It sounds strange, doesn’t it? Getting OCD about OCD? Weird. Yet it happens to many sufferers of Obsessive Compulsive Disorder. They instinctively know they have OCD, they’ve formed their own conclusion, others have told them straight up they suffer from OCD or they’ve flat out been told by a highly trained mental health professional but either suddenly or over time doubt creeps in and they’re left wondering if they have OCD at all.

It happens all the time.

I spend quite a bit of time on online forums, assisting sufferers on their journeys to wellness. Often I come across posts from bewildered people asking the same basic question: How do I know I have OCD? Variations include, What if I don’t have OCD or I’m not sure I have OCD.

What these people are really looking for is reassurance. That doubt that creeps into their minds takes hold and begins to convince sufferers that maybe their problem isn’t about OCD, but about something else. It’s all a big lie. There is no OCD. They’re just bad people with sick thoughts. They’re actually psychotic or sociopathic. It’s anything but OCD. These are the types of thoughts that people who have OCD about their OCD think.

So what is going on? Quite simply getting OCD about OCD simply means that the chosen topic for the disorder has switched to whether the person has OCD or not.

Let’s back up a second. OCD is where a person suffers obsessions (commonly referred to as intrusive thoughts but could be intrusive images, feelings, urges, impulses or sensations) that cause varying amounts of distress (what most people call anxiety) and lead to compulsions (acts, behaviors, rituals or mental rituals done to try and alleviate the distress caused by obsessions. And it’s all wrapped up in a veil of doubt. Short form: obsessions lead to distress and cause compulsions. Knowing that, let’s apply it to the subject matter of this post.

A sufferer suspects or knows they have OCD. At some point they get an intrusive thought (an obsession) that they don’t have OCD or may not have OCD or have some other affliction. This causes doubt and a sufficient amount of distress for the sufferer to feel uncomfortable. In response, the sufferer dwells on the obsession and performs compulsions. It’s simply having OCD where the subject matter is OCD itself.

What types of compulsions are usually performed? The big one is ruminating. Typical sufferers of this OCD theme will endlessly debate with themselves about whether they have OCD or not. They’ll look at evidence for or against having OCD. They’ll have arguments with themselves. Another big compulsion is reassurance seeking, which is exactly what is going on when this type of sufferer posts on an online forum, asking how they can be sure they have OCD.

A professional diagnosis of OCD, even by a leading psychiatrist or psychologist in the field, is not a guarantee that a sufferer will never develop this OCD theme. Doubt is doubt and OCD can latch onto pretty much anything and make a mess of it.

Ruminating over the question of OCD or not will rarely if ever lead to a firm conclusion and stop the doubt. Reassurance given will similarly fail to quell the obsessions and doubt and lead to a peaceful mind. So what should a sufferer do if they find themselves with this OCD theme?

If a proper diagnosis has not been forthcoming, then the sufferer should get one, being careful to choose a mental health professional with lots of experience dealing with people with OCD. Yes, this would be getting reassurance but it is once and only once and the sufferer must refrain from future second and third opinions.

If a proper diagnosis has been given, the sufferer needs to step back and look at what’s going on rationally, keeping in mind the basics of how OCD works (I covered that a few paragraphs back when I described what OCD is). The sufferer should be able to identify his/her obsessions, see doubt at work, realize there is distress involved and identify their compulsions. That is all the evidence required for OCD.

Then the sufferer, knowing what her/his obsessions are, must put into practice a regimen of delaying and stopping the compulsions they’ve identified. It doesn’t help to sit there and say, “I have OCD and that’s all that’s to it.” That’s a form of self reassurance and it too is a compulsion. Rather, the sufferer must become comfortable with the fact that their current situation is being generated by the very disorder they are doubtful of and be satisfied with that.

Lastly, the sufferer should challenge their OCD, as in conducting Exposure and Response Prevention, by agreeing with the obsessions and then practicing not doing compulsions. This would be done by sitting down and thinking something along the line of, “I do not have OCD and there is something else the matter with me,” then letting that thought float around for a while as no compulsions are done.

You’re not going crazy if you suffer from this common OCD theme. It’s just another trick in the OCD arsenal. You can recover from it as sure as you can recover from any other theme.