Living with Religious OCD

What’s going on?

Religious OCD, also known as Scrupulosity, is an observed condition that dates back to the 1600s in the Catholic church. It was noticed that some monks were engaging in excessive prayer. Their behavior and constant praying weren’t in keeping with what they believed to be an expression of God’s love. They were actually trying to achieve an unrealistic state of holiness. This is where the term Scrupulosity comes from.

As a subset of OCD, Scrupulosity means you’re constantly preoccupied with doing the right thing. Religiously. Morally. Ethically.

Common Scrupulosity OCD obsessions:

• Fear of living a life of sin or one that God wouldn’t approve of.
• Fear of doing something that doesn’t align with your moral or ethical standards.
• Constantly wondering if you’re praying enough or the right way.

Common Scrupulosity compulsions:

• Excessive prayer: Saying the same prayer over and over again until a state of certainty has been achieved. You feel as if God would approve of the amount.
• Reassurance: Seeking constant reassurance from God.
• Excessive reflection: Making sure that you haven’t said something God would blasphemous.
• Going to church or temple: Constant visits to places of worship.
• Confession: Excessive confessions to a priest, rabbi, other clergy or even a significant other.
• Thoughts of unholiness: Having natural associations that you think are unholy and offensive to God.

Common misconceptions about Scrupulosity:

• OCD only comes in one, general type. Subsets like Scrupulosity don’t exist.
• You’re more devout than other non-sufferers.
• You care about your character, morals or ethics more than other non-sufferers.

How Do I Know it’s OCD?

Everyone gets intrusive thoughts, but having them doesn’t mean you have OCD. For people who do have OCD, these thoughts can be debilitating, causing extreme anxiety and discomfort. No matter how hard you try, they won’t go away. If you have Scrupulosity, you engage in rituals as a way to ensure you’re meeting God’s or society’s standards of correctness.

There’s a complete lack of fulfilment in partaking in these rituals. Unlike non-sufferers, you don’t feel a sense of satisfaction by doing right by God. When it comes to ethical standards, non-sufferers feel a sense of success. Sufferers, on the other hand, don’t.

Everyday Examples of Scrupulosity:

• You have intrusive and arousing thoughts about Jesus. You pray every day and night for forgiveness. You may even seek out confession.
• You’re an attorney at a law firm and you constantly check your briefcase to make sure you didn’t accidentally steal a pen or piece of paper.
• You said you arrived home at 4:30 p.m. but it was actually 4:31 p.m. In this instance, you’re afraid you’ve lied about your arrival time and restate it just to be safe. 

How can my family help with my Scrupulosity?

It’s OK for family members and friends to get involved. If they notice your overly cautious or devout tendencies, their best bet is to let you know that it’s a treatable condition. They should not engage in reassurance by telling you things like “Of course you didn’t sin, it’s not like you.” or “God wouldn’t care about that.” While it may be momentarily comforting, these reassurances can make your OCD worse in the long run. They may want to get involved in your treatment to learn the do’s and don’ts of recovery.

Is Recovery Possible for Me?

Yes! People with Scrupulosity can get much better through Exposure Response Prevention Therapy (ERP). ERP is when you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsion to neutralize or stop the fear. By repeatedly facing something you’re afraid of, you force your brain to recognize how irrational it is.

Examples of ERP treatment:

• You may be exposed to different levels of risk starting with something small like sampling a piece of cheese at a deli then walking away. This simulates the idea of stealing, even though you really weren’t.
• You may be asked to take a piece of paper and then litter on the street.
• The risks gradually increase to a point where you might be asked to repeat to yourself that the Virgin Mary may not have really been a virgin.

There are other treatment options as well. Mindfulness-based Cognitive Behavioral Therapy, also known as CBT, teaches people to identify, understand and change negative thinking patterns and behaviors. Patients are taught problem-solving skills during therapy lessons and then instructed to practice them on their own time in order to build positive habits.

Can medication help?

Medication can help alongside ERP, but it shouldn’t replace it. Doctors should always be consulted before considering medicinal options.

The main family of medicines used to treat OCD are known as Selective Serotonin Reuptake Inhibitors, or SSRIs. SSRIs enhance your natural serotonin activity and are used to treat major depressive disorders and anxiety conditions. Examples include Lexapro, Prozac, Paxil and Zoloft. 

What is the goal of therapy?

Some people with Scrupulosity recover completely through ERP. But for many, their obsessions never fully go away. Progress comes in the form of distancing your character from you intrusive thoughts. You realize that they do not define you. OCD recovery has more to do with managing the condition, than it does with eliminating it. However, that doesn’t mean you can’t lead a healthy, happy life. By prioritizing treatment and positive lifestyle habits, sufferers often gain confidence and freedom. Even if some anxiety is still present by the end of therapy, you’ll no longer feel debilitated by the condition.

If you suffer from OCD, you have a severe anxiety disorder. But it can be treated. Start by getting educated and making healthy living choices. Then find a clinical psychologist in your area who specializes in OCD and Exposure Response Prevention (ERP).