Responsibility OCD: It’s all my fault

By: Suzanne Feinstein, PhD

Responsibility OCD is a subtype of obsessive compulsive disorder in which a person feels overly responsible for situations, events or outcomes that are beyond their reasonable control. They feel that if they do not do everything in their power to prevent, solve, or correct a problem, then then they are morally at fault for causing that problem to occur. They live by the motto, “If I can, I should” and feel excessive guilt if they break this self-imposed rule. They live with perfectionistic rules which expect them to go above and beyond the call of duty in order to be loved, respected and accepted by others.

The pressure to be perfect causes considerable anxiety amongst people who struggle with Responsibility OCD. They fear making mistakes, disappointing others, and being judged as irresponsible if consequences are anything short of perfect. They set their personal goals to unrealistically high standards which takes a toll of their physical and mental wellbeing. It also negatively affects their relationships and their ability to find pleasure in daily life.

People with an inflated sense of responsibility often feel paralyzed with fear when it comes to making decisions. The possibility of making the “wrong” decision causes them to delay or avoid making decisions altogether. Catastrophic thoughts lead to risk aversion, and ultimately, an inability to push forward with anything that can be perceived as dangerous. 

People who struggle with this subset of OCD tend to be people pleasers, and are known to ignore their own desires or wellbeing. They are driven by guilt and anxiety and often apologize for outcomes that are not their fault. 

What are some examples of hyper-responsibility?

The following are just a few examples of how Responsibility OCD can present itself: 

  • People pleasing 

An example of an exaggerated sense of responsibility includes feeling overly responsible for someone else’s feelings, thoughts or actions. For instance, if you work diligently to plan a family vacation and the hotel does not meet your family’s every standard, you feel exceedingly guilty that you chose the wrong accommodations. In order to make up for the perceived negligence and guilt, you upgrade the room, book additional excursions, and take inventory of anything else your loved ones might require to keep them satisfied. You compulsively seek reassurance that your family is happy while surrendering your own chance at a relaxing vacation. 

Although these compulsive people-pleasing behaviors alleviate some of your short-term guilt, they leave you feeling exhausted, overwhelmed and unappreciated.  It seems that the harder you work to accommodate, the more your anxiety and irritability chip away at the very foundation that you are trying to achieve. 

  • Fear of causing harm 

You may find yourself excessively anxious about something bad happening like a burglary or a fire. In order to neutralize the fear, you compulsively check stoves, electrical outlets, door locks, etc. The more you check, the more your brain doubts what your eyes see. Checking becomes more frequent, tension rises, and safety concerns mount. The uncertainty about whether or not you adequately checked makes it increasingly difficult to leave the house or fall asleep. The more you rely on yourself to maintain safety measures, the more unsafe you feel within yourself.

  • Fear of spreading illness 

If you are someone with an exaggerated sense of responsibility, getting sick is more than just the miserable symptoms that come with it. It’s fraught with judgment for not being careful enough or possibly even judgment toward someone else’s irresponsibility in spreading illness. You may engage in compulsive hand washing, bleaching surfaces, hyper awareness of your surroundings, and avoidance measures. 

Yet, despite all efforts, the viruses, airborne and virulent, prove to be bigger than you are. Not only are you exhausted from excessive contamination rituals, you now must face the disappointment that you caught the virus anyway. You also dread the possibility of spreading the virus. The idea that someone could catch the virus from you, and blame you for being irresponsible feels more than you can bare. And the thought that someone could get sick or possibly die because of you throws you into a critical state of dread and despair. It challenges your inner values and questions whether you are truly good enough at the core.

What is the treatment for Responsibility OCD?

If you are struggling with Responsibility OCD, cognitive behavior therapy (CBT) is a highly effective treatment option. This therapy teaches you how to reframe your distorted thought patterns and modify your maladaptive behaviors in order to cope better with life’s stressors. It also incorporates mindfulness and meditation into your daily life to help you further manage your fear response and live a more peaceful existence. In addition, CBT will help you optimize your physical health to add to overall wellness. This is a holistic approach meant to have lasting results.

Learn more about the supportive treatment we offer. Contact us today at Advanced Behavioral Health to schedule an initial consultation. 

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