The Power of the Word "Maybe"
What comes to mind when you hear the word "maybe?" How do you feel? For some, this one word can evoke a feeling of distress - a desire to force that maybe into either a yes or a no - into anything that will take them out of that dreaded gray-area space and into one of definites and certainties.
For this very reason, when I mention the word "maybe" and how it can be used to effectively help individuals with Obsessive Compulsive Disorder (OCD) recover, I am met with disbelief. How can this one word have the power to help someone properly manage their OCD symptoms?
Let me explain.
Someone with OCD battles intrusive thoughts, images, and urges, then seeks relief from their discomfort through the use of rituals. These rituals (physical or mental) are done with the hopes of preventing their worst fears from coming true - getting sick from contamination, being responsible for a house fire that destroys everything, having a "not just right" feeling that will never end, winding up in jail for committing an unthinkable act - the list is endless. For someone with OCD, acknowledging the possibility that their core fear can come true is painful, and the very reason they turn to rituals to provide short-term relief.
The key word here is short-term. No matter how many rituals an individual engages in, the future will continue to remain an uncertain place. Someone without OCD has no more certainty about their future than someone with OCD. We all struggle with not knowing what our tomorrow looks like, or what our future will bring 10+ years from now. While it's not pleasant to imagine possible worst-case scenarios, having the tolerance to embrace this uncertainty, and to make room for it in our every day lives, is the key to living a meaningful and fulfilling life.
How do you embrace uncertainty with respect to OCD-related fears?
Cue to the use of "maybe."
OCD treatment is unique. It involves a specific form of Cognitive-Behavioral Therapy (CBT) called Exposure-and-Response Prevention (ERP), which can be enhanced with the use of Acceptance and Commitment Therapy (ACT) - I know, quite a number of acronyms right there! Everything you've probably learned about treating anxiety is seemingly flipped upside down. Instead of trying to prove just how irrational one's fears are, and provide reassurance that one's worst-case scenarios will not happen, OCD treatment focuses on the "maybe," the uncertainty, the possibility, that ones nightmare scenario, the one they try so hard to prevent through the use of rituals, can actually come true - that "maybe" I will contract a terminal illness one day and die, that "maybe" I will forever be focused on a "just wrong" feeling and never be able to succeed, that "maybe" I will commit a morally wrong act, and that "maybe" my true sexual orientation is not in fact what I think it is.
Scary, isn't it?
The rationale for this approach is as follows: The use of "maybe" is an exposure-based practice to help improve one's tolerance for uncertainty. Now, be mindful that becoming tolerant to the possibility of a fear coming true is not the same thing as saying you want it to come true or that you don't care if it comes true. Acknowledging the possibility of a feared outcome is also not the same as saying there is a 50/50 chance. The goal is not to try and figure out the exact probability of your feared story playing out, nor is it to learn to like it. Instead, the goal is to build a tolerance to it, to make room for the possibility of it showing up one day, vs. fighting with it. As you may know, trying to fight a specific fear - and seek a guarantee that it won't come true - doesn't work. You inevitably find yourself caught in a vicious loop of feeling triggered ---> experiencing high anxiety ---> using rituals to reduce this anxiety ---> getting retriggered ---> experiencing high anxiety ---> using rituals to reduce this anxiety.... and so on. Embracing the "maybe" of your fear, along with the short-term discomfort it will evoke, allows you to finally break this cycle.
Think about all the uncertainties and "maybes" we face every day. We get in our cars and drive to the store knowing "maybe" I can get in a fatal car crash. Our family members go to work and there's that possibility that "maybe" they don't come home. How frightening to think about! Yet, we continue to get in our cars, and our family members continue to leave for work. While these fears may not be highly probable (hence why they are called "worst-case" scenarios), they are still possible. We operate alongside this possibility - the "maybe." We tolerate these uncertainties and make room for them.
The goal then becomes generalizing this skill to core fears driving OCD symptoms. We want to practice the use of "maybes," while refraining from avoidance behaviors, or using any rituals to bring down the discomfort it will initially evoke. The goal is to continue about your day, bringing your discomfort along for the ride, while focusing on more meaningful activities that trying to play the OCD-certainty game (a game that can never be won!). You want to allow the initial discomfort to rise, and make room for it. This is where essential learning takes place! Your mind is learning to tolerate, vs. run from, discomfort, and when repeated over and over, your mind will begin to recognize that it is okay to think about your feared story, and while it may feel uncomfortable, you can tolerate it. Think about what would happen if you reminded yourself that "maybe" I will get in a fatal car crash on my way to work, and then refrained from getting in your car. Your mind learns that driving is dangerous, and before you know it, your independence becomes limited. The same happens when ritualizing in response to the discomfort elicited from your core OCD fear.
If you've been struggling with OCD symptoms and have been fearful of embracing the uncertainty of what you fear most coming true, it can be helpful to work with a trained professional on how to incorporate your own "maybes" into your daily life. This will feel scary, but keep in mind, you are capable of a lot more than you think.
DISCLAIMER: The blog posts shared on www.StacySmithCounseling.com contain the opinions of Stacy Smith, MS, LPC, and do not reflect the opinions of any organizations or affiliates. While Stacy is a licensed mental health professional, all blog posts on her site are for informational purposes only, and are never a substitute for professional advice catered to your individual needs. Stacy Smith is not liable for any diagnosis, treatment plans, or decisions made based on the information presented on this website.