The Type of OCD We Need to Talk About

I was recently diagnosed with obsessive compulsive disorder (OCD). In just a few short months, this diagnosis has already led to a great deal of unearthed insight into my thinking and behavior. It’s helped to make sense of some of the symptoms I just brushed aside as “maybe a bit OCD” for years – the checking of locks, taps and lights, for example. But it’s also brought up a new labyrinth of questions about what OCD means to me, and how this diagnosis frames my understanding of myself, my life story, my fears and my “rules.”

I’ve always known myself to be a bit of a “perfectionist” (OK, a lot of one!). True relaxation has seemed unattainable to me for as long as I can remember. I beat myself up easily over mistakes I’ve made or not, reaching some lofty, self-prescribed goal. These attributes of my mental health were easy enough to compartmentalize, decipher and accept. But other aspects were hidden under the surface, too shameful to wear as a badge of pride like I could being a “high achiever.” It was only when I learned I have OCD that I began to also accept and understand the “less palatable” sides of my mind.

OCD often morphs and changes in how it displays itself. The most pervasive and longest-held presentation of my OCD is one that’s pretty easily hidden, and therefore, misdiagnosed or dismissed. This particular OCD sub-type, or recognized cluster of symptoms, is known as moral scrupulosity. This sub-type most commonly occurs in people who are religious, with themes centering around religious moral matters. The religious presentation of this sub-type is so common that when searching for information about “moral OCD” or “moral scrupulosity” online, most of the results focus on “religious scrupulosity” only.

I’m not religious, and therefore, my moral scrupulosity doesn’t manifest in the “typical” way. I believe this was one of the reasons it took me over a decade to be diagnosed. Other more visible ways that my OCD was presenting, such as lock-checking, were not “debilitating” for me, so I didn’t think they warranted further investigation. However, my moral scrupulosity, though more constant and disruptive, was far more difficult to identify. Even when these symptoms were observed by others, they often just presented as occasional  “weird” behavior which was out of character for me. Also, because so many of my obsessions and compulsions were inwardly-focused, I simply believed that I had a particularly brutal inner critic.

Non-religious moral scrupulosity is also a very common OCD presentation among children. There are no media representations of this sub-type, and many parents and medical professionals miss it due to a lack of awareness. In children, this sub-type will often start displaying as the child feeling the need to “confess” to thoughts and feelings they’re experiencing. It can look like a child repeatedly approaching you and cautiously whispering, “I’m sorry, I had a mean thought about you/my sibling/my friend.” They may feel compelled to tell you every single time they ever lied about something or did something “bad,” no matter how small or inconsequential. The central theme is that the child feels they are morally “bad” or “wrong” for a thought or behavior that they had or did, and the only way they can deal with the building anxiety is to “confess” and get it off their chest.

With a quarter-life’s worth of ego development behind me, my moral scrupulosity-related obsessions and compulsions can be quite complex and “nonsensical.” Without a religious background providing me with rules defining what is “moral” and “immoral,” my OCD has developed its own set of classifications. These are somewhat based on broader society and its values, and also twisted versions of my personal values. They have been crafted by my OCD as well-meaning, but ultimately unhelpful tools to avoid shame and abandonment.

Some of these “rules” seem to make sense at first, with “don’t lie” being one of them. Why has my OCD prescribed this rule? Because lying makes you a “liar,” which makes you “bad.” Society teaches that if you are a “bad” person, this may lead to ostracism, shame and abandonment. Therefore, “it is bad to lie” may seem like a fair enough moral judgment at first. But what are the implications of this thinking for me, someone who lives with moral scrupulosity OCD?

In my reality, living out the rule “don’t lie” looks like not being able to read something aloud to my partner without reading it exactly word-for-word because to paraphrase is “lying.” It means not being able to round up numbers when I’m telling someone what the time is or how much something costs because then I’m “lying.” It means that if I say something about a loved one to someone else which my OCD tells me could have been perceived as critical, I feel consumed by guilt and a tremendous urge to “confess.” Surely, if I don’t confess to things that I’ve done/said/thought that were “bad,” that means I’m lying through omission, which is even worse! Of course, the relief that comes from “confessing” or seeking reassurance only lasts so long. Before I know it, I’m beating myself up for another “moral infraction.”

Occasionally, the obsessions and compulsions will completely tie me in knots. These are the kinds of behaviors that led to my diagnosis because they made absolutely no sense and made me realize there must be something “wrong with me” that needed investigating. For example, with the “don’t lie” rule – what does this mean when I am confronted with a lie that I told in the past? Of course, it would make sense to be honest about the fact that I’d lied, according to my rules. Except, lying itself is seen by my OCD as so unforgivable, shameful and “bad,” so instead of admitting I’d lied in the past (which would reinforce feelings of shame and therefore the belief and fear I am inherently “bad”), my OCD has compelled me to tell another lie – that I didn’t lie in the past.

The anxiety that stems from having to acknowledge the fact I’d lied, and am therefore “a liar,” can be so tremendous that in the moment, I lose all insight into why lying in the present is worse than admitting to having lied in the past. This type of irrational, OCD-driven thinking and consequent behavior creates a “shame snowball” of epic proportions, and in one instance led to a severely debilitating episode. The silver lining of this is learning what I was experiencing was caused by OCD finally led to my diagnosis, and subsequent acceptance and understanding.

My moral scrupulosity has brought my deepest and darkest fears to the surface, leading me to live days which felt like walking nightmares. Starting down the road to recovery has been challenging, as it’s made me confront the feelings of shame I have tried so hard to avoid, and which my OCD has counter-intuitively compounded. However, my therapist taught me that when we make mistakes, even if these are seen by society or our OCD as “bad” (like lying), what matters is our intent behind that behavior. Knowing I have good intentions, and am a “good” person at my core, even if I sometimes do things that could be considered “bad” by whichever moral standard, has helped me tremendously in escaping the shame spiral that my OCD traps me in.

If you also live with non-religious moral scrupulosity, I hope this helps you to know that you are not alone. There is support, treatment, and a community available. It can be both comforting and incredibly freeing to learn that there is a diagnosis which can help you to understand, detangle and resolve the complexities of this type of OCD. Getting help can lead to the realization that the only “liar” is your OCD – you are a good person, you do deserve good things (like recovery!) and you are more than what your thoughts and feelings tell you. I am learning I am so much more than what my OCD tries to convince me I am. I’m excited to meet the person  I am becoming, the “good,” the “bad,” and all the shades in between.