OCD subtypes
Race OCD

What Is Race OCD? Overview, Symptoms and Treatment Options

7 min read
Keara Valentine
By Keara Valentine
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety

Race obsessive-compulsive disorder (OCD) is an OCD subtype that is characterized by ongoing intrusive thoughts and compulsive behaviors around the fear of being racist. People with race OCD experience frequent intrusive thoughts about the idea that they may 1) be racist without their control, 2) behave in a racist way without their knowledge or 3) be perceived as racist. They experience frequent worry and guilt about what this might mean about them as a person (for example: “Did I accidentally offend this person on the phone? Does that mean I’m racist?”). The guilt, shame and anxiety drive people with race OCD to engage in various compulsions aimed to alleviate their distress (for example, asking a friend for reassurance that they’re a good person and not a racist). 

Racism OCD symptoms

OCD tends to fixate on what is most important to a person, and when combatting racism is central to a person’s identity, OCD will sometimes latch on and provoke obsessions and compulsions centered around the thought that they might be racist. Because this contradicts their core values, the doubting thoughts feel all the more anxiety-provoking. 

Many conscientious people may be concerned they have unacknowledged racial bias that is contributing to their behavior — indeed, it’s important for everyone to examine their biases from time to time. However, with race OCD, the concern is never-ending, and these doubting thoughts can feel impossible to let go of despite extensive reassurance. Someone with this condition may have a thought come into their mind after a conversation with a stranger. They might begin thinking: “Did I say anything strange? Was I racist just now when I asked them about their day? What if I was racist? Maybe I’m a horrible person, and I don’t even know.”

This unrelenting anxiety and fear about being racist may cause a person to seek reassurance from a friend, research racism extensively or engage in other compulsions. But confirmation they are not racist may only ease the anxiety temporarily. It’s a matter of time before the thoughts kick back in, and they begin to think, “Well, maybe I wasn’t racist in this instance. But what about in this one?” Regardless of the confirmation, the person’s OCD will come up with more and more fuel for their doubting thoughts. 

Examples of race OCD obsessions

People with race OCD experience obsessive thoughts focused around potentially being racist or being perceived as a racist. Here are some examples of common themes:

  • Was the real reason I was annoyed at this person because I’m actually racist?
  • What if I accidentally say the wrong thing? What if I use a politically incorrect term because I’m actually racist?
  • Am I being racist to my friend because I don’t want to see him tonight?
  • Am I being racist because I want to pay for my friend? Is it a nice gesture or is it condescending? Would it have been better to split the check? What if I’m actually racist and my friend can tell?
  • What if I’m not really a good person, and I’m just pretending, and everyone knows it?
  • Do I not want to date this person because I’m actually racist? How do I know for sure? Maybe I should date them just so I know for sure.
  • Was I racist to the person at the store just now? 
  • Did the way I spoke to this person come across as rude? Maybe I really am rude and I just don’t know it. Maybe I think I’m better than everyone because of my race, and this comes across to everyone I talk to.

Examples of race OCD compulsions

In response to their obsessive thoughts, a person with race OCD will engage in compulsive actions as an attempt to alleviate their anxiety. Here are some examples of what that might look like:

  • Reassurance seeking: A person with race OCD may excessively turn to friends and loved ones for reassurance that they aren’t racist. They may ask a friend direct questions like, “Do you think I’m racist?” or more subtle questions like, “Do you think this person in the news was racist?”
  • Excessive research: Some people may spend hours researching what makes someone racist, how you can tell or topics like how to be an anti-racist. This research is motivated by the compulsive need to relieve the anxiety of potentially being racist.
  • Social comparing: An individual may excessively compare themselves to other people in their lives and online and try to understand whether they are racist based on other people’s behaviors. They might think, “Well, everyone in the media is saying this person is racist, so she must be. Would I ever do something like what she did?” They may spend hours researching a news story about a racially motivated crime to try and determine whether they would do something like this, too. “I wouldn’t do that, so I must not be racist. But how can I be certain?”
  • Mental review: A person may spend hours mentally reviewing their past actions to determine whether they are racist. They might think, “I laughed at that joke. Does that make me racist? Who else was laughing? Was it just a funny joke, or does it mean that I am racist?” This mental review could take hours of a person’s day, as they search their mind for answers to reassure themselves that they are indeed not racist.

Race OCD ERP therapy

The best course of treatment for race OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found effective for 80% of people with OCD. The majority of patients experience results within 12 to 25 sessions. As part of ERP therapy, you will track your obsessions and compulsions and make a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective, and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.

The idea behind ERP therapy is that exposure to these thoughts is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety. 

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People with race OCD may face particular challenges during ERP therapy because they may be convinced certain exposures will cause them to act against their moral values. As the nature of these OCD thoughts is to convince you that you are indeed racist, a therapist who’s familiar with race OCD will be able to help you work through these thoughts in a way that isn’t overwhelming and does not feel contradictory to your moral compass. 

Examples of race OCD exposures

ERP therapy works to get you acquainted and comfortable with the unknown, since it’s the fear of the unknown and the need for certainty driving the obsessions and compulsions.

Let’s say you’re constantly concerned you’ve committed a microaggression, a question or comment that appears innocent but is actually motivated by racial bias. Each time an intrusive thought comes in about this, the fear of potentially being racist is so high you call a friend to share the interaction and ask if you were acting racist. 

In ERP therapy, the goal is to prevent yourself from acting on your compulsions. Instead of asking your friend for reassurance, a therapist may have you think to yourself, “Maybe I am racist. Maybe I’m not. It’s impossible to know for sure.” This teaches your brain a new thought pattern and begins to get you comfortable with the uncertainty fueling your obsessions and compulsions. In order to avoid overexposure and overwhelm, you’ll work with a therapist to come up with a hierarchy of anxieties and related exposures and gradually work your way through them. 

For example, if at first the idea of not being able to ask a friend for reassurance feels impossible, you might work with your therapist to wait five minutes before making the call. Eventually, you’d be able to wait 10 minutes, and then work your way up to an hour. With practice, you’ll find the intense need to engage in your compulsion will wane. You will get to a point where the anxiety subsides, and you no longer need to call a friend for reassurance at all.

How to get help for race OCD

Race OCD can be challenging to diagnose because many intrusive thoughts, concerns and behaviors may come across as hyper-conscientiousness. A therapist who isn’t informed about this OCD subtype may simply tell someone they have nothing to worry about without knowing they are actually fulfilling the person’s need for reassurance. However, a mental health professional who specializes in OCD will be able to make an accurate diagnosis.

If you’re interested in learning about race OCD and how it’s treated with ERP, you can schedule a free call with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.

Learn more about race OCD 

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating Race OCD

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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