It is common that OCD causes people to have thoughts that lead to extreme guilt and anxiety and, no matter how hard the person tries, those thoughts and feelings won’t go away. This guilt may have been initially caused by a traumatic experience, but your OCD will latch on and make the feeling worse. This is known as “Responsibility OCD.” The gold-standard treatment for all subtypes of OCD, including Responsibility OCD, is exposure and response (ERP) therapy. During ERP therapy, the person struggling with OCD is exposed to the stimuli that causes them to feel anxious and guilty, and they are prevented from engaging in their compulsions and rituals. For example, part of ERP can be to purposely think the exact thoughts you would prefer not to have, and then actively resisting any urges to “push out” or “get rid of” those thoughts. Over time, with repeated exposures, your brain learns that experiencing those thoughts doesn’t have to mean anything about you as a person, and there is less of an emotional reaction to them. ERP therapy should be done together with an OCD therapist. With trauma-related OCD or OCD that is co-occurring with PTSD, you may also need a different type of therapy. It’s best to speak with a NOCD therapist or another mental health professional to determine the best treatment plan. There is hope and happiness at the end of this journey.

I’ve been struggling with religious OCD for the past month or so (blasphemous intrusive thoughts, fear of going to hell, etc). I’m a Christian. I’ve been in ERP and I’m learning to let the thoughts just be which is hard, but I’m struggling with the overwhelming feelings of guilt about having the intrusive thoughts. I know the thoughts aren’t from me and don’t reflect my true self, but sometimes if feels like I’m bringing the thoughts on if that makes sense. Does anyone have any advice on overcoming the guilt? OCD is also telling me I’m never going to get over this and my relationship with God will never be the same. I just want to be able to praise God without all of this and it’s making me incredibly sad and lonely. Any words of encouragement are appreciated.

I had just posted a summary of ERP for a group member, and I thought it might be useful for everybody. Here it is below (with a little extra added)…. ERP therapy is researched-based. Most other therapies don’t work. There have been people who have been literally stuck in their houses (from their OCD) who gained their lives back through ERP therapy. NOCD does ERP therapy exclusively. You can find it in other places too, but you have to ask around. There are two tenants of ERP therapy: The first one has to do with the repetitive thoughts inside our heads. These thoughts are actually defined as “obsessions”. You are not supposed to do anything with the obsessions. You are supposed to let them run through your head freely, without trying to fix them or stop them. Imagine a tree planted by a river. The leaves fall off and float down the river. You can see the leaves falling, but you don’t try to stop them or pick them up. You don’t try to fix them. You just let them float away. This is really important to do with your obsessive thoughts. The more you try to fight them off, the worse they get. I used to have blasphemous sentences running in my head 24/7. I felt like I had to put a “not” next to each sentence in order to “fix” it. But this just took hours of my time every day, and it was very scary, because I was worried that if I messed up, that I would go to hell. It was very freeing to learn later that I could just let those sentences run freely through my head without trying to fix them. The second part of ERP therapy is all about “denying your compulsions.” Every time OCD tells you that if you don’t do things a certain way that something really bad will happen, that is a compulsion. Once you recognize what your compulsions are, ERP therapy will have you practice stopping doing all of those things. For some people, that will mean stopping washing their hands or touching lights switches or, in my case, putting “fixing” words in their head. Compulsions are safety behaviors. During ERP therapy, you will practice stopping engaging with safety behaviors. All this is very hard to do and scary, so during therapy you will be given tools to help you deal with the fear. Often ERP therapy will take people from being non-functional to functional. I highly recommend it. ————————————————- PITFALL #1: After you have been doing ERP for a while and become somewhat successful, the OCD will try subtle little tricks to bring you down again. The first one is to tell you that your thoughts are REAL and not OCD, and therefore you can’t apply ERP therapy. Don’t fall for this trick! All thoughts are just thoughts. They are all meaningless. Don’t try to figure out what is real and what is OCD. Just treat all thoughts with ERP therapy. PITFALL #2: The second pitfall is that OCD will tell you that you can’t move forward unless you have absolute certainty that you will be safe. Hate to tell you this, folks, but there is no certainty in life. You will never know for SURE that you or your loved ones will be “safe” from the OCD rules. Therefore, you have to move forward in the uncertainty. It’s hard, but it gets easier with time and practice. We got this, guys !!!!!!

The subject of OCD matters to the sufferer because it feels like confirmation that they are fundamentally unlovable and unwanted—as if even existence itself doesn’t want them. They feel like an error, carrying a deep sense of guilt and shame, as if they were inherently wrong. They suffer from low self-esteem and a deep internalized shame, because long ago, they were fragmented and learned a pattern of fundamental distrust—especially self-distrust. But the real trouble doesn’t come from the content of the most vile or taboo thoughts. It comes from the fact that the sufferer lacks self-love. That’s why, when you begin to walk the road to recovery, you’re taught unconditional self-acceptance—because that’s what all sufferers of OCD have in common: if you aren’t 100% sure, if there isn’t absolute certainty, the doubt will continue to attack you and your core values. It will make you doubt everything—even your own aversion to the thoughts. You have to relearn how to trust yourself—not because you accept that you might become a murderer someday—but because you enter a deep state of acceptance about who you truly are. It’s not about becoming a monster at all. It’s about making peace with what lies at the root of the fear. Making peace with the guilt. With the shame. Making peace with yourself and the person you fear you might be. Because that fear is not rooted in reality. It’s not rooted in any true desire to act. It’s rooted in your identity—specifically, in what might threaten it. That’s what confirms the belief that you are fundamentally wrong. And OCD fuels that belief by using intrusive taboo thoughts to attack your very sense of self. But then I wonder: let’s say, for example, someone fears being or becoming a sexually dangerous person—how could that person practice unconditional self-acceptance? I would never accept myself if I were to harm anyone—the thought alone makes me want to cry. I know it’s not about whether or not someone acts on the thought. It’s about the core fear underneath it. So how do you accept yourself when the thoughts—and the feelings around them—feel so completely unacceptable ?