OCD treatment: Living with uncertainty

“Are you willing to learn to live with uncertainty?”

That is the key question OCD sufferers must answer before embarking on the program in Dr. Jonathan Grayson’s Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty.

Grayson holds the premise that there is no certainty in life. Even things that we think we can be certain about, we can’t.

One example Grayson uses is the belief we have that our car is in the driveway. But unless we’re looking at it, we can’t guarantee that it’s there. It could have been stolen and no longer be in the driveway.

  In addition, unless our loved ones are right in the room with us, we can’t be sure that they are safe and unharmed.

He says, “The inability to feel or be certain is reasonable. . . . Improbable is not impossible” (p. 9).

Grayson says that those with OCD already know that uncertainty is a given in life. No matter how hard we try with some of our rituals, we can’t arrive at absolute certainty in those things.

I can relate to that. My need for certainty tends to revolve around the safety of my loved ones, and even of people I don’t know. I want assurances that they will be safe and well, and a lot of my OCD ritualizing has to do with efforts to make that happen.

But keeping others 100 percent safe and well is an impossible task for me. I cannot guarantee their safety, and all of us are going to die eventually.

Grayson says that just knowing that uncertainty exists is not enough. We have to be willing to live with uncertainty.

“It is quite likely that you agree with the premise that you can never be certain. Indeed, the persistence of your OCD symptoms and its constant attendant doubt have shown you that certainty is unattainable. Yet you persist in trying to achieve the impossible. Why? Why won’t you accept what you know?

Answering the question with a ‘yes’ means choosing acceptance of what you already know instead of denial” (p. 52).

A way that we hold on to denial is through “fantasy and wishing. In the case of death, denial is not a delusional fantasy of believing the dead are alive; it is comparing the present with how much better life would be if the deceased were still alive” (p. 52).

There is a price to pay for living in denial, according to Grayson: “However, when we compare reality with fantasy, we also destroy and demean the moment” (p. 52).

That statement hit me like the proverbial ton of bricks. I had never thought of denying uncertainty as denying reality. I had never thought of denying reality as disrespecting the very moment we’re in.

Acceptance of reality means acceptance of uncertainty. Acceptance of uncertainty, living with uncertainty, means living with the uncertainty of whether the lights in the office are off, whether or not my hands are contaminated, whether or not the stove is off, and so many other uncertainties in life, including the big ones, like whether or not my loved ones are safe and well.

My answer to the question? Yes.

  How important do you think it is to accept uncertainty?