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The role of shame in OCD, and how to let go of it

8 min read
Vicki Rackner, MD
By Vicki Rackner, MD

This is a guest post by Dr. Vicki Rackner, from the organization Free Me From OCD and the OCD Secrets Campaign.

Do you remember the movie Wayne’s World? In one scene, Alice Cooper invites the main characters, Wayne and Garth, to hang out with him. Our protagonists drop to their knees, saying, “We’re not worthy. We’re scum. We suck.”

In some ways, that’s shame in action. However, shame is no laughing matter. Unmanaged shame leads to secrecy and lies that can keep you from being free from OCD.  So, let’s deconstruct shame.

Why Do We Have Shame?

Shame, like any other kind of pain, is designed to keep you safe. Just like when you touch a hot stove, pain is what causes you to withdraw your hand. In caveman days, exile from the tribe was a death sentence. So your brain is programmed with three feelings intended to secure your safe standing in the tribe: embarrassment, guilt, and shame. 

You feel embarrassment when you say or do things that negatively impact the way others see you. You feel guilt and shame when you say or do things that negatively impact the way you see yourself. We all hold standards about who we are and who we want to be. We’re also human. We miss the mark. We make mistakes. But guilt and shame communicate the message that you fell short of your standards. 

Why Do Some People Experience Guilt and Others Experience Shame?

Shame expert Brenee Brown says that people who experience guilt say, “I made a mistake.” People who experience shame say, “I am a mistake.” She found no differences in the life circumstances of the two groups. The shame group did not have more run-ins with the law, divorces, or bankruptcies than the guilt group.

However, they had different answers to the question, “Are you worthy of love?” One group said, “Yes.” The other group said, “Maybe.” Someone with shame says, “I’ll be worthy when I ….get ‘cured’ from OCD/lose weight/make this much money…. (fill in your own circumstances).” 

Here’s the catch: You can’t hustle your way to worthiness. It’s like chasing the pot of gold at the end of the rainbow. The belief that you are conditionally worthy causes shame-related damage. 

I recently read the article “How I Became a Pathologic Liar” by Joshua Hunt, where he says that he started lying as a child. He believed that if others knew he lived in poverty, he would be rejected. Joshua lived in the shadow of shame. He said his biggest lie was that he was normal and did not need help. 

This is the lie many people and families touched by OCD live. They want to be seen as normal. They want to be people that do not need help.

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What Causes Shame?

We tend to believe that shame is caused by circumstances. Brenee Brown’s work says otherwise: She says that shame is the feeling you get when you think, “I did this, so now I’m unworthy of love.” 

So shame is caused by a thought—not by a circumstance. When you have shame, you hold the thought, “I’m unworthy.” Shame might be triggered by circumstances, but it’s caused by a thought.

Where Do Thoughts Come From?

Let’s talk about the four sources of thoughts:

1. Your primitive brain. Your reptile brain evolved to keep you alive. Our earliest ancestors needed the tribe to survive. We evolved to avoid behaviors that would get us kicked out.  

People with OCD have a heightened concern about safety. They might be more sensitive to guilt and shame, just like redheads are more sensitive to physical pain.

2. Your childhood experiences. Your parents taught you how the world works. In some families, kids get allowances for being family members. In other families, kids earned their allowances.

The same holds true for worthiness. 

Joan said, “My mother caught me doing something naughty. She screamed, ‘You should be ashamed of yourself!’ and sent me to my room. My mom gave me the cold shoulder for weeks after the incident. I learned I had to behave in certain ways if I wanted my mother’s love.”

Compare that to Tim’s story. He said, “We lived next door to a boy who had a stutter. One day my mother overheard us taunting the boy. She took me aside and said, ‘We believe that all of God’s creatures are worthy of respect. You’re going to go over to his house, apologize and invite him to play here.’” Tom and his neighbor became lifelong friends.

What did your parents teach you about your worth?

3. The thoughts of people you surround yourself with today. 

You are influenced by the thoughts and beliefs of people around you. As a physician, I observe that we live in a society that holds a special insidious prejudice I call healthism. People with certain medical conditions are judged, shamed, and shunned. Think about fat-shaming. Healthism works similarly to racism.

In general, medical conditions that are poorly understood are the most frightening and the ones most subject to healthism.  And, unfortunately, few healthcare professionals or families understand what OCD is–and what it is not. 

When you begin to have conversations about OCD, you break through healthism. That’s why organizations like NOCD are so critically important.  

4. For people with OCD, there’s a fourth source of thoughts: your brain-wiring glitch.

Obsessive thoughts or images are random, nonsense messages created by these wiring glitches. If you have a thought that you are going to harm your beloved cat, you might wonder, “What kind of terrible person am I? Sociopaths harm animals. Am I a sociopath?” Further, people in the grips of moral OCD may constantly ask the question, “Am I a good person?” In other words, this kind of OCD sets you up for shame.

How to Manage Shame in 4 Simple Steps

1. Remember that shame is just a feeling. 

You gather information about the world around you through your five senses. Think of feelings as your sixth sense. Treat your feelings like something you touch, see, hear, smell or taste. 

Shame won’t kill you, although it might feel like it will. While painful, shame, like any other feeling, is just a sensation that sweeps through your body.  You can apply all the lessons you learned from exposure and response prevention (ERP) when you feel shame. 

You can also try this exercise:

  • Name it. What does shame feel like for you? Where in your body do you feel it?
  • Feel it. Ride the wave of this feeling. Avoid resisting it. What you resist persists. 
  • Accept it. Avoid judging yourself for having a feeling. 

You’re not a bad person because you feel shame; however, if you feel shame, you believe on some level that you are a bad person. Shame is like the check engine light on the car dashboard. It alerts you that you are feeling unworthy.    

2. Don’t keep secrets. 

The natural response to shame is to lie and hide. But secrets make it harder to get to the other side of OCD. Find a safe place to tell your secrets. Maybe it’s your ERP therapist. Maybe you tell your friend or trusted family member.

Here’s another option. Join the OCD Secrets Campaign. Send us an anonymous postcard with your deepest, darkest secrets. Get out your markers and unleash your artist-within! I will share these postcards, and you will see that you are not alone. You’ll find the mailing address below. 

3. Remember that you are not your OCD.  

OCD and shame are like the chicken and the egg. Someone with unmanaged OCD might think, “If someone knew what was happening in my mind, or put a video camera in my house, they would run the other way.” The shame can lead to secrecy, which can then cause OCD to grow. 

However, you are not your OCD; your OCD is a medical condition you are managing. If you got COVID, you would know that you are more than just the infection. Now substitute “COVID” with “OCD.” OCD is just a medical diagnosis that describes a certain kind of brain-wiring glitch. It says nothing about who you are.

Here’s another exercise to try: Imagine a friend or a small child coming to you and telling you the exact circumstances that triggered your shame. What would you say to them? “I can’t believe you did that! You should be ashamed of yourself!” No! You probably wouldn’t do that.

Ideally, you treat yourself with the same compassion you shine on others.

4. Know that you can change your thoughts. 

Your belief about your worthiness is just a thought. You can change your thoughts. It’s simple but not easy. If you tried jumping from “I’m unworthy” to “I’m worthy,” your brain wouldn’t buy it. Instead, you can climb the thought ladder. 

Maybe in the past, you made a mistake and reached for the thought, “I’m such a loser.” How about going to a neutral thought like, “I just made a human mistake. This proves I’m human.” Maybe the next step is to say, “Worthy people make human mistakes.” Then, “I know someone with OCD who is worthy.” The last step might be “I’m a worthy person—OCD and all.”

Acting from the thought that you have inherent worth will support your effort to be freed from OCD. You don’t have to be perfect to be worthy. Just be perfectly who you are. You can rewrite the lines of Wayne’s World. Imagine Wayne and Garth facing each other saying, “We’re worthy. We’re most excellent. Party on!”

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Send a postcard with your OCD Secrets to:
OCD Secrets
Vicki Rackner MD
2355 Fairview Ave N #219
Roseville, MN 55113

Vicki Rackner, MD

Dr. Vicki Rackner is the mother of a son who was diagnosed with OCD when he was in college, a retired surgeon, and a certified life coach. She coaches families touched by OCD to say yes to life by saying no to the tyranny of OCD through her organization Free Me From OCD (https://www.ocdpowerparenting.com/podcast-menu-page).

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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.

Madina Alam

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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.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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