How do you accept uncertainty and problems with OCD?

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This is one of the parts of life that's so difficult for me to try new things and move forward in life. I can't stand uncertainty. I've basically now got a lot of OCD and I like to go to bathroom at a certain hour and loads of other things I can feel distressed if I can't do them. I also get a lot of bathroom anxiety, and the thought I might not be able to go in a public place because of shy bladder or if there's no toilets is enough for me not to step out the house for many hours. Uncertainty is also why I don't ever want to drive and I don't have a job outside the house.

One of the worst ways this affects my life is social interaction, or trying to find my first partner. Social interactions are completely random. When I'm watching a show or movie I can understand the social interactions and what's going on, and the uncertainty dosen't bother me because I know it has been constructed and I have time to digest what's being said and read cues.
But in real life its so unpredictable, and there's so much all at once you have to comprehend. I find it really hard to take charge of my life because of it.
I recently found my OCD got much worse since I tried to live away with strangers but then moved out. One of the major challenges I had was you had people coming back at random times and appliances which went wrong in the property etc. etc..

I don't want to be at my parents all the time though and I see myself wanting to many things which are uncertain in future like travelling or hopefully sooner than later find love, but I really struggle with this. I've had CBT before but I don't know how helpful I found it.

I'd be grateful for any help or advice on uncertainty, particularly around social interactions/relationships and whether having rigid rituals every day is a good or bad thing.

Any help regarding tackling uncertainty in life would be much appreciated, thanks!

Hi LimboMan,

You should really research RDI by Dr. Gutstein. His therapy (RDI) in my opinion is the best explanation as to what ASD at its core really is, and how to treat it so that people living with it have a great chance at a better quality of life (less problems). I’ve included some links to the RDI website, please read them/watch the videos in order for a good understanding how ASD develops and how it affects a person from birth to later in life. DO NOT skip the #posts as they build knowledge that is needed to understand the next post (I’m sure you’ll skip right to post #15 OCD, but try not to). It’s taken me two years to fully understand the RDI approach to ASD and its treatment – I have a son with ASD who is doing RDI.

I’ll try to briefly answer what OCD is and how it is a comorbid disorder caused by ASD, but not ASD itself. Simplifying the brain, it has two types of modes: Static Thinking Mode (stuff you already know) and Dynamic Thinking Mode (what kicks in when you don’t know something or executive functioning). The brain kind of behaves like a battery, it wants to conserve energy, and it’s default mode is the Static Thinking Mode. When presented with a change or moment of uncertainty, Dynamic Thinking Mode kicks in and you learn something new. This is how a brain usually develops, it starts at birth and fluidity between these modes of thinking grows as a person does.

ASD interferes with this development process of the brain, and at moments of uncertainty the brain cannot or is impeded from switching to the Dynamic Thinking Mode. As a result of this, the brain’s Static Thinking Mode grows and overdevelops, which over a lifetime leaves a person with an underdeveloped Dynamic Thinking Mode or impaired executive functioning.

Our brain’s also have what’s generally called a Fight or Flight response, as our mammalian brains evolved we’ve retained this function or mechanism. When a moment of uncertainty happens THAT WE CANNOT HANDLE stress hormones are released and effectively shut down our prefrontal cortex (the place where much of our executive functioning happens), and this is to divert our mental energy/resources away from the prefrontal cortex and use it in our lower centers or more basic parts of our brain – to prepare us to fight or run from danger.

For example, imagine if you’re a rabbit in a field just happily eating and then you hear a noise and you turn around and a cougar is just about to pounce on you – what happens? This moment of uncertainty triggers an instant release of stress hormones which prepares your brain to switch to its fight or flight response. You no longer need to deeply think about anything, it’s a very basic instinctive choice, run or fight, and in this case the rabbit who runs has a better chance at living. Evolution evolved our brains to work like this.

Obviously we are not rabbits and have more complex brains but it still affects us in the most basic ways. Another example when people get into heated/emotionally stressed arguments and say horrible things to each other that they don’t mean or would never say under normal/happy circumstances. Why does this happen? It’s the same basic fight or flight response as the rabbit/cougar, a point of uncertainty happens and stress hormones are released, our executive functioning/prefrontal cortex is momentarily impaired and you call someone you love something terrible. Then later, when the stress hormones wear off and your executive functioning/prefrontal cortex returns to normal you wonder why you would ever say something liked you did.

So how does the above develop into a comorbid OCD for a person living with ASD? First, life in general is dynamic and constantly changing – this is the world’s environment that we live in. If a person with ASD Static Thinking Mode overdevelops/Dynamic Thinking Mode is impaired and is not able to respond to the dynamic world, they can be in a near-constant anxiety driven fight or flight mode and need for routines, having things the same aversion from uncertainty develops. Maybe for some it’s not too bad and can be easily lived with, maybe for some it’s really bad and yields severe OCD.

I hope the above helps you understand your situation and I hope you consider RDI therapy, it may help you. Good Luck!


RDI Home Page: http://www.rdiconnect.com/
Brief RDI Overview: http://www.rdiconnect.com/autism-growth-is-possible/

Dr. Gutstein’s Blog:

http://www.rdiconnect.com/category/dr-s ... in/page/5/
http://www.rdiconnect.com/category/dr-s ... in/page/4/
http://www.rdiconnect.com/category/dr-s ... in/page/3/
http://www.rdiconnect.com/category/dr-s ... in/page/2/
http://www.rdiconnect.com/category/dr-steven-gutstein/

Be warned, for the most part, I have trouble handling OCD episodes sometimes. I try to focus on an intense memory, recent or long ago, and I try to wait too be pulled back into reality. To most, if appears I am spacing out.
Otherwise, it is unbearable like you described. I also have Tourettes, but I hate having to grunt or blink uncontrollably.
Socially, I barely speak. Most people lead conversation ahead of me. I try to make something up based on what the Kai person said, but this might mean I am a pathological liar.

I'm not too OCD, but over the years (approaching 50 now), I've learned to just STOP CARING about the things that make me OCD. It runs contrary to my compulsion to do everything perfectly, but forcing myself to adopt a "I don't care" attitude has slowly helped me to combat my OCD inclinations. So, rather than be OCD, I keep telling myself that I don't care, or it doesn't matter, and I find it easier to "roll with the punches" than I used to.

Of course, maybe it's just me, but as you get older, you just don't have the time or energy to throw yourself into everything like you used to in your youth...it's too exhausting.

It's like that scene from Big Bang Theory where Sheldon's been kept up all night by Penny who's playing a World of Warcraft type of game, and when he gets in an argument with his nemesis at work, he starts and then stops and says with exasperation, "I just don't have the energy to do this" because he can barely stay awake.

The I don't care or give a f**k attitude helps to combat giving into my OCD compulsions. I have been able to break many of the compulsions and limit the effect of the remaining ones. Everytime you give into a compulsion, the complusion becomes stronger. Everytime you refuse to give into a compulsion, the next time you encounter the same compulsion, the desire to give in will be weaker. Exposure Response Prevention (ERP) a type of CBT specifically designed for OCD really helped me.

I used to have a lot of problems with compulsive hoarding, organizing/arranging objects, checking, and germaphobia. All but the germaphobia I have been able to get almost entirely under control, and the rare compulsion that I do have is easier to resist. Germaphobia is more difficult for me to deal with and is a work in progress each day using the same CBT techniques each day to try and limit the impact my OCD in that area has on my life. Since CBT takes mental resources to complete each day, days where I am physically and mentally exhausted from unrelated physical health problems cause those days to be particularly more challenging to cope with than other days when I am not as ill.