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OCD and Decision Making

Janet Singer's son Dan suffered from obsessive-compulsive disorder (OCD) so severe he could not even eat. What followed was a journey from seven therapists to ...Read More

We are very lucky. We live in a society of unlimited possibilities. From what clothes to buy, to what to eat, to deciding when or if to marry, to career paths and lifestyle choices, we are barraged by seemingly endless decisions daily. This combination of freedom and abundance affords us opportunities galore to create ideal lives for ourselves.

Not surprisingly, however, many of us often feel overwhelmed by the complexity of our lives. There are just so many choices. Whereas we used to go to the library (or perhaps a bookstore) to get that book we wanted, we now have the additional options to read it on Kindle (or perhaps Nook) or order it online (but from which site?), or perhaps get the audio version (but which one and from where?).

While these daily choices can be distressing for anyone, they can be especially difficult for those who suffer from obsessive-compulsive disorder. Since doubt is the cornerstone of OCD, sufferers often have the need to know, for certain, that all these decisions they are making are the right ones. This is much easier said than done. Sure, you like the way your new jacket looks, but maybe the cheaper one you didn’t choose would have been just as nice. The restaurant you took your co-worker to for lunch was great, but maybe the “other one” would have had better specials. You love your job, but maybe if you’d continued on with your education, you’d have an even better job now. And so the ideal life that freedom and abundance offers doesn’t exist. Perfection eludes us; there is always doubt.

OCD sufferers might also worry how their choices will affect others, and agonize (to the point of obsession) over even the most minor decisions. “What if the movie I choose is boring for my friend?” “Will I insult my child’s teacher if I say no to a volunteer project?” “Will my doctor be upset if I choose another healthcare provider?”

Or those with OCD might make a decision they are quite sure of, only to then have OCD sabotage it. A vacation destination you’ve been dreaming about for years can now finally be a reality, but OCD might force you to second-guess your choice. The weight attached to all kinds of decisions can be too much to bear, at which point OCD sufferers may avoid making decisions whenever possible. Unfortunately, avoidance is never the answer, and while this tactic may temporarily quell anxiety, in the long run it will make OCD stronger. Exposure Response Prevention Therapy can help sufferers learn to accept the uncertainty that inevitably comes with decision making.

Barry Schwartz, a psychologist and author of The Paradox of Choice, explores the connection between depression and the abundance of choice. He talks about how when we have no choice in a matter and something goes wrong, we have no reason to blame ourselves. If a tornado comes along and destroys our home, we don’t go around assigning blame; instead we begin to rebuild. When we do have a choice, whether it’s something as trivial as which jeans to buy, or something more significant like a career move, we have high expectations and expect everything to be perfect. When these expectations fall short, we blame ourselves. After all, we are the ones who made the decision. Maybe we should have made a different choice? There is often regret that may lead to depression.

According to Dr. Schwartz, too much choice undermines happiness. I agree and believe this is as good a reason as any to simplify our lives as much as possible. We need to be grateful for all that we have because yes, we are indeed lucky. But none of our lives is perfect. And whether we have OCD or not, we need to be able to accept the decisions we make and continue on. If we don’t, our mental health will surely suffer.

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