Obsessive Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts and compulsive behaviours. Living with OCD can be overwhelming, as it can have a profound impact not only on one’s daily life but sometimes it may lead people to question their own identity. In fact, OCD can radically influence how people see themselves In this article, we’ll explore how OCD can affect people’s view of themselves

OCD and Intrusive Thoughts

One of the most common symptoms of OCD is the presence of intrusive thoughts. Intrusive thoughts are unwanted thoughts and images that pop up in one’s mind unexpectedly. These thoughts can be very distressing, and they can be about anything ranging from fears of contamination, harming oneself or others, or concerns about morality. A person with OCD often struggles with these thoughts consistently throughout the day. The persistent occurrence of intrusive thoughts may lead people to doubt their identity and beliefs because these thoughts often conflict with who they truly are and what they value. 

The Ego Dystonic Nature Of Intrusive Thoughts

Most intrusive thoughts in OCD are ego-dystonic. This means that they are totally opposite to one’s true nature, personality and values. For example- a person might be really scared that they might stab their spouse, even though they would never actually do it, Their mind might keep generating thoughts and images about the same, leading to feelings of disgust. Repeated exposure to these distressing, intrusive thoughts may create a sense of internal conflict where people start doubting their own intentions and actions. 

OCD and Thought-Action Fusion

Thought-action fusion is the tendency to believe that merely thinking about an action is equal to committing the action. For ex- if an unwanted thought pops up in your mind about harming a loved one like your brother, you might believe that it is equivalent to actually hurting them in real life, 

Additionally, with thought-action fusion, people also believe that thinking about a negative event increases the likelihood of it happening in real life. For instance, people might believe that thinking about a loved one getting hurt in a car crash might make the accident more likely. This kind of thought-action fusion is common in OCD and makes people doubt themselves and their reality. 

Feelings of Shame And Guilt

People with OCD often struggle with feelings of shame and guilt, even though they might not have done something wrong or bad. This is because they struggle to differentiate between intrusive thoughts and reality. Intrusive thoughts are often believed to be facts, leading to feelings of guilt and shame.  Thus, constant feelings of guilt and shame can lead people to believe that they are ‘bad’ or ‘wrong’, harming their identity

How To Overcome Identity Issues In OCD?

As mentioned earlier, OCD can harm one’s self-esteem and perception of self. However, one can overcome identity issues in OCD  by treating OCD symptoms. A few ways to treat OCD are:

  • Remember, Thoughts Do Not Equate To Actions

It is important to remember that intrusive thoughts do not reflect your true nature or your intentions, rather, they are just thoughts that occur as a part of OCD. Understanding that intrusive thoughts are different from your real self can help improve your self-image.

  • Cognitive Behaviour Therapy (CBT)

CBT is a form of psychotherapy that can help you challenge negative thoughts about yourself and replace them with more realistic thoughts.

  • Exposure and Response Prevention (ERP)

ERP is a form of therapy that focuses on helping you face intrusive thoughts and fears without indulging in compulsions. It can also help you learn effective ways of coping, leading to a reduction in OCD symptoms and improvement in self-image


In summary, OCD can indeed change one’s perception of themselves and make them feel as if they are a different person due to the ego-dystonic nature of intrusive thoughts. Additionally, feelings of guilt and shame and the thought-action fusion in OCD can also contribute to negative self-perception. However, one can deal with these negative effects by remembering that intrusive thoughts don’t define who they are. Apart from this, ERP and CBT can also help improve self-image in people with OCD


  1. LPC, S. Q. (2022, November 14). Feeling like a monster when you have OCD. NOCD. https://www.treatmyocd.com/blog/feeling-like-a-monster-when-you-have-ocd
  2. LPC, S. Q. (2023, July 24). Can OCD change how you see yourself? NOCD. https://www.treatmyocd.com/blog/can-ocd-change-how-you-see-yourself
  3. Mullin, A. B. (n.d.). Obsessive-Compulsive Disorder and Identity: The Role of Ego-Dystonicity.
  4. OCD Identity Issues: Thoughts, Fears, and Causes. (2018, March 18). Psych Central. https://psychcentral.com/ocd/ocd-and-identity
  5. Thought Action Fusion and OCD: Symptoms, Effects, and Treatment. (2016, February 8). Psych Central. https://psychcentral.com/ocd/ocd-and-thought-action-fusion
  6. Thought-Action Fusion and OCD. (n.d.). Verywell Mind. Retrieved February 21, 2024, from https://www.verywellmind.com/thought-action-fusion-and-ocd-2510478
  7. What is Ego-Syntonic and Ego-Dystonic OCD? | Boulder, CO. (n.d.). Kairos Wellness Collective. Retrieved February 21, 2024, from https://www.kairoswellnesscollective.com/blog/what-is-ego-syntonic-and-ego-dystonic-ocd
Dhruva Koranne

Dhruva Koranne has completed his Masters in Applied Psychology from Tata Institute of Social Sciences, BALM. He has been practicing as a counsellor since 2020 and works to create a safe space for clients where they can open up. In addition to this, Dhruva loves researching and studying about upcoming theories in the field of Psychology. Connect with him on Linkedin