The "O" in OCD: All About Obsessions

by, Dr. Katy Manetta

Is the oven REALLY off?

Some may have heard of OCD referred to as “the doubting disease”. This label is actually not an inaccurate one. OCD, at its very core, is a disorder that emerges from a fear of doubt and uncertainty. The graphic above reflects one of the many objects that can trigger feelings of uncertainty.All human beings are hard-wired to try to reduce doubt and uncertainty when they feel unsafe. As such, each of us has likely had the experience of walking away from the stove only to be struck by a sensation of doubt--Hmmm...Did I really turn off the stove? And it's likely that each of us, from time to time, has gone back and glanced at the stove again--just to be sure that it's off.

As mundane as this experience may seem, there is a principal here that is fundamental to understanding the "O" of OCD. And that is the question of whether or not we can ever truly be certain that the stove is off. We can definitely think that the stove is off...we can be fairly certain...but can we ever achieve 100% certainty?

Throughout life, we are faced with situations in which there can be no certainty. And indeed, if we think hard enough about it, it may be difficult to identify anything that we can be 100% certain of, of which there is 0% doubt. But most of us are comfortable to go through life accepting a certain degree of uncertainty as we live our lives. But what if a situation arises in which you believe you can't accept any uncertainty? That, for whatever reason, you believe that you must remove all doubt? Obsessive Compulsive Disorder is a fear of uncertainty coupled with an unwillingness to tolerate it.​

Obsessions
Obsessions are nothing more than thoughts--repetitive, intrusive and sometimes maddening thoughts. Obsessions can relate to literally any topic that can possibly occur to a human being. In popular media, individuals with OCD are often portrayed as having obsessions about contamination and germs. And while some individuals with OCD do have obsessions about germs, this is but one of the infinite number of topics that can become an obsession.

Obsessive thoughts can be about whether we may inadvertently cause harm to ourselves or our loved ones, about whether we might carelessly make an error in our work that would damage our future prospects, about whether our thoughts about sex suggest that we may become a sexual deviant, about why a particular part of our body feels strange, about whether or not we are hearing, reading or seeing things correctly, about whether we will go to heaven, about whether we might be misunderstanding things, about why a particular physical movement or daily activity feels "off" or "wrong", or about whether we might impulsively do something harmful or embarrassing. And while many individuals with OCD have obsessions about topics that are either scary or taboo, obsessions can also be about the most mundane of topics that appear to have no relevance or import to our lives. The rule is, if you can doubt it, it can be an obsession. And what can human beings doubt? What topics or assumptions can we feel uncertain about? The answer is ANYTHING. Humans can come to doubt or feel uncertain about literally anything. Even the most irrelevant thought can become maddening if it's put on a never-ending loop that repeats itself over and over in our mind.

Whether scary or mundane, obsessions invariably result in us asking ourselves the same questions...why am I having this thought? Why can't I stop myself from thinking about this? What does this thought mean? This process of questioning and attempting to figure out the cause of our obsessional thoughts often becomes its own monster, it's own obsession. Family members of individuals with OCD may find themselves saying things like, "Just don't worry about it!" "Just stop thinking about it!" and "Don't let it bother you!" They may feel frustrated that their loved one continues to focus on things that cause them distress. They might be confused about why the individual doesn't just "move on" or let go of the thoughts. And while to outsiders it seems as though it should be easy to just stop thinking about it, to the individual with obsessions, it is just not that simple. They are living with a broken record, an unending and repetitive soundtrack that plays in their mind and that feels impossible to stop.

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Authored by Dr. Katy Manetta

Dr. Manetta is a practicing psychologist with over 15 years of experience in the field. She provides therapy to clients and supervises and trains fellow therapists in Cognitive Behavioral Therapy (CBT).