OCD Q&A Part 1: Shame and Common Compulsions
October 13th, 2022
6 min read
Avoiding shame and learning about common compulsions.
Written by Noah Tile
Obsessive compulsive disorder (OCD) is among the most common, stigmatized mental health conditions. We are answering some of the most common questions that therapists hear from students to equip you with the knowledge and skills to navigate this complex condition.
What do you want to know about OCD? We’re answering questions about shame and compulsion in this installment. Feel free to contact Resolvve on social media or via email (info@resolvve.ca) if there are questions you wish to be addressed.
“I struggle with shame related to my obsessive thoughts and need advice.”
This is such a difficult struggle and feeling shame is natural, so no shame in the shame. I hope to share some ideas for you to consider.
Thoughts do not define you and do not need to be there for ‘a reason’. It is what it is. Your obsessions can become the way they are for so many reasons, but it is how you relate to them from now on, which will determine your mental health.
We have around 6000 thoughts a day. We cannot control what thoughts pop into our awareness. Everyone has intrusive thoughts; in fact, there is no difference between the content and nature, however taboo, between intrusive thoughts of those with OCD and those without.
Thoughts do not define you and do not need to be there for ‘a reason’. It is what it is. Your obsessions can become the way they are for so many reasons, but it is how you relate to them from now on, which will determine your mental health.
It is our relationships to the obsessions which matter. I know it might not always help, but intrusive thoughts are human, even if nobody talks about them.
Your intrusive thoughts may turn into obsessions because of your sensitivity and care as a person, not because they are somehow more real or desirable to you (yes, some reassurance is good in certain contexts!).
As simple as it sounds, take some time to remind yourself of some of the ideas above. At least try, with words and heartfelt feeling to destigmatize them from your own consciousness.
Then, consider talking about it with loved ones. If they don’t understand OCD, there are great resources. I like the Family Guide to Getting Over OCD by Dr. Jonathan Abramowitz.
Just being open about it, means you are facing the shame, which can be its own exposure and you will (hopefully) learn that others accept you and understand. But of course, you know better than anyone whether it is worthwhile to take the risk and to decide who to trust. Use your judgment.
As well, if circumstances permit, seek therapy treatment. It can help with OCD symptoms and the shame that surrounds it.
“What are different forms of mental compulsions?”
In order to understand mental compulsions, it is important to remember that they operate no differently than any other compulsion. The only difference is that they are a form of covert (hidden) behavior. They cannot be seen, but they are just as real.
Whatever you do in your mind in the form of thinking and imagination in response to intrusions/obsessions is a mental compulsion.
You might:
Ruminate on past events, as well as motives and intentions
Worry and plan excessively about the future to ensure safety
Undoing obsessions by actively thinking and imagining something opposite
Mental reviewing of past or future situations
Repetitive thinking as forms of reassurance
Whatever you do in your mind in the form of thinking and imagination in response to intrusions/obsessions is a mental compulsion.
Note that intrusive thoughts are not mental compulsions. Compulsions are behaviors in your control. Often mental rituals take place in response to intrusive thoughts. For example, you might have an intrusive thought about pushing someone onto a subway track. You cannot control that.
The compulsion is when you argue in your head over and over, saying “No, I would never do that! I am a good person!” Or you may repetitively imagine yourself not doing it. Or imagine yourself doing it, but hating it and then making sure your body feels gross, or disgusted.
(In that scenario, a mental compulsion interacts with a physical compulsion, namely to make yourself feel disgust.)
Learning to allow intrusive thoughts to do what they want, while practicing not engaging in active thinking, problem solving, and imagining is an important skill for response prevention. Thoughts and thinking are not the same thing.
Check out Dr. Michael Greenberg's articles on mental compulsions and rumination.
That’s it for this installment of the OCD Q and A.
Please note that this post is written for educational purposes, it is not therapy. If you need to talk to a professional please book a consultation with a psychotherapist through Resolvve.
