Hyper-Responsibility and Anxiety

We all have to take responsibility in our lives at various times. We take responsibility for getting the essentials done e.g. bill paying, picking the kids up from school and to try and avoid harm coming to us and to those around us e.g. by locking our doors at night, holding our infant child's hand when near a busy road and adhering to the speed limit when driving. All of these things are normal everyday things that most functional adults do, however, things can get tricky when we experience hyper-responsibility.

What is Hyper-responsibility?

Hyper responsibility can be thought of as an over inflated sense of responsibility. In other words, feeling and behaving like you have more control than you do and taking responsibility for preventing harm around events that you can't really prevent. People with hyper-responsibility tend to hold beliefs that they must prevent harm or 'bad things' from happening even if these things are beyond what they are able to control. They believe that it is their responsibility to keep others safe and look out for everyone. This can lead to behaviours designed to evoke a sense of being 'in control' either by taking action to prevent harm from happening or taking action to fix a problem in hoping that it will not happen again. People who struggle with hyper-responsibility often feel very guilty or tell themselves that they are a 'bad person' or that it would be absolutely their fault if something bad was to happen or if it happens. They also tend to worry that catastrophic events will happen if they encounter uncertainty in a situation and that they will be responsible for this. Presentations of hyper-responsibility definitely vary but below, you will find the example of Jane.

​Jane is very concerned about harm coming to her family and goes to extreme lengths to prevent this from happening. Jane washes her hands many times a day, often washing her hands again if she experiences any doubt about there still being germs on her hands, she wipes down anything brought into the house with antibacterial wipes and changes her clothes/showers whenever she returns home. Jane spends a lot of time cleaning her home multiple times a day, wiping down door handles and surfaces with antibacterial cleaner. Jane checks all plugs are switched off and that doors/windows are locked multiple times before she goes to bed, often getting up to check again, she sometimes takes photographs of the plugs, doors and windows to prove this to herself. These rituals help Jane feel calmer and less anxious, she finds it very difficult if not impossible to resist the urges to do these things. Jane fears that if she doesn't then she will be responsible for any catastrophe that might follow such as a break in that resulted in harm coming to her family, a house fire or her family becoming seriously unwell (or worse).

What is the problem with hyper-responsibility?

Some people think it sounds great to be thought of as a really responsible person and we all do things from time to time in order to prevent harm from coming to others. For example, most people if they saw a nail on the floor might have the thought 'that could be dangerous' and pick it up. For some people the heavy weight of their perceived responsibility for preventing harm can cause life to feel near enough impossible. Consider Jane's example above. Jane finds it difficult to function due to the rituals and checks that she needs to complete in order to manage the anxiety and distress that her thoughts cause. Her thoughts consume her day, she frequently feels tired and her checks/rituals take up hours in her day that she would prefer to spend with her family and friends.

Hyper-responsibility might mean needing to perform different kinds of rituals or compulsions e.g. tapping something a certain number of times, repeating phrases/prayers or needing to do things a specific way in order to prevent terrible things from happening e.g. natural disasters or other catastrophes that are out of our control. For others, it may present as feeling worried that they might have harmed someone by accident (e.g. have an intrusion that they have run someone or something over), this might cause them to need to check that they have not caused harm throughout the day e.g. needing to go back and check. In a more generalised anxiety presentation, hyper responsibility might look like worrying about everything and feeling intense responsibility to think/worry excessively about hypothetical and current problems.

As you can see, hyper responsibility can present in various ways and at varying levels of intensity. Hyper-responsibility is common and as therapists we often see this in presentations such as obsessive compulsive disorder (OCD) and generalised anxiety disorder (GAD). There has been recent research that has shown that inflated responsibility beliefs could increase the likelihood of developing GAD or OCD.

How do we address hyper-responsibility?

As we have just discussed, heightened responsibility beliefs are often seen in presentations such as generalised anxiety disorder (GAD) and obsessive compulsive disorder (OCD). CBT is an empirically supported treatment for both of these conditions meaning that it is a treatment method that has proven effective in controlled research studies. CBT therapy is also a first line recommendation from the National Institute for Health and Care Excellence (NICE). NICE guidelines provide evidence based recommendations for healthcare in the UK.

You can access CBT therapy by finding a BABCP accredited therapist or also through NHS provided services in the UK. If you would like a referral for free NHS treatment then you can contact with your local IAPT service to find out how to refer (lots of these services accept self referrals).