Where's the Boundary Between Doubt and Obsession?

“Patient fights no longer against his doubts but fights for them.” —Jaspers, 1963.

"Doubt is not a pleasant condition, but certainty is absurd." —Voltaire

Obsessive-Compulsive Disorder (OCD) is a complex condition marked by a cycle of obsessions and compulsions. One central aspect of this disorder is doubt, which triggers a series of protective rituals, profoundly impacting an individual's daily life. OCD can encourage doubts that frequently manifest as obsessions, which are persistent, unwanted thoughts causing significant distress (Abramowitz, Taylor, & McKay, 2009; Nardone and Portelli, 2013; Vitry et al., 2021; Gibson et al, 2016) These doubts can vary widely, encompassing fears about personal health, morality, or causing harm to others. To alleviate the anxiety stemming from these doubts, compulsions emerge. These are repetitive behaviours or mental acts that an individual feels compelled to perform (Salkovskis, 1999; Nardone and Portelli, 2013). But what is it about doubt that is so intriguing to the human mind?

The Psychology of Doubt and the Rational Mind

Doubt has profound implications in both the psychology of rational thought and philosophy. The presence of doubt within the ‘rational Western mind’ manifests as a significant source of cognitive and emotional turmoil (Descartes, R., 1996). Rational thinking, which typically thrives on clarity, reliability, and logical coherence, encounters substantial disruption when confronted with doubt, as we see in OCD (Gibson, et al., 2016). This disruption stems from uncertainty, which impedes our logical faculties and complicates decision-making processes. This leaves the rational mind in a quagmire, struggling without a firm foundation and with us questioning our beliefs and decision-making Gettier, E. L. (1963).

Doubt and Knowledge

Doubt has been instrumental in shaping discussions about the nature of knowledge and understanding in both psychology and philosophy (Descartes, R., 1996). We often find ourselves questioning our actions and abilities, such as our driving skills or our capacity to handle severe illnesses. A particular type of self-doubt involves doubting our capability to understand properly or hold accurate beliefs.

This kind of doubt is common and understandable, given our propensity to err. However, it leads to a paradox when we use our reasoning to question our reasoning ability. Resolving this conflict between our initial belief and our doubt poses a significant philosophical and practical dilemma.

Socrates for example was aware of his lack of knowledge about major concepts like virtue or justice and his awareness led him to avoid committing to specific beliefs and instead seek others' views. Our willingness to admit ignorance opens the doors to new learning. On the other hand, Descartes took a more radical approach, questioning everything, even his sensory experiences, to rebuild his base of beliefs from the ground up, scrutinizing the very roots of his knowledge.

Simpler examples of this are where we reassess our beliefs based on new insights about our judgment abilities, for example, if we acquire a new skill or professional insight. In other cases, the right course of action is less clear. For instance, an eyewitness to a crime, upon learning about the unreliability of eyewitness testimony faces a dilemma about trusting their memory.

Questioning Reality

Doubt challenges the desire for definite answers, causing decision-making delays or 'paralysis by analysis' (Schwartz, 2004), as it impedes firm decisions. Besides, doubt's emotional impact, like anxiety or insecurity, affects rationality, blurring clear judgment and increasing frustration. Doubt prompts individuals to critically reassess their beliefs, a process that's intellectually engaging but often mentally strenuous, especially with fundamental or longstanding convictions, leading to cognitive dissonance, where one struggles with conflicting beliefs, as Festinger (1957) described.

Rene Descartes’ methodical scepticism (1996), for instance, exemplifies how doubt can be utilized as a tool to dismantle unfounded beliefs, eventually leading to foundational truths, as epitomised in his cogito argument (Descartes, 1641). Similarly, Socratic dialogues highlight the role of doubt in driving the pursuit of knowledge, emphasising the importance of recognizing one's ignorance as a precursor to understanding (Plato, 380 BC) just as Davis Hume’s empirical scepticism cast doubt on the reliability of sensory experience and rational deduction, challenging the very foundations of our understanding of the world (Hume, 1748). Even Nietzsche’s perspectivism suggested the inevitability of doubt given the subjective nature of all understanding (Nietzsche, 1887). Others even framed doubt as a central element in the existential quest for meaning and authenticity (Camus, 1942; Kierkegaard, 1843).

The Dangers of Excessive Doubt

While doubt plays a crucial role in rational thought and the quest for knowledge, excessive doubt can lead to significant challenges and adverse effects, particularly in the context of psychological disorders such as OCD. This persistent and often overwhelming sense of doubt can become paralysing, disrupting one's ability to make decisions and engage confidently with the world. In the grips of OCD, doubt is not merely a philosophical or intellectual exercise; it manifests as a relentless, distressing force. It drives the cycle of obsessions and compulsions, where the individual is caught in an endless quest for certainty and control over their intrusive thoughts (Abramowitz, Taylor, & McKay, 2009; Gibson, et al., 2016, Nardone and Portelli, 2013). This relentless pursuit can lead to severe anxiety, impacting mental health and diminishing quality of life.