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2006/8/5

OCD - What 'Accepting Uncertainty' REALLY Means

Morning folks,
 
Have been thinking about this a little after a discussion with fellow sufferer Cher a few days ago and I feel it's something worth having an entry about for sufferers AND for everyone else.
 
The phrase "accepting uncertainty" is one you find bandied about by quite a few psychologists re: OCD - in terms of H-OCD, one of the most influential articles by Dr Phillipson (linked to on the front page) put great emphasis on it.
 
The thing is...it's not quite accurate in the way many sufferers interpret it. And, in my experience, the way both some fellow sufferers and psychologists try to apply it is misleading.
 
Will explain it explicitly to my Homosexual OCD obsession BUT can be applied across the board, especially for purely mental strains of OCD.
 
When first encountered by me, I took it to mean this: that there can be no certainty about your sexuality and that, in seeking this cast-iron certainty, you're feeding the constant worry-reassurance pattern that is one of the defining parts of our illness. By accepting that there's no such thing as being 100% certain (effectively saying 'so be it, whatever'), that's meant to ease the anxiety by making you worry less - hence stopping the obsessive pattern and allowing your confidence in your sexuality to come back naturally. I've had one psychologist and some other sufferers push this argument - and heard many who've had it put upon them.
 
Folks - it's rubbish and doesn't work like that at all.
 
The 'accepting uncertainty' concept only really works when you accept the thing that the experts are often reluctant to tell you, especially early on - you have this for life and it isn't going anywhere. The trick to OCD isn't cure (they haven't even got the drugs TO directly treat it, after all), it's cope: it's making it manageable on a daily basis. It also lies in accepting that you have what you have...even when diagnosed, most of us have been in a circle of thinking for a while regarding our obsessions an compulsions, wondering whether it IS a big problem or just a worry that's got out of hand, whether it's an illness or not...for some, whether they're really being affected by an 'outside force' or whether they secretly want these terrible things, hence the repeating imagery and thoughts about them. That's difficult to break and, as much as a diagnosis is a relief, you don't just turn that off straight away. Accepting you have an illness that causes it (and absolving yourself of the guilt re: where you may've been mentally for some, me included) takes a long time - still have moments with it myself, and that's 15 months on from diagnosis.
 
Once you accept that and start actually believing it, that's when the 'uncertainty' principle can work. It simply means - again, I'll use H-OCD as an example - that you have to accept that you're never going to have a 100% degree of certainty about your sexuality BUT that it's because of your OCD, not because there's any real issue there. It applies to other strains as well - it takes a realisation that you have OCD and, as a result, there are times when you're going to be stressed and unsure about something and can't control that, but that the uncertainty is due to the OCD and not because there's a 'real' problem.
 
And I know how that sounds to many - if you know there's no problem, why are you worrying about it anyway? Welcome to OCD, folks! Remember that the obsession (worry) itself is actually immaterial - it's the need to do it, the brain's need to funnel it's stress/anxiety into an area in order to ground it which is the key. The brain of an ocd sufferer is going to do that regardless of whether a problem is real or imagined.
 
Also, one more word of warning re: the misapplication of the principle. In sexual areas, OCD can cause huge problems with confidence and the like - you don't realise just HOW much we're defined as people by our belief and confidence in our own selves until a bedrock of it is attacked by such a thing. What kept me together for 8 years before starting to get help, even in the midst of terrible stress, images, obsessions, compulsions etc, was gripping onto that fact of KNOWING who I was before my OCD kicked in. Of knowing that up until the age of 23 things were fine, I was straight and never had any doubts about it. Just having that there as an unalterable fact and holding onto it may have caused a mental conflict (then again, that's OCD for you) BUt it was the only way I kept hold of 'me' and who I was. Letting go of that in the way some suggest in the 'accepting uncertainty' principle would have been absolute suicide for me. If you know and are sure of who you are then THAT'S WHO YOU ARE!! Especially if, like me, you have a recognisable point you can look at for where your OCD kicks in. Remember that who you were before OCD is who you are still - don't let a so-called 'expert' play with those concepts too much as, most of the time, they're simply applying whatever theory they happen to believe in at the time from a textbook as an interesting experiment that matters little to them once the surgery door closes.
 
Anyway, that's how it works - in my opinion, anyway.

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