Have you ever heard of existential OCD? Possibly not. That’s because far too often, Obsessive-compulsive disorder (OCD) is severely portrayed in pop culture and the media. We get images of “germ-phobic” people who are hyper-organized. While these characteristics occur, they are mostly stereotypes that do not come close to representing the condition or the people struggling with it.
OCD, of course, manifests differently for each person. It also takes many forms. The variations of OCD are limited only to one’s imagination. In other words, they are infinite. For example, existential (or “philosophical”) OCD is a thing. As you are about to learn, this form of OCD finds people overwhelmed with some of life’s most challenging questions.
What Is Existential OCD?
As you know, OCD earns its name due to the obsessions and compulsions it can impose upon people. A fearful or anxious thought (obsession) must be soothed by a reactive ritual (compulsion). In the case of existential OCD, the obsessions arise from relentless philosophical questions. For example:
- “What is my purpose?”
- “Why are we here?”
- “Is the world real and if not, how would I know?”
- “Is there a God?”
- “What about life after death?”
The list goes on — and so does the questioning.
Such questions, on their own, are not alarming or even rare. With existential OCD, they are all-consuming. They are intrusive thoughts and — as with other versions of OCD — they provoke a powerful urge to perform compulsions. In the name of effectively answering the deep questions, the compulsions frequently involve hours and hours of “research.” In addition, if someone in your life has existential OCD, you will regularly be asked to reassure them.
Since the types of questions found in existential OCD are unanswerable, the person with this disorder is on a non-stop quest. Every supposed answer can a) be doubted and b) lead to even more questions, obsessions, and compulsions.
Since having existential thoughts is nothing unusual, the person becoming obsessed with such thoughts may be slow to identify it as a problem. When they finally do seek help, it can be mistaken for depression or generalized anxiety disorder.
Treatment for Existential OCD
While there are many forms of OCD, treatment approaches remain very consistent. The presence of intrusive thoughts is the point. The content of those thoughts will be discussed but the goal is to identify the obsessions and short-circuit the compulsions. Therefore, the gold standard of OCD treatment is the go-to for this variation.
Exposure and response prevention (ERP) therapy does precisely what its name suggests. The person is guided by their ERP therapist to not avoid anxious thoughts. Exposing oneself to them increases your ability to tolerate the uncertainty that provokes compulsive rituals. It might look something like this:
You choose a thought that is not the most triggering. When the urge to do something compulsive arises, allow yourself to not immediately act. It could be as basic as counting to 10. If the compulsion has multiple components, work on not completing all of them. Over time, you can lengthen the pause and increase the number of subtracted components. The goal, of course, is to be able to experience the obsessive thought without having to take any action.
How to Cope with Existential OCD
Outside the therapy room, you will be expected to carryover the ERP homework, e.g.
- Exposure: Choose a feared idea and make it present in your life. This could be accomplished via recordings, notes to yourself, etc. Don’t avoid them. In fact, take steps to activate them.
- Response Prevention: Allow the feared idea to exist without you taking action. No arguing with it, seeking reassurance, or looking up information.