Need to confess
author image Dr. Paul Greene
author image Dr. Paul Greene
Dr. Paul Greene is the founder and director of the Manhattan Center for Cognitive Behavioral Therapy in New York City. With 14 years of dedicated service in private practice, Dr. Greene brings a wealth of experience to his role. His career also includes teaching at the Mount Sinai School of Medicine and conducting research at the Memorial Sloan Kettering Cancer Center.

Updated: August 17, 2023

OCD and Confessing

A rarely discussed symptom of OCD is an overwhelming need to confess “sins,” even when the transgressions are very slight. Typically this will arise in the context of a marriage or romantic relationship. At first, what is confessed may not seem so minor. However, if the problem is not addressed, the confessed acts often become quite trivial.

For example, let’s say that a man with OCD feels attracted to a co-worker. If he suffers from this form of OCD, he might feel very anxious, telling himself that he has to tell his girlfriend about this situation so as not to risk damage to their relationship. If he does, in fact, tell his girlfriend, she might react by saying, “Oh, okay. Just don’t act on it — no big deal.” Then, the man with OCD will feel relieved. This completes a cycle of anxiety for this man — he engages in the compulsion, and immediately feels relief from anxiety. Doesn’t sound too terrible, right?

Where Does It End?

The problem is that this pattern often does not stop. Next week he might be confessing more minor things, like having wondered whether a female acquaintance likes him, or even having thought his 9th-grade homeroom teacher was attractive (many years ago). Although these latter two situations might seem less important to most observers, they provoke just as much anxiety for the OCD sufferer.

woman with ocd who wants to confess

It is often a downward spiral that can reach the point where spouses/ boyfriends/ girlfriends can become frustrated at having to listen to meaningless confessions every day. Ironically, this can strain a relationship more than if the OCD sufferer had not mentioned anything.

How to Cope with Confession Compulsions

For people suffering from this symptom of OCD, the key is recognizing the role anxiety plays. Do they need to confess because it’s the right thing to do, or is it because they’ll feel relieved? (This happens due to a phenomenon called negative reinforcement.) Do they want to confess despite having been told by their partner that it is not necessary or helpful? Working with a therapist trained in exposure and response prevention can be a helpful way to change the way one deals with anxiety in these situations.

Perhaps what helps the most for people struggling with a compulsive need to confess is improving their ability to tolerate “having a secret.” If you are struggling with this problem, try to delay the confession if you’re not able to refrain altogether. Will it really matter if you tell them five minutes later than when you have the impulse? Once you get some practice delaying, you can gradually increase the length of the delay. As you do so, you steadily weaken the compulsive habit. Good luck!

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Dr. Paul Greene Psychologist
Dr. Paul Greene is the founder and director of the Manhattan Center for Cognitive Behavioral Therapy in New York City. With 14 years of dedicated service in private practice, Dr. Greene brings a wealth of experience to his role. His career also includes teaching at the Mount Sinai School of Medicine and conducting research at the Memorial Sloan Kettering Cancer Center.

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