First, guilt is an emotion that most people experience. For example, if someone lies, they may feel guilt. If someone steals, it’s likely they’ll feel guilt. If someone has deliberate unkind thoughts about someone, they may feel guilt afterwards. If someone shows themselves up at a party by getting drunk and doing something unheard of, they might feel a sense of shame and guilt the next day. The list goes on… you get the general idea.

Levels of normal guilt

Normally, unkind thoughts and misdoings tend to have a relationship in terms of the level of guilt a person feels. The intensity of guilt however does not usually preoccupy the person’s mind for too long, not in the general sense of things at least. Even on occasions when a person is likely to feel overly guilty for various reasons, such as fearing being morally bad for a particular wrongdoing or perceived indiscretion, they are still able to eventually move on and let the emotion pass.

Guilt associated with Scrupulosity

When Scrupulosity plays a role in this otherwise natural emotion (guilt), it’s fair to say that it isn’t a fluke that OCD has found the person’s vulnerability about what matters to them most. As a result, a person’s moral standards are thus affected because the misplaced guilt intrudes on the way they believe they should think, feel and behave according to the person’s values, religion or other doctrine.

What is an example of a person’s experiencing normal guilt?

Let’s take “John” as an example. His family is religious. They have brought him up to have strict moral standards. Still, when he was 15 years old he had thoughts to steal a chocolate bar from his local newsagent. One day he gave into those thoughts. Later that day he felt shame and guilt.

John’s guilty conscience followed with a series of what-ifs? For example, what if he was to go back into the shop and the newsagent announced that he saw him steal the chocolate bar? What if the newsagent were to tell his parents? What if he were to call the police? There were lots of worst case scenarios going on, and all tangible, because something really did happen for John to feel shame, guilt and regret.

Time passed and when John grew to adulthood he happened upon one of the Ten Commandments on Wikipedia whilst Googling something for his religious studies. The words “Thou shalt not steal” triggered thoughts about the earlier theft incident. The nature of what he did all those years ago started to play on his conscience. Thoughts crossed his mind about whether he should have owned up to stealing the chocolate bar; or at least prayed for forgiveness.

On reflection, John decided it would be better for him to put the shop-lifting incident to rest rather than dwell on it. He felt he could do this because internally he knew he had done wrong and was sorry for that. He was aware that having a conscience was enough to know that he’d been dishonest and that this in itself was punishment enough. And so from this perspective, he was able to pray for forgiveness, forgive himself and move on.

In the above example, you can see how, when scrupulosity OCD is separated from natural guilt, the “what-ifs?” are appropriate in this situation, because this is a factual story, and so the resolve for John was in accordance with the emotions experienced.

Now let’s take a look at another example that considers the relationship between OCD and guilt

This time John experienced intrusive and unwanted sexual thoughts, images and impulses towards religious figures when he was 16 years old. The thoughts were driven on a biological level; therefore he had no control over these involuntary obsessions.

None-the-less, he felt shame and guilt for having such thoughts and would conjure up good images to block the intrusive ones. John didn’t understand why he had these thoughts and often asked himself “what-if” questions such as: “What if I’m not worthy of going to church?” “What if the vicar is suspicious of my thoughts and knows my mind repeatedly “sees” him naked as he gives his sermons?” “Should I go to confession?” “What if God punishes me and sends me to hell?”

Again, lots of worst case scenarios going on, just like in the actual shop-lifting event, but in this case the “what-ifs” were hard to define. They were hard to define because intrusive thoughts have no substance. They are intangible simply because they are not subject matter. Obsessional thoughts had latched on to what mattered most to John, except at that time, he hadn’t realised that OCD was the crux of the problem. Subsequently, he failed to see that his intrusive thoughts were at odds with his true moral values.

Time passed by and John soon reached adulthood. The intrusive sexual thoughts had faded over time, but John suddenly found himself becoming preoccupied with trying to make sense of them. His preoccupation was triggered after reading about a religious sex scandal in his local newspaper. This had him wondering why he’d ever had such thoughts and he began to think that his conscience hadn’t been cleared. He labelled himself sexually immoral and decided that perhaps “confessing” to his past obsessions could be the answer to relieving himself of the “guilt” and “shame” he felt now. The thought of being morally unacceptable was too much for him to cope with. Once again OCD had found its grip. Subsequently, he felt urged to “tell” his closest and most trusted friend about his “immorality” and felt a sense of relief because his friend reassured him that all was fine. However, it wasn’t long before he started to think that perhaps he should seek out reassurance one more time, and so it went on.

Exactly how did OCD play a role in this otherwise natural emotion for John? How could he forgive himself and move on, just like he did with the chocolate bar incident?  But wait… Was there anything to forgive?

No, because John’s past experience of intrusive thoughts is a counterfeit situation. Earlier it was noted that usually an actual misdeed has a complementary relationship with the level of guilt experienced. Yet, when someone has a OCD episode one feels false guilt, not actual guilt. This is the part that is hard to define. Thus a resolve can never be in accordance with the emotions experienced because both are invalid. Put simply, John never committed any misdeed, and so “confessing” to something that’s already null and void was, and is, pointless.

So what’s the solution?

First, and as seen already, Scrupulosity involves holding strict standards of religious, moral, and ethical rightness. There tends to be no grey areas for people who live their lives according to their particular religion for example. Obsessive fears that one may have sinned or acted immorally in some way causes the person great distress and to the extent he or she fears being severely punished by God (or the devil). Others live in terror believing their family will go to hell for their perceived misdeeds; or that some other punishable event will occur.

So back to the solution. In John’s situation (and others) it would be wise to first accept that intrusive thoughts were, and are, just that. Cognitive behavioural therapy with exposure response prevention is the treatment of choice. The cognitive side of therapy helps to alter thinking errors that link to entrenched earlier beliefs. With new healthier beliefs people who have the same experiences as John place themselves in a better position to then identify that their recently established “confessing”, and/or other compulsions to relieve anxiety momentarily, no longer need to be given into. This is because the rituals only serve to reinforce and feed the obsession – that is, that one’s conscience hasn’t been cleared. Yet, there is no conscience to clear. Resisting “confessing” and related compulsions (e.g. checking, reassurance-seeking, mental counters, and so on) whilst tolerating the distress until it reduces naturally, and thus allowing the habituation process to take its course overtime is, therefore, the solution for reducing or eliminating false guilt for John and others who are going through similar experiences.

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