When Your Brain Won’t Stop Questioning Right and Wrong: Moral OCD Therapy in Boston, MA
Moral OCD, often called moral scrupulosity, is—in my experience—a very common theme in OCD. The obsessions (those stuck, intrusive thoughts you wish you could turn off but feel like you can’t) tend to center around whether you’re doing the right thing, whether you’re a bad person, or whether you’ve done something wrong in the past. It can also overlap with other OCD themes.
How Moral OCD Can Show Up in Everyday Life
For example:
If you struggle with health OCD or health anxiety, you might fear catching something contagious like HIV—not just because of getting sick, but because what if you gave it to someone else? That thought spirals: “That would be wrong. How could I live with myself?” That’s moral OCD and health anxiety.
Another example:
If you deal with sexual obsessions (which are often taboo—like intrusive thoughts about incest or sexual violence), moral OCD can make you feel like a terrible person just for having these thoughts. You might start wondering why you're having these thoughts or images in the first place, and the more attention you give them, the more they seem to show up. The anxiety and guilt can feel so overwhelming that you end up confessing these thoughts to loved ones in an attempt to get reassurance and relieve the guilt—even if just for a moment.
Why Your Anxiety Doesn’t Mean You’re a Bad Person
If any of this sounds familiar, I hope it’s encouraging to know you’re not alone. Not only are you not alone, but this pattern is actually your brain’s way of trying to protect you from your fears—not proof that you’re a dangerous or a shameful person. The discomfort these thoughts cause is actually the sign that you don’t want to do “bad” things. I mean—do sexual predators feel disturbed by their thoughts? That’s the whole issue: they don’t. The very fact that you’re upset by yours means something different is going on here.
But please, dear reader, don’t go back and reread that last paragraph over and over for reassurance because that is a compulsion. If something made sense and resonated for you then trust yourself and turn away from debating or analyzing what your thoughts could mean about you and continue reading on.
The Fear Beneath Moral OCD
Underneath all OCD—regardless of theme—is fear.
In ERP (Exposure and Response Prevention), we call this the core fear. In Inference-Based CBT, it’s called the Vulnerable Self Theme. In both cases, it’s the thing you're afraid might happen if you don’t do your compulsions.
Take Sue, for example:
Sue is terrified of being dishonest in any way. So she often over-explains, tries to find the “perfect” words, confesses things she’s unsure about, and obsesses over whether she’s being a good person. Why? Because if she doesn’t do these things, she fears she’s being dishonest. And her anxious thoughts say if she is dishonest, that means she’s a liar and if she is liar then she is a bad person. And if she’s a bad person, she could hurt others. And if she hurts others, she could lose everything—her relationships, her stability, her whole sense of self. She’s terrified of being abandoned, rejected, and left to cope with intense guilt, shame, and panic.
The Real Fear: Uncertainty and Not Being Able to Cope
So what is Sue really afraid of? She’s afraid of being miserable and not being able to cope with an immense amount of distress. More specifically, she’s afraid of the uncertainty that her worst fear might be true.
As an OCD therapist, I believe at the core of every OCD theme is just that: a fear of uncertainty. So, dear reader, when we talk about different OCD themes — whether it’s moral OCD, relationship OCD, contamination fears, or any of the million other disguises — try not to get swept up in the specifics. OCD loves content. It wants you tangled in the details, analyzing, questioning, doubting, solving. It says this one really matters — this is special, dangerous, high-stakes, morally urgent, and must be figured out right now.
Sound familiar?
Yeah — I hear it every day. And it’s always the same trick.
What We Work On in Moral OCD Therapy in Boston, MA
With love, I’m telling you: it’s just noise. Meaningless, anxious, bloppidy gloop. OCD content feels personal and terrifying — but the process behind it? It’s the same every time. It wants certainty. It wants relief. It wants you to prove you’re good, safe, kind, responsible — and it wants you to keep proving it on a loop forever.
Here’s the reality: OCD is not about the content. It’s about your relationship to doubt, fear, discomfort, and uncertainty. We explore this relationship in OCD therapy.
In Exposure and Response Prevention (ERP), we help you face that uncertainty directly by resisting the urge to neutralize, fix, or try to get certainty. In Acceptance and Commitment Therapy (ACT), we help you hold the discomfort lightly while you keep living a life that reflects your values. And in Inference-Based CBT (ICBT), we zoom out and look at how your mind even started believing this imagined fear as reality — and help you reconnect to your actual, here-and-now experience.
Finding Freedom Beyond OCD’s Demands
Different tools, same goal: to get you unstuck from OCD’s trap and back into your life.
So what does this mean, practically? It means we don’t need to figure out whether you’re a good or bad person. We don’t need to dissect every memory or thought. We don’t need to be 100% sure that you were honest, or kind, or safe enough.
In OCD therapy services, you learn to trust yourself — your values, your common sense, your ability to choose how you want to live, even when your brain is screaming for certainty.
You value honesty? Great. Then trust that, even when your thoughts try to convince you otherwise. You don’t need to feel perfectly honest to be honest. You don’t need to feel 100% safe to live safely. You don’t need to feel totally good to be a good person.
And hey — you are important and special. But this OCD theme? This “what if” that’s hijacking your life right now?
Nope. Not special. Just another clever trick.
Let’s treat it like one.
You’re Not Broken
If you’re ready to stop chasing certainty and start trusting yourself again, let’s talk. As an OCD and anxiety therapist, I specialize in evidence-based therapy for moral OCD (which is just OCD :) ), and I’d love to help you find some breathing room from all the mental noise.
Book a free 15-minute consult and let’s get started.
Find Clarity and Relief with Moral OCD Therapy in Boston, MA
If your mind constantly questions whether you’ve done the right thing—or you’re stuck replaying past choices, seeking reassurance, or fearing you’re a “bad” person—you’re not alone. These are signs of moral OCD, and healing is possible. As a therapist specializing in moral OCD therapy in Boston, MA, I help clients untangle guilt, self-doubt, and fear through evidence-based, compassionate care. In OCD therapy services, we’ll quiet the mental noise so you can reconnect with your values and sense of peace.
Here’s how to begin your path toward clarity and self-trust:
Schedule a free 15-minute consultation to discuss what you’ve been experiencing and learn how moral OCD therapy can help you find relief.
Start virtual OCD therapy sessions from anywhere in Massachusetts or California, tailored to your experiences, goals, and pace.
Begin building confidence and calm as you learn practical tools to manage uncertainty, reduce rumination, and stop seeking constant reassurance.
You don’t have to live in fear of doing something “wrong.” With the right support, you can let go of endless questioning and start living with confidence, balance, and self-compassion.
Specialized OCD Therapy for Clients in MA and CA
You don’t have to be in Boston to start your OCD recovery journey. I offer virtual sessions for adults throughout Massachusetts and California, making it easier to access specialized, evidence-based care without the hassle of commuting or added stress. All you need is a private space, an internet connection, and a commitment to taking that first step toward healing.
During OCD therapy, we’ll focus on helping you break free from fear-driven cycles, build tolerance for uncertainty, and reconnect with your sense of confidence and stability. Whether you’re beginning therapy for the first time or returning after time away, you’ll receive compassionate, research-supported care—all from the comfort of home.
Additional Support for Your OCD Healing Journey
Alongside individual OCD therapy, I offer additional resources to help you stay grounded and continue making progress between sessions. The Common OCD Themes page outlines the intrusive thoughts and behaviors many clients experience, helping you identify patterns and realize you’re not alone in what you’re facing. The OCD and Social Life page explores how OCD can impact friendships, dating, and daily connections—offering practical strategies to strengthen confidence and ease anxiety in relationships.
These tools are meant to complement your therapy, providing continued guidance, education, and support as you deepen your understanding and build lasting resilience on your healing journey.
