Obsessive-Compulsive Disorder
OCD (obsessive-compulsive disorder) is a mental health condition comprised of obsessions and compulsions. The first comes from internal or external triggers, such as seeing or thinking about dirt and developing subsequent contamination fears. The second is feeling compelled to perform safety behaviours to eliminate the consequences associated with the obsession and reduce anxiety. For example, a person might repeatedly wash to prevent illness and alleviate anxiety.
Obsessional Doubt
When someone develops the onset of OCD, their ability to identify facts and reality becomes clouded by constant doubt. This makes it difficult for them to manage uncertainty because their perception of reality is no longer aligned with the facts.
Let’s take, for example, a scenario where someone has turned off the stove. Despite seeing and using their common sense to confirm that it is indeed off, the person still doubts it. This doubt is new and wasn’t present before their obsession with switching the stove off. In order to regain the certainty they once had, they rely on compulsive behaviours, such as repeatedly checking the oven. However, this only serves to increase their doubt rather than providing the certainty they seek.
Non-Obsessional Doubt
Let’s take another example of a person choosing what to wear. Ordinarily, the person makes up their mind pretty quickly and feels okay with it, even if they are a little uncertain about whether they’ve made the right choice. But they don’t generally feel anxious about it or take time dwelling on it.
But suppose the person choosing what to wear experiences an internal inference that something terrible could happen if they choose one item of clothing and not the other. Suddenly, they are fearful of this awful consequence. As a result, they no longer trust their senses and common sense in the here and now.
Therefore, due to the anxiety caused by doubt and the resulting fear of potential consequences, individuals seek to regain the certainty they had before the obsession developed. In other words, they resort to performing rituals in an attempt to eliminate those consequences and alleviate their anxiety. Paradoxically, however, these rituals intensify their fears and make OCD worse, and their ability to carry out day-to-day activities becomes impaired.
Solution
Inference-based therapy is an evidence-based treatment allowing people to reorient from the obsessional way of living to their authentic selves and reality. Subsequently, they reconnect with their senses and common sense and make sound decisions in the here and now, ultimately overcoming OCD. Inference-based therapy is an effective stand-alone treatment but can be combined with other therapies for OCD.
The following book includes more information on inference-based therapy.