OCD can cause extraordinary stress when it is focused on a decision that must be made. An example is a woman who is presently living with her three children and her husband in the house of her in-laws. Everybody is sick of them living there: her family, her in-laws, and herself. Money isn’t the problem. Why are they staying? Because every time they find a house to buy, she finds a problem with it. “It’s too close to the freeway;” “There’s a bad neighborhood only a half dozen blocks away;” “It’s too old a house, there might be asbestos they are not telling us about.” Yet, the pressure is building. Soon, a decision must be made.

For the individual caught up in an OCD nightmare such as this, it is as if she is skateboarding up and down the sides of a half-pipe, never reaching the top. Each time she comes close to making a decision, she can’t. In psychological jargon these are called “avoidance-avoidance conflicts.” A decision involves two possible alternatives, and both are bad. When the individual gets close to choosing one of them, anxiety peaks so high that the decision cannot be made, and she falls back into complete uncertainty.

As the time approaches when a decision must be made, the stress can become almost unbearable. Such was the case with an environmentally conscious student. Upon graduating from college, she received an excellent job offer from a well known, global high-tech company. Unfortunately, she found reason for concern. “What if their computers are made by slaves overseas…that wouldn’t be ethical to work there.” Her family and her best friend argued that her fears were unreasonable, that it would be stupid to pass up the job. But she couldn’t decide. Every time she got close to taking it, the fearful thought would overwhelm her, “What if they use things made in a sweat shop?” Yet she had to decide in two weeks, or she would lose the job. She was in a terrible state.

An understanding of what happens in such situations helps to clarify things. That fact is that when we do compulsions, our obsessions get stronger; and as they get stronger, they become more and more believable. This is what hardly anyone understands about OCD. Even the stupidest fearful concern can become truly believable. Then as that happens, we actually lose our ability to weigh the importance of the fear. We can no longer put it in any sort of a reasonable perspective. We simply become unable to make an informed decision. My OCD friend. If you get in this situation, you’ve had it. The more you struggle, the less judgment you will have to make a good decision. So what to do?

It often comes down to this: You must do what a reasonable person without OCD would do. Take the case of hand washers. It is astounding how they lose their judgment about what amount of hand washing is reasonable. They have no idea. That’s why books on OCD have “hand washing rules.” I tell such people, “Ask your sister how much she washes her hands, and make yourself do what she does.” The same sort of advice was helpful for the student with the job-decision obsession. I told her, “You have to trust someone else’s judgment. Yours is shot.” She did, and now she is fine with new job.

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2 Response Comments

  • Donna   at

    1 Corinthians 10:13 says “No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.” ERP is the way of escape.

    I also went through avoidance-avoidance conflict. My OCD didn’t start off this way, but the more I gave into it, eventually it then spiraled into not being able to make important decisions. I was a real mess 😊 However, practicing ERP in the smaller obsessions/compulsions that were easier to tackle eventually got me to the point of overcoming avoidance-avoidance conflict. Luke 16:10-12 He who is faithful in a very little thing is faithful also in much…. There really is a light at the end of the tunnel.

    I have a concern about accountability. ERP makes me wonder about self will and freedom. It feels like one with OCD is enslaved, but we still have some freedom or else ERP wouldn’t work. I went to confession about all the times I gave into my compulsions. I didn’t confess my obsessions because I can’t control what pops into my head. The priest told me I wasn’t responsible for my compulsions, but I feel some accountability for them since I choose them over trusting in God. I mean they do feel a bit superstitious.

    I pray that God will bless our efforts and that every time one of us refuses to give in to the compulsion that that act of love is blessed and multiplied and gives God glory.

    Thanks for your blog Dr. O. It is always a source of encouragement.

    • Liliana   at

      Hi, i also have ocd, puré ocd!!!, these words that you wrote really help me so much!!!, its really difficult living with OCD and believe in God, after months praying im tired really tired..