OCD and men: Separating shame from recovery

By Taneia Surles, MPH, NOCD

For generations, cultural norms have reinforced the idea that men should be strong, self-reliant, and always in control. These expectations can make it difficult for men to show vulnerability or seek help for their mental health.

For men living with obsessive-compulsive disorder (OCD), those pressures can create an added layer of shame. Intrusive thoughts—particularly harm-related obsessions—can leave men terrified of being seen as dangerous or “not manly enough.” Rather than opening up, many remain silent, worried that they’ll be judged or misunderstood. Without support, this isolation takes a toll—men die by suicide at four times the rate of women.

This cycle of stigma and suffering can keep men trapped in obsessions and compulsions, preventing them from ever finding relief. Breaking through the link between masculinity and silence is key to recovery. By separating cultural shame from clinical OCD symptoms, men can access effective, evidence-based care and lead a life based on their identity and values.

Masculinity and mental health

Society often tells men that they should be “strong,” “dominant,” and “invulnerable.” However, these perceptions can discourage men from being open about their struggles or seeking professional help, an especially damaging barrier for those living with OCD.

“It’s usually the men who most adhere to those ideas—‘I need to be tough, I don’t talk about my feelings, or I’m only here because somebody’s making me be here,’” says Daniel Kasper-MacMillan, MA, LCPC, a therapist and Clinical Training Specialist at NOCD. “As a therapist, I’m not asking you to be soft or give up your value system. I’m asking you to explore your inner world and see what’s working and what’s not.”

The numbers reflect this gap. In the United States, about 41.6% of men with mental illness received treatment, compared to 56.9% of women in 2022. Cultural expectations about masculinity don’t just shape attitudes—they can directly influence who gets help and who continues to suffer in silence.

Shame and vulnerability in OCD

Men living with OCD that targets their sense of identity may feel intense shame when they don’t live up to society’s standards of being self-sufficient or “manly enough.”

“You give OCD an inch, it takes a mile,” Kasper-MacMillan says. He further explains that OCD can latch onto the most extreme ideals of masculinity and constantly measure the person against them. For some men, this might show up as worries that their voice isn’t deep enough, or fears that their partner would prefer someone who’s “more masculine.”

Fears of being perceived as dangerous

Harm OCD—the fear of harming oneself or others—is a common subtype that men may present with. When masculinity is tied to the experience, intrusive thoughts can become even more distressing.

“A man living with harm OCD might think he’s more dangerous just because he’s a man or that feelings of anger or frustration mean he could lose control and hurt people,” Kasper-MacMillan says. “Add in the masculinity element, and it feels very scary.”

The impact is often silent. Men may avoid people or situations, isolate themselves, and even delay treatment for fear of shame. This withdrawal reinforces the shame cycle that OCD feeds on, keeping them trapped instead of moving toward recovery.

“You care deeply about people and their well-being, but your compulsion to avoid or isolate is not really in alignment with your value system,” Kasper-MacMillan explains. “Instead of nurturing healthy relationships with your loved ones, you shy away from them out of fear of what could happen.”

Breaking the silence: Disclosure and recovery

For men struggling with intrusive thoughts tied to masculinity, the first step toward recovery is openness. Yet for many, seeking therapy can feel “unmanly,” reinforcing stigma and discouraging them from seeking help. In reality, facing OCD is one of the strongest things a man can do.

“If your role as a man is to be a provider and a protector, I would say therapy is particularly masculine,” Kasper-MacMillan says. “I’m asking you to face things that are hard—things that are scary and uncertain—and make the best judgment you can in those moments through exposure and response prevention therapy.”

Exposure and response prevention (ERP) therapy is the most effective, research-backed treatment for OCD. It helps people gradually face their fears without engaging in compulsive behaviors, such as avoidance or reassurance-seeking.

For men hesitant to start, Kasper-MacMillan often begins with motivational interviewing—helping people identify what matters most to them—and psychoeducation, ensuring goals are aligned with what the person actually values. “I never want to make people attain goals that don’t matter to them,” he says. “Everything we’re doing is aligned with what they want.”

Community support also plays an important role. For men who may be reluctant to share their struggles with loved ones openly, peer communities offer a safe space to feel seen, heard, and inspired by others’ recovery journeys.

Ultimately, therapy provides a safe and steady path forward. “I'm going to ask you to do things that are hard,” Kasper-MacMillan says. “We're going to go slow and steady, but we're not doing anything to overwhelm you—and you’ll get stronger for it.”

Reframing masculinity and OCD recovery

It takes significant courage to seek help for OCD—mainly since the condition often attacks the things a person values most. While being vulnerable about mental health can feel uncomfortable, facing one's fears head-on is the pathway to real relief.

It’s also important to remember that finding the right therapist may take some time. Not every fit is perfect at first, but that doesn’t mean recovery is out of reach. With the proper support, men can work through identity-related fears and move toward the life they want.

“Recognize that therapy is going to be a challenge, but it’s one worth undertaking to be the best version of yourself you can be—if not for yourself, but for the people that you protect and provide for,” Kasper-MacMillan says.

OCD is a highly treatable condition, but escaping the cycle starts with openness. Intrusive thoughts—no matter how distressing—are not a reflection of a person’s character or values.