Updated: Jan 3, 2021
Struggles with uncertainty are at the core of most manifestations of OCD (there are exceptions to this that I may write about in a future post). When we struggle with some kind of anxiety (sometimes it is guilt) it is usually because there is an inability (impossibility is probably a more applicable word) to obtain a sense of knowing that our fear, anxiety, guilt et cetera is unfounded in reality. For example, "My eyes naturally darted toward that child in a bathing suit on television. Something is wrong here - possibly something is wrong with me and I need to know that nothing is wrong". Wham! This is where the uncertainty factor comes in to play. There is a doubt and over-attendance to the bodily process and thoughts around my eyes moving toward the child in the bathing suit. "Perhaps it is a sign I have an unconscious desire to sexualize children. Or, it's not even unconscious, but rather I am just in denial". This reasoning is highly incongruent with my values, hence the extreme degree of distress it causes. This high amount of contrast in thinking and feeling is known as ego-dystonia. That is, thoughts, feelings, sensations are not in agreement with how I truly think and feel. Now, the sufferer may ask "How do I know how I really feel, or who I really am? Which thoughts and feelings are the REAL me?" We are back to the issue of uncertainty. In this scenario I need to know I'm not some sexual misfit; my whole character and integrity are on the line here! This is usually where the compulsions begin. I may review the event over in my mind and rescan my genitals for a sign of arousal. Or I may express my concerns to people in an attempt to get reassurance that there is nothing wrong with me (I highly advise NOT doing this with someone who doesn't understand OCD as it can seriously backfire). I may do all sorts of things to try and get assurance that I'm ok. I may even intentionally look at a child in a swimsuit to see if I'm aroused or if it felt 'natural.' At times this may work, at best, temporarily. Then the next situation arises later that day, or in the week/month, etc. We OCD sufferers know the insidious cycle all too well; get hit with uncertainty, feel fear, make an attempt to quell fear, which further reinforces the obsession, then we find ourselves getting hit with the obsession again in the future.
The core issue in the above paragraph is an intolerance to what I like to call focused uncertainty. I prefer the term focused uncertainty because we actually possess very high degrees of tolerance for uncertainty in areas outside our OCD realm. For example, (for those without health anxiety) who's to say that headache I had the other day was just a headache and not a symptom of a more serious condition? Generally, we make decisions based on what we think we know and how we feel. For example "Headaches are a common occurrence in people. I'm probably fine, besides I was highly stressed with that work task earlier". The example of driving is a great example. When we tell our loved ones "I'll be right back, I'm just going to drive over to the store and grab some groceries". What we are really saying is "I'll be right back so long as something tragic doesn't happen, like me getting murdered or getting into a car accident". Of course, we don't speak in these terms because embracing uncertainty verbally in everyday life would make for some very long, confusing, frustrating, and uncomfortable conversation. So we make the assumption that we will get back home safely. Which we usually do, given what we know about driving on average. Yes, car accidents are possible, but out of the last 500 times I've left the house in my vehicle I haven't gotten into any accidents, this is not to say that it won't happen, however. Further, people drive all the time. In fact, they even place their young children in these hunks of metal that travel at high speeds and have the capability to kill. If we realize these negative outcomes are even the slightest possibility, why the heck aren't we rushing to the doctor or never leaving the house? Why would someone take such a risk? Because a life without such risks is no life at all. When we leave the house, we FEEL as if we'll be okay and make it home safely, but we don't really KNOW FOR CERTAIN. This can be a terrifying realization or thought for someone with OCD. Most people are able to take the driving risk mentioned in the prior scenario. If this is a focus of your OCD, however, it will not be so easily navigated.
Some input that may be helpful when caught up in an OCD loop is asking yourself the following list of questions from the non-exhaustive list below:
What is it that I feel I need certainty over? What do I need to know?
Can I open myself up to the fact that I can never truly know with 100% certainty? If not, what are my alternatives? (Unfortunately, there are none, but if you do find one please let me know!)
Am I holding myself to a double standard? Do other people have to encounter this as well? How would I think they would handle this situation?
Am I over-attending to my thoughts, feelings, or sensations? That is, giving them more importance than they deserve.
Can I be open to the possibility (NOT probability, these two things are VERY different) of my worst fear being or coming true?
Lastly, why would I be willing to live with and even embrace this uncertainty? How has OCD hurt me and my loved ones?