Legitimate Concerns and OCD

Sigmund_FreudI’ve grown tired of politics, so here’s a rant on a psychological issue that genuine victims of Obsessive Compulsive Disorder (OCD) can contemplate. In his classic book on OCD, “Brain Lock,” Dr. Jeffrey M. Schwartz, M.D. explains that the first step to combating OCD is to re-label a thought/fear/phobia as stemming from the psychological condition of OCD, i.e. label it an obsession. But how can you differentiate between a legitimately-loaded concern and an obsession?

Anyone who has even a mild case of OCD will recognize that OCD and everyday psychological conflicts (e.g. battling obesity, coping with financial problems, unraveling relationship woes, fixing education/career failures, experiencing general paranoia, untangling ambiguous sexual identity, and genuine shyness) do not mix well. If you have OCD, it’s important to separate what is an obsession from what is an actual real-world psychological conflict that may require its own resolution. Dr. Steven J. Phillipson, Ph.D. somewhat addresses this dilemma in one of his essays:

Some people report that they have difficulty distinguishing between spikes* and “legitimate important thoughts.” A foolproof litmus test for telling the difference is to ask yourself, “Did the thought or question come with an associated anxiety, feeling of urgency or feelings of guilt?” Ultimately it is wise to place such thoughts in the realm of OCD and make the CHOICE to accept the risk. When asked, “What if it’s not OCD,” I say “Take the risk and live with the uncertainty.”

*A “spike” is a thought that triggers someone with OCD to transcend into a cobweb of obsession and anxiety, e.g. “I left the stove on…”

In sum, the best way to distinguish an obsession from a truly legitimate concern is to determine if the thought or concern is triggering intense anxiety/panic and thoughts that it must be resolved with unrealistic immediacy. Many real world stressors and thoughts will create intense anxiety and restlessness (e.g. “my rent is late”), but one way to differentiate them from irrational fears and obsessions is to observe whether or not they are triggering immediate panic/anxiety and an urgency to solve the problem/”make the worry go away” during an irrational point in time. The example below will make this more clear.

If you suffer from OCD, imagine that you are dealing with the concern that your girlfriend/boyfriend is cheating. Perhaps your partner has given you a legitimate reason to be concerned. This is, then, a legitimate, albeit heavily loaded, concern. Someone without OCD will experience the thought and become anxious, angry, and concerned, but likely patient and inquisitive, perhaps they’ll even let it go prematurely. Someone with OCD, however, will become obsessed/anxious/panicked and determined to find out the answer with unrealistic immediacy.

Perhaps there is a realistic chance the partner is cheating, but at this point it is an obsession and time to take a step back and put the concern into proper context. Do you have proof? Can it wait until the morning? What will really happen if you don’t know the answer right now? As with other obsessions, embrace the chance that it is true and go with it. Instead of seeking an immediate answer, just say, “Yup, they’re cheating… okay… I’ll deal with that later.” Never give a legitimately-loaded concern the power to unravel you into an endless spiral of overthought and panic– such concerns are never settled or resolved with immediacy –instead, approach the concern with patience and clarity of mind by taming your OCD-reflex and embracing a healthier disposition. Or said otherwise, “When you worry you make it double… so don’t worry… be happy.”


Phillipson, Steven. 1991. “Rethinking the Unthinkable”. OCD Online.!rethinking-the-unthinkable/cbqk

Schwartz, Jeffrey M. (1996). Brain Lock. New York. Harper Collins