What I’ve noticed about people with OCD…

A good number of the clients I see in my practice at any given time have OCD, or OCD like symptoms. Some come to me already having been diagnosed with OCD, while others just suspect that they have it. I do assess for OCD in my practice using formal tools, but I also spend a good amount of time chatting with whoever it is I am seeing, to get a flavor of what they’re experiencing. Most tell me about their obsessions - more often than not, they fall into the classic OCD categories. Obsessions about harm, obsessions about contaminations, obsessions about sexuality or their relationship. Obsessions about morality or doing the “right” thing. Preoccupations with finding the answer. 

OCD is known as the “doubting disorder” - it is characterized by a pervasive sense of doubt and accompanying anxiety. People with OCD doubt if they completed certain tasks (did I lock the door? Did I really crate my dog?) or even their own identity (am I really attracted to men? What if I’m not a good person?). These types of concerns can be normal, but what characterizes OCD is an inability to move on from these doubts or accept any information that dispels them. This means that the person who doubts if they crated their dog won’t be satisfied by looking at their dog in the crate - they’ll continue to check again and again.

But what I want to talk about here is how that pervasive sense of doubt affects how people with OCD speak. I am not a researcher, so what I am about to say isn’t based on empirical or qualitative evidence - it’s merely what I’ve observed about working with people with OCD. 

They often don’t speak declaratively. Their speech is peppered with “I think” or “probably.” Their uncertainty often extends beyond their particular OCD obsession and veers into how they think and communicate about many things.

I know this way of speaking - as someone with OCD, I’ve done it too! Sometimes, it has made me sound unknowledgeable about things I do know about. 

Here’s a perfect example - I once talked to a bunch of undergrad students about becoming a therapist. One of the students asked me if you needed a master’s degree to become a therapist. I know you need at least a master’s degree to become a therapist, but I had a total OCD moment and ended up saying something along the lines of “I’m not aware of any pathways you can take to become a therapist that don’t involve getting a master’s degree.” It was a weird answer, and the facilitator of the event (a former professor of mine) quickly stepped in and said affirmatively “You need a master’s degree to become a therapist.” 

I was embarrassed that I gave that answer, but I know the thought process that led to it - I questioned the information I had about becoming a therapist - what if there was some other pathway that I just hadn’t heard of? What if I was wrong? Even though a part of me knew that you needed at least a master’s degree to become a therapist, I didn’t listen to that part - I llet doubt take over and spoke in a way that reflected that.

I didn’t trust the information that I had and most importantly - I didn’t trust myself!

Since becoming aware of this, I’ve tried to combat this way of thinking and speaking. As someone with OCD, it’s hard for me to feel very sure about anything, but I’ve come to accept that I can be sure enough about something to speak declaratively about it. When someone asks me a question, I try to give them an answer that doesn’t start with “I think” or “It’s likely” or “probably.” I just answer the question! Speaking affirmatively has made me a better communicator. My answers are clearer and sound like true answers, not something I’m just speculating about.

If you have OCD or suspect that you do, I would love to hear from you. Is this something that you struggle with too? And lastly, as always, here’s a gentle reminder that therapy can help - it’s a starting point for building self trust, and having that reflected in your way of speaking.