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Obsessive Compulsive Disorder: Truly a Disease of Doubting Yourself

The French used the phrase “folie du doute” to describe OCD, which loosely translates to “the illness of doubt” or the “doubting disease”. Anyone with OCD who hears this description instantly understands what it means. OCD has you constantly doubting if items are clean enough, if you checked something enough times to make it safe or perfect, or even asking yourself, “does this intrusive thought mean I’m a bad person?”.

 

There are many types of OCD to include:

 

  • Germ or contamination fears

  • Checking rituals

  • Perfectionism

  • Illness Fears

  • Religious OCD or Scrupulosity

  • Harm fears (of harming yourself or others)

 

OCD typically chooses what’s important to you which is why your health, leaving your home vulnerable to burning down, fear of harming yourself or others, your religion, or your academic or professional reputation are all common OCD fears. The good news is that OCD tends to occur most often in highly intelligent people. The bad news, however, is that means OCD is just as smart as you are and therefore knows just what to say to get you doubting yourself and to give into its rituals.

 

Rituals can take many forms to include:

 

  • Cleaning/Washing

  • Checking

  • Reassurance-seeking from others

  • “Figuring-it-out” rituals

  • Avoidance rituals

 

Fortunately, there is highly effective treatment available for OCD. Exposure & Response Prevention (ERP) is a first line, evidence-based treatment where we very gradually expose you to your fear and help you learn to tolerate the fear without it being so overwhelming. We then help you learn to resist the OCD rituals associated with that fear. There is also a lot of work done with patients to learn to better tolerate uncertainty overall. Prescription Selective Serotonin Reuptake Inhibitors (SSRI’s) such as Lexapro (Escitalopram) and Zoloft (Sertraline) are also helpful for OCD and can be used in combination with ERP if you choose to take medication or if your symptoms are troublesome enough that you need both treatments.

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