TL; DR

Uncertainty is a significant challenge for those with OCD, often leading to a compulsive need for certainty that amplifies anxiety. This "intolerance of uncertainty" causes individuals to obsess over doubts (like whether doors are locked or if they’ve washed their hands thoroughly), leading to a never-ending cycle of reassurance-seeking behaviors. Attempts to eliminate doubt are futile, as OCD will always introduce new uncertainties. The key to breaking this cycle lies in resisting compulsions and learning to tolerate uncertainty, allowing for a more fulfilling life. Embracing the idea of "safe enough" through OCD treatment can lead to freedom from OCD's grip.

What is “Intolerance of Uncertainty?”

Raise your hand if you got to this blog by Googling:

Do intrusive thoughts mean I want to hurt someone?
Can you get sick from _____?
Can you get someone pregnant from a toilet seat?
Do pedophiles worry they are pedophiles?
How do you know if you’re in love?
Can you commit a sin without realizing it?
How to know if something counts as abuse?
Can OCD feel real?
How to know if a thought is intrusive?

You’re not alone! Those questions, and ones like them, are common web searches for people with OCD. No matter how much logic we throw at our particular OCD concerns, there’s still a nagging doubt, and the feeling doesn’t go away. The fear remains. This doubt is a part of OCD, and OCD causes folks to feel an urgent need to get rid of this doubt at any cost.

This feature of OCD is often called “intolerance of uncertainty.”

It’s natural for humans to be afraid of the uncertain or the unknown. The unknown can mean danger. But with OCD, that danger becomes amplified even when we are relatively safe. For example, most of us in our homes at night are relatively safe. With the doors locked, unwanted visitors cannot get in easily, and there isn’t much need to worry. However, people with OCD may experience doubt that their doors are locked. “Did I really lock them?”

Even though the chances are fairly low that they forgot, and even if they did forget, the chances are even lower that, this one night, there would be a serial killer going around their neighborhood checking for unlocked doors. Along with intolerance of uncertainty, there is an underlying overexaggeration of the possibility and/or the intensity of danger for folks with OCD. In combination, it can feel like those chances are very high.

What’s wrong with trying to eliminate doubt?

The problem with attempts to eliminate doubt and gain certainty is that it's never enough. No matter what is found with those Google searches, or whatever method is used to try to find certainty, there is always going to be another doubt. I could start washing my hands to be certain that I don’t get sick. But then the next doubt will be what if I’m not washing them well enough? Then maybe I start wearing gloves. That will keep the germs away, right? But what about the rest of my skin? Should I start wearing a hazmat suit? Even then, there could be a tear in the suit.

So maybe I should just pool together all of my money and live the rest of my life in a hermetically-sealed chamber where no germs can get in or out, hooked up to an IV with enough fluids to survive, in a white-padded room. That is the logical endpoint to chasing certainty. And even then, your OCD will still come up with something else to be concerned about. In fact, a completely germ-free environment is lethal to humans. These include the lava crater in an actively erupting volcano and possibly NASA clean rooms (even in those, some species have survived). If it were even possible, a completely sterile life would not be a life at all.

Certainty is an illusion.

In my online Wisconsin therapy practice, I remind clients that there is more gray in the world than there is black and white. And “reasonably sure” is not enough for OCD. So it keeps pushing, urging you on its wild goose chase, while, in the meantime, your life gets smaller and you are no longer really living. A former supervisor of mine liked to illustrate this with old arcade games. You know the ones, like Atari, where the maximum number the game could store for the score was 999,999. After that, the score would roll over to 0. OCD has you playing one of these old arcade games, telling you that you absolutely have to get to 1,000,000 points. It’s imperative. It threatens you and coerces you.

So you play. You play, and you get to 999,999. You think to yourself, “Just one more point. Then it’ll finally be ok. Then I can stop and have peace.” You get that one more point. And the score goes to 0. You pause. OCD speaks again, telling you the same thing as before. You have to get to 1,000,000. Keep playing, keep going. You need to get to 1,000,000. Keep going. On it goes, this cycle. No matter how close you get to 1,000,000, it’s never enough for OCD, and no matter how hard you try, the fact is that it is simply not possible. As an experienced OCD therapist, I want to hear this: You will never be certain. The only way to move forward is to stop playing OCD’s game.

What does ‘not playing the game’ look like?

How does one stop playing the game? This involves identifying compulsions and resisting them (and maybe doing the opposite!) It also involves finding ways to approach uncertainty rather than avoiding it. Get creative and actively find ways to be uncertain. It’s a skill, and it’s incredibly counterintuitive, but it really works to disrupt the OCD cycle.

Not to brag, but I’ve gotten pretty good at it. When you think hard enough, you can find a reason to be uncertain about anything. What’s the most certain thing you can think of? Something you’re never worried about? How about the sun coming up? The sun came up today. As far as I know, it has come up in the morning every day for all of human history. But does that really mean it is going to rise tomorrow? Sure, scientists measure the sun and its heat and activity. But what if they are wrong? Scientists have been wrong before. Maybe there is going to be some big explosion, and it’ll engulf the earth and die out in a blaze of glory, and there will be no sunrise and no earth tomorrow. But here’s the thing: I can know that this is technically a tiny possibility, but I’m not going to spend my entire day worrying about it. What am I going to do about it anyway? I am going to move on with my day.

Freedom is Within Reach: Final Thoughts From an Online OCD Therapist

Since everything is uncertain, you are already tolerating uncertainty in many areas of your life. “Safe enough” is good enough in those areas. You can live with uncertainty in this area, too. I recognize that this logic does not get rid of the fear and doubt. Your mind is always going to say, “But what if?” Logic doesn’t change how we feel, but it can help us choose to act against how we feel.

That is what exposure and response prevention (ERP) in OCD therapy is all about. It’s not enough to logic out of it, so we have to show our bodies and mind through experience that we can tolerate uncertainty and learn to live with “good enough.” This is the path toward freedom.

You Don't Have to Keep Chasing Certainty. Online OCD Therapy in Wauwatosa Can Show You A New Way.

If you've found yourself stuck in the loop of doubt, reassurance-seeking, and never quite feeling "sure enough," you already know how exhausting it is. OCD therapy can help you stop playing the game and finally start living on your own terms.

Leap Counseling and Consultation is a Wisconsin-based solo therapy practice that specializes in OCD and anxiety disorders. Through personalized, evidence-based treatment, Dr. Wood helps clients build a genuine tolerance for uncertainty, so that doubt no longer has to run the show. Getting started is simple:

Step out of your comfort zone and book a free 15-minute consultation
Work one-on-one with an experienced OCD therapist in Wauwatosa, WI
Begin learning to sit with uncertainty and loosen the grip of compulsions

Other Services Leap Counseling Offers in Wauwatosa, WI, & PSYPACT States

Facing OCD head-on in therapy means learning to tolerate uncertainty rather than fight it. For many people, that shift opens the door to a life that feels genuinely livable again. With the right tools and consistent support, it's possible to quiet the cycle of doubt and compulsion and start showing up more fully in your own life.

OCD isn't always the only thing people want to work through, and that's okay. Beyond OCD treatment, my Wisconsin-based online therapy practice also addresses a range of anxiety disorders, including Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Social Anxiety Disorder, and Phobias. As a licensed online therapist in Wisconsin and all PSYPACT states, I'm able to work with clients across a wide region.

Wherever you're starting from, change is possible, and it doesn't have to feel as far away as OCD makes it seem. Explore my mental health blog for more on how therapy can help, and when you're ready to take that first step, reach out to schedule an appointment.

About the Author

Dr. Johanna Wood knows firsthand what it's like to chase certainty and come up empty. Having navigated intrusive thoughts and the anxiety spiral of relationship OCD herself, she's lived the very cycle this blog describes and found her way through it with ERP. That personal experience of learning to sit with uncertainty, treating each exposure as a "leap of faith," is woven into everything she brings to her clinical work.

Dr. Wood is a Wisconsin-based clinical psychologist specializing in OCD and evidence-based treatment, particularly Exposure and Response Prevention (ERP). She earned her PhD in Clinical Psychology from Northern Illinois University and completed her doctoral internship at Rogers Behavioral Health in the OCD and Anxiety Adult Residential Program, where she later supervised clinical staff. She is licensed in Wisconsin, holds PSYPACT authorization, and is an active member of the International OCD Foundation, including contributing to national education efforts on scrupulosity OCD. Dr. Wood brings both deep clinical training and genuine lived insight to her ERP-based OCD therapy practice in Wisconsin.

Uncertainty in OCD: Why the Need for Certainty Actually Fuels Anxiety