Shame: OCD’s Best Friend

Shame. That heavy pit of nausea in your stomach. The hot flush of humiliation and embarrassment on your face. The urge to withdraw and hide, to get out of there no matter what, and to become as small as possible. The self-critical voice that says, “I’m a bad person”, and won’t stop replaying the shameful event over and over again in your head.

It’s different from guilt. With guilt, you feel remorseful for a specific thing you did – “I did a bad thing”. With shame, you believe and/or fear you are inherently bad or that there is something intrinsically wrong with you.

Many things can make us feel shame, and everyone has experienced it at some point or other. It can come from others, where we may have been teased for mispronouncing a common word, compared to our high achieving sibling, scolded for expressing an emotion or bullied for how we looked in a bathing suit. It can also come from ourselves, where we may blame ourselves for getting the answer to a question wrong, being caught in a lie, or that time we were rejected by an important person in our lives.

Shame is very common in people with obsessive-compulsive disorder (OCD). A study conducted by Marques and colleagues in 2010 found that 53.2% of people with OCD felt ashamed of their problems, and 58.2% felt ashamed of needing help with their problems.

Many people with OCD feel shame when they have a thought pop into their head that clashes with their personal values/morals and that they deem as unacceptable. For example, they may have a violent thought about harming themselves or others, they might have a sexual thought about someone or something they didn’t expect too, they may have a blasphemous thought, or they may question whether they really love their partner. These thoughts can lead people with OCD to worry about whether they may subconsciously enjoy paedophilia, incest, bestiality, or harming others. They may wonder if they are the only person who has such thoughts and whether they are a bad person because of them.

People with OCD can also feel shame around the behaviours they have developed to cope with the shame and/or anxiety associated with their obsessions (i.e., compulsions). Many people with OCD feel shame when there is the potential for their behaviours to be noticed and/or negatively evaluated by others. For example, a person with OCD may experience shame if someone notices them repetitively and excessively washing their hands, seeking reassurance, swallowing/blinking, checking their locks or to see if they ran over someone. They may worry about whether they are crazy or will lose control and do something they regret.

In line with all of this, Marques and colleagues identified shame as a significant barrier to seeking help. This means that many people with OCD are often scared and afraid to tell anyone (family, friends and professionals) about their thoughts or behaviours in case their worst fears come true and they are told they are crazy, reported to authorities, and/or locked up in a prison or psychiatric ward. Because no “normal” person has unpleasant, intrusive thoughts, right? And, if this is true, there must be something inherently wrong with someone who has these thoughts, right?

Wrong.

Almost everyone experiences unpleasant, intrusive thoughts about unpredictable things. The thoughts are involuntary and do not say or mean anything about the person experiencing them. Most people can brush these thoughts off without paying too much attention to them or attachment any meaning to them. A person with OCD, however, finds it difficult to brush these thoughts off and, instead, obsesses about the meaning of the thoughts. OCD will stop at nothing to grab your attention with disturbing thoughts that hook you, reel you in and make you question and doubt yourself. As a result of this, it often targets the people and things we love the most. It can make you feel difficult emotions, such as guilt, shame, and anxiety, as though you’d acted upon the thought.

So, because of all this, many people with OCD carry the burden of their obsessions and compulsions alone for a long time before deciding to open-up to someone about them. Indeed, feelings of shame can be all-consuming, overwhelming, and suffocating, where people can withdraw and isolate from everyone and everything that makes their life meaningful, because they feel unworthy of enjoyable experiences. Learning about what is happening and how OCD operates can help lift the feelings of shame and allow you to be yourself again. It is important to know that OCD can be successfully managed with gold standard treatments, such as Exposure and Response Prevention (ERP), and that the OCD Clinic has helped countless people struggling with OCD to reclaim control over their lives.