OCD: Your Identity on Trial

Obsessive Compulsive Disorder (OCD) gets its nickname, the “doubt” disorder because it can make you feel like there is a dark doubt cloud over you. The feeling of doubt can attach to anything, and that is why there are so many different themes of OCD. The doubt can range from whether you left the stove on to whether you genuinely love your partner or children. When you continue to buy into OCD’s doubt stories and get lost in the cloud, you then start to doubt who you are as a person. Many of my clients come into OCD treatment feeling very confused about who THEY are vs. the stories that OCD is telling them. My mentor, Dr. Steven Phillipson, coined the term “character indictment” because it can feel like your identity is constantly on trial, and the more you try to disprove OCD, the louder and louder it becomes. So what do you do? You learn how to separate from the doubt and create your own story separate from OCD.

The Feared OCD Self

From a young age, we are taught that our thoughts define who we are. According to research, an average adult has about 6,000 thoughts daily. For us to say that all those thoughts define who we are is ridiculous. Our thoughts do not define who we are; our value-based behaviors define us. This is a crucial distinction for someone with OCD because they will experience more sticky intrusive thoughts and images than the average person. Individuals with OCD will often take the content of their intrusive thoughts or images, especially ones of a taboo nature (e.g., harm OCD, pedophilia OCD), and use them as evidence against their character.

Examples: 

Intrusive Thought: “What if I hurt my baby?”

OCD Self-doubt: “This must mean I’m a horrible mother.”

Intrusive Thought: “What if I left the stove on with my dog home?”

OCD Self-doubt: “I’m irresponsible and an awful pet owner.”

Intrusive Thought: “I probably got everyone sick in the office when I coughed yesterday.”

OCD Self-doubt: “I’m so careless.”

Intrusive Thought: “What if I cheated on my partner last night?”

OCD Self-doubt: “I’m a heartless cheater.”

Intrusive Image: “You’re cutting up food, and there is an image of you stabbing your mom.

OCD Self-doubt: “I can’t trust myself. I’m secretly a monster.”

Buying into OCD’s self-doubt stories leads to not only anxiety around the intrusive thought/image itself but also feelings of doubt, shame, guilt, and sadness because you are questioning who you are as a person. We buy into OCD’s narrative for three reasons: first, we believe the rule that “good” people shouldn’t have these kinds of thoughts/images. Second, the intense emotional response paired with the thought (e.g., anxiety, doubt, shame, etc.) makes it feel real & urgent. Third, OCD is one huge confirmation bias, meaning that it will look for evidence in your behaviors, emotions, and thoughts to prove that these fears are valid. For example, if you are buying into the thought that you are a “careless person,” OCD will point out every mistake you make and say, “See, look at all of this evidence!”

Inference-based Cognitive Behavioral Therapy (I-CBT) labels this self-doubt as our “OCD Self” or our “Vulnerable Self” because this is the self that we are terrified of becoming. You feel you might genuinely be a monster or a cheater, and you’re hiding it from everyone. You feel like an imposter fooling everyone you love. Within all of my work in treating OCD, I believe this is one of the most burdensome symptoms of OCD to live with. Individuals can go years believing in the OCD Self, and it can be challenging to break free from it when we are trapped in reinforcing cycles of obsessions and compulsions. However, I’ll let you in on a little secret: your feared OCD Self is the complete opposite of your true authentic self. You feel like the OCD Self is true because of all the emotions you are experiencing around them. Emotions make thoughts FEEL REAL. All of my clients who come into therapy buying into the thought that they are monsters are some of the kindest and most empathetic people I know. Unfortunately, that reassurance I just gave you won’t last for long. OCD will argue with that statement and say, “Well, don’t listen to that because you’re different. You’re TRULY a monster,” and then cue the anxiety, doubt, and shame that makes that thought FEEL REAL.

OCD Doubt in Everyday Life

OCD self-doubt may start from an intrusive thought, but it can quickly spread to so many areas of your life without proper treatment. Many individuals with OCD have difficulty knowing who they are and what they want from life. It can feel like a part of you is constantly gaslighting yourself and doubting your reality. That cloud of OCD doubt can come up in any small or big decision, whether picking what to wear each day or quitting your job. Due to these feelings of doubt and anxiety from OCD, nothing feels like the “right” choice. You hear others say to “go with your gut,” but that feels impossible because of the doubt and constant questions from OCD. So not only do you feel lost within your OCD theme, but you also begin to feel lost in everyday life. 

If this post has resonated with you so far, I want you to know there is hope. It is possible to break free from the feared OCD Self and doubt in everyday life. You can learn how to separate from OCD thoughts and emotions while connecting and trusting with your authentic self. It takes hard work, but I’ve witnessed many clients do it. I’ve taken my knowledge from my work as an OCD expert and outlined five C’s of key elements in taking back your authentic self from OCD.

The 5 C’s in Building Your Authentic Self

1. Clarify Your Values

One of the core fundamental principles of Acceptance and Commitment Therapy (ACT) is connecting to our values despite challenging emotions or thoughts. Values are belief systems that shape our goals, guide our behavior, and connect us to a meaningful life. Values are a compass that guides our behavior every day. They are not a destination we suddenly arrive at but what we consistently strive towards. My first assignment with all my clients is a values clarification exercise to help them look at what is important to them in life. Clarifying what is meaningful helps us guide our energy to what matters. If OCD doubt is clouding your life, your energy is probably dedicated to seeking answers/relief, engaging in compulsions, and avoiding. This leaves little energy to connect to your values, and you often lose sight of what is important to you. It is also important to note that OCD doubt tends to stick to parts of our values system (e.g., family, partner, health), making it seem more challenging to connect to those values. Once you begin to avoid your values because of OCD, you no longer feel like you have a purpose. If our path isn’t clearly defined, we feel like we’re just floating through life. 

For many clients, it is hard at first to clarify and connect to values because of OCD doubt. I always remind my clients that OCD loves to question everything. So, when they are engaging in this exercise, it’s okay if questions come up. The real work is connecting behaviorally to those values. This is when the power of AND comes into play, and implanting this word into your daily language is crucial for getting your life back. You can have symptoms of OCD AND make value-based choices. You can feel OCD doubt AND connect to things your authentic self values. For example, your OCD can tell you you’re an awful parent, AND you still play with your children. Once you start behaviorally connecting to things you love and value, no matter what OCD tries to make you feel or believe, you start connecting to the authentic YOU!

2. Connect to Your Strengths

Self-compassion and owning your strengths can feel challenging with OCD doubt. However, this is extremely important in your recovery journey. My clients can hear validation from me or loved ones, but that can only do so much. External validation and compassion are great. However, if we rely solely on others to remind us that we are worthy, we will constantly seek reassurance and be unable to have our own view of ourselves. Internal validation is a game-changer with OCD because you are starting to create a separate story from the OCD Self. This is why I will also have my clients complete a strengths exercise to help them begin to own these other parts of themselves. This might be hard to do at first and feel very much forced and inauthentic because you have been buying into the OCD Self story for so long! 

This is where separating from the feeling of doubt starts. You can feel like you don’t believe in your strengths, but that feeling is just doubt. OCD will also give you intrusive thoughts about your character alongside this feeling. Being able to own your strengths is saying, “I feel OCD doubt, I recognize OCD intrusive thoughts, and I still believe that I am a strong, independent, and kind person.” Feelings are different than beliefs, and this is crucial in OCD work. Unfortunately, what happens is that you are most likely waiting for this feeling of doubt to go away before you start trying to believe in yourself. With OCD, we have to work backward – we have to start believing in ourselves despite the uncomfortable feelings of doubt or anxiety being there. There also needs to be an acceptance that OCD will push back on you owning your strengths, and that’s OKAY. We are not trying to argue with OCD or change its mind about you (this would be engaging with OCD as a compulsion). The goal is to recognize the OCD Self stories, give irrelevance to this story, AND hold your own simultaneously. Once you consistently hold beliefs, validate yourself, and show up meaningfully, OCD starts to take backstage, and you start calling the shots of your life.

3. Cultivate Agency

One of the biggest questions I get asked in sessions is, “So, how do I start trusting myself again?” The answer is to start making and following through on decisions independently without seeking reassurance or engaging in checking (i.e., mental or behavioral checking). Self-agency is when we believe and have faith in ourselves without feeling certain. This is a significant part of OCD treatment because, as stated earlier, we will be going against this feeling of doubt. When OCD doubt shows up, you stop making decisions because OCD leads you to question and doubt every move you make. There is a constant fear that you will make the “wrong” choice or that your worst OCD Self fears will come true if you move forward with something or resist checking. OCD doubt can also lead us to question our senses and even our reality in decision-making. However, whenever you avoid making a choice, engage in checking, or seek reassurance on your decision, you reinforce the belief that you don’t trust yourself. There may also be a fear of taking accountability for your decisions. It is much easier to blame someone else for something not working out than to hold ourselves accountable. If you seek reassurance, you can say, “Well, I technically didn’t make the choice, so it’s not my fault.” This assures you won’t feel shame or guilt because you can put that emotion onto the other person.

Two things reinforce avoidance, checking, and reassurance seeking: 1. You are avoiding uncomfortable feelings of anxiety, doubt, shame, or guilt, and 2. You don’t believe in yourself to handle the worst-case scenario from a decision. To fully trust yourself again, you need to: 1. Be compassionate to yourself when you make a mistake, 2. Develop trust in your senses and reality again by resisting to check, and 3. Believe that you can handle anything that comes your way after you make a decision. Notice that I say when you make a mistake, not if you make a mistake, because guess what – it’s going to happen. Yes, maybe sometimes we leave the toaster plugged in, perhaps we make a choice at work that gets us reprimanded, and maybe we get short and lose our temper with our kids. We are human. We are going to make these mistakes. OCD doesn’t like this because it needs complete certainty and control that everything will be okay. However, we can NEVER give OCD this certainty because it doesn’t exist. The only certainty we can give ourselves is that when we take risks and make mistakes, we will catch ourselves when we fall, which is how we cultivate self-agency.

4. Create Hobbies

As we grow into adults, some lose touch with their hobbies, while others may never have had the luxury of having these fostered in childhood. I understand that in the hustle and bustle of everyday life, hobbies seem unrealistic and out of reach. We’re just trying to survive. However, many of us base our worth on work and family responsibilities and feel lost outside of them. Connecting to what brings you child-like joy outside of these responsibilities can be invigorating and allow us to cultivate our sense of self. However, you might feel lost on where even to start. I always tell my clients to start small and set realistic expectations. Even if you engage in a hobby for 30 minutes every week, that is still something! The goal is to try to make, not find time, in your busy schedule. 

As you explore your hobbies, here are two things that might arise for you. 1. When you have OCD, you are more likely to avoid hobbies because symptoms like doubt, anxiety, and intrusive thoughts can ramp up during downtime. If you’re following this article so far, you might guess what I’m about to say next – yep, we are going to engage in exploring hobbies AND welcome in symptoms of OCD. 2. Your perfectionistic inner critic can creep in and say things like, “You’re not doing this right,” or “You’re so lame for trying this,” leading to feelings of shame. Putting ourselves out there and trying new hobbies can feel scary! Your brain is trying to protect you from feeling the shame of failure, so it tells you not to try. So, it is essential to let go of expectations of what your hobbies “should” look like and be compassionate to yourself when learning new things. Letting loose and allowing yourself to look silly can be so freeing. If you want to learn and discover who you truly are, separate from the OCD Self, you must take the leap and try!

5. Commit to Skills

As you’re reading the 5 C’s to building your authentic self, it may all sound pretty straightforward. However, this 5th C – Commit to Skills is the most important. You can read about OCD therapy all day long, but the only way you’re going to get freedom is by doing the hard work. When I say the word “skills,” I mean tools from evidence-based treatments for OCD, including Exposure & Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), or Inference-based Cognitive Behavioral Therapy (I-CBT). These skills can be learned from a therapist specializing in implementing these treatments.

Committing to treatment and going against OCD feelings and intrusive thoughts can be SO HARD! I will always validate how difficult it feels to break free from OCD, and I would be lying if I said it was easy. It can feel like I am telling you to jump in front of a moving car even though you logically understand there is no car in front of you. Remember, OCD is emotional, not logical. If you continue to wait for the emotional part of your OCD brain to catch up to your rational brain, you are going to be waiting forever. You are never going to feel ready because OCD doubt, and anxiety will make sure of that. You choose to start this journey because you no longer want OCD to call the shots. When you begin treatment, you don’t have to be perfect, but you must be consistent with these skills daily. This is a lifestyle change, not a quick fix. You are choosing each day to commit to skills you learn in therapy. You are choosing to connect to your values, strengths, and hobbies while building self-agency despite how you feel. That is how you give OCD irrelevance, get back into the driver’s seat of your own life, and live life as your authentic self.

Share This Post:

© 2023 Dr. Melissa Jermann Psychology Services LLC - All Rights Reserved - Disclaimer: This site should not be construed as therapeutic recommendations or personalized advice. Interaction with this blog does not constitute a therapeutic relationship. This blog aims to provide general information for educational purposes only. It is not intended or implied to supplement or replace the advice of your mental health professional. This information should not be used to self-diagnose mental health conditions. Consult with your mental health provider before implementing anything read here.