Sunday, April 29, 2012

OCD: Struggling to live with uncertainty

A few weeks ago, during a cognitive behavior therapy session, my therapist and I talked about the consequences of following through with an exposure, the one where I would get rid of my pile of unopened mail and other papers.
I could see only a positive outcome from making the paper pile disappear into files and trash bags: I wouldn’t have that task hanging over my head, causing me to feel anxious.
So when my therapist asked me what the consequences would be, I replied, “The anxiety about it will be gone.”
He then brought up a point that I had failed to fully consider: “But won’t you keep on getting mail?”
His point was that as long as I received mail, I would face potential anxiety. I would continue to worry that I had somehow missed something, an unpaid bill, the discovery of something legally important that I had failed to do, etc.
“You’ll never be able to be certain that everything is taken care of,” he said.
He was right. Getting rid of one pile of paper would not take care of any uncertainty I would ever have in my lifetime about my efforts to take care of all my business.
What I had to do, he said, was to learn to live with the anxiety, to feel the anxiety but then refocus my attention and actions and move on.
* * *
This week, a couple of my fellow bloggers wrote about uncertainty and living in the “gray” area. Sunny, of 71 degrees & Sunny, wrote about uncertainty surrounding the health of her cat and her husband’s battle with IBD. Janet at ocdtalk wrote about getting out of the black and white thinking into the gray.
Their posts prompted me to think more about uncertainty and how to handle it.
Those of us with OCD often struggle with uncertainty. One of the reasons we perform compulsive rituals like cleaning and checking is to try to be certain that, for example, there are no germs lingering on the surfaces, that nothing has been left undone that could cause a fire or some other danger.
Compulsive rituals cannot bring certainty, though. OCD thoughts are not rational. They are not rooted in reality. They cannot be tamed with some short-term assurance of certainty. Giving into the rituals doesn’t keep the doubts from returning.
Everyone, not just people with OCD, has uncertainty. There’s just no way for any of us to be certain about many things.
* * *
I made up a list of things that I am uncertain about for myself and for my loved ones:
Will we develop cancer, heart disease, Alzheimer’s or some other serious disease?
Will we have a wreck during any of the many times we travel by car from one place to another?
Where will the next terrorist attack occur?
Will fire, a tornado, a flood or some other natural disaster destroy our home?
Are the decisions we make about our finances the right ones?
Will we always have the benefits of health insurance and access to care?
Will I have a job tomorrow?
* * *
If uncertainty is a given, then how can I live with it in a healthy way?
The only way I know is to embrace the here and now and remind myself that I will handle whatever comes the best I can.
If the only thing I have for certain is the present moment, then I need to fully live in the present moment.
I need to make sure that what I’m doing in the present moment is something good and meaningful and helpful to the world.
I need to say what I need to say now, and do what I need to do now.
I need to be grateful for what I have right now.
Living in the now doesn’t preclude planning for and preparing for the future. What it precludes is worrying about the future.
Of course, all this is easier said than done. But I have hope and faith. They are key for me.
The easiest area of my life to live with uncertainty is my spiritual life. But that is for another blog post, which I will write soon.
* * *
What is your relationship with uncertainty? How have you made peace with uncertainty?

27 comments:

  1. Oh boy - this is soooo key!!! I think it's a bit of a philosophical thing too. I find that as soon as I make up my mind to commit to living with uncertainty - the obsessing usually goes away pretty quickly! It's such a fine nuance - the difference and I can quickly flip back into trying to gain certainty about things so easily. But I still HATE uncertainty, and really wish that I could FEEL certain about so many other things in my life. I remember Dr. Jon Grayson made a comment in his book that even FEELING certain about something doesn't necessarily mean anything because many people FEEL certain that they are marrying the right person on their wedding day, but look how many weddings end in divorce? That was a good point, I thought.

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    1. POC, that is a good point--feeling certain doesn't equal certainty. I, too, can quickly flip back and forth between being OK with uncertainty and trying to achieve certainty. I guess it will always be a battle to some degree.

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  2. Uncertainty and I are like an old, bickering married couple. Sometimes we get along, sometimes not so much. In some ways, I have simply given up the fight with regard to controlling things. I just can't keep all the balls of life juggling at once any more. More than that, I just don't care about all the little details as much. Between the torment of my near breakdown in the Fall of 2009 and living through my husband's illness, life just seems different since then. I guess it really convinced me of the fragility of life and the absolute need to embrace what I have at this moment. Furthermore, CBT/ERP plus being properly medicated has also helped me deal with the day to day anxiety of uncertainty. Lastly, one of the things I've come to realize is that even when I did everything humanly possible to combat uncertainty (all the rituals and checking, planning, worrying) it was never enough. Never. No matter what, there was always something I missed or something I had no control over. Mentally, I'm just so tired of fighting with uncertainty. I give up. It wins.

    I know the mail is very difficult for you. I'm sorry. You will get through this. Literally, just one piece of mail at a time. You seem to have incredible insight into your OCD, and that is a huge advantage. I think your doc is right. Sitting with the anxiety is important. I know you will eventually beat this.

    Oh, thanks for mentioning my blog!

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    1. Sunny, I love the "old, bickering married couple" analogy! And I totally get just getting so exhausted with trying to control everything and find certainty. I think giving up on trying to get certainty is a healthy thing.

      And you are so right--none of the rituals are ever enough.

      Thank you for your encouragement! :-)

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  3. Uncertainty is obviously a big deal for me too. Whether it's dealing with germs or whether or not I may have/haven't touched something. Sometimes I get to the point where I'm just to tired to care. Like the bottle of Tide still sitting in my laundry room floor.

    Just out of curiosity when you do try to organize your mail do you label it or put it in a container or folder? Maybe once you've paid it you can mark it as paid and slip it into a notebook or box. Then only keep it for a few months and then dispose of it to add more. Maybe store it quarterly or something. I don't know all of the details with the mail and your anxiety, but it's just a thought. I'm sure it's been suggested before though. Anyway, I know you're going to eventually overcome the mail anxiety just like you've done with other issues in the past. One day at a time. :)

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    1. Yes, one day at a time. That's all any of us can do! :-)

      I create folders, but I end up "stuffing" things into them or not using them enough. I bought some banker's boxes and folders, so I've got the tools ready. I probably do keep some documents longer than I need to. Thanks for your suggestions!

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  4. I think dealing with uncertainty, or the unknown, is definitely an anxiety-causing issue. Great post as always Tina.

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    1. Keith, when I realize how much really is unknown, it can throw me for a loop! Thanks for your comment!

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  5. I've been struggling with uncertainty lately with regard to living in a new town and state. Though we're having a lot of fun, I still have to work through the anxiety. I'm still figuring out the layout of the food co-op, so grocery shopping, normally a relaxing task, feels nerve-wracking.

    The good news is that I was able to move at all, and I am giving myself plenty of time and space to work through those anxious feelings. Having the tools to cope makes all the difference in the world. It may take me longer to relax and enjoy my new home, but I'll get there.

    Thanks, as always, for a thought-provoking post. Sounds like you continue to do great work!

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    1. Nadine, moving across the country is a major change, and it's understandable that would cause a lot of anxiety. I think you're handling it great! You've already gotten involved and started exploring things, including gardening. It's so wise of you to take it at your own pace. I hope the relaxation and full enjoyment come soon! And yes, you will get there.

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  6. While there are some things about OCD that are difficult for me to understand, not having the disorder myself, living with uncertainty is one I can relate to well. We all have to live with uncertainty, because life is uncertain. I think how we learn to deal with it is what is so important, as you say Tina. One day at a time for all of us; that's all we can do. Thanks for mentioning my blog!

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    1. Janet, Thank you for your comment. So true: life is uncertain. One day at a time helps to keep us focused on the present, I hope. :-)

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  7. I don't have a good relationship with uncertainty.

    My therapist says this is the reason we OCD people do all we do is because we are craving that 100% certain whatever we are looking for. My therapist said most people accept uncertainty without having to do compulsive rituals like OCD people.

    I am trying to learn to accept uncertainty but it is soooooooo hard. Some days are better than others.

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    1. Elizabeth, For me, too, some days are better than others. I have just recently begun to see that the rituals are a vain attempt to find certainty. I have craved certainty in just about every area of my life.

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  8. Your posts are so very interesting. I have never really heard the true perspective of somebody with OCD before. I think what you say is good advice for anybody who suffers from anxiety, though. Thank you again.

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    1. Thank you, Rebecca! :-) I do hope that even people without OCD can relate to what I write about. All of us have some anxiety--to a certain degree--at some point in our lives. Sometimes it's really difficult to deal with.

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  9. Holy Cats Tina!
    Ok, OCD wise and with my checking rituals, I am constantly saying things like this: "This is my ocd and I see the door is closed, so it's closed and if if I am wrong, which I am not, then I have to just live with the consequences of that. I hate uncertainty - I like all my duck lined up in a row. But sometimes I think I am ruining the present just by worrying about the future..so I work on that all the time:enjoying the present.
    But the reason I say "holy cats" is that I have something coming up that is super exciting but I will have to move forward with absolutely no certainty for the next few weeks and either I except this and do it, or I lose out on the whole adventure. I've chosen to face the risks and just "ride the waves" so to speak. I will be writing about it once it is over and I can't wait to share it all.

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    1. Krystal, I do the same thing--I'll tell myself things like, well, if the light isn't off (and I know it is) and a fire erupts, I will have to deal with the consequences then. It actually helps!

      I agree--worrying about the future, and the past, keeps us from enjoying the present.

      Now you've got my curiosity up. It's super exciting, and you can't write about it yet. Hmmmmm. I can't wait for you to share it! :-)

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  10. Oh, I do worry about Alzheimers! I have a family history plus I had a skull fracture at one point - both bad news in the Alzheimers front. I read this book Still Alice and couldn't sleep for like a week.

    Mostly, I run, it helps me deal with uncertainty or anything else.

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    1. Lisa, running is such a healthy way to deal with uncertainty or any kind of anxiety or worry. I used to run and found that to be true. I want to get started again, but I've been saying that for a while :-(
      Thanks for your comment!

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  11. I think about how I can respond and that I have total control over that instead of the uncertainty I have no control over. I trust in myself. This gets rid of anxiety which is really not trusting oneself.
    Love,
    Jodi

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    1. Very, very good points, Jodi. I need to remind myself of that, that I can only control my reactions to things over which I have no control. Not trusting yourself--that is a new way for me to think about anxiety. Thank you!

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  12. I used to worry a lot and be afraid of uncertainty. Life has proved that worrying hasn't helped change any situation, and I have enough things going on now to take care of.
    I loved this post! Thank you Tina.

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    1. Thank you, dear Nikky! You are so right--worry doesn't change any situation, and never will. And worrying about the future is worrying about things that may never happen/probably won't happen. Then we've worried about nothing.

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  13. Hi Tina,

    I found your blog accidentally as I browsed through internet. I too have a chronic OCD and get to the point that I accept the fact that I have OCD. Mine is specifically related to harsh chemicals; things that are too acidic or too basic. Unfortunately, this includes gastric acid which contains HCl. I always excessively checked myself whether I vomited or I belched and some vomit came up. Yes, ERP is very hard to do. I will remind myself anytime I do the ERP that nothing is certain in this world. Thanks for the blog, and I am going to start following it closely! ;)

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    1. Good to have you reading and commenting! That's a good thing to do, to remind yourself that nothing is certain as you do the ERP. That kind of drives it home. I hope to hear from you again, and feel free to "join this site" at the top of the page next to my photo.

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  14. Tina, I can relate to this so much. I am shaken, and made anxious, all over again, every time I hear of some terrible freak accident, or natural disaster, or instance of man's evil against man - such as poor soldier Lee Rigby who died this week at the hands of brutal, machete-wielding maniacs. As you said in an earlier post this week, it is only be sticking together that we can face these things.

    It reminds me of when I lost a dear friend 4 years ago - she had had cancer for a long time and we knew she was getting sicker and sicker, but she was suddenly taken by pneumonia, when none of us expected it (not even the medical staff caring for her realised how close to the end she was). That just proved to me that you really can't be prepared for anything, even when you think you are.

    I am enjoying your writing and glad to have found your blog.

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