It’s common to have fears about being a “bad person,” but for most people, these are fleeting thoughts and not true fears about being immoral.
However, this isn’t the case for people who suffer from a form of obsessive-compulsive disorder known as moral scrupulosity or moral OCD. For folks with moral OCD, these “Am I bad?” thoughts can become permanent, leading to guilt, worry and rumination.
According to Joshua Curtiss, an assistant professor in the applied psychology department at Northeastern University in Boston, moral OCD is “a subtype of obsessive-compulsive disorder that’s characterized by really intense, intrusive thoughts of being immoral, bad or unethical in some way.”
It’s all centered around the fear of being a “bad person,” added Erin Venker, the founder and executive director of the OCD and Anxiety Center of Minnesota.
This can also come out in someone’s relationship to religion, leading someone to worry that they are acting against their religion or offending God, said Meredith Hettler, the national director of the OCD and anxiety program at Newport Healthcare.
These kinds of thoughts can be debilitating and are very different than a quick worry about being “mean” or “bad.” Here’s what to know.
Moral OCD comes with compulsions.
In OCD, compulsions are repetitive thoughts or behaviors that someone does in hopes of relieving anxiety. “And the compulsions are designed to neutralize or undo these types of thoughts or fears about being ‘bad,’” Curtiss said.
Compulsions look different depending on the type of OCD, but in the case of moral OCD, they could look like someone seeking reassurance from others to prove that they are “good” and not “bad,” according to Curtiss.
Perhaps after an interaction at work that made you feel like a “bad person,” you call your mom, tell her the story and gauge her reaction to determine whether you’re “bad,” Hettler offered as an example.
It could also look like “undoing behaviors,” Curtiss said, which means trying to do something really good to make up for any “bad” or “immoral” thoughts — like volunteering after thinking something mean about a neighbor.
It could also appear as rumination, so thinking about the same thing over and over again, worrying about it and seeking reassurance, even though the reassurance is “not going to be good enough,” Venker explained.
“It’s kind of like a hamster on the wheel. They’re not going anywhere, but they feel like they can solve the problem, but unfortunately, we can never solve the problem through OCD rumination, it only leads to more questions and more doubts,” Venker added.
OCD is often referred to as the “doubting disorder,” Hettler said. “OCD, no matter what the subtype is, is always looking for 1,000,000% certainty, which we all know we’re never going to get.”
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Moral OCD can lead to guilt and distress.
Moral OCD is heavy. It can lead to guilt and “a questioning of one’s own character,” Curtiss said. “It’s almost as if you’re a judge, interrogating your own moral character in a way, as to whether you’re a good or a bad person.”
You almost put yourself on trial and overanalyze every moment, Venker added.
Constant, moral-based intrusive thoughts can be overbearing, overwhelming and distressing, Curtiss said.
Moral OCD feeds on a fear of being cast out socially.
Moral OCD, and OCD as a whole, is embedding the self-protective part of our brains, according to Venker.
“Humans are wired to care about belonging, safety, morality, social acceptance, all of those things,” Venker added. Centuries ago, if you were rejected and kicked out by your group or village, you were put directly in harm’s way.
Moral OCD feeds off this inherent fear and the possibility of “rejection, shame, or even just losing one’s identity as being a good person,” she said.
Modern cancel culture amplifies this vulnerability in many folks with moral OCD, Venker said, in the form of “public call outs [and] constant exposure to other people’s opinions.”
This is not the same as having a fleeting thought about your morals.
A one-time thought about being immoral isn’t the same as having moral OCD.
“Moments of self doubt are very, very normal and very human … everybody has intrusive thoughts,” Venker said.
“The difference is, OCD is a neurological condition … it’s like our brains are almost stuck on a highway loop, and they can’t get off the highway,” Venker said. Someone who does not have moral OCD can find an exit on the highway, so to speak, and rationally understand that one thought doesn’t make them a bad person, she added.
“People with OCD, they don’t get the all-clear signal, and so they feel like they have to obsessively try to figure out or make the right decisions in order to prove they are a good person or to find certainty that they are a good person,” Venker said.
The other defining factor of moral OCD versus a one-off moment of self-doubt is that OCD is looking for 100% certainty, Hettler said. Even if all of the people in the world tell someone with moral OCD that they’re kind and good, “there’s never going to be a thing that someone can say or do that’s going to fully stop this process forever and always,” Hettler added.
Moral OCD can disrupt a person’s daily life.
Folks with moral OCD also experience something called “thought-action fusion,” Curtiss said. “It’s the belief that, in this case, thinking a bad thing is the equivalent of doing it.”
For example, someone with thought-action fusion believes that thinking about cheating on their partner is the same as doing it. “And it brings the stakes up that much higher,” Curtiss said.
Additionally, a common differentiator between someone having a mental health disorder and not is “both the amount of extreme levels of distress it causes and amount of interference it causes in someone’s life.”
Moral OCD disrupts someone’s life and takes up a lot of time. Someone with moral OCD may go to the grocery store, leave and worry they accidentally didn’t pay for something in their cart, which would make them “bad” and a thief. This could lead them to check the receipt again and again and even go back inside and insist on paying for the item again, Curtiss said. This is very different than a moment of self-doubt followed by reassurance.
Here’s what to do if you are struggling with these kinds of thoughts.
If you think you may have moral OCD, experts told HuffPost the best next step is to reach out to a mental health professional who is trained in OCD treatment.
Not all mental health professionals are trained to treat OCD, so, instead of going to just anyone you find in your neighborhood, experts recommend looking for a provider via the International OCD Foundation database.
It’s common for moral OCD to get missed and treated improperly. “The treatment for OCD is really, really important, because regular talk therapy can actually make OCD worse,” Hettler said.
Exposure and response prevention therapy is the gold standard treatment for OCD, said Venker, and, for some, treatment may also include medication.
“Moral OCD is definitely something that is underappreciated among the general population, but it can be very distressing, very interfering,” Curtiss said.
As you seek treatment, be kind to yourself and know that there are trained professionals who specialize in helping people get past the limiting thoughts that come with moral OCD.