Healthy Doubt Versus Unhealthy Doubt

crossing NYC street

I’ve previously written about how I used to scrutinize my son Dan, trying to decipher which of his behaviors were OCD related. I finally realized my intense involvement in his life was doing us both more harm than good, and I was able to let go and just trust my son.

What I wasn’t aware of at the time is that sometimes those who suffer from obsessive-compulsive disorder aren’t sure themselves if their thoughts and behaviors are related to their disorder. Because sufferers often have such insight into their OCD, I just assumed they knew when what they were thinking or how they were acting was OCD based. However, from reading blogs and connecting with people, I realize this isn’t always the case.

So how do we know if certain feelings and/or actions are related to OCD?

In his book When in Doubt, Make Belief, author Jeff Bell discusses healthy (intellect-based) doubt vs. unhealthy (fear-based) doubt. I highly recommend reading this book, if you haven’t already. While theoretically it might be easy to distinguish between the two, Jeff, by using an example of a man deciding whether or not to cross a busy New York street, shows us how complicated it can be. As he says, “…the same fear-based doubt that can distort our thinking is also quite adept at masquerading as intellect-based doubt.” (When in Doubt, Make Belief, page 9).

In his book, as well as in this interview, Jeff talks about the five questions he asks himself to help determine the source of his doubt:

  1. Does this doubt evoke far more anxiety than either curiosity or prudent caution?
  2. Does this doubt pose a series of increasingly distressing “what if” questions?
  3. Does this doubt rely on logic-defying and/or black-and-white assumptions?
  4. Does this doubt prompt a strong urge to act — or avoid acting — in a fashion others might perceive as excessive, in order to reduce the anxiety it creates?
  5. Would you be embarrassed or frightened to explain your “what if” questions to a police officer or work supervisor?

If you answer “yes” to these questions, there’s a strong chance you are dealing with unhealthy doubt.

As the saying goes, knowledge is power, and the more aware OCD sufferers are of their disorder, the better position they’ll be in to fight it.  Of course, a competent therapist can go a long way toward helping those with OCD understand their disorder. I’d love to hear how others figure out what’s OCD related, and what isn’t.

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22 Responses to Healthy Doubt Versus Unhealthy Doubt

  1. I love Jeff Bell! He was the wonderful man who interviewed me at the IOCDF event last fall!

    Thanks for this post, Janet. So good.

  2. Thank you for sharing Jeff Bell’s ideas on this posting. The 5 questions are important ones, and when appropriate, I will ask them to my clients who have OCD. There is still so much to learn about this condition, but we do know that doubt and uncertainty, while useful in healthy doses for all of us, can torment many individuals suffering from OCD. These questions can help people tease out OCD when it is wearing the cloak of normal caution.

    Keep up the good work of reaching out to everyone in the OCD world.

    Best,
    Sherrie Vavrichek, LCSW-C
    Author of “Compassionate Assertiveness: How to Express Your Needs and Deal With Conflict While Keeping a Kind Heart”
    Behavior Therapy Center of Greater Washington
    Silver Spring, MD 20901

  3. Thank you for sharing this, Janet. That sounds like a book that I need to read!

    I try to monitor the anxiety I feel when I’m facing a decision or trying to figure out if something is OCD related. I don’t have a good way yet to explain it, other than to say that OCD anxiety feels more like frustration mixed with a fear that I would not want to try to explain to anyone else. It’s usually a thought that causes the anxiety with OCD, whereas “healthy” fear seems connected more to the 5 senses (something I see, hear, etc.).

    Great post!

    • How interesting, Tina,that you can distinguish between your healthy and unhealthy fears that way. The main thing is that you know what’s OCD and what isn’t. Thanks for sharing!

  4. 71 & Sunny says:

    Good question! There are times when I KNOW it’s OCD, other times when I strongly suspect it is, then other times when I’m pretty clueless. I can remember debating with my psychologist about a worry/doubt. I thought it was a “normal” legit type of concern. She was convinced it was OCD, and she walked me through a series of questions to break it all down, after which I surprisingly realized it was indeed OCD. Very tricky!

  5. Very helpful post. The questions are ones I can certainly make use of at home and share with clients alike!

  6. ocdmom says:

    I recently read about the idea of probiotics helping with OCD. I am new to the disorder (my son was diagnosed about 6 months ago), so I would be very interested in Janet’s opinion.

    http://mobile.theverge.com/2013/8/21/4595712/gut-feelings-the-future-of-psychiatry-may-be-inside-your-stomach

    • I did see this article as well and I guess my first thought is, “It can’t hurt.” I’m not a doctor and am certainly not an expert, but I found the article interesting……who knows? While I think it might be worth a try, the bottom line is there is currently a treatment that we know works, as long as your son is on board. ERP Therapy is the frontline treatment for OCD, and though it’s not an easy road, it does work. Please keep me posted as to what route(s) you decide to pursue, Good Luck!

      • Deb says:

        I need kind of a survey response. Is the doubt meter twisted with OCD sufferers? I am finding my OCD son who is afraid of the most minute, irrational things to be almost a risk taker with things that would terrify others.
        Examples:
        -to avoid sitting in grass where there might be bugs, my son chose to stretch in the middle of the road after running.
        – Running late is the norm due to excessive washing and various rituals, so he has become a reckless driver, tailgating and running red lights.

        I feel like I have to start over again like teaching a toddler not to touch things that are hot.

        Can OCD sufferers also be reckless risk takers?

        Deb

      • Deb, I think your comment illustrates, once again, how OCD makes no sense. As far as being risk-takers in areas other than their OCD, I never saw that in my son, but perhaps others will comment. I do think it’s true that letting OCD call the shots can lead to risky behavior (as in driving fast because you’re late). Again, another example of how OCD gives us the opposite of what we want (danger vs safety).

  7. Deb says:

    Thank you Janet for your quick response. There is a further doubt to question between ocd doubt, and real doubt. That would be regular old teenage bad judgement. It’s all such a gray area its hard to know what is the disorder and what is just being 19 years old. Also, I am very interested in the post from OCD Mom about probiotics. The whole angle of autoimmune disorder being linked to OCD along with anti inflammatory diets and probiotics. Many of these things make sense, but I feel like if yogurt were the answer we would know about it by now. Regardless, we will be overdosing on probiotic yogurt over the next few weeks around here.
    Thanks again for this blog….so i don’t feel so alone!
    Deb

    • You’re welcome, Deb. I wrote a post about a year ago https://ocdtalk.wordpress.com/2012/11/05/its-not-always-about-ocd/ about how I was always trying to figure out what behaviors were OCD related or not…..
      Please let me know if you notice any difference with the probiotics……

      • Deb says:

        Thanks Janet for the link to your post. I particularly connected to your statement;
        ” In retrospect, I don’t believe I needed to know these things. Dan had a good therapist, and he was working hard toward recovery. Sure, I could have helped by not enabling him, but really, this was not about me. It was about Dan. This was his fight, and he was on his own. What I needed to do, and what I eventually learned to do, was to believe in him.”

        I am going to talk to my son’s therapist about how much I should back off. He just has so many issues that I definitely don’t want to enable him. Backing off is a tough concept. I am not sure that Matt is at the same place that Dan was at this time. Matt still does not recognize when something is OCD himself.

      • I’m glad you liked that post, Deb. I think most people with OCD have experiences of not knowing if what they are feeling is OCD related or not. Talking to Matt’s therapist is a great idea. I know backing off is not what we mothers do naturally when our children are suffering……but it’s often the best thing to do when dealing with OCD.

  8. Luanne says:

    This is a really good point, and one I think can be applied to a lot of illnesses of all types.

  9. Hi there, I can relate to this post so much. Only today having a discussion with the therapist about questioning myself alot. That link with reality is an important aspect of my OCD as a main driving force behind it are previous psychotic episodes, the checking and obsessing are like security for me personally. Best wishes

    • So glad this post resonated with you! I read your last post as well and have a better understanding of what you are saying about your OCD. It certainly can get complicated, right? I wish you all the best as you continue to sort it all out…..

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