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 a person starts to experience OCD, doubt can make it hard for them to see facts and reality clearly. This can lead to difficulty managing uncertainty since what they perceive may not match what is actually true.
Imagine someone who has turned off the stove. They see and feel that it is off, and their common sense tells them it is safe. However, they still doubt it. This doubt is new and started after they began to worry about whether the stove was off. To feel sure again, they check the oven repeatedly. Unfortunately, this makes their doubt worse instead of giving them the certainty they want.
Compulsions: Obeying OCD
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 a personal assumption that something terrible could happen if they chose 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. Consequently, they go along with OCD’s choice to wear what it tells them to. They believe that if they go along with OCD, it will protect them and others. However, paradoxically, it intensifies the person’s fears. It makes OCD worse, and their ability to carry out day-to-day activities becomes impaired.
Solution
Inference-based cognitive therapy is an evidence-based treatment that allows 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 cognitive therapy is an effective stand-alone treatment but can be combined with other therapies for OCD.
The following book includes information on this therapy approach.