What does it mean to “live with uncertainty”?
A common phrase used in the treatment of OCD is “living with uncertainty”. But what does this mean? All of us live with uncertainty everyday. Probably more so than we typically stop to think about. For instance, no one knows with 100 percent certainty how our day will go when we get out of bed each morning. Will you spill your coffee? Will your train be on time? Will you make it safely to your destination? None of these things can be answered with certainty ahead of time. In order to function in our world there is a certain amount of risk that we must take, whether we realize it or not. While some risks are larger and more obvious than others, there really is nothing in life that is completely free from risk. Therefore, living with uncertainty and accepting risk an essential part of functioning.
OCD & Risk
For people living with OCD, an unspoken acceptance of risk exists in some aspects of life, and yet in others there is a strong demand for absolute certainty. This demand can be attached to anything. For instance “am I gay?” “am I a pedophile?” “does my partner love me?” “did I get all of the germs off of my hands?” As easily as your brain can think a thought, OCD can attach to it and insist you have certainty on the matter. The lack of certainty feels terrifying and as a result, large amounts of time and energy are put into efforts to eliminate the risk that the thing you fear most could happen.
Compulsions and risk elimination
The actions through which a person living with OCD seeks to eliminate risk and gain certainty are called compulsions. Compulsions provide short term anxiety relief by letting the brain temporarily believe that risk has been avoided. For instance, if the fear is “what if my partner is cheating on me?” you may get some relief by checking the text messages on his/her phone. However, this feeling of certainty is fleeting and before long you are re-engaged in a compulsive behavior, caught in an ongoing cycle of fear and short term relief. Relying on compulsions to provide temporary comfort can ultimately become frustrating and futile as more of your time is consumed and your goal of having absolute certainty is never achieved.
Acceptance as a treatment goal
Upon entering treatment for OCD a large portion of the work will be focused on accepting that there is no life without risk. While this might sound harsh and hopeless, there is in fact freedom in accepting this reality. Letting go of the search for certainty means allowing some questions to remain unanswered or to be answered using a “best guess”. This means that while you might not be able to know with complete certainty that all germs have been removed from your hands after one wash, you can learn to trust your best guess and hold the risk that comes with it. While it will take time to get used to the fear and discomfort associated with this practice, the long term benefits are life changing. Accepting that life without risk cannot exist allows you to move forward and engage with the world around you, rather than being stuck in an endless cycle of obsessions and compulsions. The challenging and rewarding work of living with uncertainty can help you to find value in your life in ways that previously felt impossible.
Wishing you all the best in your treatment journey,