It's common to have fears about being a "bad person", but for most people, these are fleeting thoughts. However, this isn't the case for people who suffer from a form of obsessive-compulsive disorder known as moral scrupulosity or moral OCD. For folks with moral OCD, these "Am I bad?" thoughts can become permanent, leading to guilt, worry and rumination.
According to Joshua Curtiss, an assistant professor at Northeastern University, moral OCD is "a subtype of obsessive-compulsive disorder that's characterised by really intense, intrusive thoughts of being immoral, bad or unethical in some way". It's all centred around the fear of being a "bad person," added Erin Venker, executive director of the OCD and Anxiety Center of Minnesota. These kinds of thoughts can be debilitating and are very different than a quick worry about being "mean" or "bad." Here's what to know.
Moral OCD comes with compulsions
In OCD, compulsions are repetitive thoughts or behaviours that someone does in hopes of relieving anxiety. "And the compulsions are designed to neutralise or undo these types of thoughts or fears about being 'bad,'" Curtiss said. In the case of moral OCD, they could look like someone seeking reassurance from others to prove that they are "good" and not "bad". Perhaps after an interaction at work that made you feel like a "bad person", you call your mum, tell her the story and gauge her reaction to determine whether you're "bad".
It could also look like "undoing behaviours," Curtiss said, which means trying to do something really good to make up for any "bad" or "immoral" thoughts – like volunteering after thinking something mean about a neighbour. It could also appear as rumination, so thinking about the same thing over and over again. "It's kind of like a hamster on the wheel," Venker explained. "Unfortunately, we can never solve the problem through OCD rumination, it only leads to more questions and more doubts."
Moral OCD can lead to guilt, distress, and fear of rejection
Moral OCD is heavy. It can lead to guilt and "a questioning of one's own character," Curtiss said. "It's almost as if you're a judge, interrogating your own moral character." Constant, moral-based intrusive thoughts can be overbearing, overwhelming and distressing.
Furthermore, moral OCD feeds off the inherent fear and the possibility of "rejection, shame, or even just losing one's identity as being a good person," Venker said. Modern cancel culture amplifies this vulnerability in the form of "public call outs [and] constant exposure to other people's opinions."
This is not the same as a fleeting thought
"Moments of self doubt are very, very normal and very human ... everybody has intrusive thoughts," Venker said. "The difference is, OCD is a neurological condition ... it's like our brains are almost stuck on a highway loop." Someone who does not have moral OCD can find an exit, while "people with OCD, they don't get the all-clear signal," she added. Another defining factor is that OCD is looking for 100% certainty, which we're never going to get.
Folks with moral OCD also experience something called "thought-action fusion," Curtiss said. "It's the belief that thinking a bad thing is the equivalent of doing it." For example, someone with moral OCD may go to the grocery store, leave and worry they accidentally didn't pay for something in their cart. This could lead them to check the receipt again and again and even go back inside and insist on paying for the item again. This disrupts someone's life and takes up a lot of time.
Here's what to do if you are struggling
If you think you may have moral OCD, reach out to a mental health professional who is trained in OCD treatment. Regular talk therapy can actually make OCD worse. Exposure and response prevention therapy is the gold standard treatment for OCD, and, for some, treatment may also include medication. As you seek treatment, be kind to yourself and know that there are trained professionals who specialise in helping people.