Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Hyper-responsibility & OCD

6 min read
Stacy Quick, LPC

As a child, one thought in particular haunted me: I was scared that I would inadvertently lie and something bad would happen. The idea of lying seemed so awful to me. Thoughts raced through my head about all the ways in which even a small lie could cause a huge problem. So, to cover all my bases, I tried to make sure that everything I said ended with “maybe,” “it could be,” “I think” or “ probably.” For example, my parents would ask me what I did at school that day and I would say “I worked on my handwriting, I think.” 

As time went on, these feelings expanded to become an inflated sense of responsibility for everyone else and their safety. I needed to ensure that everyone I loved would be safe, or else I would be at fault if something bad happened to them. This sense of hyper-responsibility would be at the heart of so many fears in my life. It would take many years before I realized that this was all part of obsessive-compulsive disorder (OCD). 

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A false sense of control

Most people have a sense of responsibility, especially when it comes to following guidelines and rules that are intended to keep themselves and others safe. Most people do things to try to keep themselves safe: they lock their homes at night, make sure the stove is off after using it, and hold their child’s hand when they cross a street. But what happens when someone overestimates their responsibility? What happens when someone feels that they can control things that they cannot actually control? 

These feelings might even seep into relationships—feeling like they can control how someone else feels, or feeling that they are responsible for making everyone happy or content. This can create people-pleasing patterns and make them constantly feel the need to put others’ needs in front of their own. This can look like saying yes to things they do not want to do but feel they need to do, lest someone get upset with them. Or, they may think, “If I don’t do this, then something bad might happen.”

Let’s say someone is shopping at the local grocery store when they see a can of food on the floor in an aisle. Some people may walk by and choose not to pick it up without a second thought, whereas someone who has OCD may continue to think about this later on. They may start thinking “what if someone was walking by without noticing it, and they fell and broke their neck?” They may be so tormented by this thought and the guilt of not having picked up the can that they return to the store later in the day to ensure that the can is no longer there.

When I was a child I constantly had to tell everyone I loved to wear their seatbelts—as if my mention of this phrase alone would save their lives and prevent a car accident. In my mind, if I did not say this and they did indeed get into a car accident, then it would somehow be my fault if they were injured or killed. It was my responsibility to remind them of this very important protocol. 

An inflated sense of responsibility

A person who suffers from a sense of hyper-responsibility may feel that they are responsible for preventing disasters, sometimes even natural disasters or crimes. One member I worked with felt that they had to ensure that no one was drowning anytime they were near water. They tried to keep track of everyone in order to make sure they didn’t drown. They would spend countless hours listening for anyone who may be yelling for help or looking for anyone who may be in distress. The need to be on constant alert became so strong that they eventually stopped going to beaches altogether because it became too stressful and exhausting.

Another member I worked with was at the laundromat one evening when she saw a couple of kids playing in a yard nearby. It looked as though they had water guns, and they seemed to be enjoying themselves. But this member couldn’t feel 100% sure that they weren’t real guns, so she told the owner of the laundromat, just in case. Much to her embarrassment, the woman looked at her like something was wrong with her. The truth is there wasn’t anything wrong, but she had a sense of over-responsibility for the safety of others and felt compelled to prevent anything bad that could possibly happen to anyone she came into contact with.

Anxiety and guilt are often at the root of an inflated sense of responsibility. The person with OCD thinks of all the possible repercussions of not acting in a particular scenario. They feel guilty for possible negative outcomes, often engaging in magical thinking—believing that their ideas, thoughts, actions, or other things can impact the world around them. This results in compulsions, which can take on many different forms; for some, it may involve very detailed rituals they feel they must perform to prevent something very specific from occurring. For others, it may be a vague need to do something “just in case” or to feel like everyone will be safe. 

ERP to treat hyper-responsibility

If you’re ready to stop living with an inflated sense of responsibility for the safety of others and yourself, exposure and response prevention (ERP) therapy can help. ERP is the gold standard treatment for OCD, and it works by habituating people to the uncertainty and anxiety caused by their obsessions, then teaching them to resist doing compulsions as a response.

It’s important to see a therapist who is specialty-trained to treat OCD with ERP therapy. They will understand intrusive thoughts, the anxiety they cause, and how this leads to physical or mental compulsions. They will also understand how to break this cycle, teaching you how to accept the uncertainty behind OCD fears, and they will give you the tools and knowledge you need in order to manage OCD. 

At NOCD, we have licensed therapists who are specialty-trained in treating OCD with ERP, and I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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