Just the other day, yet another OCDer tried to tell me that a new tormenting worry was not an obsession. “I don’t think this is OCD,” she said, “because this is a real problem, not something irrational.” She is an accountant, and was speaking of a possible mistake she had made in preparing a person’s tax return. It was complicated. She had called her boss who said, “don’t worry about it.” Her husband and a good friend said the same thing. Yet for weeks she had been endlessly going over and over the situation in her mind, unable to decide what to do. Fantasies tormented her of ruinous things happening, from being yelled at, to going to jail, to losing her salvation.
Okay, yes, this is a legitimate concern, particularly for a Christian who takes doing the right thing seriously. But that doesn’t mean it has not become exaggerated to the point of becoming a clinical obsession! In order to understand this important point, consider the process of how an obsessional thought is generated in the fear system of the brain.
The fear system has the critical job of establishing whether a particular concern, one which represents a threat of some type, is worth worrying about. It automatically brings the matter to the forefront of conscious awareness, analyzes what is known about it, and considers the possibilities of various outcomes. Then it either dismisses the fear from awareness (because it is not worth worrying about), or else it keeps it there for more processing. Importantly, in this critical brain process the final dismissal of an obsessional fear is not due to any choice that we make. Rather, it is done automatically by the workings of the fear system. Unfortunately, in OCD, the brain’s fear system is dysregulated in a very specific way: It does not process and dismiss a given fearful concern in a timely manner.
So, OCDers are left worrying about things that should have already been dismissed from their mind because they are not worth worrying about. It doesn’t matter whether the concern is realistic or not. That’s the reality of the situation.
What can we do? Fortunately, if we stop responding to an obsessional fear, it will gradually lessen in strength and stop tormenting us. That is the natural process of habituation. This means, of course, that we will need to remain in a painful state of uncertainty for a time. That is very difficult, yet it is what we must attempt to do. Why? Not just so that we can beat back the fear! Much more importantly, this how we learn to trust in God. We take the risk of not relying on ourselves, so we can learn to rely on Him. God uses obsessional fears as a means for us to grow in faith.