Existential OCD (obsessive-compulsive disorder) is a form of OCD that involves persistent and distressing thoughts about big life questions. Unlike traditional OCD, which is often focused on fears related to contamination or harm, existential OCD revolves around deep philosophical uncertainties. These obsessive thoughts can lead to compulsive behaviors as individuals try to gain certainty or control.
For people with existential OCD, existential questions are not just theoretical. They are often tied to intense emotional distress and the feeling that life is meaningless or that something is wrong with their sense of self. The result is an ongoing battle to find answers to questions that may not have any clear answers.
Examples of Existential OCD
No two people dealing with existential OCD will have the exact same struggles, but their thoughts can feel like a never-ending cycle of worry. Below are some of the types of thoughts people with this type of OCD often struggle with:
- The fear of being disconnected from reality: constant worry that their life is just an illusion or that they are not truly living.
- Obsessive questioning of personal identity: doubting who they really are, their purpose, or their place in the world.
- Fear of death or the unknown: intense preoccupation with what happens after death or how they will cease to exist.
- Philosophical rumination: repeatedly analyzing the meaning of existence or grappling with the concept of time, space, and the universe.
How ERP and ACT Can Help
While existential OCD may seem different from traditional forms of OCD, effective treatments like exposure and response prevention (ERP) and acceptance and commitment therapy (ACT) can help manage the symptoms and reduce the impact on daily life. Let’s learn more about these two effective treatment options.
Exposure and Response Prevention (ERP)
ERP is a treatment I utilize for OCD that involves slowly exposing individuals to their fears in a controlled way. For those with existential OCD, this might mean confronting the very thoughts and questions they are trying to avoid. Rather than engaging in compulsive behaviors to “neutralize” the thought, ERP encourages individuals to sit with the discomfort and uncertainty.
For example, a person may be asked to spend time thinking about the fear of death or existential meaninglessness without attempting to find answers. Over time, this can help reduce the anxiety associated with these thoughts and prevent them from controlling the person’s life. The goal is not to find answers but to tolerate the distress that comes with uncertainty.
Acceptance and Commitment Therapy (ACT)
ACT is another powerful tool that can help people with existential OCD learn how to accept their thoughts and feelings without being consumed by them. Rather than trying to eliminate obsessive thoughts, ACT focuses on accepting them and taking action based on personal values.
A person struggling with questions about the meaning of life may never find a definitive answer. But ACT can help them focus on what is meaningful to them, such as relationships, personal growth, or contributing to a cause. By aligning actions with values, people can find a greater sense of purpose and acceptance of the unknown.
Combining ERP and ACT
Combining ERP and ACT can be especially effective for those with existential OCD. While ERP addresses the need to confront and accept distressing thoughts, ACT helps individuals embrace those thoughts without being controlled by them. This combination allows people to define their lives by their values and goals rather than obsessive questioning.
Help Is Available
Existential OCD is a challenging condition that can make life feel confusing and uncertain. Fortunately, treatments like ERP and ACT offer powerful ways to manage the disorder. If you or someone you know is struggling with existential OCD, remember that OCD therapists are here to help. Looking for help navigating your existential OCD? Visit my contact page for more information on scheduling an in-person or virtual appointment.