OCD and Decision Making

by stuart miles freedigitalphotos.net

This week I’m sharing a post written in August 2012:

Many years ago, I saw the movie Moscow on the Hudson, about a Russian musician named Vladimir Ivanoff who defects to the United States. One scene in particular has always stuck in my mind: Vladimir (played by the late Robin Williams) goes to the supermarket and has what seems like a panic attack over all of the choices. Coming from a country where he had to stand in line for hours to get a ration of coffee, he now had the freedom to pick and choose from an entire aisle of seemingly endless choices. It overwhelmed him, to say the least.

Many of us can relate somewhat to this scenario. Our culture is one of freedom and abundance, and those two factors lead to decision making in every aspect of our lives. From what to eat and where to live to whom or if to marry, to Kindle, Nook, or actual book, to career goals and travel plans, we are faced with a myriad of decisions daily.

Now add obsessive-compulsive disorder into the equation, and it might be a recipe for disaster. Since doubt is the cornerstone of OCD, those with the disorder often have the need to know, for certain, that all these decisions they are making are the right ones. They may worry how their choices will affect others, and agonize over even the most  minor decisions. Or they may make a decision right away, only to have OCD sabotage it. The weight attached to decisions can be too much to bear, at which point decision making may be avoided whenever possible.

Unfortunately, avoidance is never the answer, and while this tactic may temporarily quell anxiety, in the long run it will make OCD stronger. Exposure and response prevention therapy can help people with OCD learn to accept the uncertainty that comes with decision making.

But those with OCD are not the only ones affected by having to make too many decisions. Barry Schwartz, a psychologist and author of The Paradox of Choice, explores the connection between depression and the abundance of choice. I recommend checking out his talk here. His ideas make a lot of sense and he is enjoyable to listen to. He brings up the point that when we have no choice in a matter and something goes wrong, we have no reason to blame ourselves. When we do have choices to make, whether it’s something as trivial as which jeans to buy, or something more significant like a career move, we have high expectations and expect everything to be perfect. When our expectations inevitably fall short, we blame ourselves. After all, we are the ones who made the decision. Maybe we should have made a different choice?

According to Dr. Schwartz, too much choice undermines happiness. I think this is as good a reason as any to simplify our lives as much as possible. And whether we have OCD or not, we need to be able to accept the decisions we make and go on with our lives. If we don’t, our mental health will surely suffer.