Episode #294 - Morality OCD

Often as we battle mental illness we find ourselves overwhelmed by guilt.  What can we do about this problem and does it have a name?

Transcript

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Welcome to Episode #294 Morality OCD.  I hope that you find greater peace in listening to this podcast and acting on promptings you might receive.  In addition, if you have the time and ability please pass this onto others that they might have the same peace and rejoicing as you.  Thank you in advance.  Now onto today’s podcast.

There exists a state of the mortal mind where one has great difficulty feeling happiness over guilt.  Guilt by its nature is intended to cause repentance which would bring us back to happiness.  But some of us, especially those who suffer from mental health problems, get stuck in the guilt mode and never really make it to the happiness mode.  I recently came across an article explaining this phenomenon in a unique way.  It was referred to as morality OCD.  While I could probably define this type of mortal addiction to guilt.  I have chosen to use a code developed by a person who has also experienced it.  This internal code that we tend to use to get stuck in the guilt phase has been explained quite well by a Dr. Nataile Engelbrecht.

My internal moral code (as shaped by OCD)  A portrait of Dr. Natalie Engelbrecht.

I must never cause harm—emotionally, physically, or morally—to anyone, even unintentionally.

I must always tell the truth—even when it causes discomfort, confusion, or personal consequences.

I must not upset anyone—even slightly—or I’ve failed as a good person.

I must always be fair, impartial, and morally pure in my intentions.

I must always make the most ethically correct choice, even if it costs me everything.

If someone sees me as unkind, unethical, or selfish, it must be true—and I must fix it immediately.

I must never break rules—even if the rules don’t make sense, or no one else is following them.

I must be accountable for every mistake, misstep, or misunderstanding.

I must not allow myself to feel good if there is still more I could do to help, repair, or be better.

I must not trust my own goodness unless it’s been externally verified.

Written by:

Dr. Natalie Engelbrecht ND RP

The need to be good

I’ve been preoccupied with being a good person for as long as I can remember. For most of my life, I didn’t think there was anything wrong with that. People praised me for it. Therapists would ask, “Why do you need to be so good?” But I didn’t know how not to be.

I am a kind person, deeply attuned to others’ emotions. When someone is hurt, I feel it in my body. My empathy isn’t just cognitive—it’s visceral. I can’t bear to see someone in pain, especially if I had anything to do with it.

But even so, there was something more happening.

Not just empathy. Not just kindness.

Under the praise was panic.

Under the care was fear.

It wasn’t just a fear of doing something wrong—it was the belief that I might be something wrong. That I might be, at my core, bad.

So I followed every rule. I apologized when no one asked me to. I replayed conversations endlessly, scanning them for harm I might have caused. If I could just make sure I never hurt anyone, then everything would be okay.

I’ve done something wrong. I can never fix it. It doesn’t matter if I’m perfect from now on—I have caused harm.

Eva reflects:

That’s terrible. You were already worrying about being bad as a child—when you’d made the fewest mistakes. It only builds over time. So existing becomes suffering.

Natalie responds:

That’s true. There were times I quietly accepted that my job was to suffer gracefully—to be cheerful, kind, and good, even when I felt like I was drowning. Because if I let the pain show, someone else might feel hurt. And that would only make it worse.

I am someone who feels deeply, thinks intensely, and holds myself to a moral standard so high it sometimes becomes unbearable. My OCD doesn’t show up as a fear of germs or an obsession with symmetry, it shows up in my ethics. In how I write. In how I speak. In how I replay conversations in my mind to make sure I was kind enough, fair enough, precise enough. It shows up in my overwhelming drive to be good.

I am deeply committed to truth, justice, and clarity, not just in what I believe, but in how I express it and how others might receive it. I don’t just want to be right; I want to be ethical. I want to make sure that no one is harmed by my words, that I haven’t misrepresented myself or others, that I haven’t missed an opportunity to prevent suffering. I scrutinize every sentence, not out of perfectionism alone, but out of a desperate need to know I’ve done no harm.

I question myself constantly, my motives, my phrasing, my tone. Even when I know I’ve tried my best, it doesn’t feel like enough. There’s always that anxious whisper: What if you got it wrong? What if someone misunderstood? What if you caused harm without realizing it?

Moral scrupulosity OCD has shaped the way I move through the world. It’s made me exceptionally thoughtful, and also exhausted. It’s made me principled, and very afraid and avoidant. I hold myself to a punishing internal code because I’m terrified of being careless with other people’s hearts.

Moral scrupulosity OCD

What I was experiencing wasn’t just “being too hard on myself.” It has a name: moral scrupulosity OCD.

This subtype of OCD involves an obsessive concern with doing the “morally right” thing, paired with compulsions meant to relieve the anxiety of possibly doing something wrong. It’s not about germs or locks—it’s about guilt.

Diagnostic criteria (DSM-5-TR)

Involuntary moral surveillance (mental replaying of interactions to check for harm)

Sense of hyper-responsibility (apologizing or confessing excessively)

Fear of moral failure (avoiding situations that might involve moral ambiguity)

Carrying excessive guilt and shame

Self-judgement and moral identity doubt (intrusive thoughts about being harmful or immoral)

The compulsions are often invisible:

Mentally reviewing conversations

Excessive apologizing or confessing

Checking one’s motives

Seeking reassurance

Researching moral frameworks to find the “right” answer.

One thing I have noticed in the scriptures is that it focuses on happiness more than a continual guilt.  Even when we have sinned and are working through the process of repentance we should be a happy people.  Guilt should not dominate our every thought.  I have struggled deeply with this as depression seems to mimic the guilt that ones feels spiritually when sin occurs.  When our body feels this guilt even when it is not warranted it immediately looks for a remedy to the pain and suffering.  Thus we trap ourselves in a sin and guilt cycle without the refreshing feelings of happiness.  We are likely to continually dredge up old sins that have long since been resolved along with a consistent replay of all our mistakes and embarrassment.  We think that others can see right through our guilt and past.  The truth is that “men are that they might have joy” not guilt.  Guilt should only be a short lived emotion that allows for repentance.

So what do we do to get ourselves out of this guilt loop.  That is a difficult question because it strikes at the very core of mental illness.  If mental illness made us happy no one would care much about it.  In order for us to find happiness we must manage an illness that doesn’t bring happiness.  I have in the past noted a few things that I attempt to do during my episodes.  The first is compartmentalizing the feeling and labeling it an illness in ones mind.  Now this doesn’t get rid of the feelings perse, but it does help with isolating the guilty feeling.  It can allow for other emotions to emerge.  In the case of past sin that feels real.  We can assure ourselves that God hears our pleadings and that past sin is past sin.  That also does not necessarily get rid of all the feelings but knowing that God is a merciful God and is ever willing to heal us of sin.  One of the beautiful things I learned as a bishop for the church is that the Lord always seem more willing to forgive individuals than they were willing to forgive themselves.  More often forgiving ourselves is the greater challenge than receiving forgiveness from God.  He would much rather we ask forgiveness and then move on with our lives than to wallow in the mire of it all.  And so we can be assured that our past sins are past.

Finally we can ask for help and happiness in our lives.  Not like we don’t do this already but it is important to understand that daily asking for forgiveness and happiness is not contrary to the laws of God.  In fact, he askes us to daily ask for daily bread which is our needs for that day.  One thing I have learned through this podcast is that daily asking for help seems to be what the Lord desires.  He wants us to come to him regularly to talk and to ask for help.  I admit at first it felt like I shouldn’t ask the Lord so often for help.  If the Lord didn’t want us to ask for help, we wouldn’t be asked to pray morning and night and consistently in our heart.  He wants us to pour out our hearts to him consistently.  Too often we use our two prayer phone calls to heaven morning and evening and forget to listen and to stay on the line throughout the day.  Often we don’t know what to expect from our day and so consistently listening and asking for that help while pouring out our souls to him is truly what he desires of us.  Does this relinquish the feelings of guilt that I feel due to mental illness.  Not entirely and that might be the case for you.  But it does provide help and healing over time.   We can become significantly closer to the Savior as we plead with him on a daily basis for our daily needs and desires.  I have found that the still small voice quiets those feelings of guilt, doubt and distress.  What I hope most of all today is that you find that the guilt you carry should not be a part of life’s journey.  While our illness may not always allow for happiness in the way we desire, we can remove the guilt we feel knowing that the Lord knows us and is ever willing to take that guilt away from us.  May the Lord bless you to find less guilt and greater happiness.  Until next week do you part so that the Lord can do his.