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How OCD Affects Self-Concept

Self-concept is a psychological term that is used to describe how we think about, perceive and evaluate our self. Our self-concept incorporates how we view our unique characteristics, abilities, behaviors, and what is important to us. It is created by information about our attributes that we’ve collected about our self from a lifetime of experiences. So from information a person may have collected about herself, she might perceive herself to be a smart, hard-working, gentle, moral and religious person. This is her “self-concept”.

A recent psychological study published in the Journal of Obsessive-Compulsive and Related Disorders proposed an interesting theory: obsessions often reflect a person’s fear of who the person is or who he may become. According to the study, this fear or lack of trust in one’s self becomes a factor in the susceptibility in the development of obsessive thoughts, particularly those that are sexual, aggressive or blasphemous in nature.

Obsessive thoughts often consist of a specific theme. For instance the person with OCD may be very troubled by violent thoughts and not troubled at all by thoughts of making mistakes. Because of the thematic nature of obsessions, several psychological research studies have found that unwanted thoughts become obsessive thoughts because the unwanted thoughts are seen as a threat to the individual’s perception of the self. The research found that individuals with OCD who valued morality, work and school competence and social acceptance but felt incompetent in these areas held a greater level of obsessive-compulsive beliefs and demonstrated more obsessive-compulsive symptoms. The study also found that when a person had unwanted, intrusive thoughts that were in conflict with the person’s self-concept, the thoughts were more likely to be viewed as important and dangerous. In addition, it was found that individuals with a fragile self-concept were more likely to interpret unwanted thoughts as threatening and significant, which intensified symptoms of OCD. As stated by psychologists Mark Freeston and Robert Ladouceur, “It is no coincidence that we typically see harming obsessions among gentle people, religious obsessions among religious people, thoughts about sexuality among highly moral people, and thoughts about mistakes among careful people: the more important something is, the worse it seems to have a thought about it”.

Psychologist Stanley Rachman proposed that OCD sufferers catastrophically interpret their unwanted thoughts as actually exposing secret characteristics of themselves, which means that the unwanted thoughts directly tie in with what one fears about one’s self. This is particularly evident in individuals who experience obsessions without overt compulsions, also known (incorrectly) as “Pure O”, involving themes of morality, violence and sexuality. Because the individual with OCD has a fragile self-concept, he fears what he may be or what he may become. For instance he thinks: “I might be a pedophile”, “I may become a psychopath”, “I may be a killer”, “I might be insane”.

Psychological research has found empirical support for the relationship between OCD and fear of one’s self. Individuals with OCD were more prone to draw a negative conclusion about themselves as immoral, wicked and crazy on the basis of their unwanted thoughts compared to individuals without OCD. In short, random unwanted thoughts, which we all experience, are often interpreted by persons with OCD as evidence that they may be dangerous.

Exposure and Response Prevention (ERP) is the foundation and gold-standard of OCD treatment. ERP has been found to be extremely effective for treating OCD. In addition to ERP, experienced OCD therapists will also focus on the more subtle and pervasive cognitive problems that are associated with OCD. Addressing issues such as self-concept with individually tailored methods of Cognitive Behavioral Therapy (CBT) often enhances the effectiveness of OCD treatment.

Approximately 1 out of every 100 adults in the United States and at least 1 out of every 200 children and teens are currently suffering from OCD. Many more are undiagnosed and quietly suffering due to a lack of awareness, shame and inappropriate treatment. OCD typically begins in childhood or adolescence. At GroundWork Counseling in Orlando, our OCD therapists are specifically trained in treating OCD and utilize the most up-to-date, evidence-based treatments.


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