OCD is known as the “doubting disorder”—it doesn’t answer to logic. I believe that one of the reasons it causes so much suffering is that people with OCD most often recognize the illogical nature of their obsessions and compulsions. People can have great insight into their own behaviors, yet feel powerless to fight them.
For someone with OCD, the existence of a mere possibility around their fear, no matter how illogical, can cause intense anxiety and distress. Despite their own logic, OCD latches onto the slightest uncertainty surrounding their obsessions. They may try to reassure themselves that they know better, and that their thoughts are completely illogical, but OCD always finds a way to overcome their logic.
Why logic doesn’t work
When someone is in the midst of an OCD attack or they have been triggered, it may be helpful to remember that they are responding based on feelings, not misunderstanding. Their brain has been falsely alerted that they are in danger and that they have to act in order to feel safe.
When you have OCD, you have developed sets of behaviors that help you relieve anxiety and distress briefly when your brain’s alarm system is set off by triggers. The problem is that this is only temporary, and it actually reinforces the idea that the trigger posed an actual danger in the first place, since you felt better for a while by responding to it. There’s no way to distinguish these false alarms from real danger, because they feel identical.
Consider an example. Someone saw a small puddle of liquid near someone’s car in the grocery store parking lot. They drive all the way home before their OCD is triggered: what if the puddle was from a leaky gas tank? What if it ignites when they drive off, causing an explosion? If they don’t turn around and warn the person immediately, they’ll be responsible for that person’s death, and potentially others. Nothing could be worse than that.
That is how powerful feelings triggered by OCD can be. You might ask them: did the puddle look like water? Did it have any smell? Why would it ignite? Wouldn’t it evaporate before you get there? Every question could expose the person to how illogical their fears are, but their fear will persist, and they’ll continue to feel anxious and afraid. There’s still a shred of uncertainty that lingers around their thoughts, and the anxiety that grips them feels 100% real. Driving the whole way back to the store, searching for the car, and waiting for its owner to return feels easier than relying on logic and sitting with their feelings. That is the allure of compulsions. They provide some degree of relief immediately—even if they take over a person’s life entirely, they feel like the easier route to take.
If logic doesn’t work, what does?
Arguing with OCD will only serve to frustrate people while OCD continues to get worse. That is because they understand the often outrageous nature of their fears, and yet feel powerless over their feelings. Initially using logic feels assuring and useful, but in the long run, it can never suffice.
Instead of trying to rationalize their intrusive thoughts and anxiety, it is far more beneficial for someone with OCD to learn about how their brain is working and how OCD causes its “alarm system” to malfunction. Learning that they can tolerate the distress that comes with uncertainty is a key component of OCD treatment. The idea is not to get rid of the anxiety or to fix the faulty alarm system that brings anxiety, but to allow the alarms to go off and sit with the anxiety without resorting to compulsions.
This process is central to Exposure and Response Prevention (ERP) therapy, the gold standard treatment for OCD. ERP uses exercises called exposures to trigger anxiety and distress related to one’s obsessions, providing an opportunity to engage in response prevention and resisting the urge to engage in compulsions.
When a person consistently responds to exposures by allowing uncomfortable feelings to be present without engaging in compulsions, their brain gradually learns that these feelings don’t pose any real danger. With consistent practice resisting compulsions, obsessions cause less distress and return less often.
ERP has been found effective for 80% of people with OCD. The majority of patients experience results within 12-25 sessions. All of our therapists at NOCD specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is for long-term recovery. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.
When using logic to solve uncomfortable feelings doesn’t work, it can feel like there’s no way out, but recovery from OCD is possible. If you think you may be struggling with OCD, please schedule a free 15-minute call with the NOCD Care Team. You don’t have to suffer forever.