Shame and embarrassment are natural human emotions. We commonly see them come up in our therapeutic work and across a number of clinical presentations, but they can be especially pronounced in obsessive-compulsive disorder.
OCD can be a debilitating disorder. The latest statistics from the IOCDF indicate that more than 2/3 of the public cannot accurately identify OCD. This number seems low in that roughly 1 in 40 adults has OCD, and roughly 2.2 million children have OCD. These statistics mean that a lot of people have OCD, but they themselves, or the people in their lives, cannot accurately identify the symptoms. As a result, people find themselves experiencing obsessions and engaging in compulsions and feeling flawed, less than, “crazy”, shameful, or embarrassed.
There are many tricks/lies that OCD uses to keep people stuck in the OCD cycle. Shame and embarrassment are especially useful to OCD as tricks/lies, because they are emotions about the self. They attack the core of the individual at the very level of their identity. Brene Brown defines the differences between shame and guilt as “Guilt is I did something bad, shame is I am bad.” A major part of beginning to disrupt the OCD cycle is helping individuals realize that they are not their OCD, and that their thoughts/obsessions do not define them. Individuals with OCD often become fused with their intrusive thoughts and feel shame and embarrassment as a result of having those thoughts. In an effort to defuse, or separate from their intrusive thoughts and OCD, sometimes we will have individuals name their OCD in an attempt to view it as a separate entity from themselves.
I had an adult client name his OCD Kramer after the character in the show Seinfeld. This was especially helpful for this client because he himself, did not behave at all like Kramer, but when OCD came in the picture in his life, it was sudden, loud, intense and demanded lots of attention. Naming his OCD was helpful in creating that distance between the self and the disordered thoughts and behaviors.
In previous blog posts, we have discussed the difference between ego-dystonic and ego-syntonic. As a quick refresher: if we agree with the thought and feel that it aligns with our values, beliefs, intentions and sense of self, then that thought is considered ego-syntonic. As a result of the obsessions being ego-dystonic, it is common for people with obsessive-compulsive disorder to suppress or “mask” their symptoms in public in an effort to avoid embarrassment, shame, guilt and ridicule.
OCD can also affect one's life course in substantial ways. People can lose years to doing rituals or ruminating, feeling that they are locked into patterns of behavior that don't help them advance toward their goals. Another place that shame and embarrassment can surface is in the comparison of oneself with others, especially if someone with OCD feels that they are "behind" their peers.
Self-compassion, CBT and ACT principles and approaches can be useful when combating shame and embarrassment with individuals with OCD. If you have OCD and are feeling shame and embarrassment, I hope this gives you some sense that you are not alone and that there are resources and support out there. All the best in your journey!
