Knowing You Have OCD With Certainty

Max in a post to this site asked what about convincing someone, with certainty, that they have OCD, since this would be comforting and reassuring.   There are three problems with this approach.  First, as I’ve noted elsewhere, research has shown us that the only people who have absolute certainty are stupid, which eliminates this as a possibility for most OCD sufferers.  Seriously, we find that attempts to reassure oneself by saying ‘x’ is OCD followed by the comfort that I don’t have to worry about ‘x,’ tends to be a short run solution.  Usually the sufferer at some point will then begin to obsess and try to reassure him/herself that the problem is OCD and the circle goes round and round (this is 2 of the three points).  We are for the sufferer admitting that it is likely that they have OCD, but that this is independent of whether or not there feared consequences are avoidable.  For example, if your OCD issues focus on wanting your loved ones to never die, the fact this is an OCD concern is independent of the fact that your loved ones might die at any time, so treatment has to help you cope with this fact of life.  Now it is true that some OCD concerns may involve lower probability fears, but that isn’t relevant to treatment.  Whatever you fear is what the focus of treatment needs to be on.   The goal is always twofold: I need to cope with the uncertainty that ‘x’ may happen; and no matter how horrific ‘x’ is, I need to try to figure out a positive way to cope with it, if it does happen.


  • I guess the way I try to deal with it is to acknowledge I have no control either way and that it may or may not be ocd and I’ll cope with it either way. accept the possibilities.

  • This is so true. I didn’t know my kind of obsessions and compulsions and fears could be OCD and it made me suicidal. I discovered what OCD really was and it took a year to believe this might be it and I am no a monster. It took nearly another year to get myself to speak to a therapist and get meds. I had had enough, see, so I was going to find out once and for all if I was good or bad and if I had OCD, it would make it easier because then I’d know I wasn’t a monster.
    I got the dx.
    I felt renewed after speaking to my therapist.
    Then I immediately went into high gear over drive wondering if I fibbed or manipulated things enough to be told I had OCD.
    I thought knowing would cure me.
    WRONG! It helps with self schooling coping skills and having my “nutter pictures” of OCD thinking and triggers so I can compare what I am feeling and relate it to a “picture” to know if it’s normal me or not.
    Stinks not having an instant fix but I’d take OCD over anything. I can beat this, I know I can.

  • Regarding the comment “The goal is always twofold: I need to cope with the uncertainty that ‘x’ may happen; and no matter how horrific ‘x’ is, I need to try to figure out a positive way to cope with it, if it does happen.” Is he referring to the “goal” being the goal of treatment?

  • I find this article so relevant to what I’m dealing with right now. Here lately, been obsessing about whether or not what I’m deaing with is ocd, Grayson vs. Brain-Lock, etc.

  • Dear Dr. Grayson

    I am so glad to know you as an Assistant Clinical Professor of Psychiatry that work about Anxiety and OCD Treatment, i find your website when i was searching about OCD, i am 29 years old woman and i have anxiety and OCD , there is 4 years that i use Clomipramine10 (Anafranil) and Alprazolam0.5 ( Xanax) under medical supervision, sure i am better but yet I’m involved with the disease.
    Dear Dr.Grayson you’re very kind to me if you can answer to my questions :
    1. Whether will fully recover Anxiety and OCD diseases ?
    2. Whether can i get pregnant until i have this disease ?
    3. What do I have to do to resolve completely my problem ?
    4. Whether do i need to behavior therapy besides pharmacological medication ?

    Best regards
    From Tehran-Iran

  • I am so sorry , i understand that my message place is incorrect , i had to write this message in Your Questions Answered ….

  • How do you decide if it’s appropriate to try to modify a risk versus living with it? For example, suppose you’re obese and obsess about the health risks of being obese (or maybe you text while driving or have unprotected sex or illegally download movies). Your compulsion is seeking reassurance that the behavior is not that bad/risky. Would treatment focus on accepting the risk you have obviously chosen to take, because we all take risks and nobody can be perfect, or could it also involve changing the behavior to reduce the risk?

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