Why can’t I tolerate uncertainty?

Humans are creatures of habit—we have a tendency to find solace in our daily routines. However, life can be unpredictable and chaotic, and sometimes we have to change or adapt at the last minute. But for some of us, living with uncertainty and doubt is difficult and painful.

“We’re constantly living in uncertainty. A car could barrel down the street and hit my house,” says Dr. Patrick McGrath, PhD, and Chief Clinical Officer at NOCD. “So, should I put up concrete barriers around it to prevent that from happening?”

Even when we find “solutions” to these potential negative outcomes, our minds may always create new possibilities to ruminate over. Let’s say Dr. McGrath did install a wall to protect his house from reckless drivers. But wait, he also lives behind an airport! “What if a plane hits my house? Should I put up a dome, too?” says Dr. McGrath.

If you’re always experiencing distress due to constant thoughts about all the “what ifs” that could interfere with your plans, you may have an intolerance for uncertainty. Keep reading to understand how that personality trait can affect you and the mental health conditions it may be linked to.

Why does uncertainty bother me so much?

During the early days of the COVID-19 pandemic, we were barraged with news stories about a virus we knew practically nothing about. Every email began with “in these unprecedented times” and virtually all future plans were off the table. The isolation and uncertainty caused a significant mental health crisis among millions of Americans. “There were just all sorts of questions and there weren’t a lot of answers,” Dr. McGrath says “And I think that that really piqued a lot of anxiety for a lot of people.” 

When situations are more ambiguous, there’s a tendency for anxiety and worries to take over. When someone has a high intolerance for uncertainty, facing the unknown becomes extremely overwhelming for them. 

An intolerance for uncertainty could be caused by previous traumatic experiences, like growing up in a home where one never felt safe. Existing in environments where there’s always a threat of danger can lead someone to see any future uncertainties as unbearable. 

Signs that you’re intolerant of uncertainty

• Doing excessive research before making any decision
• Constantly asking others for reassurance
• Needing to plan out everything
• Trouble adjusting to last-minute changes
• Difficulty enjoying spontaneous outings and activities
• Feeling insecure about relationships, work, and/or school even when there’s no reason to
• Avoidance of situations you cannot control

What is the intolerance of uncertainty scale?

Intolerance of uncertainty exists on a spectrum, and some people have more trouble handling uncertainty than others. Psychologists developed a tool called the intolerance of uncertainty scale to measure how well one can handle ambiguity. It’s a 27-item questionnaire where one is asked to rank how much they resonate with certain statements on a scale from one to five. 

Some of these statements include:

• “The smallest doubt can stop me from acting.” 
• “I must get away from all uncertain situations.”
• “Unforeseen events upset me greatly.”
• “My mind can’t be relaxed if I don’t know what will happen tomorrow.”
• “Uncertainty keeps me from living a full life.”

Utilizing the intolerance of uncertainty scale  may help you gain a better understanding of your relationship with uncertainty. Still, it’s important to emphasize that if you think you’re dealing with a mental health concern, it’s best to get an assessment from a trained professional.

How intolerance of uncertainty impacts mental health

Intolerance of uncertainty isn’t something you can get diagnosed with. It’s more of a personality trait, but a severe intolerance of uncertainty could be related to obsessive-compulsive disorder and various anxiety disorders. 

Obsessive-compulsive disorder

A need for certainty is a key marker of OCD, a mental health condition that’s often dubbed “the doubting disorder.” People with OCD deal with obsessions—which are unwanted thoughts, images, urges, sensations, and feelings—often about things that are out of their control. That might lead someone with OCD to ruminate on all the potential outcomes, like:

• “How can I be 100 percent certain that my partner won’t leave me?”
• “I can’t have knives at home. How can I be sure that I won’t ever harm my family?” 
• “What if I’m actually a bad person? How would I know?”

These thoughts do not have to necessarily be limited to worries about situations in the future. Sometimes, it’s about not trusting your own memories. For example, people with false memory OCD have frequent doubts about things that happened in the past. That may sound like “what if I accidentally hit someone while driving and I didn’t notice?” or “what if I forgot to pay my bill at the restaurant and I get arrested?”

Whatever your obsessions may be—and they can change over time—they cause great distress, leading you to perform compulsions, which are repetitive behaviors or mental acts done in an attempt to neutralize thoughts, calm anxiety, or prevent a “bad thing” from happening. For example, maybe you want to run a marathon, but you’re worried that if you don’t train hard enough you’ll embarrass yourself. You try to manage the uncertainty of the situation by compulsively exercising so you’re in perfect shape. Other examples of compulsions include:

• Asking for reassurance
• Mental reviewing (e.g., replaying past incidents in your mind to try and gain clarity)
• Endless research
• Checking stoves, doors, locks, etc.
• Excessive cleaning
• Repeating acts till they feel “just right” (e.g., switching a light on and off multiple times)
• Mental compulsions (e.g., special words or phrases repeated in a specific way) 
• Arranging objects symmetrically
• Hoarding 
• Counting
• Avoidance of specific people, places or situations 

Our compulsions give us a false sense of total control by providing temporary relief. The good news is that with evidence-based treatment, one can learn how to better tolerate uncertainty without resorting to time-consuming compulsions.

You work with a specially-trained therapist to find out what triggers your cycle of obsessions and compulsions. Your therapist will design exposure exercises based on what triggers you, starting small and working your way up to more challenging fears. 

Let’s say you’re worried that if you don’t tap every wall in your house, an intruder could break in. Even if you understand this situation is highly unlikely, your OCD is convinced otherwise. So, you do tapping compulsions every night to try and control the situation. Your therapist might address this by having you gradually reduce your tapping. You start off by only tapping half the walls in your house, then maybe you only tap one wall each night, before you try to go a day without any tapping. 

As you practice exposures with your ERP therapist, you’ll learn to deal with any uncertainty that arises without engaging in compulsions. Over time, the doubts get easier to manage. With the right treatment, you can get back to living life on your own terms, instead of being controlled by a fear of the unknown.

Anxiety disorders

Intolerance for uncertainty is also a central feature to many anxiety disorders. “We always seem to jump to the worst case scenario when we have an anxiety issue,” says Dr. McGrath. That may look differently depending on what type of anxiety you’re dealing with:

• Those with social anxiety disorder often have a fear of rejection. Dr. McGrath says this can cause them to have a hard time dealing with the uncertainty of how others perceive them. They may automatically conclude that everyone hates them even when they have little evidence. 
• With health anxiety, people struggle to come to terms with all the potential illnesses and conditions that could be ailing them. That may lead to avoidance of going places to eliminate the possibility of getting sick. 
• In panic disorder, which is characterized by frequent panic attacks, “any kind of feelings that you might have in your body, you could jump to the worst case scenario and believe that it’s a heart attack, or something like that, and you’re dying,” says Dr. McGrath.

How to deal with uncertainty

Want to develop a stronger tolerance for the unknown? Try practicing to some of these strategies: 

• Don’t avoid uncertainty. “No matter how hard you try, there are always going to be things that you won’t be able to control,” Dr. McGrath says.
• Don’t attend to all of your thoughts. The average human mind goes through approximately 6,000 thoughts a day. Remember that random thoughts just pop up in our heads, they don’t necessarily need to mean anything or signal that something is wrong.
• Live in the moment. Certain mindfulness practices like breathwork, meditation, yoga, and journaling may help you stay present.
• Accept that change is natural. Being flexible with life’s unpredictability helps us adapt better to challenging situations.  
• Focus on your meaning, identity, and purpose. Finding something you are confident about may help you feel grounded when dealing with other doubts.

The main takeaway

There are things in life we can never be totally sure about. Whether that’s existential worries about a higher power or fears about whether or not you’ll always be in love, the uncertainty can feel debilitating. The best path forward is learning to live with the fact that there may always be endless possibilities. If you have trouble tolerating uncertainty to the point that it causes you distress, it’s a good idea to reach out to a therapist for help.