Almost everyone wonders things like “Am I in the right relationship?” and “Is my job really right for me?” at some point, and almost everyone has trouble articulating answers to these questions all the time, because identity often shifts over time. Life is full of surprises both good and bad that can shake up your preferences and sense of self, which can be as disorienting as it is exciting. At the same time, you can usually rely on the fact that the things that you care deeply about are important parts of who you are.
But if you have obsessive-compulsive disorder (OCD), the quest to find perfect, unimpeachable, unchanging answers to questions like these may become an obsession that makes you ask them over and over again about everything in your life, especially the things you care about most. This constant questioning can feel totally destabilizing to your sense of identity.
How OCD drives doubt (and why this can cause people to feel dishonest)
For many people, understanding personal identity can mean paying attention to what kinds of choices and behaviors feel wrong, and which feel right. But OCD hijacks that ability by turning it into a never-ending loop, and filling you with the fear that you’re not who you say you are. You might find yourself in a place you know you care about, like a house of worship or the family dinner table, with OCD driving you to doubt whether your dedication to your faith or your loved ones is real. This can make every moment spent praying or smiling at your partner feel like a misleading performance that you’re failing to maintain.
OCD can also fuel the sense that you don’t actually deserve what you have, or belong in the spaces where you feel proud and at home. Often this feeling is referred to as imposter syndrome, especially when it’s related to a job, degree, or other achievement. Everyone experiences this from time to time, but OCD amplifies it by converting ordinary self-doubt into a sustained conviction that you’re only fooling the people around you into thinking that you’re good, or smart, or capable—and that they might find out the truth at any moment.
This pervasive sense of self-doubt can expand beyond the things you love and the things you’ve achieved to target all the facets of your identity and ways you understand yourself. Some people with OCD worry that they’re actually faking the OCD itself.
Why OCD might be attacking your identity—it seizes on the things that matter to you most
OCD wants the obsessions it creates to be the main focus of your attention. That’s why it so often latches onto the things that are the most important to you. For example, if your marriage is a huge source of comfort and joy in your life, OCD may seize on it, creating doubts. And because you care so much about your marriage, you’ll work that much harder to “protect” it from those intrusive thoughts and urges by engaging in compulsions. That’s often how the OCD cycle works. Some of the most common OCD themes that undermine important facets of identity include:
Sexual orientation OCD
SO-OCD is a subtype that causes obsessive fears around sexuality, leading you to repeated, distressing questioning of whether you’ve been in denial of your true sexual orientation, or worry that your sexual orientation might suddenly change. If you identify as gay, you might be afraid that you’re somehow “secretly” straight. If you identify as straight—even if you are an ally to the LGBTQ+ community or wouldn’t have a problem being gay—you may worry that you’re secretly gay, and hiding this from family and friends. SO-OCD can occur with any sexual orientation.
Many people wonder about their sexuality at some point, but continual, distressing, obsessive thoughts about it may indicate that you’re experiencing SO-OCD. OCD can also cause physical sensations, including a groinal response that doesn’t result from actual attraction but can lead to further anxiety about your “real” sexuality. If you have SO-OCD, you might find yourself compulsively avoiding a friend of yours to whom you fear you might be attracted.
Gender OCD
Gender OCD is a subtype characterized by doubts and concerns about your true gender. GOCD is not the same as gender dysphoria, which is a diagnostic term for the feeling of tension between your gender identity and your sex assigned at birth. If you have Gender OCD, your obsessive fears focus on the idea that no matter how you identify, you may have it wrong, and that you can never be truly certain of your gender. Gender OCD might drive you to compulsively research gender dysphoria and try to measure your own experiences against those of others by checking your reactions.
Harm OCD
Harm OCD is a subtype characterized by intrusive thoughts and urges centered on causing harm, violence, or injury to oneself or others. These thoughts and urges are often scary, disturbing, and upsetting, and people with Harm OCD may believe that having these thoughts means they actually want to carry out violent actions, which can be even more frightening. Harm OCD undermines your identity by making you worry that you may be a bad or dangerous person, and you may respond by compulsively carrying out rituals like counting or repeating certain phrases out of a belief that they will keep you from harming your loved ones.
Existential OCD
Existential OCD is a subtype that involves doubts and fears about big philosophical questions like whether your experiences are real, what happens after death, and what the point of life is. These obsessions can undermine your identity by undermining your entire sense of reality, making the pursuit of definitive answers to unanswerable questions feel incredibly urgent. It may drive you to engage in compulsions like reassurance-seeking by repeatedly asking those around you to confirm that things are “real,” creating only a short-lived sense of peace that only serves to reinforce your OCD in the long run.
Even if your experience doesn’t fit into one of these specific subtypes, OCD can still undermine facets of your identity. It does this by insisting that you must chase an impossible level of certainty about who you are, what you want, and the fact that these things will never change—and if you can’t attain that perfect certainty, then you’re a fraud.
Why OCD themes related to identity feel so destabilizing
OCD puts you on a constant quest for certainty. But identity is ultimately an internal experience, meaning you can’t be certain about it the same way you can be certain about, say, whether the kitchen light is on or off. It’s all about “what if?” questions that simply can’t be answered with total certainty, because there’s no “proof” tangible enough for OCD to accept. That makes it uniquely vulnerable to being undermined.
For many people, identity is also deeply tied to community. Ceaselessly questioning whether you’re truly queer, for example, can by extension call into question your sense of belonging not only in a romantic relationships—which is upsetting enough—but also with your friends, family, and in other kinds of organizations you may belong to, from sports leagues to faith groups. The fear of losing all of these important things is part of what may keep you chasing an impossible level of certainty. Once OCD seizes on a single thread of doubt, it can threaten to unravel the entire tapestry of your life.
ERP therapy can help disrupt this cycle
Exposure and response prevention (ERP) therapy is an evidence-based approach that is consistently demonstrated to be the most effective way of treating OCD symptoms, of all subtypes. ERP focuses on helping you learn to accept uncertainty, which is key to navigating themes that seize on a need to “prove” the unproveable. Because the compulsions caused by identity-related OCD themes are often invisible, like rumination or checking for groinal or emotional responses, they can be more difficult to notice and interrupt. An ERP therapist can teach you to slow down your reactions, so that you notice when you’re beginning to engage in compulsions. Then, they can help you build up your tolerance for the discomfort of resisting those compulsions.
If you have gender or sexual orientation OCD, for example, you might feel you have to be completely sure about who you are before coming out, pursuing gender-affirming care, or otherwise living authentically. To be clear, this isn’t a baseless feeling—publicly changing the way that you identify and live your life can have big implications, and it makes sense to put thought into that. But when “putting thought into it” becomes an endless cycle of checking, seeking reassurance, and trying to eliminate any percentage of uncertainty, you’re not figuring out your identity before making a choice. Your OCD is pushing you to hide from every choice, including those that could make you happy. Because gender and sexuality can change over time for some people, accepting uncertainty about what may be true in the future is key to making choices that can fulfill you in the present.
If you have SO-OCD that causes you to worry you’re attracted to a longtime friend, causing you to compulsively avoid them and monitor yourself for attraction when you’re around them, an ERP therapist can help you break down resisting these compulsions into smaller steps. They might recommend that you look at photos taken with your friend, and practice just sitting with whatever feelings arise, rather than analyzing your emotional and physical reactions. If you’ve avoided answering their messages for months because you’re afraid of how it might make you feel, an ERP therapist might suggest reaching out to your friend first, either to make plans or just to chat.
OCD wants you to define yourself as a fixed point that can be completely understood, and never deviate from it. Through ERP, you can make it feel less scary to act on what you want and who you are right now, with the understanding that those things may stay basically the same, or they may shift over time. Even if you change as you grow—and you almost certainly will in some ways—there’s security in knowing you’ve honored the versions of yourself that have existed over time.
