I saw a post on Twitter recently where somebody wished (albeit in good humour) any therapists good luck in relation to dealing with OCD clients whose fear had actually “come true” (a new global pandemic in this case).
This is something that all OCD sufferers have experienced, the What If question. What If my loved one does die if I dont tap the table 7 times every time I pass it. What If God does send me to Hell if I don’t say the Lords prayer perfectly every night before bed? What If I do live in the Matrix?
Of course most people would agree that the above examples are absurd and not based in reality at all. But what about these: What If I am gay* but don’t know it? What If I accidentally burn the house down? What If I accidentally hit someone with my car?
Ok you might still think these things are unlikely assuming you are clearly straight, take reasonable fire safety precautions and drive safely. But if you think that some experts consider it likely that around 10% of people are gay (not sure the calculations here are accurate, but just for arguments sake); that in 2018/19 there were 562 house fires attended by fire crews per million across Great Britain (UK Home Office), and; in the US (in 2018) pedestrian deaths by road traffic amounted to 6,283 people. Does this change your mind?
But the reality is that certain OCD related content can and does happen to varying degrees of probability
After all, people don’t choose to be gay and some don’t realise until they are older. People almost certainly don’t plan to burn their house down or accidentally kill a pedestrian when driving. But the reality is that certain OCD related content can and does happen to varying degrees of probability.
But what about people whose obsessions are even closer to “reality”. Those that obsess about things that actually do have a high probability of happening. For example, diseases exist, whether it’s a flu pandemic, cancer or something else. The vast majority get sick at some point with something. If your obsession revolves around vomit it’s probably only a matter of time before you get a stomach bug and throw up in the toilet, or have your son puke on your legs on the plane when on the way back from Majorca (sorry!).
Another example is around moral scruples and obsessing about offending people. Unless you remain hidden and silent your entire life you are going to upset someone at some point, even being silent isn’t a guarantee. A further common obsession revolves around relationships, such as obsessing about whether you are truly loved by your partner. But the sad fact is, relationships end all the time. (Not ours of course we are perfect in every way 😆).
So we have extremely unlikely, almost impossible obsessions. We have obsessions with varying low probabilities (but at least based in reality), and we have obsessions that revolve around themes that actually have a relatively high probability of occuring. Some are near enough certain (as close as you could get anyway) such as illness and/or death.
So can OCD thoughts come true?
I have thought deeply about this question over the years and I’ve come to realise that the question doesn’t make sense. It’s like asking if flying pigs exist. There is no such thing as an OCD thought, just like there are no flying pigs. However, thoughts (the same as everyone else) about things can come true and pigs do exist.
The content and the probability of the content is irrelevant
Personally, I think the reason why many of us struggle with recovery is because we cannot stop asking this non sensical question. A person with an almost impossible obsession such as getting pregnant from a toilet seat feels just as concerned OCD-wise as with someone who worries that they might upset someone. Yet the latter has an almost infinitesimally higher probability of occuring. Furthermore, the themes can often change and interchange. And this proves the point: the content and probability of the content is irrelevant.
If your obsession is about your relationship and you end up splitting from your partner because they tell you they don’t love you anymore. Does this mean your OCD thought came true? You cannot answer an illogical question. Again, the content and the probability is irrelevant. It is the pathological intolerance of uncertainty that is where the problem lies (this is the disorder, not the thought itself); either with regards to what could happen, or in terms of trying to get absolute certainty about something that did or might have happened in the past and what this might mean.
The disorder could literally pick anything to torment you with, past or future based, impossible or probable, and this is a crucial point to remember during recovery.
The greatest trick OCD ever played was to convince you that pigs can fly.
*although concerns about being gay are a common OCD theme, the vast majority of OCD sufferers do not see being gay as anything bad at all. In fact most will beat themselves up about this as they are very inclusive and tolerant people and it violates their values. It’s the uncertainty that causes the issue.