I read an interesting article today called “Casey Anthony, Reasonable Doubt, and OCD” by Stacy Kuhl-Wochner at the OCD Center of Los Angeles — you can read the entire article here.
Just wanted to quote a little bit of it for all you blog readers to consider, especially after having an interesting phone conversation along these same lines with my college roomie Megs.
Being a therapist who specializes in treating those with OCD, I can only imagine what an especially difficult task quantifying reasonable doubt would be for many of my clients. People with OCD and related OC Spectrum Disorders such as Body Dysmorphic Disorder (BDD), Hypochondria (Health Anxiety), and Social Anxietyare on a constant quest for answers to unanswerable questions. They seek to quantify that which cannot be quantified, to gain certainty when it is only possible to be “pretty sure.” These are questions that most people who do not have OCD can accept despite their inevitable doubts. But for many people who experience OCD or a related spectrum condition, “reasonable” doubt often feels unbearable.
Doubt is such an intrinsic part of OCD that the condition has often been referred to as “the doubting disease. Some common doubts seen in OCD and related OC Spectrum Disorders include:
- Are my hands clean enough to ensure that I won’t accidentally make someone sick through casual contact?
- Am I straight enough to to be certain that I am not actually gay?
- How do I know if I really love my spouse?
- What level of pain is a enough that I should visit a doctor to see if I have a serious medical condition?
- What is the right amount of eye contact to avoid being seen as socially inappropriate?
- How do I know whether I am a good person or a bad person?
- If I become angry at my child, does this mean that I do not love them enough, and that I am close to mentally snapping and harming them?
The only realistic answer to these and similar questions is to accept that nobody has 100% certainty on these issues*, and to stop the mental checking. The goal is to make decisions based on what is “most likely”, given all the evidence. For people with OCD, it may feel terrifying** to make that leap and take that chance because their brain is telling them that absolute certainty is required.
*JLS adds: That is why the point of cognitive-behavioral therapy is not to remove uncertainty but to make one okay with uncertainty.
**”Terrifying” doesn’t even touch it.
Thoughts? What’s the most basic thing you know that you have doubted before? (I have sometimes wondered if all of life that I’ve “experienced” so far is only a dream.)