A common compulsion in obsessive-compulsive disorder (OCD) is checking to make sure I did something correctly: turning off the stove, copying an address, writing a check, shutting the refrigerator, locking the front door, and so forth.
We can never know with absolute certainty that we’ve done something right, and OCD is a condition that feeds on uncertainty. As a result, many people with OCD end up checking repeatedly, sometimes for hours. The lost time is bad enough, and most people find that they actually feel less certain that they’ve done it right.
How can it be that more checking yields less certainty? A 2014 study addressed this paradox by having participants perform a computerized task and then check to make sure they’d done it correctly. The study authors predicted that repeated checking would lead to:
The study’s results did indeed show that repeated checking resulted in faster checking, as well as being less confident that one had done it correctly. The authors note that it was unclear whether the faster, more automatic checking caused the greater uncertainty.
Additionally the participants were undergraduate students, not necessarily individuals with OCD, so more work needs to be done to determine how well these results extend to OCD-related checking.
What’s the bottom line for OCD sufferers? As most people with OCD-related checking have found, the best solution is not to start checking in the first place. OCD lures us in with the suggestion that we "check once, just to be sure," which is one of OCD's favorite lies—after one check we're often hooked. It's easier to walk away from an urge to check than to “check a little” and then stop.
Of course, it’s easier to say “don’t check” than it is to actually resist the compulsive urges. Exposure and response prevention (ERP) for OCD is designed to assist a person’s efforts to break free of compulsive behaviors. Over time it gets easier not to check, leading to less distress and more time to do the things a person actually cares about.
An earlier version of this post appeared on sethgillihan.com.