The idea of making a decision based on a “gut instinct,” or intuition, may have some theoretical merit but for someone with OCD, it’s like kryptonite.
Neuroscientists have constructed complex processing theories to explain the concept of “just knowing,” or intuition. Our brains are like computers, constantly comparing new sensory information and events with memories of past experiences and stored knowledge to come up with predictions of what will happen next. This process occurs so quickly and subconsciously that we’re not aware it’s happening—hence, the idea of a gut feeling. The opposite of intuition is methodical analytical thinking. Both can be helpful, depending on the situation. But people with OCD tend to overanalyze decisions, while also falling prey to emotional—typically, anxious—reasoning. The result? Uncertainty and decision-making paralysis.
One common OCD worry is whether a relationship is “right.” Typical obsessive questions include: “Do I feel love for my partner?” “Do we share enough in common?” “ What if my feelings change?” “How can I be sure I want to be in this relationship?” Constant analysis—compulsive checking for the elusive, correct emotional reaction, seeking reassurance from relationship websites and forums, asking friends and family for advice—doesn’t resolve the doubt and causes more anxiety, making it impossible to experience a rewarding emotional connection.
A site dedicated to forming healthy relationships describes a gut instinct as “your immediate understanding of something,” requiring “no need to think it over or get another opinion—you just know” [italics mine].
This type of popular wisdom—the idea that you can “just know”–adds to the distress many people with OCD experience in the face of major life decisions—not only about whether to get married or divorced, but also about whether to have children, go to graduate school, change jobs, or buy a house. OCD makes it virtually impossible to trust your gut because one of its major cognitive manifestations is doubt. It’s more likely to kick you in the gut and overwhelm you with incessant questions about your choices than to allow for intuition to help you.
So if you have OCD, don’t expect a feeling to inform your decisions. Rely, instead, on analysis (but not too much), experience, values, and common sense to guide you. And make room for a healthy measure of uncertaintly about the choices you ultimately make.
In the wake of the #MeToo movement, I wrote a post last year about the spate of men I was seeing in my practice who worried about being perpetrators of sexual assault. It struck a chord and prompted many emails to me from men across Europe, where treatment for OCD is limited, saying they’ve been tormented by similar thoughts.
As the piece resonated with so many people, I decided to revise the original for the Anxiety and Depression Association of America website.
You can read it here.
OCD is like an opportunistic pathogen, invading hosts with weakened immune systems. So it’s not surprising to see it thrive and spread when daily news reports stoke uncertainty and fear in those who are vulnerable.
The recent spate of revelations about sexual misconduct among the rich and famous, along with controversial reports in the last few years of a campus rape crisis, have brought a new demographic into my practice: young men in their twenties who worry about committing or having committed a sexual transgression.
Some of these men have been accused—and all exonerated—of inappropriate touching, nonconsensual or consensual but inappropriate sex with colleagues, students, or classmates; others live in fear of having a casual sexual encounter from their past surface and become fodder for an accusation.
OCD is having a field day.
As reporter Emily Yoffe chillingly details in a series of articles in The Atlantic , Obama-era federal directives governing the handling of sexual-assault allegations have prompted universities to craft vague and overarching definitions of sexual assault designed to protect the (mostly) female victims while stripping the accused of their right to due process. The Kafkaesque scenarios Yoffe describes—such as a third party accusation in which a friend reported her roommate’s boyfriend as an abuser and the alleged victim, refuting the claim, was told she was in denial– create the perfect medium for OCD to flourish.
Let me be perfectly clear. I am in no way minimizing the trauma experienced by assault victims. I believe charges of rape on college campuses should be taken very seriously. They should be investigated thoroughly and, if the evidence points to a crime, prosecuted in a court of law. And I am not excusing the predatory behavior of the Harvey Weinsteins who have abused their power to intimidate and sexually exploit women.
But the men with OCD I see in my practice are not predators or rapists. In fact, most share two thinking patterns common in people with OCD: an excessive sense of responsibility and a highly developed sense of morality. They worry about causing harm and about being bad people even though, in the paradoxical way of OCD, they’re actually good people with a strong—perhaps even excessively rigid—moral compass.
So, no, I don’t secretly question if they might have done what they’ve been accused of or fear being accused of, just as I know with a reasonable degree of certainty that the people with OCD who confess to me their fears of being pedophiles are not a danger to children.
As with all OCD worries, however, facts and probability do little to assuage anxiety. So the challenge is to acknowledge the possibility of a dreaded occurrence—such as a false accusation–while not letting fear get in the way of living.
While it’s hard to push back, I can recommend a few guidelines to follow if you’re consumed by worries of being unjustly accused of sexual assault.
Shakespeare said, “Misery acquaints a man with strange bedfellows.” Resist the temptation to lie down with OCD.
This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.