Do you feel responsible for the wellbeing of those around you? Do you constantly worry about the impact of your actions on others? Do you ever fear that a negative thought might cause a negative event?
It’s common to think about the consequences of our actions, but if thoughts about your potential impact on others have become all-consuming, persistent, and intrusive, you may be navigating a subtype of obsessive-compulsive disorder, known as responsibility OCD.
Responsibility OCD is characterized by obsessions and compulsions that center around a person’s sense of heightened responsibility for the people and animals around them. People with this subtype experience frequent, intrusive, unwanted thoughts that they could be responsible for something awful happening, because they did or did not perform specific actions. Read on to learn more about responsibility OCD and how to get help.
Understanding responsibility OCD
Obsessive-compulsive disorder (OCD) is a complex mental health condition defined by two symptoms: obsessions and compulsions.
- Obsessions are intrusive thoughts, sensations, images, feelings, or urges that cause extreme distress and anxiety—often in part because they go against a person’s true beliefs or values.
- Compulsions are repetitive behaviors or mental rituals performed in an attempt to relieve the anxiety and distress brought on by obsessions. However, compulsions typically only provide temporary relief, furthering the OCD cycle.
People with responsibility OCD tend to obsess about the impact their actions or thoughts could have on others. These fears will manifest differently for each person, typically focusing on whatever you value the most. For example, if you are close with your family, you may feel it is your job to be entirely responsible for making sure they are always safe. If you are someone who cares deeply about the environment, you might develop a sense of outsized responsibility for protecting our planet.
Responsibility OCD tricks you into thinking you can have an unrealistic sense of control over outcomes. This can lead you to experience high levels of guilt, as well, or fears that you’re actually a bad person. As a result, people with responsibility OCD may perform compulsive behaviors to try to help others or prevent imagined scenarios from becoming a reality.
Responsibility OCD obsessions
People with responsibility OCD experience obsessions centered around their sense of responsibility for others. Here are some examples:
- What if someone tries to hold the train door for me, and their arm breaks?
- What if I cough in public and it gets someone else sick, and they die?
- If I think of something negative while looking at someone else, something terrible could happen to them.
- Did I lock the doors? Did I turn off the stove? I need to check, because it’s my responsibility to keep my home safe.
- Did I accidentally run someone over without knowing?
- What happens if I take out this book from the library and someone else wants to read it? What if that person is suffering, and this was the book that would change their life?
- I have to make sure my cats never interact with the poisonous flowers outside. They depend on me.
Responsibility OCD Compulsions
In response to obsessive thoughts, a person with responsibility OCD will engage in compulsive actions to try to alleviate their anxiety, or prevent a feared outcome from happening. Here are some examples:
Seeking reassurance: If you’re navigating responsibility OCD, you may constantly ask your friends and family to reassure you that you are not responsible for bad things happening. You may also look to trusted loved ones to discredit your fears. For example, you might ask, “Do you think it’s okay for me to buy the last carton of milk? Do you think someone else might need it more than I do?”
While it may feel like these questions will provide the validation necessary to relieve your anxiety, it’s only a matter of time before new intrusive thoughts emerge. Reassurance-seeking only leads to more reassurance-seeking, and for OCD, there’s no such thing as enough reassurance. In other words, the cycle can become endless.
Performing rituals: Some people may perform rituals to try to prevent bad outcomes or control the future. For example, you may pick up and put down an item in a particular way, in an attempt to prevent a fear from becoming a reality. Or, maybe you tell yourself to think seven positive thoughts each time a negative thought about a friend pops into your head.
Mental review and checking: Some people may engage in mental review and checking to reassure themselves that they are not responsible for their feared outcomes. For example, you might spend hours recalling a conversation with a friend to be sure you didn’t say anything hurtful or offensive.
Excessive Research: A person may engage in compulsive research about the fears they are experiencing. For example, if you worry you could run over a pedestrian or an animal while driving, you may spend hours researching this possibility online or looking for new reports of hit and runs you are concerned you could be responsible for.
Avoidance: Some people avoid certain scenarios, places, or people that they think could contribute to a potential negative outcome. For example, you might stop driving because the perceived possibility of hurting someone is too high. You may avoid interacting with certain people out of a fear of saying the wrong thing. Avoidance can lead some people to become homebound, as a way of trying to mitigate any scenarios that challenge their sense of hyper-responsibility.
Treatment for Responsibility OCD
The symptoms of responsibility OCD are sometimes misunderstood as generous or altruistic (even by certain mental health professionals) because the people experiencing them are constantly going out of their way for others. However, it’s important to note that while someone with this OCD subtype may appear excessively kind—and are genuinely trying to do good in the world—they don’t actually experience the pride and relief they should feel after doing something good. If you are navigating responsibility OCD, it’s important to seek treatment from a therapist who specializes in OCD, so you can find relief from the impossible goal of trying to keep everyone safe.
The best course of treatment for responsibility OCD, like all subtypes of OCD, is exposure and response prevention (ERP) therapy. ERP is a highly effective, evidence-based treatment that is specialized for OCD. Eighty percent of people with OCD who try it experience positive results, and the majority see results within 12 to 20 sessions.
ERP therapy involves tracking your obsessions and compulsions, and gradually exposing yourself to situations that trigger your discomfort—so you can eventually regain control over your thoughts and behaviors. Together with a trained ERP therapist, you’ll make a list of possible ways to face your fears, working slowly so you don’t get overwhelmed.
To better understand how ERP works for responsibility OCD, let’s consider an example. Imagine you’re struggling with vivid intrusive images of your family’s home going up in flames, and you’ve begun compulsively checking all of your household appliances before bed. In order to break the cycle of obsessions and compulsions, an ERP therapist might have you conjure these intrusive images during a therapy session. Together, you’d discuss the feelings that arise, giving them your full attention. Your therapist might then have you gradually reduce the amount you’re checking each night—perhaps starting by skipping one of the appliances you usually check, and gradually increasing from there until you are able to get through the evening without any checking at all.
While this exercise would likely be difficult at first, it teaches your brain a new response to your obsessions and the anxiety they bring. By confronting these thoughts without compulsions, you start to learn that your feared outcomes won’t occur, that you can manage the outcome if it does, and that you can tolerate the anxiety or distress that arises when you have intrusive thoughts. We can’t totally control our thoughts, but we can control our behaviors. By preventing yourself from performing compulsions, you disrupt the idea that you need to engage in them—teaching yourself new, healthier ways to respond to uncertainty and discomfort.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Key takeaways
- Responsibility OCD is a subtype of OCD characterized by an overwhelming sense of responsibility for the well-being of others.
- People with responsibility OCD may engage in constant reassurance-seeking, rituals, research, excessive checking, or avoidance.
- Responsibility OCD is sometimes misunderstood as altruism, but it can cause extreme distress, and is best treated through exposure and response prevention (ERP) therapy.
- ERP therapy works by gradually helping you confront your fears, while resisting the urge to perform compulsions—helping you break the OCD cycle.
