How To Overcome Responsibility OCD | Intrusive Thoughts

How To Overcome Responsibility OCD | Intrusive Thoughts

In this episode, I discuss Responsibility OCD. When a person has Responsibility OCD he or she experiences unwanted thoughts related to being a potential danger to others or responsible for causing harm to others. In this episode, I talk about different forms of responsibility OCD, case studies and examples, and the treatment process. I also discuss common compulsions people engage in and how to apply exposure and response prevention.


00:00 All right. Hey there and welcome to this episode where we're going to talk about responsibility, OCD. So in this episode I'm going to talk about kind of what responsibility OCD is along with different forms that can take on as well as the treatment process. And I'm going to kind of introduce an example of a, of someone I worked with with responsibility OCD. So basically when we're talking about responsibility OCT, um, it's a, it's a subset again of OCD. And what's happening is, is that the person who's experiencing it is having these intrusive thoughts about the idea that they may be a harm to someone else in some indirect way usually. So for example, um, you know, someone with contamination, OCD may be worried that they may have touched something contaminated, but with traditional contamination, it's usually this idea that they might be in danger. Where is with responsibility?

00:54 OCD, it's that they touch something that's contaminated and now they're afraid to shake someone else's hand because they could get that person sick. All right? So that's that subtle nuance. And one of the things that is, um, kind of a, another layer that the person who experiences the responsibility OST has to deal with is this idea of guilt and this worry about being a bad person. Okay. So this idea of responsibility, OCD can take on various forms, right? And so some, some of those forms could be things like I talked about with contamination, right? And so they may present with this idea that they're afraid of germs. But again, it's, it's so important if you're working with someone or if you're dealing with this to understand why, you know, because again, like I said, if it's contamination, OCT and then the exposures, you know, go with the idea of touching things that are contaminated, not washing, accepting that uncertainty.

01:47 But if it's responsibility, OCT, you have to take it to that kind of next level of exposing yourself to the guilt and the possibility of being a harm to someone else. Meaning like, Hey, look, touching a handrail that with your contaminated hands, because someone else might touch that. Right? And again, with, with exposure response prevention, you, you know, we're never really, we're never really doing anything dangerous, uh, so to speak. But people with OCD, um, you know, again, their, their brain is overestimating the level of danger in the level of threat that something is. And so that's, um, that's why we take it there with the exposures. But, um, with, with contaminant, I'm sorry, with responsibility, OCT can also take on forms, you know, such as well worrying that, you know, your family member might get sick. And so, um, I remember hearing about a case where, you know, this um, young girl would have to go and each number that she saw, she had to count to that number.

02:43 Um, you know, or else she was worried that her, um, her family, her family member would die. Right. And essentially what happens is it's like when you're walking in a hallway of school, you can imagine like one Oh two one Oh four one Oh six, you know, stopping and counting to each of those numbers or a hotel or something like that. I mean, you can imagine how, how, um, you know, time consuming that gets, and it can also, um, you know, but, but the compulsion's, um, with, with responsibility, OCD can take on various forms obviously such as silently counting, praying, doing mental compulsions. But a big part of responsibility, OCD is going to be reassurance seeking. Right. And, um, and so, you know, it could be, usually it's a loved one, but they're asking for, well, you know, are you sure I didn't do anything bad?

03:25 Like are always calling the person to make sure they're okay if they're worried about a specific person getting hurt. Um, you know, and, and again, a good example of this is a case, um, or a person, a gentleman that I worked with where he, he had, um, responsibility, OCD and he would take, it would take on various forms, um, to the point of he was worried that, what these, these realtor signs that were, um, you know, the, the signs of real estate agents put in ground in the ground with like little metal rods on them. He was worried that someone could take that sign and hurt themselves. Right. And so he felt it was his moral obligation to go and pick up all those signs so that someone couldn't possibly take in, you know, and hurt themselves. And that that is really where we distinct and, and you know, can really see, um, OCD at its, at its work there, right in the brain where it's really malfunctioning because again, he's overestimating the threat.

04:24 And then again, you'll, people with OCD will go to such extreme lengths to try to neutralize that threat, like going around and picking up all of the advertising signs of some real estate agent because they're worried that those, you know, the things could be used in someone could accidentally hurt themselves with it. Right. And, and that, that is an example of, uh, a compulsion, right. So now that we kind of understand what it is and again it can take on various forms from, you know, worrying that something that catastrophe might happen to the family, to germs to. Um, I mean it, you know, you can, you can name it, I mean the mind can come up with it, right? And so when you're looking at treating, um, and overcoming this particular form of OCD, there's kind of the dual component, right? Again, it's the same exact treatment methods as far as exposure and response prevention.

05:14 And ultimately the goal for the individual is to the willingness to accept the uncertainty and the possibility of the threat that their brain is, you know, uh, alarming them with or you know, saying as possible. Right? So if the idea of I might contaminate someone with germs, well, you know, with, with exposure and response prevention, um, a typical exposure might be the idea of, Hey, I'm going to walk into the mall and I'm going to touch the handrail and then I'm going to shake someone's hand eventually that day. Now again, this is something that most of us do without thinking about it. But what were the person with OCD? They're going to, you know, view that exercise as an extremely, you know, dangerous thing and, you know, potentially putting that person at risk. So they have this anxiety that goes with that, but then there's the higher level of actually experiencing the guilt that they experienced.

06:06 Right. And literally doing the exposure and response prevention with the guilt that they get as a result of doing the exposure, right? Because then they start to question, um, or they start to internalize the whole thing and, you know, question in doubt whether they are a bad person or an evil person. Um, you know, because, and, and, and so, and like I said, one of the big thing with ERP is removing compulsions. So after those, um, those exercises are done. One of the things is, is, um, making sure you don't do any followup compulsions. And like I said, with responsibility, OCT seeking reassurance is like one of the number one things that people will do. And, and so they'll call the person to make sure they're okay. They'll double check things subtly. Um, they may go back and, um, you know, decontaminate certain things because they're worried that someone could touch it or, you know, like I said, pickup signs.

07:01 And so really when we're talking about doing, um, you know, treatment for this and, and overcoming this, again, it's, it's the two pronged approach of doing the actual exposure of the feared thing. Whatever that is, whether it's leaving the signs in the ground, whether it's, you know, touching the handrails at the mall, whether it's, um, you know, I mean the list goes on and on, right? And then it's also the removal of that compulsion after, and then it's also experiencing the guilt and doubt and letting that habituate as well. And so it's this next layer that the person with the responsibility, OCD experiences that is not, um, usually present in the other forms of OCD. And that's one of the things that makes responsibility unique is that extra layer of doubting who you are as an individual. The, the moral responsibility, um, and just the, um, the guilt that someone experiences as a result of doing the exposure.

07:56 And that's that, um, that's that second layer that I was talking about. And so, um, but again, treatment is, is exactly the same as any other form. It's just a matter that that extra layer kind of gets added on usually with responsibility, OCD. So that's where narrative, um, you know, narrative exposures, things like that can be incorporated as well where, you know, you're taking it to the, the core of the fear and kind of addressing all different aspects of the fear actually taking place, right with the, um, the exposure narratives and then again, audio loops and whatnot as well. And so, um, so hopefully that, um, that makes sense and is helpful. Um, because again, this is a, a unique form and that intrusive thought series and it can take on so many forms and hopefully like you're seeing with the other, um, intrusive thoughts in the series, it can actually be the same exact intrusive thoughts, right?

08:45 Like contamination, OCD, poor, hit and run, OCD, um, and, and hit run. OCD kind of bleeds into responsibility OCT. But again, it's, it's really about why they're doing it, that we kind of figure out how to do the exposure. So for instance, if someone with contamination, OCT again is Washington hands cause they're afraid of getting sick, well then we don't wash our hands and that's the exposure itself. But if someone with responsibility, Yosemite is worried about touching things, then that becomes the exposure for them. So that's why it's, it's so important to really understand not only what someone's doing, but why they're doing it as well to help, um, to help really address that fear head on. So again, hopefully that was helpful. Hopefully you found, um, you know, that, that makes sense when it comes to the idea of what this is and how to overcome it and it, and again, if you found this helpful, we really appreciate your support by liking our channels and, you know, subscribing and commenting because I'm, you know, again, it just helps us to spread more awareness about this stuff.

09:41 Um, you know, across people that need help. And also we have some additional free resources that we want to give you, um, in the links down in the notes. So please check those out. We have free downloads, free assessments, and other tools that I'm, you know, we really hope will help you on your journey if this is something that you struggle with. So thank you so much for tuning in with us this, uh, this week. We really appreciate it and hope you guys have a wonderful weekend. We'll see you in the next episode where we're going to continue our series on intrusive thoughts. Take care.


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