There are two things that obsessive-compulsive disorder (OCD) loves more than anything: certainty and urgency. And, because OCD is greedy, it prefers both at the same time.
While being unsure can be stressful for anyone, OCD wields uncertainty like a weapon. It can assail you with constant “what ifs” that are as improbable as they are horrifying (“What if someone else touches the same doorknob that I touched and even though I washed my hands they have an allergic reaction to the peanut butter from my sandwich and die?”), making every moment feel like the precipice of an emergency. OCD can also ratchet up the stakes on mundane concerns (“What if I forgot to turn off the light before I left the house?”) until the inability to be absolutely sure creates so much distress that the desperate need to assuage that frantic feeling becomes an emergency in and of itself.
And the more frantic you are, the easier it is for OCD to convince you that the best and only way to feel better and escape your obsessive thoughts is by engaging in repetitive physical or mental behaviors known as compulsions. But the truth is that no amount of compulsions can help you achieve 100% certainty, or permanently quiet that sense of urgency. What can help is interrupting the vicious cycle of OCD through exposure and response prevention (ERP) therapy, the most evidence-based form of OCD treatment, which can teach you to escape the urgency and slow down.
How OCD makes you feel like everything is an emergency
When you have OCD, not knowing something for sure can feel intolerable—and what you can’t tolerate registers as an emergency. Uncertainty is so uncomfortable that it can feel like it must be resolved immediately, which often means figuring out as quickly as possible whether the “what if” thought you’re having is real, doing something to try to prevent the feared outcome from happening, or finding a way to convince yourself that it won’t actually occur.
This might lead to compulsions like checking things over and over again (did you leave the light on? Is the garage door closed?) or engaging in rituals that aren’t practically connected to your obsessions—like feeling like you need to walk in and out of a certain room to keep your family members safe—but that OCD convinces you will ward off the “what ifs” you fear (as is often the case for those with magical thinking OCD). Because any distress feels intolerable, OCD makes these compulsions feel urgent.
This can lead to a sense that there is never enough time. Being even a little bit late, for example, can activate a cascade of concerns ranging from the practical (“What if I’m late for work and get fired?”) to the existential (“What if being late means I’m a bad and lazy person?”). If you’re unable to perform a certainty-seeking compulsion because you’ve been interrupted or the circumstances don’t allow for it, the resulting urgency can feel like a physical, claustrophobic presence.
The result is that many people with OCD feel like they’re rushing through life to assuage this panic, never quite experiencing the present moment because something more pressing always seems to get in the way. Living like this can be exhausting and alienating.
How ERP teaches you to slow down
Although it may not feel like it, the urgency you feel in the midst of obsession is generated by OCD, not by reality. In some cases, distress really is a warning sign designed to direct your attention to something that requires immediate attention. But when OCD hijacks the system that produces that warning sign, the only way to re-set the system is to tolerate that distress until it becomes clear to your brain that your trigger is most likely not a threat. ERP helps you learn how to do that.
ERP won’t necessarily eliminate the feeling of urgency entirely, but it will teach you to let feelings of urgency and uncertainty exist without reacting the way OCD wants you to. Over time, this will help you stop feeling like everything is an emergency.
Building up the ability to resist your compulsions is key to building up your tolerance for distress and uncertainty. Your ERP therapist may recommend you begin with delaying your compulsions, which forces you to sit with the feel or urgency, and realize that nothing catastrophic is happening—even when your mind feels like it’s full of alarm bells. Increasing the time between the urge to engage in a ritualistic behavior and the actual act is like flexing a muscle. First, you’ll develop the self-awareness to sense when you’re feeling the urge to engage in a compulsion, rather than carrying out the behavior automatically. Then, you’ll begin to practice delaying the compulsion for longer and longer. Holding off on a compulsive action strengthens your ability to recognize that urgency is usually a feeling, not a fact.
What you gain by resisting urgency
Part of what makes the “fake emergency” so hard to overcome is the fact that OCD probably isn’t the only force in your life promoting a false sense of urgency. Many people also experience the pressure to treat non-urgent or completely mundane situations like emergencies in the workplace or in interpersonal contexts. Maybe your boss demands that you stay late in the office to finish a task that could be completed during normal work hours the following day. Maybe your mom calls you ten times in a row, because she’s cleaning out the attic and wants to know right now whether you need a box of old Barbies. Once you learn to recognize the false urgency inside yourself, you may start spotting it everywhere. And if you have OCD—and your brain is convinced disaster lurks around every corner and you’re responsible for preventing it—these constant spikes in stress can more easily consume your day.
In addition to ERP, it can be helpful to learn other ways of stepping back from the always-on email inbox, the expectation of an instant text back, and the cultural insistence that you can and should optimize every minute of the day. There is nothing wrong with a morning stretch, a daily mindfulness exercise, or an evening cool-down exercise. All of these things can be a great way to help you stay focused and in the moments of your life. We just ask that when you are doing your ERP, you just do your ERP. No need to add breathing exercises or muscle relaxation to the ERP—in fact, that can decrease the effectiveness of ERP as you will focus on those things and not the point of the ERP, which is to learn to live with doubt and uncertainty!
Ultimately, your goal is to stop reacting to made-up emergencies. Learning to resist the pull of urgency can help you make choices that are authentic to your values and priorities in all areas of your life.
