thing as a perfect choice. Sure, some options are obviously better than others: Do try to get some sleep instead of staying up for hours doomscrolling, don’t eat the sushi your roommate accidentally left on the counter overnight.
But for the most part, no matter what obsessive-compulsive disorder (OCD) might insist, there is no exact right decision waiting to be uncovered through the perfect blend of research, rumination, and reassurance-seeking. And while tactics like reading up on a topic and seeking opinions from others are common ways to make more informed decisions, not every decision warrants a deep dive, and not all information found through research or advice from friends is actually helpful, especially if OCD drives you to seek it out compulsively.
If you’re finding yourself feeling like every choice is agonizing and overwhelming, or requires a seemingly never-ending cycle of exhaustive research, rumination, or reassurance-seeking, know that you’re not alone—and that OCD may be at play. Learning how the condition could be impacting your decision-making process and how exposure and response prevention (ERP) therapy can help you manage symptoms are key steps toward feeling like your choices are truly your own. So let’s take a look at some of the ways OCD can impact decision-making.
1. OCD can cause you to distrust yourself, and make it hard to connect with your intuition
Even under the best of circumstances, it can be hard to listen to your intuition or know what you truly want—and OCD is world-class at making you second-guess yourself. Whether you’re trying to decide whether to move to a new city, change career paths, or simply choose what to have for lunch, OCD can hijack the process by demanding an impossible level of certainty.
What’s more, the intrusive thoughts caused by OCD are ego dystonic, which means they’re completely at odds with your actual values and beliefs. But this can be hard to remember when you’re fighting off a particularly distressing obsession. OCD can make you question who you really are, what you actually care about, and whether or not you’re even the sort of person who can be trusted with serious topics—like a cross-country move or career change. And when you don’t trust yourself, or when you’re constantly being bombarded with thoughts that contradict your true intuition, it can feel even harder to figure out what you actually want.
2. Excessive research, rumination, and reassurance-seeking can delay your choice
If you have OCD, you may already be all too familiar with the unholy trinity of research, rumination, and reassurance-seeking. These compulsions are particularly difficult to push back on in the midst of decision-making because, while some OCD compulsions can more easily be identified as harmful, these three often feel so reasonable.
Let’s imagine you need to buy a new hairbrush, for example. It can be good to read online reviews before pressing the “purchase” button. But if you’re spending a full week doing so in an attempt to confirm the hairbrush won’t contain microplastics or other chemicals that you worry will contaminate your scalp, or asking multiple friends whether they think the companies you’re browsing have ethical enough labor practices because you feel personally responsible, your behavior may be driven by OCD. Before you know it, more than a month has gone by, your hair is still tangled, and it starts to become clear how much research, rumination, and reassurance-seeking are slowing you down.
3. Just right OCD can prevent you from acting unless everything feels perfect
If you’ve ever had a surgical procedure, you were likely told not to make any major choices after being under anesthesia because its side effects can impair your judgment. This is a reasonable concern, and good cause to hold off on decision-making. However, if you have OCD, you may feel like circumstances are never perfect for making a major choice. Just right, or perfectionism, OCD is a subtype that can cause a pervasive and unbearable sense that something is “off.” You might feel like you can’t possibly be equipped to make a difficult decision because you aren’t well-rested enough or in exactly the right frame of mind. Or, you might get stuck in decision paralysis because none of the options before you feel perfect, and therefore, they are all impossible to pursue.
4. Hyper-responsibility can make it feel like you’re making choices on behalf of the entire world
If you have OCD, it can seem like every choice is life or death, and like your actions have an outsized impact on the world. Hyper-responsibility is a very common OCD theme that can make it feel as if you’re excessively or disproportionately accountable for preventing harm, controlling outcomes, and managing other people’s emotions. How are you supposed to buy groceries when you can’t stop thinking about how one careless purchase could mean that you’re inadvertently contributing to unsustainable agricultural practices, or supporting a company that invests its revenue in initiatives you disagree with? Hyper-responsibility can slow you down, or stop you altogether, when it comes to making decisions of all kinds—from what to buy for dinner at the grocery store to whether to apply for a new job.
5. People-pleasing and fear of rejection can drown out your own values
Of course, there are lots of decisions that do impact other people, especially those closest to you. For those with relationship OCD, which causes intrusive doubts and fears about relationships, choices that might have implications for others can feel extremely high-stakes, no matter how small the actual impact might be. And even if your OCD doesn’t focus on your relationships, common OCD themes around hyper-responsibility and distrust of self can still make it harder to ignore other people’s opinions or reactions. Many people with OCD have a powerful urge to “people please” that can lead to ruminating on social interactions or compulsively trying to meet others’ needs—at the expense of their own desires. Feelings of guilt, fears of being a bad person, and concerns about being socially rejected by others can make every decision feel like an opportunity to be judged negatively by others. In short, the fear of displeasing others or being rejected for your choices can make it impossible to act on them.
You make your decisions, OCD doesn’t
Ultimately, the biggest effect OCD can have on decision-making, regardless of the specific subtype you might be dealing with, is slowing down the process or grinding it to a halt altogether. It may feel like meticulous research, unending rumination, or other time-consuming compulsions are going to help you make the perfect choice. Your overpowering fear that you will make the wrong decision, or that a decision you’ve already made is wrong, can cause you to freeze, or backtrack once you’ve finally made a decision. But the reality is that there is no perfect choice, and these actions only add to your anxiety and cloud your judgment.
And in many situations, these actions can delay your decision until you lose the opportunity to make a choice altogether. If your partner is at the grocery store and texts you to ask what you want for dinner, taking too long to answer because you need to research or worry about their response to your request probably means you’ll end up eating whatever they decided to buy after not receiving your preference in time. And, under more serious circumstances, putting off a medical procedure because you’ve gathered all the information you can but still feel like you need more to satisfy your OCD can have a serious and lasting impact on your health.
Compulsions around decision-making can be confusing, because they can seem similar to strategies that are genuinely helpful. But if you feel an incredible sense of urgency around making a decision right now that’s driving your behaviors despite there being no actual imminent deadline, and if, after engaging in these behaviors, you feel only temporary relief, it’s likely you’re experiencing OCD symptoms rather than using effective decision-making techniques. An ERP therapist can help you learn to tell the difference.
ERP therapy, a specialized form of therapy designed to treat OCD, can help you recover your decision-making process by helping you learn to trust yourself, tune out OCD doubts, and connect with your true values and intuition—so that you can use them in making your decisions. If decision-making is a serious struggle for you, an ERP therapist might focus your work here—recommending that for small, low-stakes decisions like what to eat for dinner, you practice setting a timer and making the decision in an allotted amount of time, like 30 seconds.
For bigger decisions where it may still be helpful to utilize research or advice from others, an ERP therapist can help you learn to recognize when this behavior becomes compulsive. By learning to focus on what emotions are driving your behaviors, you can begin to discern the difference between problem-solving and rumination, and resist listening to the doubt and fear that drive you to try to delay or go back on decisions once you’ve made them. In this way, ERP therapy can help you identify what really matters to you beyond your fears.
Having OCD doesn’t mean that you have to forgo research or the advice of others entirely, or make every choice in 30 seconds. Big decisions deserve consideration, and you’re capable of that consideration. You can learn how to make your own choices, rather than having OCD make them for you.
