How OCD therapy can help us tolerate uncertainty

By Geoff Harris

I have a couple of questions for you. How many of you are worried about the long-term effects of the pandemic, whether you have been unlucky enough to get it yourself, or are just concerned about the economic fallout?

Quite a high number, I am guessing. Second question: this time last year, how many of you were worrying about a global pandemic making 2020 a memorable year for the wrong reasons? I wager the number is much lower.

The point is this. Worrying about the future, or finding uncertainty hard to deal with is something many of us suffer from, and the Covid-19 crisis has brought it into sharp focus. It is also often the case that things we worry about don’t automatically tend to pass, while it’s the problems which fall out of a clear blue sky – such as Covid – that tend to hit hard.

So, given that our uncertainty anxiety has not been helped by the events of 2020, what can we do to help us handle the unknowable in a more serene and centred way? It might be helpful to look at successful treatments for people who really, really have a hard time with uncertainty – OCD sufferers.

We’re not talking about people with a cute sock-tidying fetish, but people tortured by intrusive, irrational thoughts, and the subsequent tsunami of anxiety that they will do anything to allay. What if I have poisoned my kids by not cooking the food properly, or cleaning carefully enough, or not checking the garage for asbestos before doing that building work? What if I contracted HIV without realising it and gave it to my partner? What if my blasphemous thoughts will damn me to hell?

So, people with chronic OCD tend to turn to compulsive behaviours, which seek to quell the worry and panic: the reassurance seeking, the compulsive hand-washing and medical tests, and so on. These only give short-term relief and are more addictive than crack. It’s not pretty, but fortunately, some truly psychologists, such as Dr Jonathan Grayson in the US, have done some fantastic work in identifying the need for certainty (or the intolerance of uncertainty as a major factor in chronic OCD).

Grayson is a tough, compassionate therapist with a great sense of humour, and I strongly recommend watching some of his videos on YouTube.

A key part of his message is that accepting uncertainty is something we all have to tolerate, and do so on a daily basis. When you meet that special one, there is fairly high statistical chance it will end in divorce; when you find your dream job your boss could turn into a tyrant, or the economy could tank, and so on.

But rather than worrying or obsessing about this, so it spoils the present moment, what about realising how much uncertainty we are already able to accept in our lives? Most of us drive to the shops without giving a second-thought to getting mangled in a terrible accident on the way (it happens). You wouldn’t expect for phone or laptop to ignite as you read this and cause burns or a fire, but it has happened.

Grayson and his peers present a very simple argument in therapy. Sorry, you can't have 100% certainty about pretty much anything, except death or taxes.

As part of developing a thicker skin when it comes to uncertainty, the best OCD therapists encourage sufferers to try and recognise and escape from the endless loop of ‘what if’ thinking – these soon snowball of control.

It is usually more productive to recognise that you are going down the rabbit hole when it comes to ‘what ifs,’ and rather than waste any more energy, try to think how you would cope with an actual crisis. Chances are you’d pull yourself together, enlist the support of family and friends, and focus on some practical solutions.

Grayson makes a wonderful point about how you’d respond to a diagnosis of a life-threatening illness, which is amongst the worst news any of us could ever get. After falling apart in the doctor’s office, or on the drive home, you’d have to find some way of handling the situation. Totally collapsing and having an emotional meltdown would hardly set a great example to your kids, for example, and it would spoil what remaining time you did have left.

Another key lesson of OCD therapy is that excessive worriers tend to suffer from very black and white thinking – either things will be totally fine (for which they constantly seek reassurance) or an utter disaster. It's also possible that even if the 'worst' does happen, something good might eventually come out it. Finally, there is another great lesson from OCD therapy, what writer and OCD sufferer Jeff Bell (below) calls 'The Greater Good.' Yes, you can waste the precious present fretting about stuff you can't control and imagining all kinds of disastrous outcomes.

Or you can try and find a 'Greater Good' by recognising and accepting that you are just worrying, and getting up and doing some useful and productive instead for other people. Bell describes this process as a shifting of perspectives – “from a decision framework based on fear and doubt to one based on purpose and service.” It is well worth a try, as this challenging year is not over yet.

What if the worst does happen?

A key part of accepting uncertainty is knowing that you WILL find some way of coping if your worst fears really do come true. Steve Jobs got fired from Apple in a very humiliating and public way, but he picked himself up, set up another incredible company, and was eventually asked to come back and save Apple.

Yes, he died of cancer at a relatively young age, but he even turned that experience into a positive, giving some wonderful speeches that inspire people to this day. Sure, Jobs was a genius, but also take the example of teenage cancer victim, Stephen Sutton.

Again, he died very young, but he chose to find meaning in his fate, raising a hell of a lot of money and giving people the strength to face their own, much less serious problems...

Geoff Harris

I am a journalist and photographer and currently work as the Deputy Editor of Amateur Photographer (AP) - the oldest weekly photographic magazine in the world. Before that I served as the editor of Digital Camera, Britain's best-selling photography magazine, for five years. During my time as editor it became the UK's top selling photo monthly and won Print Publication of the Year at the 2013 British Media Awards. As well as being lucky enough to get paid to write about photography, I've been fortunate to interview some of the greatest photographers in the world, including Elliott Erwitt, Don McCullin, Martin Parr, Terry O'Neill and Steve McCurry. This has been a wonderful learning experience and very influential on my photography. Beyond writing, I am a professional portrait, travel and documentary photographer, and reached the finals of the 2016 Pink Lady Food Photographer of the Year competition. I am a Licentiate of the Royal Photographic Society and hope to take my Associateship whenever I can find the time. In addition I write about well being/personal development and antiques collecting for a range of other titles, including BlueWings, the in-flight magazine of Finn Air.

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