OCD Guilt: Why It Happens & How to Cope

Why Can OCD Cause Guilt?

OCD often involves intrusive, unwanted thoughts that are distressing and focused on morally or socially unacceptable behaviors, like harming others or breaking rules. These thoughts create an overwhelming feeling of responsibility, even though the person has no intention of acting on them. They might feel as though having the thought itself makes them a bad person, leading to significant guilt.² Additionally, people with OCD may over-analyze past actions or perceived mistakes, ruminating about whether they caused harm, even in situations where they haven’t done anything wrong. This constant rumination feeds their sense of guilt.

Another reason individuals with OCD struggle with guilt is due to their compulsions. These behaviors often consume large amounts of time and energy, interfering with daily life and relationships. Over time, people with OCD may feel guilty about how their compulsive behaviors disrupt their lives and affect loved ones. For example, they might miss important events, neglect responsibilities, or unintentionally frustrate family and friends because of their OCD rituals.

Which Obsessive Thoughts Cause Guilt?

People with OCD often feel guilt or shame, no matter the subtype, though some types of OCD may bring stronger feelings of guilt because of the specific obsessions involved.³ For example, someone with pedophilia OCD may feel intense shame about their thoughts because society deeply values child protection. Similarly, a person with scrupulosity OCD from a religious family or community may experience more guilt because religious values are strongly emphasized in their environment.

Here are some common obsessive thoughts that cause guilt:

Feeling Like You’ve Broken a Rule

In scrupulosity OCD, guilt often centers on intrusive thoughts about breaking ethical, moral, or religious rules. For example, someone with Scrupulosity OCD might obsess about committing a particular sin, leading them to feel overwhelming guilt and perform compulsions, like excessive praying or constantly seeking reassurance from religious leaders.

Fearing That You’ve Harmed Someone

In harm OCD, the intrusive thoughts focus on causing harm to oneself or others. These thoughts can be violent or aggressive, leading to strong feelings of guilt and shame. For example, someone might feel guilt over a thought about harming a loved one, even though they would never want to.

Having Unwanted Sexual Thoughts

Sexual obsessions OCD involves unwanted, intrusive sexual thoughts that can feel disturbing or inappropriate. These thoughts often conflict with the person’s values or beliefs, leading to intense guilt and shame. For example, they may have intrusive thoughts about taboo or socially unacceptable topics, causing them to worry that these thoughts mean something negative about their character. To manage this guilt, they may engage in compulsions like mental reviewing or seeking reassurance that they’re not “bad” for having these thoughts.

Worrying About Contaminating Others

Contamination OCD focuses on intense fears of germs, illness, or being unclean, and it can create guilt when someone believes their actions might harm others. For example, they might worry excessively about touching surfaces or objects that others might come into contact with, feeling responsible if anyone were to get sick. This sense of guilt may lead them to clean excessively, avoid public spaces, or constantly check and disinfect areas to prevent any possible harm.

Doubting Your Relationship

Relationship OCD involves obsessive doubts about aspects of an intimate relationship, which often leads to guilt, especially if the person’s partner reacts negatively to these doubts. Common obsessions include questioning one’s love, attraction, or commitment, causing guilt that the obsessions are harming the relationship.

Fearing That You Have a Harmful Bias

Racism OCD involves intrusive thoughts about being unintentionally racist. This worry leads to compulsions to ensure that they are not harming others through biases. People with Racism OCD often feel extreme guilt, fearing that they may be inherently harmful to others, even though this is not true to their values.

How Guilt Fuels the OCD Cycle

OCD-related guilt can play a big role in keeping the OCD cycle going.⁴ When someone with OCD feels intense guilt, especially when that guilt is tied to an intrusive thought, they often feel an urgent need to relieve it. This can lead them to perform compulsions, which are specific actions or mental routines intended to “neutralize” or counteract the guilt.^{5, 6} For example, if someone with Harm OCD has an intrusive thought about harming someone, they may feel an overwhelming sense of guilt, as if simply having the thought is wrong. To reduce this guilt, they might check repeatedly to ensure no one has been harmed or mentally replay scenarios to reassure themselves they would never actually do such a thing.

These compulsions, like checking, seeking reassurance, or mentally reviewing, can provide a temporary sense of relief from guilt. However, this relief doesn’t last long, and the person may feel compelled to repeat the behavior as soon as the guilt resurfaces. Over time, this cycle becomes consuming, with compulsions happening more frequently and taking up more time, as the person struggles to find peace from their guilt. Unfortunately, this cycle only reinforces the OCD symptoms, making the guilt feel stronger and the compulsions more necessary to manage it.

Free OCD Workbook

This collection of worksheets provides practical tools and strategies for managing OCD symptoms. Find the one you need, or download all of them here.

The Complete Workbook Download

Creating a Hierarchy of Fears Download

Understanding the OCD Cycle Download

Challenging OCD Thoughts Download

Setting SMART Goals Download

PLEASE Take Care of Yourself Download

Self-Care Inventory Download

How to Cope With OCD Guilt

OCD-related guilt can be incredibly draining, often convincing you that you’re responsible for things you can’t control or that you’re not “good enough.” However, there are ways to gently reduce OCD’s grip on your sense of self.

Here are eight tips for coping with OCD guilt:

1. Understand the Nature of OCD

OCD tends to latch onto thoughts or fears that are particularly meaningful or significant to a person. For example, someone who values kindness may have intrusive thoughts about harming others, precisely because it goes against their values. The intense emotional reaction a person has to these intrusive thoughts keeps them in their attention, making the obsessions harder to ignore. By understanding that these thoughts are a symptom of OCD, not a reflection of their true desires, individuals can begin to approach intrusive thoughts with less self-criticism.

2. Challenge & Reframe Negative Thoughts

OCD often starts with minor intrusive thoughts or behaviors. For example, a small “what if” thought or a harmless checking behavior might feel manageable at first. Over time, these thoughts or behaviors can grow into more elaborate, repetitive patterns as the person begins to rely on them to manage anxiety or discomfort. This escalation can make the OCD cycle harder to break. By pausing to recognize the specific thoughts that fuel OCD, such as “If I don’t do this, something bad will happen,” individuals can disrupt the automatic reaction to those thoughts. Learning to challenge the validity of these thoughts—asking, “Is this thought realistic?” or “Does this thought reflect reality?”—can help reframe them in a less anxiety-provoking way. For instance, reframing “I have to check the lock 10 times” to “The door is locked, and I can trust myself to remember that” reduces the compulsion to check.

3. Create a Time and Place for OCD Guilt

Try setting aside a specific time each day, say ten minutes, just for focusing on guilty thoughts—a technique known as activity scheduling. When a guilty thought pops up outside that time, mentally “put it on a shelf” and save it for later. This visualization technique gives those thoughts a temporary place, helping you continue with your day. You may even find that when the scheduled time comes, you’re less interested in diving into those negative thoughts!

4. Practice Self-Compassion

Guilt and shame can make it feel like you don’t deserve kindness, but practicing self-compassion is actually a powerful way to ease the weight of OCD guilt. By treating yourself with the same understanding you’d show a friend, you can challenge OCD’s harsh inner voice and help build resilience. Start small by doing something that makes you feel cared for, whether it’s a long, relaxing shower, savoring your favorite meal, or repeating a mantra like, “I am doing my best, and that’s enough.” Try to make self-compassion a daily habit, even in little ways—these acts remind you that you’re worthy of kindness, no matter what OCD tells you.

5. Exposure & Response Prevention (ERP) Therapy

Exposure and response prevention is considered the gold standard for OCD therapy treatment, and working with a professional who specializes in this can help you manage your OCD and the guilt you feel as a result of it as well. An ERP therapist will directly expose the client to things that trigger OCD guilt and help the client to learn that OCD guilt will pass without engaging with compulsions.

6. Lean on Your Support System

When guilt or shame feels overwhelming, it’s natural to want to pull back from others and deal with it alone. But isolating yourself often makes those heavy feelings even harder to manage. Instead, try leaning on your support system—whether that’s family, friends, or trusted people in your community. Talking things over with someone who understands can help take some of the weight off and remind you that you’re not facing this alone. Just sharing what you’re feeling can often make a big difference.

7. Set Boundaries for Reassurance-Seeking

If someone with OCD experiences guilt, it is common for them to develop a compulsion of reassurance-seeking from their loved ones. While it may feel helpful and supportive on the surface, compulsive reassurance-seeking keeps you stuck in the cycle of OCD. Discussing boundaries with loved ones around compulsive reassurance-seeking can help you manage your OCD and gauge for yourself whether or not you feel guilt for the choices you have made.

8. Use Grounding Techniques During Episodes of Guilt

It is easy to be pulled out of the current moment when a person feels guilt – considering all the possible ramifications, how many times you have made a similar choice, and what this ultimately says about you. Grounding yourself into the current moment can interrupt this guilt rumination cycle. You can ground yourself in the current moment by engaging with your senses, paced deep breathing, and attuning to events unfolding around you.

How Treatment Can Help With OCD Guilt

Treatment can make a big difference in managing OCD-related guilt by helping a person understand how guilt makes their OCD symptoms worse and by giving them tools to break the guilt-compulsion cycle. Exposure-response and prevention (ERP) is considered the gold standard treatment option. It involves facing situations or thoughts that trigger guilt while resisting the urge to act on compulsions. This helps a person get used to feeling guilt or anxiety without trying to “fix” it, which gradually reduces the need for compulsive behaviors.

Cognitive behavioral therapy (CBT) is also very helpful for challenging thought patterns that lead to guilt. For example, CBT can help someone see when they’re taking on too much blame or feeling overly responsible for things that aren’t in their control—common issues in OCD. Through CBT, they can learn to think in a healthier, more balanced way.

Medication, like selective serotonin reuptake inhibitors (SSRIs), can also reduce obsessive thoughts and compulsions, making it easier to address feelings of guilt during therapy.

How to Find Professional Support

If OCD-related guilt is causing daily distress and your symptoms aren’t improving with stress management, lifestyle changes, or support from friends and family, it may be time to seek professional help. Online mental health services like NOCD specialize in connecting people with therapists trained in OCD-specific treatments, including ERP, making it easier to find expert support tailored to your needs. This can provide the guidance you need to work through guilt, reduce symptoms, and reclaim daily life. You can also explore online OCD resources to find additional support, including educational materials, self-help tools, and online support groups.