Ocd doubting everything
The Role of Doubt in OCD
By Judy F. Minkove on 11/14/2017
It’s not uncommon, says psychiatrist Gerald Nestadt, to hear someone joke over cocktails, “I’m so OCD,” implying that the person is exceedingly fastidious about everything. But obsessive-compulsive disorder, which affects some 3 percent of the world’s population, is no laughing matter.
Now he’s digging deeper to understand another component of the disorder: doubt. “I’ve been fascinated by its clinical relevance,” Nestadt says. “Doubt is not based on insufficient knowledge to make decisions. It’s a behavioral trait.” In the context of OCD, he theorizes, doubt demonstrates a “lack of confidence in one’s own memory, attention and perception necessary to reach a decision.”
Nestadt gives the example of patients who feel compelled to keep checking their front door to ensure that it’s closed. “They check it with their own eyes, but yet still need to go back and jiggle the lock to be sure,” says Nestadt. He suspects a genetic basis for this behavior, though environment also plays a role.
In a recent study published in Comprehensive Psychiatry, Nestadt and his colleagues report an investigation of 1,182 adults with OCD who were assessed to evaluate the relationship between doubt and OCD’s clinical features. “It’s the first investigation of the clinical significance of the doubt construct in OCD,” says Nestadt.
Doubt was assessed with the following questions: After you complete an activity, do you doubt whether you performed it correctly? Do you doubt whether you did it at all? When carrying out routine activities, do you feel you don’t trust your senses—i.e., what you see, hear or touch? Cases were categorized as mild, moderate, severe or extreme on a “doubting” scale.
The study found that doubt in patients with OCD was strongly related to the number of checking symptoms and, to a lesser extent, to the number of contamination/cleaning and hoarding symptoms patients experienced.
The findings, says Nestadt, suggest that doubt has important implications for understanding the nature of OCD. For one thing, the severity of doubt was distributed in the sample such that many cases were rated as severely burdened with doubt, whereas a sizeable proportion were rated as having no or little doubt. “This suggests that doubt may not be a core feature of all OCD cases, but rather a frequently occurring symptom of, or related to, the disorder,” says Nestadt.
The biggest surprise, he adds, was the finding that “the more doubtful you are, the more dysfunctional you are; 80 percent of the doubters were extremely dysfunctional.” Most likely, explains Nestadt, these symptoms emerge “from a neurocognitive vulnerability in the mental life of the individual, which has a basis in neurophysiology.”
So, what can provide relief for these patients? “Typically, 60 to 70 percent of people respond to cognitive-behavioral therapy,” says Nestadt. “But in patients with severe doubt, only about 35 percent respond. That’s where antidepressants come in.”
Next up, Nestadt and his colleagues are developing a multi-item instrument to assess doubt dimensionally in clinical and nonclinical samples. “With greater understanding about the neuroscience behind decision-making in patients with OCD,” he says, “we can
Why it Happens and What to Do
OCD — also known as the “doubting disorder” — can make you question things that you were sure of just 5 minutes ago.
Obsessive-compulsive disorder (OCD) is a mental health condition where you experience obsessive often uncontrollable anxious thoughts with frequent compulsions in response to those thoughts.
If you have OCD, you may find yourself fixated on a single thing, like making sure the dishes are clean. Even after confirming the dishes have been washed, you might start to doubt your memory of having checked the dishes or doubt that you washed them properly. You might go back out and rewash the dishes — just to be sure.
“OCD is also known as the ‘doubting disorder,’” says Dr. Holly Schiff, a licensed clinical psychologist based in Connecticut.
“One of the driving forces of compulsions in OCD is chronic doubt. Your brain tricks you into thinking that something has been overlooked, and this fear drives the individual into repeating the action again,” Schiff explains. “Doubt is a hallmark of the disorder, and it overrides any sense of logic or intelligence an individual might have.”
At the core of OCD is doubt of your own memory. Trying to remember if something happened or if you did something correctly can quickly become an obsession. This level of obsession can interfere with your life and quickly consume your focus.
“Memory is a tricky thing,” explains Dr. Amy Marschall, a licensed psychologist.
“With OCD, the person has more doubt and uncertainty about their memory than is typical or helpful, and they have a fear of what will happen if they are misremembering,” she says.
This leads to the compulsive element of OCD, where you feel compelled to verify and double-check something as a way to relieve stress and anxiety temporarily.
The doubt that comes with OCD can really start to influence your home and work lives over time, too.
For example, if you’re trying to get a work task done but are obsessively thinking about your safety and doubting if you locked the front door, you might stop working while you think through all the possible negative consequences of leaving the door unlocked.
You might lose more work time as you act on the compulsion, leave your computer, and check on the door.
If you think you may be experiencing symptoms of OCD, you may benefit from talking with a mental health professional who specializes in OCD and other related disorders. They can help set up an effective treatment plan.
Talk with a therapist
After talking with a mental health professional about your experiences, they can provide a professional diagnosis and set up treatment options for you.
“OCD can be diagnosed by a mental health professional through a thorough diagnostic interview where you answer questions about your history and symptoms,” explains Marschall.
It is also important to talk with a professional because OCD symptoms can be shared with other disorders, meaning that while your symptoms may present as OCD, they may be stemming from a different or comorbid disorder.
“OCD can be present if someone also has another disorder, such as anxiety or depression, and it can be present in individuals with neurodevelopmental differences such as ADHD and autism,” says Marschall.
There are several ways that a therapist can help you manage your OCD symptoms. One of the most commonly used methods of OCD therapy is cognitive behavior therapy (CBT). This therapy aims to address and help you rethink negative behaviors so that they have less control of your life.
One of the most successful methods of CBT is exposure and response prevention (ERP). A 2019 review concluded that ERP is one of the most effective treatment options for OCD.
“[With ERP], you create a stimulus that triggers the desire to engage in the compulsive behavior but prevents the client from doing the compulsion,” explains Marschall. “This reduces the stress and anxiety by showing the brain that the compulsion is not needed.”
While CBT can’t fully cure OCD, it can make the symptoms of OCD more manageable.
“People with OCD can also benefit from traditional talk therapy from orientations other than cognitive behavioral therapy,” says Marschall. “There are medication options for OCD as well.”
Therapy costs can often be out of reach for some people, which means you may need to consider lower-cost alternatives. One of the best alternatives to therapy, when you are on a tight budget, is to attend a support group.
While it isn’t a substitute for one-on-one therapy, you can find a lot of comfort in hearing other people’s stories and sharing your own.
In addition, the more you can connect with people also dealing with OCD, the less likely you will feel alone in facing its challenges.
The International OCD Foundation provides a list of support groups that you can filter to find meetings closest to you. Also, there are options to attend meetings online.
According to the National Institute of Mental Health, the causes of OCD are unknown, but common risk factors are genetics, brain structure, brain function, and the presence of childhood trauma.
In other words, the factors that put you at risk for OCD are all things outside your control today.
OCD is a very real disorder and can’t be easily “fixed” by talking yourself out of it or deciding to stop doubting yourself.
It is important to remember that OCD is a complex mental health disorder and shouldn’t be ignored if it begins to take hours away from your day. Know that you don’t have to struggle with OCD alone, and there is help available if you choose it.
Doubt your partner? What to do
Uncertainty in love from the point of view of neurobiology, sociology and psychology
Külli Kittus / Unsplash
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When we meet "our" person, we will recognize him out of a thousand - this is how the myth of romantic love goes. Did Romeo and Juliet doubt each other? But in real life, we think: whether they chose the right person, whether our feelings are real - this is normal and does not always mean that the partner is not suitable for us.
However, if there is too much uncertainty, it interferes with even the most sincere love. So, with obsessive-compulsive relationship disorder, a person constantly doubts a partner and arranges relationship checks in an attempt to get one hundred percent confidence, but this only increases anxiety, writes clinical psychologist Tatyana Pavlova.
Although relationship OCD is a psychiatric diagnosis, mentally healthy people can also fall into the trap of obsessive insecurity in a partner. Why do we doubt? And how do you deal with it in a way that doesn't ruin a worthwhile relationship?
Problem #1. Feelings have cooled
What exactly we feel for a partner depends not only on the strength of love, but also on the stage of the relationship. At the beginning of falling in love, our levels of sex hormones, stress hormones, and the neurotransmitter dopamine sharply increase, while serotonin, on the contrary, decreases - so we don’t want to part with our beloved for a minute and constantly think about him. At the same time, the activity of the amygdala and hippocampus decreases, which interferes with critical perception. Then the activity of the logical part of the brain and the level of hormones and neurotransmitters are restored, and oxytocin and vasopressin come into play. If you translate from the language of neuroscience into the language of love, passion is replaced by attachment. Now we notice the shortcomings of a partner, worry less when he is not around, and pay attention to the attractiveness of other people. The thought arises: has love left the relationship? In fact, the best is just beginning: the body no longer responds to a partner with an increase in cortisol and a decrease in serotonin, and love finally protects against stress, and does not cause it.
If in doubt because the feelings have become less intense, try:
Embrace your partner's imperfect side. Psychologist Joy Davidson explains that at first we idealize the beloved - this is a kind of "honeymoon". When it passes, we discover flaws and decide that the person is "not the right one", sometimes unreasonably. Realizing that with no partner the "honeymoon" will not last forever and no one will be perfect, will allow you to build a long and close relationship.
Focus on friendship. If passionate love - both the intensity of feelings and sexual activity - can subside with time, then time only strengthens comradely love. Relationships based on friendship, comfort, and shared interests last longer and are more satisfying. Fellowship and passion are not that far apart—attraction and attachment originate in the same areas of the brain, so by stimulating one type of love, we activate the other.
Issue #2. The partner is not perfect
If you have ever used Tinder, you know that you can swipe potential partners endlessly and each time it will seem that the next one will definitely be “the one”. Even if you are not a fan of dating and have never used such services, this mindset still affects your relationship - because we live in an era of emotional capitalism and perceive love as an investment that needs to be well managed.
Scholars have found that marriage expectations are now higher than ever, as is dissatisfaction with marriage, and they call this all-or-nothing thinking. It's no surprise that trying to find the "right" person is unsettling because we're turning down other options and the choice is still not perfect. Increasingly, we choose not to make a choice at all—like that San Francisco engineer who went on 150 Tinder dates trying to find “the one,” but never made it past a couple of dates with any girl.
If you're not sure you've found the best match, try:
Give the relationship six months. Stracey Wochner, a psychotherapist who treats people with obsessive-compulsive relationship disorder, suggests postponing the decision to end or continue a relationship for six months—or at least one month if six seems too long. The more we doubt and try to gain confidence, the more confused in feelings, says the therapist. That is why it is worth giving yourself time to just date the person and not think about the solution - as soon as you stop painfully looking for an answer, it will come by itself.
Create shared goals. It is believed that those who have similar habits and interests are happy in love, and their absence leads to the idea that the partner is not suitable for us. In fact, common values and goals are more important: religion and cultural traditions, the desire to raise happy children or save money for a house. “You can work together to set goals for a year, five, or even 10 or 20 years,” advises psychologist Stephanie Sarkis. “Working together on something strengthens your bond.”
Issue #3. Sometimes sad
Mutual love makes us happy, but with relationships that do not lead to a constant feeling of happiness, something is wrong. Or not? In fact, love can cause not only joy, but also sadness - and this is normal, writes psychotherapist Ilse Sand. After all, when we agree to a relationship, we also accept the risk of losing a loved one - due to separation or death. However, not all of us are good at dealing with negative emotions and the thought of loss. If the fear is too strong, we subconsciously do everything to avoid the loss, including sabotaging the relationship. Because of this, doubts may arise in a partner - and it is precisely when the connection with him is growing stronger, because the more intense the feelings, the greater the potential pain.
If you doubt your partner because you don't feel happy all the time, try:
Write a letter to your partner. To understand the relationship, Ilse Sand advises writing a farewell letter to a partner, but not sending it to the addressee. This will help you step back and see the situation for what it is. Maybe it's really not love? Or do you doubt the ghosts of the past and the fear of loss? Writing a letter is easy, the main thing is to speak sincerely, Sand advises, and gives such a list of questions as a guide.
- What was good about what you lost?
- Do you feel gratitude and for what?
- What was unpleasant in the relationship?
- What did you want from the person you are breaking up with?
- What was your contribution to this relationship?
- What do you think you missed?
- How would you like to see this relationship?
- If the one you are breaking up with was right now, how would you spend today together?
- What did you miss in this relationship?
- What would you wish to the one you are breaking up with?
- Search not for joy, but for meaning. Philosopher Carrie Jenkins proposes to rethink what we consider necessary in love. We think that the purpose of love is happiness, joy and pleasure. But what you need to look for in a relationship is not joy, but meaning - then happiness will come by itself. To do this, it is worth abandoning the rules prescribed by the romantic myth about exactly how a relationship should look and how it should feel in them. It is relationships filled with meaning, and not pleasant experiences, according to Jenkins, that lead to true happiness.
Speech by the head of the ROC Alexander Zhukov at the IOC Executive Committee in Lausanne
Speech by the head of the ROC Alexander Zhukov at the IOC Executive Committee in LausanneAlexander Zhukov ROC head at the IOC Executive Committee in Lausanne - RIA Novosti Sport, 10.12.2017
Speech by the head of the ROC Alexander Zhukov at the IOC Executive Committee in Lausanne
The head of the Russian Olympic Committee (ROC) Alexander Zhukov delivered a speech to the members of the executive committee of the International Olympic Committee (IOC), who met on Tuesday in Lausanne.
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game diary - pyeongchang 2018, olympic games, sports, pyeongchang 2018 Zhukov, International Olympic Committee (IOC), Vitaly Smirnov (football), Russian Olympic Committee (ROC), situation with the admission of Russian athletes to the 2018 Winter Olympic and Paralympic Games pyeongchang, 2018 Winter Olympic Games, Alina Zagitova, Roman Repilov
Diary of the Games - Pyeongchang 2018, Olympic Games, Sport, Pyeongchang 2018, Alexander Zhukov, International Olympic Committee (IOC), Vitaly Smirnov (football), Russian Olympic Committee (ROC), Situation with the admission of Russian athletes to the Winter Olympic and Paralympic Games 2018 Pyeongchang, Winter Olympic Games 2018, Alina Zagitova, Roman Repilov
LAUSANNE, Dec 5 - R-Sport. The head of the Russian Olympic Committee (ROC), Alexander Zhukov, delivered a speech to the members of the executive committee of the International Olympic Committee (IOC), which met in Lausanne on Tuesday.
Agency "R-Sport" gives the full text of Alexander Zhukov's speech.
Dear President Bach! Dear members of the executive committee!
Today you have to make an important decision regarding the participation of Russian athletes in the 2018 Olympic Games in Pyeongchang.
Not only the fate of those who have been preparing to compete at the Olympic Games in South Korea for several years depends on this decision.
The Olympic anthem will be played at the awarding of Russian athletes at the 2018 Olympic Games - the head of the IOC >>>
The integrity of the international Olympic movement and the development of the Olympic movement in Russia depend on this decision.
No one, I think, raises no doubts that, whatever your verdict is today, it should be aimed at protecting the rights and interests of all "clean" athletes, regardless of their nationality.
A similar issue was on the agenda before the start of the Olympic Games in Rio de Janeiro. And then the members of the IOC almost unanimously voted for the inadmissibility of applying the principle of collective responsibility and collective punishment.
Today, representatives of individual countries and anti-doping agencies are demanding the exclusion of the entire Russian Olympic team from participation in the 2018 Games.
In this regard, I would like to ask a direct question. Should 15-year-old figure skater Alina Zagitova, 20-year-old hockey player Kirill Kaprizov, or maybe 21-year-old luger Roman Repilov be responsible for what he did a few years ago, when they were not even members of the national team, the head of the Moscow anti-doping laboratories with their accomplices?
I think the answer is obvious. Everyone must answer for their sins. Punishing the innocent is unjust and immoral. This is completely contrary to the basic Olympic principles.
However, today the disqualification of an entire country is being discussed based on the undocumented statements of a fraudster who fled to another country, who, like a magician, continues to get more and more "revelations" out of the hat before each major sporting event. For example, he stated last Saturday, and I quote: "I will destroy the entire Olympic sport of Russia for the next 5 years!" End of quote.
And based on the testimony of a man who, in his own words, “committed all possible crimes except pedophilia and homosexuality”, sanctions are being taken against Russian sports and specific athletes, and these sanctions are extremely harsh and even cruel, up to life suspension from participation in the Olympic Games, and the testimony of Mr. Rodchenkov is recognized as reliable, because he is under the protection of the FBI. This is logic that goes beyond common sense.
Russian Olympic Committee President Zhukov's membership in the IOC has been suspended >>>
As far as I know, the Court of Arbitration for Sport has already ruled that a lifetime ban from participation in the Olympic Games is illegal.
One of the options for punishing the entire team of my country, which is discussed in the open information space, is the admission to the Olympic Games of "clean" athletes in a neutral status.
But in this case, how can we explain to hockey players, curling representatives, all participants in relay races and team competitions, for example, in figure skating, that they will not be able to take part in the Games, despite the fact that there are no complaints against them, and their " cleanliness beyond suspicion?
After all, no team can compete at the Olympics in team competitions or relay races in a neutral status without a name and national identification. This is only allowed for individual athletes who have a first and last name.
So the right of a "clean" skier or skater is different from the right of a hockey player or curler? Not to mention the fact that the non-participation of Russian athletes in the team events of the Olympic program will significantly reduce the level of competition and the interest of fans in the Games as a whole.
The very ban on representing one's country at competitions not only contradicts the essence of the Olympic movement, but also goes far beyond its scope, as it limits the right of an athlete as a person and citizen.
This is absolutely unacceptable and absolutely humiliating for any athlete who prides himself on being a citizen of his country.
Today we hear athletes from some countries say that they do not trust the Russians, they are afraid of being deceived and do not want to compete with them.
Such suspicions, constantly fueled by biased and sometimes simply false publications in the media, are understandable. However, everyone is well aware that over the past two years, all Russian athletes have been under a total multi-level permanent doping control by WADA. And this control is much stricter compared to how it is carried out in relation to colleagues from any other country. Moreover, on the eve of the winter season, the Olympic Committee itself took the initiative of additional testing of Russian athletes through international federations.
Numerous checks prove the "purity" of the Russians, and the results of the performances clearly show that the victories of our athletes have nothing to do with the use of illegal drugs.
Only 0.7% of the samples that are taken annually in Russia from our athletes by foreign doping officers under the control of the British Agency (UKAD) give a positive result. This figure is below the average general statistical indicator for other countries.
Ask the leaders of the international winter Olympic sports federations if they are confident in the cleanliness of those Russian athletes who are now competing and preparing for the Olympic Games. I have no doubt that the answer will be positive.
Today we constantly hear the term "punishment" in relation to Russian sports. Apparently, it is not considered sufficient punishment that hundreds of Russian athletes do not have the opportunity to take part in international competitions, missed the Olympic and Paralympic Games, lose their medals and reputation, receive life bans.
And all this - for other people's violations, fictitious lists of "Duchess" and only mentioning his name through the lips of a fugitive swindler. Of course, the athletes will challenge the unfair sanctions imposed on them in the (Sports) Arbitration Court. But already now they have suffered huge reputational damage and psychological trauma is inflicted on them.
We are dealing with the tragedies of specific people who dreamed of linking their lives and careers with sports, with Olympism, but ended up being thrown to the sidelines without any fault, where their name is now associated with deceit.
And how should they feel, being punished without any evidence of their guilt, when they are forced to watch on TV competitions in which their foreign colleagues participate, who legally take doping drugs under numerous therapeutic licenses? Nothing but resentment and disappointment.
Over the past two years, the Russian Olympic Committee has taken the initiative and made every effort to, together with the IOC, WADA and other international sports structures, eradicate doping in Russian sports, eliminate the consequences of the crisis in the national anti-doping system and create a new effective model for combating use of illegal drugs.
Vitaly Smirnov, the head of the specially created ROC anti-doping commission, an honorary member of the IOC, will inform you about this in more detail.
Very large-scale changes in the fight against doping have taken place in our country. We have put in a lot of effort and do not intend to stop. We see the mistakes that were made in the past.
As President of the Russian Olympic Committee, I apologize for the anti-doping rule violations that have been committed in our country.
At the same time, I want to once again draw your attention to the fact that today's decision will directly affect the fate of a new generation of Russian athletes, many of whom have the opportunity to compete at the upcoming Olympic Games for the first time.
They cannot and should not be held responsible for previous violations, nor should they feel like outcasts at a major sports festival without a national identity, without an anthem, without a flag.
It seems to me that today there is every opportunity to put an end to the process of punishments, sanctions and disqualifications, which has been going on for more than two years in relation to Russian sports.