The Obsessive Conscience

“There is nothing that wastes the body like worry, and one who has any faith in God should be ashamed to worry about anything whatsoever”, Mahatma Gandhi.

The OCD patients with whom I have had the privilege of treating, especially with scrupulosity and intrusive “bad thoughts”, have taught me that along with anxiety, excessive guilt misguides them into erroneously judging the “morality” of an obsession and try to assuage that guilt by performing rituals. Unfortunately, efforts made to prove “goodness” through these rituals end in defeat and only cause more suffering. Normal cultural and religious rituals are often performed to show respect for tradition, provide time for reflection, participate in communal events and holidays, and to mark important rites of passage. They have a beginning and an end, and serve to express love and hopefully, provide peace and comfort. Rituals performed out of obsessive fear do not accomplish their intended purpose, which is to alleviate anxiety and guilt. Humility becomes pride when the OCD takes hold of the sufferer’s doubt and scares the person into its demands to be obeyed in rigid, literalistic ways.

Not every OCD sufferer is driven by guilt via his or her symptoms, but whatever type of OCD you have (see the Y-BOCS checklist at: http://healthnet.umassmed.edu/mhealth/YBOCSymptomChecklist.pdf) you probably suffer with this underlying guilt. Obsessions are typically taboo in nature, thoughts people are not “supposed” to have. OCD sufferers experience a spike in anxiety and heightened physiological arousal when triggered, which is mistaken as evidence that something is wrong (in this case, morally). Sufferers can feel horrified about the content of their obsessions and the perceived consequences that others will be harmed by any lapse in their moral judgment or common sense.

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