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Doubt is often associated with uncertainty, ambivalence, hesitation, questioning, and seeking reassurance. And while doubt can initially be thought of as hindering, it can be, and is, a healthy and beneficial part of human existence.

The doubt we can experience supports us in slowing down, being more thoughtful, and minimizing our reactivity. Doubt can preclude us from acting impulsively and assist us in making more informed decisions at important junctures in our life.

The philosopher Jiddu Krishnamurti said, “To look, you must have deep skepticism and doubt.” So a healthy dose of doubt is essential in the world we live in now.

Nevertheless, in higher doses, doubt can be debilitating resulting in an all-consuming, paralyzing, frightening, and hindering state marked by total distrust in one's ability and sense of agency in the world. I would like to suggest that the term I am coining here as “dysfunctional doubt” is akin to anxiety about one's sense of self and competence in the world.

Understanding the Impact of Dysfunctional Doubt

In recent years in my practice as a therapist and clinical supervisor, I am encountering more and more clients struggling with dysfunctional doubt, which manifests itself in all aspects of their life including doubting their purpose, identity, their life direction, and a feeling of an overall lack of groundedness.

Some of these same clients often struggle to identify what it is they want to get out of therapy or identify goals they would like to work on. They also appear to present with a sense of emptiness, and numbness, or just report feeling lost. Clients struggling with dysfunctional doubt may also present as passive and prefer that the therapist take the lead and instruct them on how to manage the session and life in general.

Often therapists may report feeling stuck or incompetent and share that their sessions seem repetitive and dragging when working with clients riddled with dysfunctional doubt.

Intrapersonal and Societal Factors Contributing to Dysfunctional Doubt

There could be many intrapersonal reasons why a person may develop a sense of dysfunctional doubt. Reasons such as having been raised by parents who were abusive, and neglectful. Or overpowering caregivers unaware of how to mirror, or empower their children, on how to learn to listen to, decipher or trust their feelings.

There are also many modern socio-cultural and technological changes that we as individuals are all exposed to that can be a breeding ground for intensifying feelings of doubt, including an increase in isolation, dissipation of a sense of community or lack of a sense of belonging, a lack of spirituality, having less face-to-face interactions, lack of faith in political institutions, post-pandemic residual, economic instability, fear of terrorism, and overexposure to social, medical, and fearful content. I know that seems like a lot.

How Therapists Can Help Clients Managing Their Doubt

As therapists, while we have limited control over the societal factors that may contribute to a sense of dysfunctional doubt, there are a number of areas of focus and skills that we can utilize to help clients manage their doubt such as:

1. Provide a holding container for doubt: The goal here is to help clients develop an awareness of their doubt, and its history and observe how their doubt is held emotionally, somatically, and in their thoughts. Developing acceptance of their doubt and learning to befriend it, rather than fight it, can help clients have a healthy relationship with doubt.
2. Assist the client in taking responsibility for their therapy: When working with dysfunctional doubt, it is important to encourage clients to identify, articulate and name their goals, while assisting them in searching for the answers to their questions within themselves. For example, it is helpful to ask clients to arrive prepared for a session with areas of discussion and goals for the session and practice activities assigned for the week. Lastly, change is the product of experimentation and action. Encouraging the client to take active change (not just talking about it) in their life is important to developing a sense of confidence and breaking through the paralyzing aspects of doubt.
3. Distinguishing functional from dysfunctional doubt: It can be helpful to understand when doubt can be helpful and when it can be dysfunctional. We can guide the client to reflect on instances when both functional and dysfunctional doubt have been employed and help them notice the differences as to how it shows up for them. We want to help clients develop a healthy balance with doubt not eliminate it.
4. Focus on what we have control over: Doubt can intensify and deplete us when clients are focused on all aspects of their existence that they don't have control over, rather than the elements that they do. For example, when preparing for a job interview, and focusing on fearing rejection rather than using energy to focus on what the client has control over, such as building a CV (resume), attitude, and interview preparation. Focusing on what one has control over can be a simple intervention that can make a big difference.
5. Connection with meaning and spirituality: Encouraging clients to connect to a larger purpose and perspective on life can release clients from their own myopic and fearful view of the world. Clients who are more connected to a sense of meaning and spirituality feel more grounded and confident in themselves.
6. Limit attention to fearful content: This is very straightforward, exposing yourself to fearful content via news and other social media channels can intensify a sense of doubt and fear. It is important to positively censor what we expose our brains to. As with food, what we fill our brains with matters too. Encouraging clients to process growth-oriented content can be transformative.

Coping With Dysfunctional Doubt in a Changing World

Dysfunctional doubt is a type of doubt that can be depleting and paralyzing. It is a type of pervasive fear involving one's sense of self-efficacy and capability in the world. Due to various socio–cultural-technological changes, clients in today's world can be especially vulnerable to dysfunctional doubt. There are various interventions that therapists can take to help clients better manage and befriend their doubts.