When You Can’t Stop Trying to Figure It Out
OCD doesn’t always look like handwashing, checking locks, or arranging things perfectly.
Sometimes it looks like spending hours inside your own head.
You may even know that what you’re doing is probably OCD.
But the doubt still feels important.
What if this time it isn’t OCD?
What if I’m ignoring something I really need to figure out?
What if this thought says something about who I am?
What if I make the wrong decision?
What if I never feel certain?
That is what makes OCD so convincing.
It doesn’t just give you an unwanted thought. It gives you a reason to believe the thought needs your attention.
And the more you try to resolve the doubt, the more important the doubt begins to feel.
My Approach to Treating OCD
I-CBT is particularly helpful for understanding the moment OCD first begins to pull you away from what you actually know.
Rather than starting with “How can I tolerate this scary possibility?” we may first ask:
Why did this possibility become relevant in the first place?
Inference-Based CBT (I-CBT)
Exposure and Response Prevention (ERP)
ERP helps you practice approaching situations that OCD has taught you to fear while reducing the compulsions you use to feel safe.
The goal is not to make yourself feel anxious for the sake of feeling anxious.
The goal is to learn that you can experience uncertainty without needing to perform a compulsion to resolve it.
Acceptance and Commitment Therapy (ACT)
ACT helps us widen the focus beyond OCD itself.
If you weren’t spending so much time trying to eliminate uncertainty, what would you want to be doing instead?
What matters to you?What kind of partner, parent, friend, professional, or person do you want to be?
OCD tends to shrink life around fear. ACT helps us build it back around your values.
Some things to know about OCD
OCD thoughts are often ego-dystonic, meaning they feel unwanted and inconsistent with your values, beliefs, or sense of who you are.
Avoidance can be a compulsion. Staying away from people, places, situations, or thoughts can reinforce the belief that they are dangerous.
OCD can be almost entirely mental, meaning compulsions may be happening mostly inside a person’s head and may not be observable
Doubt is a hallmark of OCD and a key to treatment is developing a new relationship with doubt
You don’t have to feel anxious for it to be OCD. OCD can also feel like guilt, disgust, urgency, uncertainty, or a persistent sense that something is “off.”
OCD tends to target the things that matter to you most, further increasing distress
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You may constantly question whether you love your partner enough, whether you are attracted enough, whether the relationship is “right,” or whether someone else might be a better fit.
You may compare your relationship to other couples, monitor your feelings when you are together, analyze your partner’s flaws, or repeatedly ask yourself whether you should stay or leave.
The goal of therapy is not to determine whether your relationship is perfect. It is to help you recognize when OCD has turned normal relationship uncertainty into an endless search for certainty.
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You may feel driven to determine whether you are a good person.
Did you lie? Were you selfish? Did you offend someone? Did you act with the wrong intention? Should you apologize? Are you responsible for something that happened?
You may replay events repeatedly, confess, seek reassurance, or hold yourself to standards that are nearly impossible to meet.
Therapy can help you distinguish between living according to your values and using morality as another way to seek certainty.
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You may become highly focused on physical sensations, symptoms, or the possibility of illness.
You may repeatedly check your body, search symptoms online, seek medical reassurance, or monitor whether a sensation has changed.
Even after receiving reassurance, your mind may immediately generate another possibility.
Treatment focuses on reducing the need to resolve every uncertain sensation and learning when medical attention is appropriate versus when OCD is asking for another round of certainty.
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OCD can create intrusive doubts about sexual orientation, attraction, arousal, or unwanted sexual thoughts.
You may monitor your reactions around people, test your attraction, review past experiences, or analyze what a thought or physical sensation “means.”
The more you check, the less clear anything feels.
Therapy helps you step out of that checking process and stop using internal reactions as evidence that must be decoded.
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You may feel unable to move forward until something feels complete, correct, or certain.
You reread. Rewrite. Recheck. Reconsider.
The standard keeps shifting.
What looks like perfectionism may actually be a compulsive attempt to eliminate doubt, prevent mistakes, or avoid regret.
Our work focuses on tolerating the discomfort of “good enough” and learning that certainty is not a prerequisite for action.
(not an exhaustive list)