When I was 8, I developed a chronic fear of getting in trouble. At the beginning of the school year, a friend and I had played tic-tac-toe on the bathroom wall. We’d erased it and were not caught, but for months, I obsessed over getting in trouble. Even after I moved and switched to another school, I held onto the fear that I would get punished for my mistake.
That fear exploded into other thoughts. Was I wrong for trading Garbage Pail kid cards after school because it wasn’t allowed at recess? What about the time I snuck an extra piece of candy at the diner after my mother had told me I’d had enough? Even long after the “incidents” had passed, I worried. The thoughts and fears kept me up at night, and I never told a soul about them.
These thoughts eventually faded into the background, only to be replaced by other panic-inducing thoughts, like fear of being shot, kidnapped, and of the world ending in nuclear war. In essence, I developed an anxiety disorder that I still battle today. But the first seeds of it played out in those obsessive childhood thoughts of being in trouble, or of having committed a wrong in some way.
It turns out I was not alone, and there is actually a name for this kind of obsessive thinking. Moral OCD, or Scrupulosity OCD, is a form of OCD (Obsessive Compulsive Disorder) that is dominated by thoughts of wrong-doing, being in trouble, not being good enough, and feeling constantly guilt-ridden that you will be found out to be a liar or a cheat in some way. These thoughts overtake you, and you scrutinize every detail of your life, believing that you are, in fact, a bad or amoral person.
According to Natasha Daniels, a child therapist from Arizona who specializes in OCD, this disorder is actually more common in children than many parents realize—and yet, it is easily missed or misconstrued as something else entirely.
“Moral OCD, also known as Scrupulosity OCD, starts with an obsessive thought,” Daniels, a mother of three, and writer/blogger at Anxious Toddlers, told Scary Mommy. “A thought that tells the child that maybe they aren’t good. Maybe they did something wrong. Maybe they are a liar, a cheat, a pervert, a want-to-be killer. These intrusive thoughts flood the child’s mind and overwhelm them with feelings of guilt, confusion, and self-doubt. […] They ask themselves questions like, ‘I took a piece of gum from my mom’s purse when I was five without asking. Is that proof that I am a bad person?’”
Daniels explained that Moral OCD is a subset of OCD, and that more than half of her OCD patients have it. The problem is that it isn’t always easy to detect, and parents (and even other therapists) often end up missing the signs of it. Daniels explained that kids with moral OCD will have many of the signs of classical OCD, but that Moral OCD signs might be more subtle and therefore easily missed. “Most parents will have all the other OCD themes on their radar but Moral OCD usually slips through the cracks,” said Daniels.
The reason for this is heartbreaking: Kids with Moral OCD become terrified of their own thoughts, and keep them under lock-and-key. In essence, they become prisoners of their obsessive thoughts, so paralyzed with fear that they don’t reach out for help—even to their own parents. As Daniels described it:
“Moral OCD silently destroys children from the inside out. It gives kids the most hideous, embarrassing and taboo thoughts. It takes all of the child’s moral beliefs and flips it on its head. You value honesty? You are a liar. You value your friend? You just called her a bad name. You think you are a good student? You just cheated on that test. […] There are also those thoughts that kids dare not talk about. Thoughts that are so embarrassing and disgusting they won’t even tell a therapist.”
Kids may suffer in silence for a long time, the thoughts building upon one another, and spiraling out of control. At some point, many kids do reach out to a parent to “confess” their “bad thoughts.” But things have usually gotten pretty out of control at this point, and very often, said Daniels, parents don’t know how to help their children. Their children seem extremely disturbed, anxious, and depressed.
But what most parents don’t realize is that their children are actually suffering from a form of OCD. “[Parents] often privately worry that their child may be suicidal, perverted, immoral or disturbed,” Daniels told us. “They take the thoughts at face value and give it the validity Moral OCD is working so hard to earn.”
Thankfully, some parents end up bringing their children to therapy, and if the therapist has a background in detecting the signs of Moral OCD, kids can get the help they desperately need—and parents can begin to understand that their child’s disturbed thoughts do not mean that they are damaged in some way, but that they are experiencing a psychological disorder. “In therapy, parents learn that these thoughts are generated by OCD and do not reflect their child’s true self,” said Daniels.
In fact, one of the main goals of therapy for Moral OCD is for children to begin to recognize that they are not alone in their terrifying thoughts, and that there is a name for what they are struggling with. Once that happens, most children experience a sense of relief in knowing that they are not “crazy” and that it’s just their OCD doing the talking.
Daniels said that part of the therapy involves helping parents recognize that fact as well, so that they can talk to their kids in appropriate ways when their OCD acts up. “A therapist can train parents to respond to the OCD and not their child, with comments like, ‘Tell your OCD I’m not talking to it,’ or ‘Tell your OCD I wish it would leave you alone.’ In therapy, parents can learn how to spot their child’s compulsions and differentiate a true need for support versus OCD’s need to complete an OCD ritualistic loop,” Daniels explained.
The most successful treatment for Moral OCD is a kind of Cognitive Behavioral Therapy called Exposure Response Prevention (ERP), Daniels said. Parents can learn more about the disorder at Daniels’ own site, Anxious Toddler, as well as from the The International OCD Foundation. If you think your child might be suffering from Moral OCD or another OCD disorder, you can find an OCD-trained provider here.
Most importantly, if your child is suffering from signs of this disorder, or any other mental health issue, always take your child’s needs seriously. As someone who suffered from many of the symptoms of Moral OCD as a child, as well as other anxiety disorders, I know just how important it is for kids to know that they aren’t broken beyond repair and that what they are experiencing is actually common and—above all—treatable.