Yes, worry plays a major role in OCD; in fact, OCD has been called “the doubting disease.” When we doubt things, we worry about the consequences of our actions, thoughts, or feelings or about the intentions or capabilities of others. Therefore, people start to worry in order to do one of two things:
1. If I worry hard enough, I can prevent bad things from happening. Many people have the mistaken idea that worrying about something will somehow keep it from happening. How many mothers have worried about their son driving his car at night, only to think to themselves when he arrives home safely, “If I had not worried about him, something bad might have happened”? Yet, the son’s driving played much more of a role in his safety than his mother’s worrying did. This mistaken belief is exponentially worse in the minds of people with OCD.
To see if worries prevent anything from happening, do this simple task. Hold a pen in your hand over the floor and worry about the pen not hitting the floor when you let go of it. Then, let go of the pen and see what happens. If worries could prevent things from happening, the pen would have floated in the air. If you can’t float a pen in the air by worrying about it, how will your worries prevent deaths, disasters, or other dreaded outcomes?
2. If I worry hard enough, I will be able to think of every bad thing that might happen, and if I can think of every bad outcome, then I can prepare for every bad outcome, and there will be nothing to worry about. People who try to worry about everything often do not enjoy anything because all they do is spend their time worrying. Or they think of so many bad things that might happen that they don’t do much of anything at all, as a way to avoid the bad things they fear.
So instead of enjoying the fact that their children are out playing with their friends, they may instead worry that the children will fall and get hurt or do something that will make all of their friends dislike them. Because of that fear, such parents with OCD may start to prevent their children from going out to play. Although this prevents their children from being hurt while playing or from offending their friends, it also prevents them from being kids and enjoying their childhood.
When people with OCD worry, they jump to the worst-case scenarios, the things that they fear the most. Because they are so focused on these extreme fears, they do their rituals to prevent the possibility of these things happening. However, worry is insidious, it just keeps coming back, and the worries return again and again, possibly leading to more compulsive behaviors.
The goal of therapy is to break the link between the thoughts and behaviors, getting people to recognize that just because you think something does not mean it is true and that you need to do something to undo the thought.