Verified by 
In the wake of several months of Black Lives Matter and anti-racism protests in the U.S. and worldwide, there has been a rise in people suffering from obsessive-compulsive thoughts surrounding racism and racist behavior. There does exist some literature linking racist experiences to an increase in OCD symptoms in general (e.g., Williams et al., 2017). However, there are few, if any, authoritative accounts of obsessive-compulsive disorder (OCD) causing unwanted thoughts about being a racist. Despite this lack of representation, it is clear that intrusive thoughts about racism do afflict many people with OCD, who are unsure what it means about them or what to do about it.
What Is Racist OCD?
OCD is a condition that has a wide variety of presentations, so there is no specific name for every brand of intrusive thought. Nonetheless, some people with OCD have unwanted, repetitive racist thoughts accompanied by fears of being a racist.
Racism is rooted in the belief that one group of people is superior to another, based on appearance or presumed ancestry. The racialized group then experiences discrimination—being treated as inferior or undeserving. People who are racist will display their racism through discriminatory actions that can be blatant or subtle. In most of the Western world, people recognize that racism is wrong and will adamantly deny being racist or engaging in discriminatory behavior against Black, Indigenous, and other People of Color (BIPOC). But the main difference between people taking part in racist actions and people suffering from OCD thoughts about racism is that racists truly believe that BIPOC are inferior, while those suffering from OCD will overthink and worry about it, regardless of any overt evidence that they are morally flawed.
Symptoms of Racism-Themed OCD
People with racism-themed OCD may have extreme fears about accidentally using a racial slur, accidentally or purposefully harming BIPOC, or being perceived as racist. They may also struggle with an inability to discern if their own behaviour is racist or not, and replay events in their mind repeatedly to determine if they committed a small racist act, such as a microaggression (Williams, 2020). One problem with this is that most people do have some amount of unwanted racial bias, whether or not they are acutely aware of it, so it is impossible to ever be certain that one is bias-free.
Some of the obsessive thoughts relating to racism, as well as the compulsive actions taken to mitigate those thoughts, do, however, resemble discriminatory behavior. People may have intrusive fears that BIPOC are “evil” or “out to get me,” fears of being related to BIPOC, or extreme racist stereotype thoughts. The obsessions can cause a fear of being around or of touching BIPOC, leading to avoidance. This is a racist behavior, although it is the disorder that is driving it. The OCD does not accede to conscious decision-making processes, but the end result is still racist actions requiring therapeutic intervention.
Alternatively, some people experiencing these thoughts may feel a compulsive need to be kinder or speak more often to BIPOC. One person described feeling the need to watch atrocities happening to BIPOC in an attempt to cure themselves of the thoughts. Although some compulsions may seem positive or even helpful, others may manifest as pathological. In either case, they will still worsen the OCD when performed ritualistically.
It May Be Hard to Find Help for Racist OCD
There are several obstacles that people with racism-themed OCD may face when trying to obtain treatment. First, many therapists are not comfortable having conversations about racism, period (e.g., Sue et al., 2010). Racism remains an uncomfortable topic for most people, therapists included. Most therapists are not trained or informed about how to facilitate sessions about racism. Therapists may not want to engage in such discussions for fear of making their clients uncomfortable or risk seeming like a racist themselves, so they may tend to avoid such discussions.
Those who do have training and comfort around racial issues tend to be therapists of color. However, a person suffering from intrusive racist thoughts may be afraid or uncomfortable interacting with a therapist of color because of the OCD. This severely limits the options available to someone with racism-themed OCD. It is also possible that even if a client manages to overcome this and find an OCD expert of color who can help them, this therapist may feel uncomfortable giving them the treatment they need.
OCD treatment paradigms involve client exposure and desensitization to those things they obsessively fear. If someone, for example, was afraid of using a racial slur, their treatment may involve repeatedly saying racial slurs. Therapists of color may feel especially uncomfortable doing this exposure with a client and could themselves become unduly emotionally burdened.
So, in order for a person experiencing this type of OCD to get help, they would need to not only find a therapist who understands OCD but also someone who is willing to oversee the uncomfortable treatment, which could prove extremely difficult. The lack of published information on this type of OCD will also make it nearly impossible for a person suffering from these thoughts to find any self-help materials to embark on their own personal healing.
How to Help People with Racism-Themed OCD
It can be challenging for White therapists to empathetically discuss issues involving race. The solution, however, cannot be for only therapists of color to treat such clients. Although it is now mandatory for all U.S. and Canadian psychologists to receive some diversity education in their training programs, the quality of such training varies widely, and older clinicians may have had none at all. And despite better training, the level of expertise and comfort with issues of race remains inadequate to serve clients with difficulties in this area. There needs instead to be more training for therapists of all backgrounds to talk about racism with clients and an ongoing sensitization to make it comfortable to facilitate these important conversations.
Further, there is a clear dearth of publications on OCD and intrusive racist thoughts with regard to treatment, prevalence, etiology, or clinical course. There is a need for more public discussion on the topic of OCD and intrusive racist thoughts so that people who are suffering can identify themselves as having OCD and access effective care.
Visit the International OCD Foundation to watch a recent Town Hall Meeting about Racism & OCD.
LinkedIn Image: fizkes/Shutterstock. Facebook image: Antonio Guillem/Shutterstock
References
American Psychological Association. (2017). Multicultural Guidelines: An Ecological Approach to Context, Identity, and Intersectionality. http://www.apa.org/about/policy/multicultural-guidelines.pdf
Sue, D. W., Rivera, D. P., Capodilupo, C. M., Lin, A. I., & Torino, G. C. (2010). Racial dialogues and White trainee fears: Implications for education and training. Cultural Diversity and Ethnic Minority Psychology, 16(2), 206-214. doi: 10.1037/a0016112
Williams, M. T. (2020). Managing Microaggressions: Addressing Everyday Racism in Therapeutic Spaces. Oxford University Press. ISBN: 9780190875237
Williams, M. T., Taylor, R. J., Mouzon, D. M., Oshin, L., Himle, J. A., & Chatters, L. M. (2017). Discrimination and symptoms of obsessive-compulsive disorder among African Americans. American Journal of Orthopsychiatry, 87(6), 636-645. doi: 10.1037/ort0000285
