OCD and Compulsive Honesty

Obsessive-compulsive disorder (OCD) involves obsessive, intrusive thoughts combined with repeated behaviors called compulsions to cope with the anxiety caused by the thoughts^[1]. Some individuals with this disorder are overly scrupulous, which can lead them to become obsessed with honesty. Alternatively, some people with OCD may appear to lie compulsively, but this is typically related to symptoms of the disorder^[1][2].

What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a diagnosable mental health condition. People who live with OCD experience repeated upsetting thoughts or images called obsessions. These obsessions cause fear and anxiety, and to cope, a person with OCD engages in repeated behaviors called compulsions. Compulsions are performed to cancel out the anxiety or fear related to obsessions^[1].

As an example, a person with OCD may have repeated, unwanted thoughts that they or someone they love has become ill. In response to these thoughts, the person may engage in compulsive hand washing to alleviate their anxiety^[1]. Because of these behaviors, affected individuals tend to have impaired social functioning.

They may also have difficulty with family relationships and interactions with colleagues in the workplace. Time spent worrying about obsessions and engaging in compulsive behaviors can interfere with typical social functioning and make it challenging to maintain healthy relationships^[3].

What Is Compulsive Honesty?

OCD can go hand-in-hand with compulsive honesty, sometimes called compulsive truth-telling. Compulsive honesty involves constantly replaying conversations in one’s head to ensure lying did not occur and tending to overexplain oneself to ensure the truth is told in its entirety. For some people with OCD, the fear of lying becomes an obsession because they believe in strict adherence to moral standards^[4].

While most people would agree honesty is essential, compulsive honesty in OCD can become excessive and distressing. A person may spend hours daily obsessing over conversations and minor transgressions, worried they have failed morally. This behavior occurs because the person is experiencing obsessions related to their overwhelming need to be truthful^[4].

How Does Scrupulosity Impact Honesty?

Some forms of OCD are described as involving excessive scrupulosity. Scrupulous individuals become obsessed with religious and moral standards. Someone with this form of OCD may worry that lying violates religious or moral principles, leading to excessive and compulsive honesty^[5].

With the scrupulous type of OCD, a person may become obsessed with avoiding sin or any immoral conduct, so any form of lying can become particularly anxiety-provoking. To deal with this obsessive worry, the person may overshare details related to their behaviors, worried that they must disclose the entire truth to avoid punishment^[5].

How Does Hyper-Responsibility Impact Honesty?

While some with OCD have a fear of lying because of scrupulous tendencies, others engage in what appears to be compulsive lying. OCD and compulsive lying may occur because of hyper-responsibility in individuals with this mental health disorder. Research has found that beliefs related to hyper-responsibility are central to OCD symptoms. Hyper-responsibility refers to the tendency of those with OCD to believe that they have the power to prevent negative events and, therefore, must assume responsibility to avoid harm to themselves or others^[6].

Thoughts that someone may be at risk of harm can create intense anxiety. To cope with this, a person often must engage in compulsive behaviors to neutralize the anxiety^[6]. Sometimes, this might involve lying to prevent harm. For instance, a person with OCD may believe they are responsible for preventing hurt feelings; to do so, they may lie so as not to upset someone.

Lying vs. Compulsive Behaviors

Sometimes, people believe that OCD and lying occur together. While there isn’t much research looking specifically at this association, what we do know is that OCD can involve compulsive behaviors^[1], which might include lying. It’s important to understand that when lying occurs in the context of OCD, it’s a symptom of the disorder, and it’s usually not done with malicious intent.

Compulsive lying may be a response to obsessive thoughts, such as the fear that the truth will upset someone. Since those with OCD are likely to believe they’re responsible for preventing harm to others, obsessive thoughts can lead to lying, which is a compulsive behavior undertaken to reduce anxiety^[6].

The Emotional Toll of Lying and Honesty in Individuals with OCD

While OCD may involve either compulsive honesty or compulsive lying, the truth is both behaviors are distressing for the affected person. This behavior is not undertaken because of malice or a desire to annoy others. Instead, it’s a response to obsessive thoughts in OCD, which are unwanted, intrusive, and anxiety-provoking^[1].

For many people with OCD, symptoms of the disorder are highly debilitating, meaning they struggle to function in daily life and maintain relationships. They may have difficulty at work, earning good grades at school, or being present in their social relationships.^[1].

In cases of compulsive honesty, a person may be fearful that they’ll be punished or condemned for failing to tell the complete truth. They may also worry about being possessed or somehow letting God down if they are not entirely honest, leading to extreme guilt^[5]. Similarly, those who engage in compulsive lying due to OCD are likely also coping with discomfort. They may have fears that harm will come to themselves or someone else, and compulsive lying is seen as a way to avoid this^[6].

When to Seek Professional Help for OCD

OCD symptoms can interfere with daily life, making it difficult to care for a family or maintain a job^[1]. Fortunately, treatment is available and can improve quality of life. If you’re struggling with OCD obsessions and compulsions, such as extreme fears and compulsive truth-telling, it may be time to seek professional treatment. When OCD symptoms take up a significant amount of your day and prevent you from being fully present in relationships and other important life areas, it’s time to seek treatment.

One of the first treatment options for OCD is the use of medications called selective serotonin reuptake inhibitors (SSRIs). There is substantial evidence showing that these medications are beneficial for treating OCD symptoms. In people who do not experience significant relief with SSRIs, other medications, such as the mood stabilizer lamotrigine, may be beneficial^[7]. A doctor can help you determine the best medication for treating your OCD symptoms.

In addition to medication, psychotherapy, also called talk therapy, is used to treat OCD symptoms. A specific type of therapy called cognitive-behavioral therapy (CBT) in combination with exposure and response prevention (ERP) helps people to reduce anxiety associated with obsessions and reduce the need for compulsive actions and is an effective treatment. There is evidence that a combination of medication and therapy may be the best option for treating OCD^[8]. Recent studies have found that CBT can be effective even when delivered via the Internet, making treatment easier to access^[7].

With treatment, OCD symptoms such as compulsive lying and truth-telling can improve. There is no shame in reaching out for help; in fact, accepting treatment demonstrates responsibility and courage.