As someone with OCD and a therapist who specializes in the treatment of OCD, my experience has been that those who struggle with OCD often doubt themselves on a deep level and distrust their own experiences. They may 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 that they are experiencing don’t align with their beliefs.
Never being quite sure enough
You have likely heard that OCD is called the “doubting disorder”: this is because doubt is an underlying hallmark of this condition. People with OCD often lack trust in themselves and in whether or not an action has taken place. It can seem as though the parts of the brain that remember past events—even events that took place minutes before—are sometimes hindered.
This can cause them to feel unsure about even the most mundane of activities, such as whether they locked a door, which may cause them to repeatedly check to ensure it is locked. Fueling this is an insatiable feeling that often tells them “I need to redo this or figure out an answer, just in case it means something.”
Many people that I have worked alongside would say they know logically that what they are experiencing is a mental glitch of sorts; for example, they know they checked they locked the door. And yet, there is this nagging pull that says “but what if you didn’t?”
Though the triggers and fears differ, the commonality for many people with OCD is the need to re-examine information in great detail in an attempt to find complete certainty. One member I worked with would have to say the same very specific prayer any time she felt triggered. This could take up a significant amount of time because she would question whether she had included certain parts of the prayer just mere seconds after having said it. Another person I treated feared coming into contact with items that could be potentially contaminated and would excessively ask his partner for reassurance about whether or not he had touched them. Even after his partner had confirmed he had not, it would only take minutes before he felt compelled to ask again, never feeling quite sure enough.
Feeling stuck in a spiral of “what ifs” and “just in case”
People with OCD often report a lack of confidence in their ability to make decisions or recall events correctly. It has been suggested that people with OCD may have an impaired ability to rely on the past. Not being able to rely on past information or memories may lead them to question not only past events, experiences, and feelings, but also causes them to perceive unpredictability when faced with similar circumstances in the present.
This means that people with OCD may have trouble believing something even when evidence exists that it is factual. By rechecking or redoing tasks, they are actually experiencing further distrust in their memory and confidence to accurately recall what has taken place. In other words, the more a person with OCD tries to review events or feelings that have taken place, the less likely they are to feel confident in what took place—all of which leads to greater anxiety.
These feelings of doubt and mistrust often lead people to feel “stuck” in a seemingly endless spiral of thoughts, with questions of “what if?” haunting them night and day. Even when they feel confident “enough” about something, there is still often a lingering need to perform a compulsion “just in case.” The act of engaging in compulsions almost always inadvertently teaches their brain that they must do them to prevent any danger.
What we know, however, is that people do not need to “do” anything when they are triggered by OCD fears—they are able to tolerate the feelings of anxiety and uncertainty due to intrusive thoughts, feelings, and urges, even as uncomfortable as they are. The less the person gives in to doing a compulsion for temporary relief, the less that faulty danger signal goes off in their brain in the long run.
Most people without OCD can accept some uncertainty—an example would be that a person who is not struggling with OCD can likely drive down a busy highway, pass by several people walking near the street, and accept with reasonable probability that they have not hit someone with their vehicle. By contrast, someone who has OCD might be in that same situation and mistrust their entire experience. They may think, “how can I be sure I didn’t hit someone? What if I did and I am now responsible for their death?”
They seem to confuse possibility with probability. Even in a situation where there may be a one in a trillion chance that something has occurred or could occur, that nagging feeling of uncertainty can grasp hold of someone who suffers from this debilitating disorder. But there is hope: as paradoxical as it may sound, when you accept uncertainty and live life in spite of it, you find freedom.
ERP can help you become “unstuck” and find freedom
Though it might seem hard right now, you can learn to sit with the discomfort of not knowing if you did or did not do something. 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 about yourself. 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. We learn that possibilities do not equal probability.
If you are struggling with self-doubt, a lack of trust in yourself, 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 is passionate about the treatment of this debilitating disorder and is trained by world-renowned experts. To learn more about working with a NOCD therapist, schedule a free call with our care team.