While OCD can manifest in multiple ways, the distressing thoughts (obsessions) and attempts to neutralize these thoughts (compulsions) are nearly always present in some form or another. While these symptoms receive the most attention in treatment and in the OCD literature, there are also certain emotional dynamics of OCD which can often be equally distressing. Of these emotional factors, intense shame is an especially common and painful emotional response to OCD symptoms. For some, this can be particularly relevant before researching their condition and realizing that what feels like “unacceptable thoughts” are, in fact, OCD. This realization alone can bring significant relief, however, even after understanding OCD’s role in spurring these thoughts, many individuals continue to maintain a deep sense of shame.
The experience of shame is not unique to a specific theme or set of themes, however, it is most commonly associated with what are known as the stigma-based OCD themes, which include harm-OCD (HOCD) and pedophilia OCD (POCD). Individuals experiencing either theme generally maintain a set of values which run directly counter to the nature of their intrusive thoughts. For example, someone who is naturally more passive and peaceful by nature is more prone to be triggered by thoughts of harming others. Those who intuitively understand and connect with kids and view this as a core part of their identity, may be particularly stressed by thoughts of exploiting children.
Stigma based themes often carry a strong dose of “thought-action fusion” or the belief that experiencing a thought is nearly the same as engaging an act. This can become especially draining, as the process of avoiding thoughts or triggers for thoughts can become so time-consuming that it can impact an individual’s quality of life and make it near impossible to have a moment of peace. Even when one does manage to experience calm, there remains a nagging worry that something may trigger the thought cycle.
In addressing these themes, there are several important factors to consider:
Engage in exposure work
In order to regain a sense of internal peace it is crucial to learn how to sit with the uncomfortable thoughts that one is trying so hard to avoid. By developing an improved ability to tolerate these intrusive thoughts, they become less “sticky” and there is no longer the same urgency to avoid triggers, which can provide significant relief while also allowing you to re-engage in your life.
Practice self-compassion
While relevant across OCD themes, the role of self-compassion is particularly relevant for those dealing with stigma-based themes. While this can take on different forms, two salient messages to work towards include:
> Even if I experience unwanted thoughts, I am still someone who deserves love and support from myself and others the same as the next person.
> Empathizing with yourself as you experience the stressors involved with OCDKnow that you are not alone
It can be helpful to hear the stories of others who have experienced similar OCD themes. There are several podcasts available that offer accounts of individuals who have experienced similar OCD themes. OCD support groups can also provide a helpful medium for feeling less isolated. These steps cannot and should not replace exposure, but they can complement the benefits achieved in exposure work.
Sharing your story
Secrecy fuels shame regardless of the source of these feelings. It is not uncommon for individuals to harbor these thoughts alone for several years due to the fear that they would be alienated by family members if they were to disclose the nature of their thoughts. In fact, by understanding the nature of these thoughts and sharing them with family members there often can be significant relief. It can often be helpful to talk with someone out of your inner circle first to build momentum before talking with close friends or family members.
Resources
- The OCD Stories Podcast by Stuart Ralph offers both personal accounts of living with OCD, in addition to recommendations from expert researchers and clinicians
- Overcoming Harm OCD: Mindfulness and CBT Tools for Coping with Unwanted Violent Thoughtsby Jon Hershfield MFT>
- The article: Am I a Monster? An Overview of Common Features, Typical Course, Shame and Treatment of Pedophilia OCD (pOCD) by Jordan Levy PhD can be found on the IOCDF website
