OCD and the Weight of Responsibility: Understanding the Link

As a clinical psychologist, I often meet clients living with Obsessive-Compulsive Disorder (OCD) who describe feeling an overwhelming sense of responsibility—not just for their own actions, but for preventing harm to others, avoiding mistakes, or getting things exactly right. This goes far beyond being careful or conscientious. It becomes a kind of mental burden: a sense of excessive responsibility (also called an 'inflated sense of responsibility') that drives anxiety and distress.

This isn’t just a personal trait. Research shows that excessive responsibility is a key feature in many experiences of OCD. Understanding this link can be an important step toward feeling more in control of your thoughts and behaviours.

What Is “Excessive Responsibility”?

In OCD, excessive responsibility means feeling personally accountable for preventing bad things from happening—even when those things are extremely unlikely, or outside your control.

For example, someone might feel they have to check the oven repeatedly or someone could get hurt. Others might feel intense guilt for having a fleeting, distressing thought—believing that even thinking something bad makes them a bad person.

This isn’t about caring too much—it’s about feeling too responsible. The anxiety often leads to compulsive actions like checking, seeking reassurance, avoiding certain places or people, or going over things in your mind again and again.

Why Does This Happen with OCD?

We all have intrusive thoughts from time to time—random, odd, or even disturbing ideas that pop into our minds. Most people brush them off. But in OCD, those thoughts are often taken very seriously and interpreted as dangerous or morally wrong.

When someone feels excessively responsible, an intrusive thought like “What if I hit someone with my car and didn’t notice?” can become a crisis. Even the smallest chance of having caused harm can feel unacceptable. To cope, they might retrace their driving route, avoid driving altogether, or mentally replay the event again and again.

This is part of a well-understood cycle in OCD. Cognitive behavioural models (e.g. Salkovskis, 1985; Rachman, 1993) show that beliefs about danger, responsibility, and control can maintain OCD symptoms over time.

Where Does the Feeling Come From?

This sense of excessive responsibility can be shaped by many things. Some people grow up in environments where mistakes had serious consequences, or where being “good” meant always being careful. Others may have experienced difficult or traumatic events that left them feeling they have to be in control to stay safe.

It’s also common for people with OCD to have very strong values—they care deeply about doing the right thing and not hurting others. Ironically, it’s often this strength that OCD turns into a source of distress.

Making Sense of OCD

How Therapy Helps

Cognitive Behavioural Therapy (CBT), especially Exposure and Response Prevention (ERP), is a first-line treatment for OCD. It helps people gradually face feared situations without performing compulsions, allowing the brain to learn that feared outcomes are less likely—or more tolerable—than they feel. Other models, such as Acceptance Commitment Therapy (ACT) and Trauma Processing can also be very helpful and allow for deep exploration of underlying processes.

A key part of therapy is also learning to challenge unhelpful thinking patterns. With support, clients begin to ask questions like:

• Is it really my job to prevent every possible mistake?

• What’s the actual risk here—and can I live with a little uncertainty?

• If someone I cared about felt like this, what would I say to them?

The aim isn’t to stop caring—it’s to reduce the fear-driven pressure to be responsible for everything.

Moving Forward

If you recognise yourself in this description, please know you’re not alone. OCD often targets what matters most to us—and if you feel weighed down by a strong sense of responsibility, it says more about your values than your flaws.

With the right tools and support, it is possible to unhook from the compulsions, think more flexibly, and reconnect with a healthier sense of responsibility—one that reflects who you are, not what OCD tells you.

If you’d like to explore support, feel free to get in touch.

References

• Rachman, S. (1993). Obsessions, responsibility and guilt. Behaviour Research and Therapy, 31(2), 149–154.

• Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571–583.

• Salkovskis, P. M., Wroe, A. L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., & Reynolds, M. (2000). Responsibility attitudes and interpretations are characteristic of obsessive-compulsive disorder. Behaviour Research and Therapy, 38(4), 347–372.

• Abramowitz, J. S., McKay, D., & Taylor, S. (2008). Clinical handbook of obsessive-compulsive disorder and related problems. Baltimore: Johns Hopkins University Press.