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OCD and guilt – understanding why you feel that you’ve done wrong

Many people with OCD experience extreme guilt. Certain symptoms can trigger this feeling, such as having sexual or violent thoughts or believing that you are responsible for causing harm to others.

The belief that you have done something wrong can lead to you being extremely self-critical, where you punish yourself for thinking in an ‘unacceptable’ way, such as in a sexual or violent manner, or for causing potential harm to other people. You may have also found that you are starting to withdraw from others as the guilt and shame become too much and you worry about how people would judge you if they ever found out.

If you are dealing with OCD and are experiencing guilt because of your symptoms, it is important to understand that people will want to support and connect with you. Also, there is professional treatment available that can help you tackle your symptoms and deal with the impact that they are having on your health and wellbeing.

Obsessive thoughts can lead to shame, worry and guilt for people with OCD

A person with OCD can experience thoughts that lead to them struggling with guilt and shame.

If you experience thoughts related to harm, you may feel guilty in moments when you believe that you have caused damage and destruction to another person or being. Some of the obsessive thoughts that can lead to feeling guilty include:  

  • Making a mistake or doing something wrong – you may worry about an email that you sent has been misconstrued as rude or offensive. You can also think that you have left an electrical appliance on at home or forgot to lock the front door. At work, you may worry about a mistake you’ve made, or a mistake you could have possibly made
  • Uncertainty over causing an accident or disaster – you may obsess over thoughts that you have knocked over a cyclist or pedestrian when driving. Or after you leave work, you may worry that an action or non-action you carried out in the day has led to a fire or flood
  • An urge to prevent harm or bad luck – you may believe that seeing or hearing an unlucky number, tragic news story, or a place, thing or person that is associated with harm, unluckiness or unhappiness will lead to harm or bad luck for others

You may also feel guilt and shame if you struggle with unacceptable thoughts, which can include the following:

  • Unacceptable thoughts or images about sex or violence – you may be worried about having these unacceptable thoughts despite having no history of sexual deviancy or violence
  • Immoral or sacrilegious thoughts and images about God and blasphemy – you may obsessively worry about these thoughts despite having no desire to offend God
  • Thoughts about killing yourself – you can experience these thoughts without having any desire to carry out the act
  • Doubts about whether you truly love your partner – you may fret about whether your partner is the right person to be with, or whether they are the right person to marry, despite loving the person and wanting to be with them
  • Doubts about your sexual orientation – you may obsessively worry about your sexual orientation, despite having an understanding of your identity
  • Thoughts or doubts about doing, saying or writing something awful, improper, or embarrassing – you may be concerned about doing this despite having no desire to
  • Acting on thoughts of extreme harm and violence – you may have thoughts of causing extreme violence or harm to others, and worry about whether it has happened in the past or may happen in the future

Most people experience intrusive thoughts from time to time, but are able to let them go without paying too much attention to them or attaching any meaning to them. When you have OCD, you become unable to ignore these thoughts, and instead, you obsess and attach meaning to them. The thoughts are treated as though they are facts, causing you to feel guilt, shame and worry, as though you’d actually acted upon the thoughts.  

Obsessive thoughts can lead to compulsions

People with OCD are often driven to carry out compulsions in an attempt to resolve or manage their thoughts, doubts and feelings.

If you experience obsessions related to harming others or yourself, you may carry out checking behaviour in an attempt to prove to yourself that the harm didn’t happen or won’t happen in the future. This can be an attempt to deal with the worry and guilt that you feel over possibly causing harm. These compulsive rituals can include:

  • Repeatedly checking locks, electrical appliances, electrical switches and gas taps
  • Repeatedly checking emails and work-related documents
  • Repeatedly checking that important things aren’t lost such as purses or phones
  • Frequently checking with others that something bad won’t or has not happened
  • Mentally reviewing scenarios to check that nothing bad happened
  • Following a specific routine or repeatedly carrying out an action
  • Counting to a certain number

If you grapple with worry, fear and guilt as a result of intrusive thoughts, you may carry out compulsions in an attempt to get rid of them. You may also carry out compulsions to check that you haven’t acted out on such thoughts in the past, and to prevent the thought from happening in the future. These compulsions can include:

  • Repeatedly carrying out an action or ritual
  • Repeatedly thinking or saying a particular phrase or mantra
  • Carrying out superstitious behaviour
  • Checking your level of arousal
  • Mentally checking and reviewing your actions and your current state of being
  • Repeatedly checking the internet for answers
  • Frequently seeking reassurance from others

Receiving treatment for OCD at Priory Group

Priory Group is able to provide support and treatment to people dealing with OCD. CBT is the recommended treatment that is used for OCD at Priory Group, and is in all treatment plans for the mental health condition.

CBT for OCD includes exposure and response prevention (ERP), where your fears are tested out in order to help you learn to tolerate the distress that you feel. Through the programme, the aim is to help you overcome your avoidance and compulsive behaviours, so that you can stop OCD from continuing to impact heavily on your life in your future.

Where appropriate, medication can also be prescribed alongside therapy to complement the work that is being carried out. The most common forms of medication used include selective serotonin reuptake inhibitors (SSRIs).

Our inpatient OCD treatment programme at Priory Hospital North London

Priory Hospital North London runs a nationally recognised inpatient programme for OCD. Led by international OCD expert, Professor David Veale, the programme provides you with access to one-to-one therapy and group therapy sessions, all of which are run by specialist OCD therapists.

Blog reviewed by Professor David Veale (MBBS, BSc, DIP, MD, FBPsS, FRCPsych, FBABCP, MPhil), Consultant Psychiatrist at Priory Hospital North London

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