Does My OCD Need Reassurance? Maybe, Maybe Not.
What is reassurance-seeking?
It’s completely natural to want clarity or comfort when we’re experiencing one-off anxieties. You might double-check with a friend if you have anything stuck in your teeth before you meet your date, or look to your parent for grounding before your speech competition. But for people with OCD, this experience becomes something much bigger.
Reassurance-seeking in OCD can look like:
Asking the same question multiple times because the answer doesn’t feel believable
Checking medical websites for every sensation and symptom you feel
Checking and re-checking that all the doors are locked and that the appliances are turned off, never convinced that you’re safe
Washing your hands multiple times in a row until they “feel” clean
Replaying the same scenarios over and over in your head to make sure you didn’t do or say the “wrong” thing
Repeatedly checking your bank account to see if same amount of money is still there
Scheduling something for every minute of your waking day so you’re not “wasting” time
Looking at news reports for hit and runs because you feel convinced you ran over someone with your car
Individuals do this because their doubt (…that they are a good person …that they are clean …that the door is locked, etc.) is so strong that this checking brings immediate relief from the distress (anxiety) brought on by that doubt. The catch for anyone with OCD is that this relief is only temporary. Not only that, but it’s a clever trap set by the OCD to keep it in power—the more the person seeks reassurance for their doubt, the more the brain learns to keep seeking reassurance.
What does someone with OCD do to address reassurance-seeking?
Develop a tolerance for uncertainty to strip the OCD of its power in the immediate present. A doubt appears as a sudden “what if?” thought: “What if I hit someone with my car on the way to work?” “What if I didn’t wash my hands enough and get someone sick?” “What if I actually have a rare disease?” “What if I sounded rude?” These “what if"?” questions want a guarantee. The anxiety says that your own senses and your own judgement aren’t enough; you need feedback from others to feel better. It also reinforces the idea that uncertainty is always dangerous, when in reality, we live with all kinds of uncertainty all day. We don’t know at all times whether our hair is in the right place, or what someone is thinking about us, or if we’ll get sick. The reassurance-seeking offers us an illusion of certainty.
Developing tolerance can look like:
Saying “maybe, maybe not” to leave the “what if?” open-ended (alternatively, “we’ll see” or “it is what it is”)
Waiting 5-10 minutes before engaging in compulsive reassurance-seeking (the urge may begin to subside on its own)
Connecting with your values: “Is this really what I want my life to be about?” “What is something that gives my life more meaning?” “If I wasn’t having this thought, what would I want to be doing right now?”
Check in with your senses and the here and now. Visually seeing the door in the lock position. Trusting that washing your hands once after using the bathroom is enough. Acknowledging the positive feedback you get from your boss.
Practicing mental flexibility. OCD doubt is a prediction, but it is one prediction out of many.
Recovery is possible.
You can handle uncertainty. You already do, your OCD just erases the ways in which you trust yourself and your senses. Feeling more confident is about standing tall even when you don’t have all the answers.
I use a combination if I-CBT and Acceptance and Commitment Therapy to address reassurance-seeking and uncertainty tolerance. Exposure and Response Prevention (ERP) is also still recognized as the gold standard for OCD therapy. If you would like to try I-CBT, ACT, and some Accelerated Resolution Therapy (ART), feel free to reach out to me.