Responsibility OCD is an unofficial subtype of OCD that centers on overwhelming guilt or fear about causing harm or letting others down. It often leads to compulsive behaviors meant to prevent mistakes or ease the constant sense of responsibility.
In response to obsessive thoughts, people with responsibility OCD engage in compulsive behaviors. These are intended to control outcomes.
While there’s no cure for responsibility OCD, you can learn to manage your symptoms with the right support. This typically involves therapy, self-management techniques, and medication (if needed).
Once in a while, you might hear someone say that they’re “a little OCD.” People often use this phrase if they have a strong preference for order or cleanliness. But it’s important to remember that obsessive-compulsive disorder (OCD) isn’t a quirk or personality trait. It’s a serious mental health condition.
OCD is characterized by intrusive, upsetting, and uncontrolled thoughts (obsessions) and resulting ritualistic behaviors (compulsions). This condition can affect people in different ways, but it often follows some similar patterns.
Some people live with a subtype of OCD known as responsibility OCD. It involves intense anxiety about being accountable for preventing harm, controlling outcomes, or managing other people’s emotions. There’s nothing wrong with being caring or conscientious but responsibility OCD goes much further. The fears are irrational or unfounded, and people often worry nonstop about how their actions could affect others — even in situations they can’t control.
Left untreated, OCD can negatively affect a person’s ability to function in daily life. So if you or someone you care about is living with responsibility OCD, don’t hesitate to ask for help. The good news is that, like other forms of OCD, it can be managed with the right support.
Signs of responsibility OCD
To better understand how responsibility OCD differs from other forms of OCD, let’s review some examples.
Common obsessions and compulsions in responsibility OCD
Obsession: “If the windows aren’t locked, someone might break into my home while my family’s asleep. They could take my children, and it will be all my fault.”
Compulsion: “I repeatedly wake up in the middle of the night to check that my windows are securely locked and my home alarm system is set.”
Obsession: “To get to my office, I have to use an elevator. I’m scared that if I touch the buttons and then shake someone’s hand, I could transfer germs to them, and I’d be responsible for getting them sick.”
Compulsion: “After exiting the elevator, I head to the bathroom and repeatedly wash my hands before I enter my office.”
Obsession: “If I say the wrong thing in a meeting, my coworker will feel hurt or upset, and it will be my fault for ruining their day.”
Compulsion: “I replay conversations in my head for hours, apologize repeatedly, or over-explain myself to make sure no one is upset with me.”
All forms of OCD involve an overinflated sense of responsibility or an overestimation of one’s ability to control outcomes. But what you’ll notice about these examples is the emphasis on protecting other people.
This is an important distinction from other subtypes of OCD. For example, in contamination OCD, a person may repeatedly wash their hands or sanitize surfaces. But in that case, it’s out of a desire to keep themselves from getting sick. It doesn’t have the same focus on protecting others.
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What causes hyper-responsibility in OCD?
Experts are yet to completely understand the relationship between OCD and hyper-responsibility. But research suggests that it might be due to the cognitive distortions or false beliefs that accompany OCD.
An “overestimation of threat” tends to be present among most forms of OCD. In other words, people with OCD are often afraid of things that aren’t likely to happen. This false belief can lead to compulsive behaviors, like repeated washing, checking, and hoarding. Perfectionism, an inability to tolerate uncertainty, and a strong desire for control may also play a role in responsibility OCD.
How to manage responsibility OCD
The best thing you can do to manage responsibility OCD is seek professional help. Therapists who specialize in treating OCD can offer evidence-based care. Specifically, exposure and response prevention (ERP) therapy has been proven highly effective in treating OCD. In ERP, you’ll slowly and gradually engage with your triggers under the supervision of your therapist. Over time, ERP can help reduce obsessions and compulsions and help you learn to cope with your fears in healthy ways.
You can also consult with a psychiatric provider to help you manage your responsibility OCD symptoms. Psychiatrists and psychiatric mental health nurse practitioners (PMHNPs) can prescribe approved OCD medication, collaborate with other members of your care team, and refer you to other helpful resources.
In addition to seeking professional help, you can also do some things on your own to manage responsibility OCD. One way to do this is by putting some distance between yourself and your obsessive thoughts.
For example, if you think, “If I don’t dry every inch of this floor, someone will fall and break a leg,” try to label that thought. Say something to yourself like, “That’s my OCD talking again,” and don’t try to fight it. Instead, try to let the thought exist without reacting to it. This process might take some practice. But eventually, it can help you change your relationship with intrusive thoughts so you feel less compelled to act on them.
Conscientiousness is healthy care for others, but responsibility OCD twists that into feeling like you must prevent every possible harm. Therapy can help separate true care from unfair pressure you put on yourself.
Brandy Chalmers, LPC
Clinical reviewer
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People with responsibility OCD have irrational, intrusive worries about harming others. In response, they engage in repeated compulsive behaviors in an attempt to keep people safe. This exaggerated sense of responsibility can be difficult to control. Left untreated, it can negatively affect a person’s mental health and ability to function.
Fortunately, responsibility OCD is a treatable condition, and you can manage your symptoms with the right support. Interventions like exposure and response prevention (ERP), psychiatric care, and self-management strategies can help you interrupt the cycle of responsibility OCD and improve your quality of life.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
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Liz Talago
Liz Talago, M.ed. is a mental health professional turned content writer and strategist based in the Detroit metro area. As an independent consultant for mental health organizations, Liz creates meaningful connections between brands and their audiences through strategic storytelling. Liz is known for championing diverse perspectives within the mental health industry and translating bold ideas into inspiring, affirming digital experiences.
In her free time, you can find her hiking with her two German Shepherds, puttering around her dahlia garden, or spending time with her family.
Brandy Chalmers, LPC
Having faced challenges like childhood abuse, neglect, and the loss of her father to suicide, Brandy Chalmers is deeply passionate about providing compassionate care. She is a Licensed Professional Counselor, Nationally Certified Counselor, and Registered Play Therapist with a Master’s Degree in Clinical Counseling and Marriage and Family Therapy.
Brandy also teaches at a university, sharing her expertise with future mental health professionals. With over a decade of experience in settings like inpatient care and private practice, she specializes in helping clients with perfectionism, trauma, personality disorders, eating disorders, and life changes.
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