Introduction
I have recently written two articles about Exposure & Response Prevention therapy (ERP). Today, I will be moving on from this to the closely related topic of Accepting Uncertainty. If you have not read the two articles on ERP, and want to read them first, then you can read Part 1 here, and Part 2 here. If you do not wish to read them first however, then I will try to very briefly summarise them (I would highly recommend reading them at some point if you are not already familiar with ERP).
ERP is a proven technique for treating OCD, that, depending on which theory you believe, works either by showing your brain that anxiety will go away if compulsions are resisted, or by showing it that the anxiety can be tolerated, and will not lead to catastrophe. You are thereby teaching your brain that even though it might feel like something awful will happen if the anxiety is not soothed, it won’t, and/or that you won’t be stuck with the anxiety forever.
In this article, I will be talking about what ‘Accepting Uncertainty’ means, what it involves, why it is so important, the relationship it has with ERP, what barriers there are that make it harder for me to do, and finally, I will be starting to talk about how I am working to overcome these barriers to progress.
As always, nothing you read here should be taken as medical and/or professional advice, and you should always follow advice you receive from a medical professional over anything you read here. The content of this site should instead be seen as my personal opinions, drawn from my own experience of having OCD. For more information on this you can check out the site’s disclaimer.
Uncertainty & OCD
Accepting Uncertainty is an absolutely crucial tool to have when it comes to recovering from OCD.
This is because OCD demands certainty, and thrives off of your need for it. In fact it demands absolute certainty. It is not enough for you to be merely ‘pretty sure’ of something. It tells you that must know for certain (or at least whatever your OCD accepts as certainty, however reliable that may or may not actually be).
It might tell you that the reason why you are spending time going over all these thoughts, again and again, is because you have done bad things, and that you are a bad person. That that is why you spend such an abnormally long time going over all these doubts and fears, which you know most other people don’t have to do. That it is not just because you have OCD.
However, the thing to always remember about OCD, is that it is a liar. It both fuels, and exploits the need for certainty, in a way that is anything but normal. It really does cause you to hold yourself to a far higher standard than a normal person would, and probably than you would hold someone else too as well, and this need for certainty is neither normal nor healthy.
Yes, part of the problem with OCD is the occurrence of intrusive thoughts in the first place (which is still not a sign that there must be some truth to them), but it is also the reaction that it causes to them. This comes in the form of twisting your judgement of them, as I have spoken about before, but also in the form of changing the burden of proof, and in the amount of certainty it requires of you, so that while a normal person would be able to simply dismiss the thought, you feel unable to, and instead engage in compulsions to satisfy it’s need for certainty.
I often think of my OCD rumination as being like a courtroom proceedings. In this courtroom though, as opposed to a normal one, it is absolutely a case of guilty until proven innocent, with the thought not having to suggest why it is true, but instead, me having to prove why it is false. This huge disparity between the amount of evidence my OCD provides (what if I did this?), and the effort I had to put in to prove it wrong (going over it in fine detail to convince myself for certain that it wasn’t true, until I felt emotionally satisfied), was one reason why it was so difficult and exhausting to deal with.
In many ways it more resembles a social media court of opinion, which is just one reason why I believe that social media can be particularly harmful to those with OCD, although that is a topic for another day. However you want to see it though, the need for 100% certainty, and the intolerance of any uncertainty are at the heart of the issues that OCD causes. Accepting uncertainty therefore serves to undermine the power that it has over you.
Why is Accepting Uncertainty so important?
As such, if you always have to be absolutely certain that none of these thoughts are true, then you will keep engaging with them, thereby fuelling your OCD, so the thoughts will just keep coming. Every half-thought-out worry will demand examination, and they will just keep coming.
Sometimes I will feel the urge to go over a thought I have checked plenty of times before, not because I think it is true, or because I have any new information about it, but instead, simply because I haven’t been over it in a while. Or perhaps I do worry it is true, but I know that this is probably because I am in a low frame of mind for whatever reason, but I still feel the need to check.
Therefore, maintaining a level of 100% certainty about my morality and past actions all of the time simply isn’t sustainable. At least not whilst having a good quality of life. The only way for me to be able to live my life normally, then, is to accept uncertainty about things, in this case about my moral self-worth.
I can instead recognise that these thoughts that I am having probably aren’t true (and almost certainly wouldn’t be as bad as they seem anyway) and that it is better to allow myself to live my life, and accept the chance that I am allowing myself to get away with something, than to spend the rest of my life going over them, just on the off chance that one of them turns out to be true/as bad as it seems one day. I can learn to accept that risk, in order to live my life.
This does not have to be seen as an all or nothing thing. At the moment I am still engaging in compulsions sometimes, but I at least feel like the bar for having to do this is a lot higher than it used to be (unless I am particularly low).
For me to engage in compulsions now, there usually does have to be some ‘new information’, and even when I do do compulsions, the level of certainty that I require has changed from having to prove for ‘certain’ that the thought isn’t true, to proving it to myself to a more ‘reasonable’ level of certainty. This means that I can usually satisfy my OCD without even having to go through the whole thing start to finish, let alone having to go through the thought multiple times, from lots of different angles.
With that having been said though, the better I can become at accepting uncertainty, the better my life should be, so this is something that I am still actively working on. The better I get at it, the less of an issue my OCD will be for me, and the more I will be able to live my life as I see fit, instead of how my OCD would have me live.
What does (and doesn’t) Accepting Uncertainty actually mean?
When I say ‘Accepting Uncertainty’, I mean exactly that. All I am doing is accepting that I don’t know everything for sure, that I probably can’t know everything for sure (and I am certainly not willing to pay the price of doing so anyway, if that means I will remain at the mercy of my OCD and its need for certainty), and that I don’t need to know everything for sure, in order to be okay, and to be able to live my life.
What I am not doing by accepting uncertainty, is accepting that these thoughts are true.
By not pushing back, that does not mean that I am giving up, and saying that I can’t push back, or that I am accepting that my OCD is correct. I could respond to my worries if I wanted to, and I would more than likely end up discovering that the thought isn’t true, but then another one would come along and the cycle would continue. So I am making the conscious decision not to respond to them. I am choosing to rise above my OCD’s games, not surrendering to it.
So for me, with my core fear usually being that I am bad person, who has done bad things, accepting uncertainty means accepting that I may (or may not) have done bad things, and that I may (or may not) be a good/bad person. I am accepting that my worries may, or may not, be true, and that despite all this, I am still allowed to live my life, as if this uncertainty did not exist, or as if it doesn’t matter anyway.
I am accepting that I do not have to be 100% certain about this in order to go about my life, and so I don’t have to put everything on hold to deal with my fears, the second I feel even so much as a little bit of doubt. I can live my life as normal, without guilt or doubts about doing so. Equally, I can go on with my life even with guilts and doubts, in the times when they do occur, and trust that they will pass, and that I don’t have to do anything about them (practically or morally speaking).
I am also not allowing my OCD to say that just because I have all these thoughts, that that means there must be some truth to them. That surely they can’t all be wrong. Yes, they can all be wrong, I am just not going to spend the rest of my life proving it. Does that mean that they are definitely not true? No. It just means I shouldn’t allow my OCD to cause me to feel as if they are true, because they probably aren’t. Even though they might be. But also they might not be. I am accepting uncertainty. No more, no less.
Now I know this might sound harsh. It felt deeply unfair to me to begin with. I feared that in doing so, I would be surrendering a piece of myself in some way, and accepting a sort of hollow, half-life. But as it has turned out, this is absolutely not the case. In fact, somewhat counterintuitively, I actually feel far more confident in my own morality, now that I have stopped checking so much, and become more willing to say: maybe, or maybe not, and my quality of life is much better than it was before.
How and why does Accepting Uncertainty work?
While this does seem counterintuitive at first, it does make sense to me (at least to some extent).
When I respond to my thoughts to ‘prove’ they are not true, rather than teaching my brain that these thoughts are false, I am teaching it that there must be some validity to them, because I am telling it that they are worth responding to. So even after ‘proving them all wrong’, I still end up on some level feeling like there must be some truth to them, Because I have had to spend all this time going over them: because why else would I have to, if I didn’t do more things wrong than a normal person?
This is why the ultimate goal with OCD recovery is to not respond to the thoughts, which inherently means having to accept uncertainty about them. When my OCD demands to know if a thought is true, I have to be able to not check, and to instead accept that I am accepting uncertainty instead. Sometimes this is a fairly passive process, of simply not responding, but sometimes I do have to actively remind myself that I do not have to check; that I am accepting uncertainty instead.
By doing this then, I am breaking the cycle, and showing my mind that these thoughts do not control me. That they are not important. That it doesn’t need to flag them up to me, and that I don’t have to respond to them even if it does.
This is not always easy. In fact sometimes it is very hard. And perhaps I will never reach a point where it always feels okay, and instead there will always be times in which I feel doubt about myself and about the whole idea of accepting uncertainty. But I have to do it anyway. ‘Accepting Uncertainty’ is not just a phrase, it is actually something I have to do, and that will feel uncomfortable at times, but it is still the right thing to do, and it does get easier.
Ultimately, this discomfort is just another thing that I have to accept, and then move on. Doubt is not a signifier of truth. It does not mean that the thought is true, or that this method is wrong, it is just something that I may feel at some points. And if I keep doing it, my life will be so much better for it.
To be honest I still find it somewhat perplexing that I can do it now, even with the logic behind it, and I feel like perhaps I shouldn’t look this particular gift horse in the mouth. I am now able to think things such as: ‘well maybe that happened, maybe it didn’t’, and then just move on with my life. It is somewhat amazing how well it works, even when I feel like perhaps it shouldn’t.
How has Accepting Uncertainty benefited my life?
By accepting uncertainty, I am helping myself to no longer need to respond to my thoughts. As a result, I am now able to accept uncertainty about things that I simply wouldn’t have been able to before. I can have the thought, and not be overwhelmed by the need to check.
Now that I have stopped entertaining my thoughts as much, my mind has been able to settle, and my sense of self worth has begun to recover. I am happier, and I have more time and energy to live my life, rather than being constantly embattled and drained by my OCD, and spending my days going through the misery and anxiety that the compulsions provoke.
Intrusive thoughts are now less frequent, and the ones that I do have are less overwhelming. I am no longer finding myself paralysed by my thoughts, and that wave of negative emotions that used to cause me to feel like I was dissolving. Even when I do feel the need to engage in compulsions, it is so much less emotionally distressing a process.
As for where my life is in general, I am starting from a low point, but now that my OCD is far less overwhelming, I am starting to be able to visibly make progress, week on week, month by month. I am starting to achieve things, and feeling like less of a failure. I can enjoy things, without feeling like I am unworthy of feeling joy. I can be happy, and content, and I have respite from those constant waves of shame and guilt that used to batter me, and that constant fear that the sword of Damocles was hanging over me, ready to fall at any moment.
So while accepting uncertainty may not always be easy, when I look at my life now, compared to where I was before, it has certainly been massively beneficial to me. Certainly a lot of the progress has come from doing ERP sessions, which has ‘rewired’ my mind to accept uncertainty, and made my OCD much less of a problem for me. But, had I not also been working on accepting uncertainty outside of the ERP sessions, and applying it to my life in general, then this progress could well have started to become undone (this is also a key part of doing ERP, as accepting uncertainty and ERP are absolutely interlinked).
The relationship between Accepting Uncertainty & ERP
How exactly ERP is related to accepting uncertainty, is something that is a bit beyond me. What I certainly would say though is that ERP is a very effective tool for training yourself to do it, and ‘rewiring’ your mind to do so.
This is because, inherent in not responding to the thoughts, and not doing the compulsion, is that you are showing your brain that you are willing and able to accept uncertainty about the thought, and so showing that you do not have to seek certainty about it (whether this is not analysing the morals of a past event, or not washing your hands in response to a worry about contamination, or anything else).
Additionally, by not responding to the fear, and not trying to mitigate the fear by doing compulsions, you are behaving as though the thought is not true, or at least showing your brain that you are accepting uncertainty about it, and that you are willing to accept the ‘risk’ that may come with that, in order to be able to live your life. You are thereby teaching your brain that you don’t need to check whether or not the thought is true, and that you are able to live your life while accepting uncertainty about it, despite what your OCD may be telling you.
However, for me, I found that ERP only really focused on the ‘how’ element of accepting uncertainty. As such, while I have learnt from doing ERP that I can choose not to respond to my anxiety, without being overwhelmed, or anything bad happening as a result, and I can acknowledge that doing so is good for me (and contrary to what I feared, actually made me feel better about myself and more confident that my intrusive thoughts are not true), I feel I need to go further.
I want to understand more about why I am accepting uncertainty, especially regarding the question of why I am able to do it to morally. I felt like I needed to understand why it was okay to apply accepting uncertainty to my life as a whole, rather than just doing it within an ERP session, for a worry that I know I am only having because I chose to have it in the first place, so that I could apply it to other situations, and to thoughts that I feared I was having not because I deliberately provoked them, but because they were all too real.
The risk of letting myself off, when Accepting Uncertainty
Ultimately I would say there are two main obstacles in the way of me accepting uncertainty. The first of these is the fact that not responding to OCD thoughts is so emotionally arduous. OCD targets the things that are important, and so they are the things that it is hardest to accept uncertainty about. And of course it can feel so real in the moment, that the urge to do the compulsions can feel completely overwhelming. This is where ERP can be so helpful.
The second obstacle for me though, is the issue of whether it is morally acceptable for me to not check, and to instead accept that it is okay not knowing about things that are so important to me morally. To accept that I can live my life when I don’t know if these awful things are true or not.
Of course this can simply be a backdoor way for the OCD to get you, as ultimately OCD loves to disguise its demand for uncertainty in different ways, to make if seem like it is your problem, rather than its. Nevertheless though, I do still feel like it is something I do need to understand, in order to apply accepting uncertainty to my life as a whole, and crucially to be able to do it consistently, even when I am worried about whether it is morally okay to do so.
If you have no such moral qualms about accepting uncertainty, then feel free to skip this section (and if your OCD tells you that you ought to read it in case you are missing something, don’t listen to it).
The barrier I have to accepting uncertainty, and simply choosing to no longer respond to any of my thoughts, is that even though I know it would work, and that it would be good for me, I fear that it would be morally wrong to do so, and that I would simply be letting myself off, or at least risking doing so.
I know that these behavioural changes do work, and that I could probably brute force my way through it. I know that this is probably what I should do. However, the fact that it works is also precisely the thing that worries me about it. Yes, I can stop checking, and I will become comfortable with accepting uncertainty, and not having to check my thoughts. But what if I am simply becoming comfortable with doing the wrong thing, and so am teaching myself to become a bad person who no longer cares about right and wrong?
The main reason why I would engage with the thoughts (or at least why I believed I was), was because I was choosing to do so, because I felt like I ought to morally. Now, as it turned out, this was only part of the truth, as I found out when I tried to stop. However, it is still something that feels important to me. If I might have done something awful, shouldn’t I check? How can it be okay to just say: ‘I am accepting uncertainty about this thing?’ about such important things.
Accepting uncertainty about a minor thing that happened in the past is one thing. But accepting uncertainty about issues that are still active (ie. present and future actions and moral dilemmas etc), or about more serious themes (worries related to sexual themes, POCD etc); well simply accepting uncertainty about those, rather than checking, feels like something else entirely.
This is especially the case because I can’t help feeling like some of the thoughts probably are true. That sense that there must be some truth to it, because I have found too many incidents where I have had cause to question my behaviour, for them all to be nonsense (even though I know this is a trick that OCD likes to use, as I mentioned earlier).
Some of the worries about past-events definitely seem to have merit, and I definitely think that I did do something wrong. Of course I also know that everyone has done things that are wrong, and that just because I did something wrong, that doesn’t mean that it is nearly as bad as my OCD would have me believe, or that my OCD’s assessment of what the consequences would be if it were true is accurate either.
But it does still feel to me sometimes that I don’t really deserve the chance to put all this behind me, and live my life, and also that if I probably am a bad person, then the chances are that I did do other things wrong, and that some of these thoughts are true, and so I should continue to check them.
Why I believe I have to keep accepting uncertainty anyway:
‘Accepting uncertainty’ doesn’t just mean ‘accepting uncertainty when you know that these thoughts definitely aren’t true’. It means accepting uncertainty, when you are uncertain, which means accepting it even when you feel like the worries might be true. Especially then in fact.
Perhaps someone without OCD could ignore the thoughts that are nonsense, and still be able to recognise the ones that are true. But I don’t have that option. So, I can either spend the rest of my life checking all of my thoughts, knowing that they will probably all be nonsense ones (or at least not as bad as they seem), or I can not do that, and accept that I may let a real thought slip through.
It is very difficult to accept this risk, however big or small it might be, and how big or small it might seem to me to be (which are very likely not the same), because of how important these thoughts seem to me. However, it is precisely because these thoughts are about things that are so important, that accepting uncertainty about them is so important. Because they are too important to be under constant review and scrutiny.
To bridge this gap, while brute force could well have worked, instead, alongside discipline where it is needed, I have tried to pair the ERP process of ‘hijacking’ my brain and changing my emotions/reactions, with a ‘logical’ explanation for why it is okay to do this, in order to try to make my ability to accept uncertainty more resilient, so that it doesn’t all just fall apart the first time I hit a bump in the road (such as a low mood, or a particularly troublesome thought). Perhaps this is just playing more of my OCD’s games, but if so, it felt like a game I couldn’t avoid.
I will be talking more about this in the next article, as well as talking about tools to help with accepting uncertainty in general, but to provide a preview, it combines my recognition that if I don’t stop responding to my thoughts the cycle will continue, with aspects of ACT (Acceptance and Commitment Therapy), such as considering my own inherent value as a human and the importance of my own happiness and wellbeing, while also considering my own values, what is important to me, and my own values on things such as forgiveness, compassion, and second chances, and about applying all this to myself.
For more on the subject of accepting uncertainty in the meantime, you could check out this link: https://www.treatmyocd.com/blog/5-strategies-for-accepting-uncertainty for some strategies for accepting uncertainty.
