OCD and Guilt

by frameangel freedigitalphotos.net

by frameangel freedigitalphotos.net

If you have obsessive-compulsive disorder or are close to someone who does, then you likely understand why OCD is sometimes referred to as the “doubting disease.” Doubt is what fuels the fire for OCD, and that is why those with the disorder need to be able to embrace living with uncertainty if they are going to beat OCD.

In addition to doubt, OCD sufferers typically deal with a lot of guilt. Over what, you might ask? Well, just about everything! OCD is typically accompanied by cognitive distortions, and many of these cognitive distortions can lead to feelings of guilt. For example, my son Dan suffered from hyper-responsibility. It’s not hard to imagine how his feeling responsible for “saving the world” led to tormenting guilt when things didn’t work out as he felt they should. Some other cognitive distortions that might lend themselves to feelings of guilt include black and white thinking, personalization, and thought-action fusion. A recent study of those with OCD focused on the precuneus, a part of the brain often involved with responsibility. According to the researchers:

The level of precuneus activity was greater for individuals with greater levels of obsessive-compulsive symptoms, and the activity increased when someone experienced greater ‘thought-action fusion’ – believing a negative event would become reality.

While those of us without OCD might become frustrated at what we perceive as our loved ones overblown feelings of guilt, these emotions are very real for OCD sufferers. Telling our loved one to “stop feeling guilty,” is likely to be as successful as telling him or her to “stop obsessing.”

So what do we do?

The first step, I believe, is to find a therapist who specializes in treating OCD. In addition to using exposure and response prevention (ERP) therapy, Dan’s therapist also helped him understand the cognitive distortions he was dealing with; this awareness alone was extremely helpful. The next step was to work on ridding himself of these cognitive distortions and this greatly reduced his feelings of guilt.

Guilt is a healthy emotion for us all. A child who feels guilty for “stealing” cookies from the cookie jar, or an adult who feels guilty for purposely hurting a loved one, are both displaying appropriate guilt. But when you add OCD into the mix, “appropriate guilt” often goes haywire, and can overtake the sufferer’s life. Just one more reason to seek treatment and work toward recovery.







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10 Responses to OCD and Guilt

  1. Tomcordy says:

    Hi Janet,

    Thanks once again for the blog. Always interesting and informative, I’m sure all of us appreciate the effort you put in. I don’t know if you remember, I sent you a link to an article in the Guardian about Pure O. Well, the author, who’s a lovely girl, is trying to publish a book. She’s raised about 50% but has stalled a bit. If you could ask your readers to pledge, I’m sure it would be a great help. It’s really worth it because she’s a good, and funny, writer and I’m sure we would all appreciate the book.

    Here is a link to pledge – http://unbound.co.uk/books/pure And here’s a link to a video she made to explain the book – http://unbound.co.uk/books/pure

    Thanks very much Janet and take care,

    Best wishes,


    Enviado do meu iPad

    No dia 11/08/2014, às 00:13, ocdtalk escreveu:

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  2. Another great post! Sometimes I feel like Guilt is my middle name because it is so easy to feel guilt even about things that aren’t my fault. I have hyper-responsibility too, and it’s hard to let go of it. The habit of feeling guilty can remain even after good treatment for OCD.

    • Thanks for your comment, Tina, I know I make things look easy sometimes: “Treat your OCD and your guilt will go away.” The reality, of course, is that this is all very messy. I hope you can find a way to address your hyper-responsibility and release some of the guilt you feel. It is such a heavy weight to carry.

  3. Carrie says:

    This is a great post. I was just getting to write something about doubting and/or guilt. I have never heard the term “thought-action fusion” before. I also think it’s interesting how some mental illnesses or maybe even a way of thinking or acting (e.g. codependency) have some similar characteristics such as guilt, hyper-responsibility, etc.

    • Thanks, Carrie! I agree that there is overlap of symptoms for various mental illnesses. After all, the different types of “mental illnesses” are just labels for a group of symptoms that describe how we think, feel and act. Thanks for sharing!

  4. Barbara Rath says:

    Thank you for providing insight into the illness of OCD.

  5. Emily says:

    Reblogged this on Smashing the Bell Jar and commented:
    Brilliant article about the guilt accompanying OCD

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