Joan Davidson, Ph.D.
Co-Director of the San Francisco Bay Area Center for Cognitive Therapy
Uncertainty can feel uncomfortable, very uncomfortable. It can feel frightening and even dangerous. We can’t avoid it, although we often try. Yet, when we learn to work with it and even embrace it, (yes, embrace it!), we can be more open, curious, and free from the struggle of trying to control it.
Uncertainty is a word that’s showing up a lot these days in psychological literature and in social media. How do we handle uncertainties in life? How do our patients view uncertainty and what do they do when faced with it? Uncertainty is something we must contend with as human beings. We’re pretty certain that we will die. Most of us don’t know when, where, or how. Everything between now and then is chock -full of uncertainty. It’s how we live with uncertainty that makes a world of difference.
When I was younger, life was full of uncertainty yet it seemed like one big exciting adventure. The older I get, some things have become more certain, and that’s what frightens me! But everyone has their own relationship with uncertainty. People prone to worry spend much of their life trying to control it. People with Obsessive Compulsive Disorder (OCD) respond to certain triggers of uncertainty as life-threatening. Trying to get out from under uncertainty and find reassurance may seem to make good sense but usually results in more problems than benefits.
Uncertainty lies at the heart of OCD, and it’s what our patients accept and embrace as they face their fears without using compulsions.* Recently, I’ve been researching and writing about transdiagnostic mechanisms underlying a range of psychological problems, and intolerance of uncertainty is a theme that cuts across many of them.* Clinicians are benefitting from decades of research about the role that intolerance of uncertainty plays in psychological disorders. There’s even a cognitive-behavioral protocol (CBT-IU) for Generalized Anxiety Disorder (GAD) that targets intolerance of uncertainty and related psychological mechanisms.*
Coping with uncertainty is not just a problem for people with anxiety disorders. It can be a struggle for many people during the course of everyday life, which is why I’m delighted to work with Jeff Bell and Shala Nicely as part of their organization, Beyond the Doubt, offering workshops to help everyone consider embracing uncertainty in the service of pursuing their greater good goals in life.
Jeff’s book, When in Doubt, Make Belief , includes insights from a range of inspirational people about their perspectives on uncertainty. By embracing uncertainty, we can help ourselves and others find increasingly creative and meaningful ways to live the lives we aspire to live.
Bell, J. (2009).When in doubt, Make belief: An OCD-inspired approach to living with uncertainty. Novato, CA: New World Library.
Davidson, J. (2014). Daring to challenge OCD: Overcome your fear of treatment & take control of your life using exposure and response prevention. Oakland, CA: New Harbinger.
Frank, R.I. & Davidson, J. (2014). The transdiagnostic approach to case formulation and treatment planning: Practical guidance for clinical decision making. Oakland, CA: New Harbinger.
Robichaud, M. (2013). Cognitive behavior therapy targeting intolerance of uncertainty: Application to a clinical case of generalized anxiety disorder. Cognitive and Behavioral Practice 20, 251-263.