How guilt can impact people with OCD and ways to lighten the load

Think of the last time you did or said something you regret. Most of us know what it feels like to put our foot in our mouths, disappoint someone, or make a cringeworthy mistake. And, if you’re like most people, you probably felt a little guilty when that happened. 

Guilt is a normal emotional response to doing something that a person believes harms someone else. On its own, it’s not a sign of a mental health condition. But it might be something that people with obsessive-compulsive disorder (OCD) feel more often due to the troubling thoughts (obsessions) and behaviors (compulsions) that accompany the disorder.         

Does OCD cause guilty feelings?

Guilty feelings are a common feature of OCD, and researchers are still working to understand all the reasons why. However, there seems to be a strong relationship between guilt, shame, and the cycle of obsessive thoughts and compulsive behaviors caused by OCD. 

OCD can show up differently in different people. While cleanliness and orderliness are common stereotypes associated with OCD, it’s important to recognize that the condition can take many other forms. 

For example, some people with OCD have obsessive, uncontrollable thoughts that violate social norms. They may fixate on things like sex, religion, or violence. Although they have no real desire to act on these thoughts, they may feel guilty for having them. A person may also feel ashamed of their OCD diagnosis or live in fear of feeling guilty if they act on their obsessions.

Signs of excessive guilt in OCD

Guilt can be either healthy or unhealthy, and this distinction applies to everyone, not just those with OCD. Healthy guilt arises when you feel remorse for a mistake or wrongdoing, even if it was unintentional. This type of guilt can be constructive, motivating you to take responsibility and make amends. And it can lead to personal growth and help you make better choices in the future. 

Unhealthy guilt, on the other hand, may involve excessive or misplaced feelings of responsibility, which can be detrimental and lead to ongoing distress.

It can be concerning when OCD-induced guilt makes other OCD symptoms worse or gets in the way of daily functioning. People with different OCD subtypes may experience excessive guilt in different ways. 

Check out these examples to learn how guilt might show up in different expressions of OCD:

• Relationship OCD: I’m constantly worried that my partner might leave me, and I’m always seeking extra reassurance. I feel so guilty for questioning their loyalty when they try so hard to be a good partner to me.
• Checking OCD: Every night, I check that the door is locked ten times before bed. I worry I’ll feel guilty if something bad happens if I only check it nine times.
• Harm OCD: Sometimes, I have horrible thoughts about hurting my family. I love them and would never act on these thoughts, but I feel ashamed for having them.
• Existential OCD: Almost all day long, I’m thinking about the meaning of life and why we’re all here. It stresses me out, and I feel guilty for not being able to find an answer.
• Magical thinking OCD: Sometimes, I think I can make good things happen if I think or behave a certain way. I feel guilty when something bad happens because I think I may have caused it.
• Just right OCD: I have strong perfectionist tendencies. If I don’t do things in a particular way, it upsets me and feels wrong. I feel guilty when things aren’t “just right.”
• Sexual orientation OCD: I’m always questioning my sexual identity. Sometimes, I feel guilty because it feels like I’m lying about who I really am.
• Religious OCD: My religious beliefs consume my thoughts, and I have a black-and-white view of right and wrong. If I do anything to compromise those beliefs, even something small, I feel immense guilt.
• Sensorimotor OCD: I’m so focused on my body and its internal processes. I feel ashamed that I can’t seem to concentrate on anything else.
• OCD-related hoarding: I just can’t seem to part with things, even items other people may see as junk. I feel guilty throwing away something that could be useful.  

These examples can help illustrate the many ways that guilt can show up in people living with OCD. This is important because, left unchecked, guilt and shame can make OCD symptoms worse. 

Overcoming obsessive feelings of guilt and shame

If you have OCD and you’re struggling with guilt, remember that these feelings are a result of a mental health condition, not a reflection of who you are. Practice self-compassion, and try to challenge your obsessive thoughts when they arise. 

For example, when you feel guilt rising up inside of you, question the source. Ask yourself if your guilt is really warranted in the situation. You can also use mindfulness techniques or grounding exercises to help you stay focused on the present and keep guilty feelings at bay. 

When guilt feels overwhelming, one of the best things you can do is connect with a mental health professional. They can talk to you about your experience and create a treatment plan to address your symptoms. By treating your OCD more broadly, a therapist can help you reduce your feelings of guilt and shame. 

One of the most common OCD treatments is cognitive-behavioral therapy (CBT). CBT can help you challenge negative thought patterns, including the ways you think about yourself. This can help reduce guilt and shame and encourage new ways of responding to uncomfortable emotions. 

Another common treatment for OCD is exposure and response prevention (ERP). This is a specific form of CBT that gradually exposes you to things that might typically make you feel guilty. When conducted within the safety of your therapist’s office (or virtually), this can help foster self-compassion and reduce the impact of shame-inducing triggers.

Find care with Rula

Guilt is a distressing but common part of living with OCD. Guilt related to obsessions and compulsions doesn’t have to define you — and it can be managed with the right support. A mental health professional can help you interrupt self-criticism, challenge unhelpful thoughts, and cultivate self-compassion.

When you need affordable, accessible OCD treatment, we want to welcome you to Rula. Our therapist-matching program makes it easy to find a provider who takes your insurance and offers the specialized care you deserve. And thanks to our teletherapy platform, you can connect with a therapist from the comfort of home at a time that works best for you.

Find a therapist with Rula