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When in Doubt, Make Belief: An OCD-Inspired Approach to Living with Uncertainty

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NOTE: I received a free copy of this book to review for the web site Metapsychology Online; a more complete version of my review can be found on that site.

This book, subtitled An OCD-Inspired Approach to Living with Uncertainty, is a follow-up to author Jeff Bell's fascinating memoir about his struggles with Obsessive-Compulsive Disorder (OCD), Rewind, Replay, Repeat. In When in Doubt, Make Belief, Bell presents the specific strategies which he found to be most helpful in confronting the fears and uncertainties produced by his OCD, sometimes referred to as the "doubting disease."

In the first part of the book, Bell provides an excellent feel for the experience of living with OCD. He distinguishes healthy vs. unhealthy doubt, reviews some of the hallmarks of obsessional thinking, and finally, discusses the most common compulsions, for which he utilizes the useful metaphor of trapdoors--he identifies the most frequent trapdoors as checking, reassurance-seeking, ruminating, protecting, fixing, and avoiding. In Part 2, the "Making Belief" section of the book, Bell presents ten specific steps for getting out of doubt, a model which he developed based on the "Structure of Belief" pyramid that he first shared in Rewind, Replay, Repeat. Bell focuses on the four levels of the pyramid--reverence, resolve, investment, and surrender--and he offers several principles associated with each tier.The concept of investment most directly addresses motivation, with Bell encouraging readers to exercise freedom to choose, including choosing to direct one's attention and choosing to act for the Greater Good. The Greater Good then becomes the central focus in the final part of the book. Bell argues that what is missing in traditional OCD treatment models is the motivational component; he maintains that professionals need to give patients a reason to confront their worst fears.

Bell concludes the book with interviews of several famous figures, including Patty Duke. He also weaves both personal stories and highlights of his interviews with OCD experts and others throughout. Overall, this is an extremely hopeful and encouraging work, not only for OCD sufferers, but also for anyone who has been plagued by the anxieties, fears, and worries which stem from doubt.

Uncertainty and the discomfort which accompanies it are inevitable in each of our lives. The central question then is not how we avoid uncertainty and discomfort but... how do we embrace it?

Radio and television news veteran, Jeff Bell, has tackled this subject in "When in Doubt, Make Belief" which provides an inspired approach to living with uncertainty and doubt; developed over many years as he tried to free himself from a life of chronic uncertainty resulting from OCD (obsessive-compulsive disorder). OCD provided a laboratory for understanding the drivers of uncertainty and for developing strategies to limit counterproductive reactions to it.

Bell distinguishes between healthy doubt and unhealthy doubt and provides a series of questions to help the reader discern which is which. Unhealthy doubts stem from emotional reasoning (a term he coined) which leads to confusion, trouble, and is one of the ten distorted thinking patterns that trigger anxiety as well as depression.

Using his Belief Pyramid, Bell provides the ten steps out of doubt which leads to belief:

1. Choose to see the universe as friendly.
2. Embrace possibility in every moment.
3. Affirm your universal potential.
a. Live with purpose, mindfulness
4. Put your commitments ahead of your comfort.
5. Keep the sight of the big picture and the Greater Good.
6. Claim and exercise your freedom to choose - choose between the stimuli we are confronted with and our responses to them.
7. Picture possibility and "direct" your attention. - how much attention are we giving certain thoughts and feelings?
8. Act From Abundance in ways that empower.
9. Accept what you cannot control and let go. - the therapy of trust and of faith.
10. Allow for bigger plans than your own to unfold.

The path to belief and freedom includes embracing the concept of the Greater Good and the role each of us plays in an infinitely greater universal plan. "The Greater Good choice must inherently involve objectives bigger than ourselves and our doubts." The universe is available to each of us to the extent that we are willing to draw on it in ways that serve one's Greater Good. This enhances one's sense of purpose and compels each to be of service to others as they seek a Greater Good. Fully grasping and believing in the Greater Good provides a infinite source of strength that will trump uncertainty and doubt.

Every moment of this life is rich with possibility. Squandering these moments by fixating on the past, future, doubt, and uncertainty is self-limiting and destructive. Bell's lessons provide a "reverential practice" trumping the traps that keep us from seeking meaning and purpose at every opportunity.

"The purpose of life is a life of purpose."

If you're suffering from OCD, another book that will change your life is by Les Fehmi, PhD called "The Open-Focus Brain." I coincidentally picked up these two books at the same time in the library and realized they were intertwined. I was already familiar with Les Fehmi's work, but didn't realize it worked for OCD. There's a free CD in the back of the book with focus exercising. I'd highly recommend that you read both these books.

I didn't feel like this book provided any important breakthroughs. Most of the information I have seen in other books. From a medical perspective this book lacks a lot of credentials. It was interesting to hear about the authors story but I found it to be pretty generic.

For people like me who suffer from OCD religious scrupulosity,we really have a hard time. Believing that God is damming one to hell is super stressful and will claim another soul to the streets.I found only Brain Lock to help me with the worrisome feelings concerning God etc. But Jeff has been an additional blessing by writing this book.I had been using and blaming God for being a big bully. But this book has helped me see that God is not the bully at all. OCD is the big bully. If you apply they techniques in this book "the trap door" "the big bully" etc along with the "impartial spectator" from the book, "Brain Lock" one will get help and get their life back. Dr. Schwartz should have a Nobel Prize,speak up OCD suffers. Jeff maybe you should have one too my friend. Thankyou very much Jeff. I owe you and Schwartz for an eternity!!! Randy

This book is written to give people with OCD an effective strategy for overcoming this "doubting disease", as Jeff Bell describes it. However, the principles and practices suggested here would benefit anyone suffering from uncertainty, especially in these times of financial and global instability. Specifically, anyone could benefit from learning the distinction between healthy Intellect-based doubt and unhealthy fear-based doubt unhealthy and exaggerated doubts and reactions and this distinction is explained here and anyone could benefit from the strategies for confronting fear and worry.

The approach recommended in this book for overcoming the debilitating effects of OCD are based on Cognitive behavioral therapy (CBT), or ERP Exposure/Response - Prevention specifically. The essential keys for making this happen are what Jeff calls the Ten Steps out of Doubt. Of course, the book goes into sufficient detail to explain how and why these steps work as well as how to apply them.

1. Choose to see the universe as friendly
2. Embrace the possibility in every moment
3. Affirm your universal potential
4. Put your commitments ahead of your comfort.
5. Keep sight of the big picture and the Greater Good
6. Claim and exercise your freedom to choose
7. Picture possibility and "direct" your attention
8. Act from abundance in ways that empower
9. Accept and let go of what you cannot control
10.Allow for bigger plans than your own to unfold

This book is a fairly quick read and the methods are easy to understand and apply. As Jeff states, there is no magical cure for OCD but through hard work and time, it is possible to adjust thought patterns so that the bully (his metaphor for OCD) loses it power.

I sought this book out to help with my form of OCD known as scrupulosity.

Jeff Bell is a good writer and I commend him for consulting many experts in the field of mental health as well as successful figures from various walks of life. I found his own testimony quite enjoyable and I naturally could relate.

However, for Christian readers searching for a book on OCD, I would suggest looking elsewhere. I was hoping that the principles could be applied regardless of one's faith, but I discovered that there is quite a pluralistic/secular worldview woven throughout the book. I am not sure how a Christian is to follow steps such as these:

Step 1. Choose to see the universe as friendly.
Step 3. Affirm your universal potential.
Step 5. Keep the sight of the big picture and the Greater Good.

Two works that have greatly influenced Jeff Bell include Stephen Covey's "The 7 Habits of Highly Effective People" and Victor Frankl's "Man's Search for Meaning." There seems to be the belief that we direct our own lives and can choose our own meaning. Also, the Buddhist practice of "mindfulness" is advocated and at least one Buddhist author is interviewed.

Here's a quote that is illustrative of the worldview found in this book: "From the tenets of Judaism, Christianity, and Buddhism, to the themes of the self-help and applied spirituality books I was reading, the message was clear: try not to take life too seriously."

There seems a great gap in the content of this book and my desire to cope with my illness in a manner consistent with my faith.