How does the obsessive fear of solipsism manifest?

A fear that the self is all that can be known to exist becomes apparent when a person is emotionally terrified on a daily basis, and to the extent they question endlessly whether their own existence is real and/or that their loved ones around them could be just figments of their imagination.

Why can’t solipsism be refuted?

Solipsism is a theory.  This shows that while philosophical findings come across as “truths” the search continues to lead to one doubt after the other and one truth after the other, and so it goes on. Announcing the “belief” that the only thing somebody can be sure of is that he or she exists, and that the true knowledge of anything else is impossible, will never be set in stone. This is because realistically there will never be any reliable evidence to humanly prove or disprove this concept. So basically any dispute will continue to be questioned with doubt or possible validity.

If solipsism cannot be refuted, how can I be sure that I am real?

There are a number of things you can do. These include finding a CBT therapist who has a good grasp of what OCD is and how it is treated. For all types of OCD, not just solipsism OCD, you would be looking at exposure response prevention, because this is what starves the obsessional fear. Medication and mindfulness are often also helpful.

Do you have an example of an effective exposure technique for solipsism OCD?

Yes, one effective strategy for this type of obsession is to use a short exposure script.

How does this work?

Well, each time you use this method you expose yourself to your fear, and so do be prepared for an initial increase in anxiety. The procedure for this strategy is to read the script onto a loop tape and play it back repeatedly for 20 minutes three or four times a day for one week. You are encouraged to repeat this weekly, and until habituation takes place.

How can I monitor my exposures to know when habituation has taken place?

First, remember your anxiety will get higher, so it’s important to bear with this increase until it reduces naturally as this is part of the habituation process. Anxiety would normally decrease within 15-30 minutes, and usually no longer than an hour. When listening to the tape each time, you would note down the following and keep for your records:

  • Your level of anxiety before, mid-way and after exposure on a 0-100 scale. View the exposures as practice goals and aim to get your anxiety lower on the scale with each exposure, and towards your main goal, which is habituation – habituation would usually be around 20-25 on the 0-100 anxiety scale. So anything higher than this, keep up with the script until this is down to a regular 20-25.
  • Record other emotions such as low mood, guilt, sadness, despair. Note down each emotion with a level of intensity between 0 and 5 and gauge your moods each week. Anything gauged at 3 or below is fine. If certain mood states continue above 3, check with your therapist about Managing Depression with Obsessive Compulsive Disorder.

It’s also important that all compulsions relating to the obsession are resisted. These include not asking for reassurance, not reading any material relating to solipsism, no checking, no googling information, no questioning other people about their views on solipsism, and to not fall into the compulsion to ruminate about existence or consciousness. Basically, practicing the exposure script is there to help you live more comfortably with uncertainty – see further reading on OCD and Pathological Doubt (Blog).

Below is a simple exposure script for this obsession. You will notice that there are absolutely no reassurance statements in the script. This is because your goal is to become bored with your fear instead of feeling anxious and threatened by it. Because anxiety and boredom exist separately, you can learn to live more comfortably with uncertainty once boredom overrides anxiety.

EXPOSURE SCRIPT: “In life, the truth is that I can never have 100% certainty about anything. No matter how many times I question, ruminate or how thoroughly I check or seek reassurance about the true knowledge of my consciousness and whether I am the only mind which exists, I can never be 100% sure; nor can I ever be 100% sure that others are not figments of my imagination. Further, the more I listen to OCD and let it ascertain the limiting factors of my behaviours and actions, the more my symptoms will intensify. The sooner I recognise that my compulsions serve emotional functions only, the sooner my recovery will start; or improve.”