Obsessive compulsive disorder - OCD treatment and therapy from NOCD

How to deal with shame and self-criticism from OCD

By Stacy Quick, LPC

Jul 19, 20236 minute read

I think everyone has an “inner critic.” But at a certain point, problems with self-esteem and questions of self-worth can be indicative of mental health problems. When someone is struggling with OCD, for example, their inner dialogue is often consumed with accusations and self-criticism. It can feel nearly impossible to escape the torment of their own minds. 

One’s inner critic makes no noise, yet it screams internally louder than any other voice could. It tells you about all of your worst fears, all of the worst-case scenarios that could happen, and how they will all be your fault. It is as if it was a loop tape set on repeat all day long. It sees offenses where none occurred. It denies you peace and wants you to be punished. It ignores all the good and inserts doubt and fear everywhere. Even worse, it is also your own voice, and it feels as though it cannot be reasoned with. 

Self-judgment only leads to more distress

As a therapist who specializes in the treatment of OCD, I’m regularly confronted with the amount of self-judgment and self-deprecation that people tend to have towards themselves when they’re struggling with the condition. The way they treat themselves versus those they care about can be vastly different. 

And it’s often a vicious cycle: higher levels of self-criticism only lead to more intense distress. People with OCD already feel intense distress over their intrusive thoughts, images, urges, or feelings, and the intense scrutiny they place themselves under only leads to more debilitating emotions: shame, guilt, and hopelessness.

Part of this is something that lies at the very heart of OCD: distress intolerance. People with OCD often feel as though they cannot possibly endure uncomfortable feelings—they have to do something about them. That’s where compulsions like avoidance come in, and they only make the problem worse. 

It’s pretty easy to see why: when people try to keep themselves from ever feeling uncomfortable emotions out of fear that they can’t tolerate them, they can never learn otherwise. In fact, the belief that their avoidance is keeping them safe from dangerous feelings only grows stronger. On the other hand, the more a person allows themselves to feel difficult emotions, the less intimidating they become. This is so imperative for people with OCD who compulsively avoid their fears and distress. 

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Your own worst enemy

You have probably heard the statement that you can be “your own worst enemy.” For those with OCD, this couldn’t be more true. Shame and guilt are often key components of the OCD sufferer’s experience. When your brain constantly tells you stories of all the bad things you may have done or that could result from your carelessness, you tend to start to believe some of them. Your brain is bullying itself.

In this way, compulsions can act as a form of self-punishment—a duty one feels compelled to follow due to a sense of guilt, shame, or even potential guilt for something as insignificant as a wayward thought. Overcome by negative emotions, they may avoid doing things they enjoy, feeling they do not deserve these things. They may deny themselves of certain pleasures that others partake in. At the extreme, they may even self-harm. 

People with OCD are notoriously hard on themselves, putting far greater expectations on themselves than they would on others. They may struggle with a sense of over-responsibility, a belief that they can control things that are out of their control. They can ruminate for hours about ways in which they could have or should have acted differently. This can lead to a negativity bias that only creates more internal distress—anything less than perfection can feel like a fatal flaw. 

The good news is that this can change. It is possible to overthrow this negative influence in your mind. But it will take practice, consistency, and dedication. 

How can I learn to give myself self-compassion

This term “self-compassion” is thrown around a lot, but what does it really mean? More importantly, what does it mean to people with OCD? Think of self-compassion as the antidote to the poison of self-criticism. Self-compassion is showing kindness to yourself. It is giving yourself grace and forgiveness. It’s allowing yourself the same consideration that you so freely give to others. 

It will be important to learn to recognize the voice that is mean and cruel, the voice that OCD wants you to hear loud and clear. Once you recognize it, it will be even more important to separate your true self from this voice. You will need to remind yourself of your values, of your authentic self—not the self that OCD ascribes to you. This will be a process that will take time. You did not start to believe the worst about yourself overnight and it is unlikely that you will begin to see your true identity, apart from OCD, overnight. The goal is to start. 

It will be important to develop and nurture a new inner voice. You will need to give yourself permission to think more highly of yourself and to look for your strengths. A key component of this process will also be recognizing that you may not always feel that something is true, but that’s okay. Remember that feelings can oftentimes be misleading, especially when you have OCD. Just because you feel like a “bad” or “unworthy” person, doesn’t mean that you are—in these times, you can learn to return to your values and feel confident, even when you’re uncertain. You can learn to recognize your values and move towards them, not away from them in fear. 

ERP to help battle self-criticism

Building tolerance for distress and anxiety lies at the heart of exposure and response prevention (ERP) therapy, the gold standard in OCD treatment. In ERP, you’re gradually exposed to the things that trigger your anxiety and discomfort, and your therapist guides you in resisting the urge to engage in compulsions for short-term relief. Instead, you sit with uncomfortable feelings and accept uncertainty—as a result, you can learn to give yourself grace for your imperfections, rather than avoiding them or self-punishing.

ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. At NOCD, all therapists specialize in OCD and receive ERP-specific training. If you have questions or think that you may need ERP therapy for your OCD, speak to someone on our care team on a free 15-minute call.

Access therapy that’s designed for OCD

ERP therapy was developed specifically to treat OCD and has helped many people who struggled with the condition regain their lives. All therapists at NOCD have specialty training in OCD and ERP.

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