How to Cope with Shame in OCD

The Role of Shame in OCD: Why It's More Than Just Anxiety

When most people think about obsessive-compulsive disorder (OCD), they think about anxiety. And for good reason: anxiety is often the most visible and painful symptom. But there’s another emotion that plays a powerful, often hidden role in OCD—shame.

Dick Schwartz once suggested that shame is an evolutionary response. We as humans are tribal beings. Historically if we got kicked out of the tribe we would die. If we were doing something bad enough to risk getting kicked out we would feel shame, an emotion so profoundly painful that we would immediately modify our behavior. The problem, is shame thinks it's helping us but usually it just convinces us we are not redeemable and makes us worse.

Recently I was on the international OCD foundations website looking at trainings wanting to brush up on some skills. The first suggested training was on shame and OCD and it felt so validating. For years I've felt this is a part of OCD we don't talk about enough. The thoughts and behaviors we get from OCD often make us feel like we will or should be rejected by our tribes.

What Is Shame, and How Is It Different from Anxiety?

Anxiety and shame often coexist, but they’re not the same thing.

• Anxiety is fear about what might happen. It’s future-oriented and usually centers around uncertainty.

• Shame is about who you believe you are. It’s identity-based and often comes with a painful feeling of being bad, unworthy, or broken.

In OCD, intrusive thoughts trigger anxiety. But when those thoughts are wrapped up in shame, they become stickier and harder to let go. They don’t just feel scary—they feel true. They feel like proof that you’re a bad person.

This is why shame is so central to OCD. It doesn’t just accompany the fear. It supercharges it.

How Shame Fuels the OCD Cycle

Let’s break down a typical OCD cycle:

1. Intrusive Thought: You have an unwanted, distressing thought (e.g., "What if I hurt someone?").

2. Interpretation: You interpret this thought as meaningful ("Why would I have that thought unless I’m dangerous?").

3. Emotional Response: You feel anxiety—but also shame ("I must be a terrible person").

4. Compulsion: You try to neutralize or cancel out the thought or feeling (e.g., mentally reviewing, seeking reassurance, avoiding people).

What many people miss is that shame drives the interpretation. It’s what turns a random thought into a perceived moral failure. It’s what makes you ruminate for hours or engage in compulsions you don’t even recognize as compulsions.

Let’s look at some OCD subtypes to see how shame plays a central role:

• Harm OCD: You fear you might hurt someone. Shame turns this into, "I must want to hurt people." You feel disgusting, evil, broken.

• Scrupulosity OCD: You fear being morally or spiritually wrong. Shame says, "If I didn’t pray just right, maybe I’m a fraud." You feel condemned or unredeemable.

• Relationship OCD (ROCD): You doubt your love for your partner. Shame whispers, "If I’m uncertain, maybe I’m manipulative or cruel." You feel selfish or incapable of love.

These thoughts don’t just create anxiety. They attack your identity. That’s the power of shame.

Signs You’re Struggling with Shame in OCD

Shame can be sneaky. It often hides beneath the surface of anxiety. Here are some signs that shame is playing a bigger role in your OCD than you might realize:

• You constantly worry that you’re a bad person, even when there’s no evidence.

• You engage in mental rituals like apologizing to God or going over your actions again and again to prove you're good.

• ERP feels emotionally unbearable, not just because of anxiety, but because it feels morally wrong.

• You punish yourself internally or resist self-compassion.

• You struggle to accept that your thoughts are "just thoughts"—because they feel like proof of your brokenness.

If any of this resonates, it’s not a sign that something is wrong with you. It’s a sign that shame is part of your OCD cycle.

Trauma and Shame in OCD

Shame is often rooted in trauma. And if you’re someone who grew up with emotional neglect, abuse, or highly critical environments, you may have internalized the belief that you are fundamentally wrong or unworthy.

When OCD enters the picture, it hijacks those old shame stories. It takes your deepest fears about who you are and wraps them in the language of intrusive thoughts.

For example:

• If your trauma taught you that you’re dangerous or not in control, Harm OCD may latch on to that.

• If you were raised with rigid moral or religious standards, Scrupulosity may emerge as a way to constantly check whether you’re good enough.

This can make traditional ERP therapy feel retraumatizing if it’s not adjusted for trauma. Asking someone to sit with the thought "Maybe I’m evil" is different when their entire nervous system is already wired to believe that.

This is why trauma-informed care is so critical in OCD treatment. We can’t just address the compulsions. We have to gently unravel the shame underneath.

Healing Shame as Part of OCD Recovery

So what do we do with all this?

First, we still use ERP. It’s the gold standard for OCD treatment, and it works. But when shame is deeply entrenched, ERP needs support from compassion-based and trauma-informed tools.

Here are some ways we work with shame in OCD therapy:

1. Self-Compassion

• Learning to treat yourself with the same kindness you would offer a friend.

• Saying things like, "I’m having a hard time right now" instead of, "What’s wrong with me?"

  
  

2. ACT (Acceptance and Commitment Therapy)

• Helps you notice self-critical thoughts without fusing with them.

• Encourages you to act according to your values, not your fears.

  
  

3. IFS (Internal Family Systems)

• Explores parts of you that carry shame and sees them as protective rather than bad.

• Helps you create a compassionate inner dialogue.

  
  

4. EMDR or Trauma Processing

• For clients with significant trauma, EMDR can help reprocess shame-laden memories that OCD is built on.

  
  

ERP alone may not touch the deeper identity wounds that shame creates. But when combined with these approaches, recovery becomes more than just reducing compulsions. It becomes about rebuilding your relationship with yourself.

Reframing the Narrative

OCD doesn’t make you a bad person. Intrusive thoughts are not reflections of who you are. Compulsions are not moral failures. And shame is not the truth about your identity.

Recovery from OCD isn’t just about managing anxiety—it’s about changing the story you tell yourself.

It’s about moving from:

• "I must control this thought because it means something about me"to"This thought doesn’t define me."

• "I have to do this compulsion so I can be a good person" to "I can choose to live according to my values, even in uncertainty."

• "I can’t forgive myself" to "Maybe I can be human here, too."

  
  

Final Thoughts

Shame is often the hidden force behind OCD. It’s what makes intrusive thoughts feel threatening, and what makes recovery feel so personal and painful.

But shame isn’t permanent. It’s a wound that can heal. And when we bring shame into the light—with compassion, courage, and support—it loses its power.

If OCD recovery feels impossible right now, know this: you are not alone, and you are not broken. Your thoughts do not define you. Your worth is not up for debate.

You can recover. You can build a relationship with yourself that isn’t rooted in fear and self-punishment. And it starts with letting go of the lie that you’re too much, too flawed, or too far gone.

You’re not.

Need help working through shame in OCD recovery? I offer trauma-informed therapy for OCD, including Harm OCD, Scrupulosity, and ROCD. Text 801-477-0813 for a free consultation.