Obsessive-Compulsive Disorder is a disorder of uncertainty, and its treatment provides valuable insights into how we can be more present and engaged in our relationships.
Our culture is saturated with messages calling for us to find “The One.” Just look at the plethora of reality dating shows in which contestants constantly suggest they may have found their soulmates. These are messages which tell us, with conviction, that love is not only intense but also certain. They teach us that, if we find true love, we know it was destined from the start. Reality looks much different though. In fact last year USA Today reported that only about 50% of the couples we see on reality dating television have actually remained together. Although the idea that half of marriages end in divorce is more myth than reality, the CDC reported that between 2011 and 2015 about a third of first marriages were disrupted (either by separation, divorce or death) within the first ten years. Love, like many things in life, can be a nebulous and uncertain thing. Whether it be platonic, romantic or familial, daring to love can easily send us into an anxious spiral of “what if’s” which can stop us from feeling present or secure in a relationship with each other.
So what can we do? I was fortunate enough to learn an invaluable lesson in my time working with adults living with obsessive-compulsive disorder. OCD is characterized by intrusive, distressing thoughts which often result in anxious uncertainty. What if I hit someone with my car? What if I’m a bad person? What if I spread a disease to someone I love? This is typically paired with behaviors which attempt to reduce this anxiety, often by creating a sense of reassurance and/or certainty.
For example, a person may drive around the block multiple times to make sure they didn’t hurt anyone, they may continually pray and confess what they feel they may have done wrong, or they may wash their hands and body to the point of injury. These behaviors are what we call compulsions. In fact, one subtype of OCD, called Relationship OCD (rOCD), centers upon uncertainty one may experience in a relationship. This may involve uncertainty about whether a person may or may not have found “the One,” whether the person with OCD might cheat or betray their partner, or whether a person really loves/is loved in their relationship. These aren’t typically impossibilities, but compulsively seeking reassurance can counterintuitively create distance and/or ruptures in the relationships they’re attempting to protect.
Treatment for OCD doesn’t seek certainty. Quite the opposite. Through exposure and response prevention therapy (ERP), people learn to tolerate the distress of uncertainty. More than that, they learn that they can live meaningfully and presently alongside ambiguity and anxiety. This isn’t a skill reserved for those with OCD, and those I’ve worked with have inspired me to accept uncertainty more in my life, too. Can I enjoy a date even if I’m anxious that the other person doesn’t feel the same? Can I share how I feel even if I think it might ruin another person’s day? Can I allow myself to be imperfect even if I think others might think less of me? In my experience, yes. It’s uncomfortable and yet I avoid things less and challenge myself to take meaningful risks more. How different we might feel if we could let go of needing to know if that person is the one. Can we dare to love the thrill and terror of that uncertainty, as though we were riding a rollercoaster? In truth, there’s no definitive answer. That’s the best part!
Mike Shirek is a third-year graduate student completing his master’s degree from Lesley University in clinical mental health counseling with a specialization in expressive arts therapies. He received his Bachelor of Arts in psychology from Harvard University. He is a member of the International Expressive Arts Therapy Association and is working towards becoming a licensed mental health counselor and registered expressive arts therapist. Mike has 2 years of clinical mental health experience working in both partial-residential hospital and non-profit community settings. He has experience in exposure and response prevention (ERP) therapy, CBT and DBT skills, expressive arts interventions, trauma-informed care and narrative therapy techniques. He is committed to honoring individuals’ personal stories and experiences and seeks to empower individuals to pursue meaningful changes in their lives.
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