Understanding OCD: A Compassionate Perspective on Fear and Certainty

9 min read

by Katia Erokhina, MA Gestalt Therapy | PACFA Certified Practising Counsellor

Marsha Truman Cooper’s poem has been used in OCD communities as a powerful metaphor for avoidance and the way fear can gradually restrict a person’s life. In a few lines, it shows how fear changes the geography of a life.

Suppose that what you fear
could be trapped,
and held in Paris.
Then you would have
the courage to go
everywhere in the world.
All the directions of the compass
open to you,
except the degrees east or west
of true north
that lead to Paris.
Still, you wouldn’t dare
put your toes
smack dab on the city limit line.
You’re not really willing
to stand on a mountainside
miles away
and watch the Paris lights
come up at night.
Just to be on the safe side
you decide to stay completely
out of France.
But then danger
seems too close
even to those boundaries,
and you feel
the timid part of you
covering the whole globe again.
You need the kind of friend
who learns your secret and says,
“See Paris first.”

(Cooper, n.d.)

At first, danger has a single address: Paris. The rest of the world still feels open. But gradually, the city limits become too close for comfort. Then the surrounding countryside feels unsafe. Soon, all of France is off-limits, until the fear that once occupied a single city seems to reach across the entire world.

This is one of the most painful ways OCD and anxiety take hold. The more carefully we try to contain fear, the more of our lives it begins to claim.

When fear becomes the figure

Gestalt therapy understands experience through the relationship between figure and ground. At any moment, something comes forward and asks for our attention. Hunger, a sound, a memory, a longing, or the face of the person in front of us may become the figure. The rest of experience moves into the background.

With OCD, one possibility can become so vivid that it overwhelms the wider field. Did I definitely lock the door, or am I remembering it incorrectly? What if I contaminated someone and made them ill? What if I caused harm without noticing? What if something terrible is about to happen and I am responsible for preventing it? Why did I have that thought? What if it means something disturbing about who I am?

The possibility may be remote, but it feels immediate and years of lived evidence recede into the background. The intrusive thought moves to the centre and attention narrows around it, so the person may feel compelled to check, wash, review, confess, avoid, compare, research, or seek reassurance.

These actions can bring a brief sense of relief. For a moment, Paris seems contained. But because absolute certainty is impossible, another doubt soon appears.

A creative adjustment, not a personal failure

One of the most compassionate ideas in Gestalt therapy is the concept of creative adjustment. We develop ways of responding that make sense within the situations in which they arise. A response may later become rigid, painful, or limiting, but it began as the best available attempt to manage something difficult.

Francesetti (2017) applies this perspective to obsessive-compulsive experience. He suggests that obsessions and compulsions can be understood as attempts to create distance, order, boundaries, and predictability when experience feels uncertain, uncontained, or overwhelming. Obsessive thinking moves experience into a cognitive and logical form that can feel more manageable, while rituals offer predictability, a temporary sense of control, and brief relief. Perfectionism reflects the longing to bring an experience to completion, even though that feeling of completion never fully arrives.

This does not mean that compulsions are beneficial or should be maintained. It means that they are doing a job.

If we see a compulsion only as irrational behaviour, we may overlook the suffering it is trying to manage. We may also add shame to an already exhausting struggle. A person with OCD is not failing to be logical. They may be working relentlessly to create a sense of safety that never feels secure enough to rest in.

From this perspective, the questions begin to change. Instead of asking, What is wrong with me? we might ask, What relief is this compulsion promising me? What happens if I do not follow it? And how much of my life is this pattern asking me to give up?

When the world begins to narrow

Francesetti (2017) uses the image of a siege to describe obsessive experience. The person’s world begins to contract as they try to control what can enter, what can leave, what may touch what, and where danger might cross a boundary. Yet every new defence seems to reveal another possible gap.

This can be felt in many forms of OCD. With contamination fears, the line between clean and unclean becomes increasingly fragile. With checking, the boundary between safe and unsafe never feels fully established. With moral or harm-related obsessions, the person may inspect thoughts, memories, bodily sensations, and intentions in an effort to prove goodness or innocence beyond all doubt.

The body can become tense, watchful, and tired. Time also changes. There is no satisfying conclusion, only another cycle. The door is checked, but the feeling of completion does not arrive. The memory is reviewed, but certainty does not settle. The question is answered, but the answer does not hold.

For some people, this may be the emotional world beneath the visible ritual: not a wish for control in the ordinary sense, but an exhausting attempt to hold uncertainty and feared catastrophe at a distance. Francesetti (2017) suggests that this struggle can also be profoundly solitary, particularly when comfort through connection does not feel available.

It is important to remember that OCD is complex, and no single theory explains it for everyone. Yet this lens can offer something profoundly human: symptoms that look senseless from the outside may carry an understandable protective logic from within.

The contact boundary: where self meets the world

“The contact boundary” comes from foundational Gestalt therapy theory, particularly Perls, Hefferline, and Goodman (1951). It describes the point at which a person and the environment meet and experience is formed.

OCD can make this boundary feel dangerously uncertain. A thought may feel morally contaminating. An object may feel too close. Another person’s safety may seem entirely dependent on one’s vigilance. The person tries to construct a perfect barrier, but life keeps presenting ambiguity, change, and risk.

The painful paradox is that the effort to create perfect safety can reduce genuine contact. Attention moves away from the meal, the conversation, the journey, or the person we love and toward the internal emergency. Life becomes organised around preventing what might happen rather than meeting what is happening.

Gradually, Paris becomes more than one place to avoid; it begins to shape every road we consider taking.

“See Paris first” needs a relationship

The last line of Cooper’s poem does not say, “Just go to Paris.” It introduces a friend, someone who learns the secret before offering the invitation.

Approaching fear is different from being pushed into it. The kind of support that helps is neither dismissal nor endless reassurance. It is the presence of someone who can understand why the fear feels powerful without agreeing that compulsions must control the route.

In Gestalt therapy, healing is relational. The therapist pays attention not only to what the client says, but to what happens between them in the present moment. Does urgency fill the room? Does the client feel alone with an impossible responsibility? Does the therapist begin to feel pressure to provide the perfect answer? Can both people notice that pressure without immediately obeying it?

Francesetti (2017) emphasises the importance of contact that offers steadiness in the face of uncertainty. The therapeutic relationship can become a place where fear is experienced with another person rather than managed in isolation. Over time, the client may discover that uncertainty can be present without destroying connection, dignity, or choice.

This is not the same as reassuring someone that the feared event will never happen. Reassurance may soothe anxiety briefly while strengthening the demand for certainty.

Making room for uncertainty without abandoning yourself

A Gestalt perspective can complement established OCD treatment. Cognitive behavioural therapy with exposure and response prevention, commonly known as ERP, helps people gradually face feared situations or thoughts while reducing the compulsive responses used to obtain relief. Medication, particularly selective serotonin reuptake inhibitors, may also be helpful for some people (National Health Service [NHS], 2023).

Gestalt therapy can add careful attention to embodiment, relationship, meaning, and the present moment. It can ask how anxiety is felt in the body, how the search for certainty unfolds between client and therapist, and what support makes it possible to remain in contact without retreating into ritual. When OCD is the main concern, it is important that therapy is informed by specialist knowledge and does not reinforce reassurance seeking or avoidance.

The aim is not to tear away a person’s protection before other support exists. Nor is it to eliminate every frightening thought. The work is to develop enough ground beneath one’s feet that uncertainty no longer feels like free fall.

This may begin in very small moments: noticing the urge to check before acting on it, allowing an unanswered question to remain for a little longer, feeling both feet on the floor, returning attention to the person across the table, or choosing an action based on values rather than fear.

Each moment restores a little of the map.

Paris becomes a city again

OCD often promises freedom after certainty: Once you know for sure, once everything is clean, once you have reviewed the memory correctly, then you can return to your life. But the promised certainty keeps moving further away.

A different freedom becomes possible when life is no longer postponed until fear disappears.

You may still notice Paris. Its lights may come on at night. Anxiety may tell you to turn back, check the route, or redraw the border. But with awareness, appropriate treatment, and relational support, Paris can become one place on the map rather than the centre of the world.

An affordable online OCD program

Self-guided resources can offer a helpful and affordable place to begin. THIS WAY UP provides a research-backed, six-module online OCD program based on cognitive behavioural therapy. The self-guided option currently costs AUD $59, while the clinician-guided option is free with a prescription from a healthcare professional.

Yet OCD often thrives in isolation, and exercises on a screen cannot replace the experience of being supported by another person. Therapy offers a relationship in which fear and uncertainty can be approached gradually at your pace.

If OCD or anxiety is impacting you and your life, you are welcome to contact me katia@relationalhome.com to explore how therapy might support you.

THIS WAY UP is an independent recommendation, not a paid advertisement or sponsored link. Program details and fees may change, so please check the website for current information.

References

Cooper, M. T. (n.d.). See Paris first [Poem].

Francesetti, G. (2017). “Suspended from shaky scaffolding, we secure ourselves with our fixations”: A phenomenological and Gestalt exploration of obsessive-compulsive disorder. British Gestalt Journal, 26(2), 5-20.

National Health Service. (2023, April 4). Overview: Obsessive compulsive disorder (OCD). https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/overview/

Clinical note

This post offers general information and one therapeutic perspective. It is not a diagnosis or a substitute for individual medical or psychological care. If intrusive thoughts or compulsions are causing significant distress or disruption, seek support from a qualified health professional with appropriate OCD knowledge. If there is an immediate risk of harm, contact local emergency or crisis services.