head-in-handsThough it comes in many flavors, one of the more common OCD themes I’ve seen is that of crime and punishment or what could be considered as guilt OCD. Some websites and professionals call this OCD theme something like real-life OCD, because an event did take place in real life that has become the focus of the sufferer.

The sufferer believes they made an egregious mistake or have even committed a crime (what they did was so terrible), yet everyone around them responds that no such crime exists or that the mistake is nothing to worry about. This theme has one thing in common: the sufferer’s steadfast determination to punish themselves for the perceived transgression.

Many times I’ve seen people raise this type of OCD then vehemently stick to the belief that the situation has nothing to do with OCD. I see that so often that one would have to wonder how it could not be OCD, since the issue is usually raised on an OCD forum. Further, people with this particular theme often have other, more easily identifiable versions of OCD, lending credence to the belief that the current problem is also OCD.

The main reason why people balk at the thought that OCD is involved is that the situation (the crime) was real. OCD apparently didn’t have any part in the formation of the crime/mistake. While that appears to be true in most cases of this theme, the person nonetheless is dealing with OCD now. Real mistakes or errors in judgment or perceived crimes can happen in real life. OCD comes into play when the person becomes overly focused on the mistake/crime/error to the detriment of their ability to live a quality life.

Sometimes the ‘crime’ took place recently. In many cases it happened years and years ago but suddenly popped into the mind of the OCD sufferer. In all cases sufferers with this theme become obsessed with what happened. They fixate on the alleged crime and can’t shake it from their mind. The thought of what happened (obsession) causes distress. And the sufferer performs compulsions, most notably ruminating — going over the event in their mind repeatedly.

A notable manifestation of this theme is the very common belief that the crime/mistake/error made in the past is absolutely terrible. Sufferers commonly come across as being devastated that they made such a mistake, which they believe is life changing. Interestingly, the nearly unanimous verdict of responders to people about this OCD theme is that the crime/mistake/error appears to be minor in origin and not worth worrying about.

One by-product of this OCD theme and the way it manifests is what can be an overwhelming feeling of guilt. As everyone should know, OCD involves obsessions (intrusive thoughts) that cause distress. With this theme the majority of that distress is expressed as guilt. Consquently, sufferers with this theme commonly believe that they should be/must be punished for their transgression. This is expressed in self loathing comments and an interest shown in confessing the transgression to loved ones/the police.

Other people look at the situations and see they are minor incidents that should be dismissed, but the sufferers of this theme truly believe it is a case of crime and required punishment. Attempts at reassuring sufferers that they did not do bad, that they are not bad and that they deserve no punishment usually fall on deaf ears.

Like with other OCD themes, sufferers of this theme are their own worst enemies. Although the obsessions (thoughts that the sufferer did wrong) can be fleeting and last only seconds, sufferers can spend hours and hours ruminating on the subject. They can perform other compulsions, such as searching the Internet for stories of people who similarly screwed up, searching to find out what truly bad people do as a way of comparison, seeking reassurance and confessing.

Interestingly, with this OCD theme, the reassurance seeking can be the reverse of what is normally seen. While some people may ask for reassurance that they aren’t a terrible person, some sufferers come across as if they want confirmation that they are bad and that what they did was egregious, terrible and worth punishment.

This theme can result in cognitive distortions being exhibited, including all-or-nothing-thinking. “I did X, therefore I am evil.”

Even though this OCD theme could be considered odd and definitely far different than the well known contamination/hand washers, it’s still OCD. There are obsessions (intrusive thoughts that something bad has been done by the sufferer). The obsessions cause distress (notably a feeling of overwhelming guilt). There are compulsions performed.

Like any other theme, this theme can be dealt with using the tenets of CBT. From the cognitive side the person can start saying positive statements as opposed to negative, all-or-nothing-thinking statements. (I am a good person. I make mistakes but I am still a good person).

On the behavioral side, it is important that sufferers identify the compulsions they perform and work to resist them. No doubt ruminating is a big one with this theme. Refusal to confess past transgressions is essential, as is stopping searching on the Internet for similar stories.

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