Feelings of shame in OCD

I see many clients who experience feelings of shame in relation to their OCD. This can be connected with the behaviours they engage with, where a fear of being noticed while carrying out rituals can give rise to feelings of embarrassment or shame, coupled with the potential for being questioned about their behaviours.

A lot of compulsions are carried out covertly for these reasons, for example by trying to blend them in with ordinary activities to lessen the risk of them being discovered, or by waiting until others have left the room to carry them out.

Other times, shameful feelings can manifest in different ways. Many OCD topics feel scary to experience and there are themes that bring the sufferer intense feelings of being a 'bad' person as a result of experiencing these themes. They wonder what kind of person they are to have their thoughts, images, feelings, sensations or urges. What do these say about them as people? What would others think of them if they knew what's going on in their minds on a daily basis? Would they judge them, distance themselves, report them to the authorities?

There is often also an unfounded but deep concern that they may somehow lose control and do harm to people as a result of experiencing unpleasant thoughts, despite there being no evidence whatsoever that this would happen. Whenever I ask my clients what kind of harm they have inflicted in the past, I always get the same answer: none!

The thoughts, images or feelings these OCD sufferers experience usually relate to physical or sexual harm inflicted on people, often children. The harm may be carried out either by themselves or by others. They can also relate to inappropriate behaviour, which would be deemed wrong by society. Frequently, the themes experienced by sufferers involve the people they love most, or their treasured pets, which has the effect of making them feel all the more harrowing to the sufferer.

There is a sense within the person that experiencing these thoughts, images or feelings means that there is something inherently wrong with them. That 'normal' people don't have these experiences. For example, they often wonder if having an unpleasant intrusive thought, image or bodily sensation (usually what is known as a groinal response) when near a child or a family member means that they are a paedophile or incestuous. It's easy to see how difficult these sorts of topics can be to talk about and often sufferers carry them within themselves for a very long time before deciding to open up about them.

It's important to know that these and many other less talked about OCD themes are extremely common and that they don't say anything about the sufferer. They say something about the condition of OCD. Feelings of shame can become pervasive and suffocating, to the point where people feel unworthy of living a normal life, of interacting with others and of having enjoyable experiences with them. Their sense of isolation can in this situation become overwhelming.

Sometimes clients also carry with them a more general sense of shame resulting from their life experiences. It can be helpful to process these experiences in general counselling or with the help of a trauma specialist.

With regard to shameful feelings resulting from OCD themes, what I have found is that clients gain comfort from simply learning more about the condition of OCD and how it operates in their life. OCD is on a constant mission to get our attention and to engage us in rituals. It will stop at nothing to achieve this goal.

As OCD sufferers, we are usually by nature extremely sensitive and compassionate humans with very high anxiety. When OCD brings us harrowing themes, these will definitely get our attention. As far as OCD is concerned the more disturbing the theme, the better. Once it has us hooked we begin ruminating and before we know it, OCD has control of our lives.

Thankfully, there are very good ways to work with this to enable us to manage our situation better. These particular themes are no different to any others and they can therefore be successfully managed with the help of Exposure and Response Prevention. What I tell my clients is that, once we start to manage the clutter of our intrusive thoughts, we become better able to access our true self. What this means is that it becomes easier to decide which thoughts belong to us as people and which ones belong to the condition of OCD. This new perspective can also clear the path to looking at our lives in more depth if we feel this would be helpful.

For help with managing OCD, please find a therapist experienced in working with Exposure and Response Prevention. For informal support and information contact the UK charity OCD Action.