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"Needing to Know for Sure" by Dr. Martin N. Seif and Dr. Sally M. Winston

Authors own image - Ruby and Needing to Know for Sure: A CBT-Based Guide to Overcoming Compulsive Checking and Reassurance Seeking by Dr. Martin N. Seif and Dr. Sally M. Winston

I spent a ridiculous amount of time at my best friend's house when I was a teenager. Her mum would pop into her room to check on us or ask us if we wanted anything, and every time she left, my best friend would ask her, "I didn't shout, swear, or say anything rude then did I?"

All three of us used to laugh at this. Even my best friend knew intellectually that she hadn't shouted, swore, or been rude to her mum. But she couldn't stop saying it.

I constantly seek reassurance, too, but in a different way. I seek reassurance through rational self-talk.

This is because, like my best friend, I experience obsessive intrusive thoughts.

I don't mean TikTok's definition of obsessive intrusive thoughts (what if I dyed my hair blue?) I mean Mind UK's definition: thoughts that can be "frightening, graphic and disturbing" (what if I kill myself or someone else?). These thoughts aren't a reflection of my desires. I don't want to hurt myself or someone else. That's what makes them so frightening.

I started looking for resources that might help me manage my intrusive thoughts and the anxiety they bring. I came across the book 'Needing to Know for Sure: A CBT-Based Guide to Overcoming Compulsive Checking and Reassurance Seeking' by Dr. Martin N. Seif and Dr. Sally M. Winston on Amazon. I'm a word person, I learn through reading, so I decided to order it.

It's been life-changing.

According to their profiles, Dr Martin N. Seif specialises in anxiety disorders, while Dr. Sally M. Winston specialises in treating phobias, panic, OCD, and other related disorders. Between them they have written numerous books.

The book first explains the difference between productive and unproductive reassurance: productive reassurance is accepting doubts while unproductive reassurance is trying to eliminate them. The problem is, of course, we can't eliminate doubts. Nothing in life is ever 100% certain. So, we end up in a cycle of compulsive checking and reassurance seeking.

For example, if I have a thought, "what if I kill myself or someone else?", I might respond to this by thinking, "you would never do that, you're not a violent person". I might accept this for a short time, but then, more doubts arise: "What if I stab myself or someone else in my sleep? What I've already killed someone and hidden their body under my bed, and I just can't remember doing it?". Before I know it, I'm checking under my bed for dead bodies.

Dr. Martin N. Seif and Dr. Sally M. Winston distinguish between three different voices — Worried Voice, False Comfort, and Wise Mind. Worried Voice and False Comfort are fairly self-explanatory. Wise Mind accepts doubt and understands nothing can ever be certain. She knows that thoughts are just thoughts.

They suggest that reassurance reinforces the need for reassurance the next time an intrusive thought arises. It makes us reliant on it, especially if the reassurance does lead to a short-term drop in anxiety (like when I look under the bed and see that there aren't, in fact, any dead bodies).

I suppose this is akin to when I had eczema growing up — scratching felt satisfying in the moment but only led to more skin damage.

The authors suggest using therapeutic surrender instead. This involves, and I'm oversimplifying here, embracing uncertainty when intrusive thoughts arise, avoiding reassurance, and avoiding distractions. In other words, sitting with the uncomfortable thoughts without trying to "fix" them.

I've been implementing this technique for a few weeks, and I'm already starting to feel the benefits.

I found avoiding reassurance immensely difficult at first. I want to comfort myself when I'm in pain. I want short-term relief, and refusing to reassure myself denies me of it.

I found an exercise that helped me immensely in the beginning until I was able to tolerate sitting with the thoughts better. I would tell my body to make a particular movement while actively preventing myself from making it. For example, I would repeat the thought, 'stand up' over and over again in my head but choose to remain seated. This helped me to remember that thoughts have no power and no inherent truth.

Now, when I have an intrusive thought, I imagine that it's a miniature boat, and I'm watching it pass me on a river. I don't yank it out of the water. I let it be.

I still have setbacks. I still spiral sometimes. I'm using Dr Martin N. Seif and Dr Sally M. Winston's recommendation of having 'reassurance coupons' (in other words, only letting myself seek reassurance a few times per week), and that's helping. Hopefully, I'll soon get to the point where I don't need any coupons.

My biggest takeaway from reading the book is that, contrary to most of what I've learned in my recovery, I don't have to control or eliminate my thoughts. I just need to recognise them for what they are.

I would highly recommend it to anyone who suffers from compulsions and intrusive thoughts. At the very least, it will leave you feeling as seen as I did when I read this hilarious quote:

"They [checking compulsions] can even seem bizarre: I know it makes no sense, but let me just check one more time that I did not lock a child in the refrigerator." (page 19).

Everyone deserves to feel like they aren't alone in having a messy mind, and everyone deserves to feel like they aren't the only ones whose mind seems to work against them. This book gave me that. I hope it can give the same to you.


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