DECISION OBSESSIONS

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.