Often patients, in the course of their treatment for OCD, will question whether they actually have OCD or not. This doubt feels different to them than the doubt arising from the intrusive thoughts that initially brought them into treatment. But this doubt about having OCD is OCD! OCD demands certainty and convinces the sufferer that bad things will happen if they’re not certain. The content of the intrusive thoughts is always irrelevant, but the content can distract patients (and sometimes clinicians) from dealing with uncertainty and risk.