How Well do You Tolerate Uncertainty? Well? Or Maybe Not Quite As Easily As You Had Perhaps Hoped!

Being able to tolerate uncertainty is a well -known concept in psychology circles. It has been widely written about by very eminent Clinical Psychologists such as Michel Dugas and Paul Salkovskis, in relation to anxiety disorders and Obsessive Compulsive Disorder (OCD) in particular, and it helps us to understand why OCD can be such a difficult disorder for sufferers to deal with.

Imagine a typical scenario which most of us experience at some time in our daily lives, where you are going out for the day and your home will be empty for that time. Before you leave, you may do a general check of windows and doors being shut, turning lights off and check that cooker switches are off. You lock the front door, get in the car, and half way down the road, you suddenly wonder if you locked the door properly. This might be the time that even though it was minutes ago, you can’t quite remember if you did it thoroughly or not. This sets up a mental dilemma. Do you turn around and go back home to check, in which case you will be late, or do you carry on and hope that you did lock it. Except that your brain will probably be telling you by now that if you hadn’t locked it and you get burgled because you were irresponsible, then it would be all your fault. The insurance wouldn’t pay up and your family would be devastated at losing all their precious possessions.

This uncertainty has to be weighed up and dealt with pretty quickly. For many people without OCD, they are able to have the thoughts and over- ride them, perhaps telling themselves “I probably did lock it, I’ve just forgotten. Even if I didn’t lock it, I live in a quiet road, it will be ok. I need to get to work or I’ll be late”. You are able to continue your journey and the chances are, with all the other distractions around, the feeling of panic fades, and if you do still think about it when you reach your destination, you can then picture the memory of you having locked the door. You have “tolerated” the feeling of uncertainty and dealt with it.

People who are vulnerable to OCD and other anxiety disorders are not so lucky, and they experience huge problems dismissing uncertainty. In more recent years, research has found that the messages of doubt which we can all experience seem to have a super- efficient highway to the “fight or flight” mechanism for people with OCD. This means that their bodies go on hyper- alert, adrenaline is pumping, and the uncertainty becomes overwhelming and impossible to ignore, particularly if it is linked to something that they feel is their responsibility. This unfortunately means that they are likely to HAVE to go back and check the front door as the only way to seek immediate reassurance.

Learning to tolerate uncertainty can be useful for all of us, regardless of whether we have OCD or other anxiety disorders. Learning relaxation techniques can be very helpful for calming down our negative thoughts and our stress alerts. There are also many other Cognitive Behaviour Therapy techniques which help to deal with these problems. There are 3 different relaxation videos to try on my website: . These are a good first step to developing good coping strategies for the time when you catch yourself thinking “Oh no, what if I have forgotten to …..”

Dr Sue Webb

Chartered Clinical psychologist

August 2022