Scrupulosity


Warning

This section is based on my personal life experiences and of fellow sufferers I have personally known. I am not a qualified medical expert, rather I have placed these thoughts online in hope that they may be of interest to the medical and mental communities, as well as useful to sufferers in their struggles. Please seek an appropriate medical expert’s advice.

Introduction

Obsessive-Compulsive Disorder (OCD) is a tremendously difficult mental disorder that rampages against its sufferers with unabated passion. It is most commonly recognized in individuals who have the most well-known compulsions – washing hands, counting numbers, following rituals. However there is another aspect of OCD which I as a sufferer have experienced. This is when OCD becomes intertwined with religion. This form of OCD is technically known as scrupulosity.


What is the difference between General OCD and religious OCD? I would define the differentiating factor thus: A sufferer of general OCD is usually aware of the inappropriateness and strangeness of their actions, as well as their unreasonable nature but continues to engage in such actions because of the overwhelming mental anxiety brought about by the mental obsessions. A sufferer of religious OCD is generally not aware of the inappropriateness and strangeness of their actions, nor their unreasonable nature, instead believing such actions are at the core of their right relationship with God.[1]

When I think about my sufferings with OCD I thank God for the “general OCD” I suffered.[2] It was only because I was able to recognize the general ocd as irrational that I began to question my other behaviors. If I had suffered from purely religious ocd[3] I do not believe I could have escaped OCD’s firm grasp[4]. If I could not look at my life and recognize that I had irrational habits of checking, washing, and speaking I would not have recognized that my extreme religious perfectionism was a symptom of my Obsessive-Compulsive Disorder.

As you read what I have to say – I ask you as professionals to hear me out and to ask me questions. I want to be engaged on this subject. While there is some literature on the subject, there is a need for more.[5] Especially since erratic behavior is oftentimes mistaken for religious spirituality within some religious circles[6] and can result in extremely unhealthy relational dynamics. For the sufferers, I look forward to hearing about your experiences and your agreement or disagreement with my hypothesis.

What Does Religious OCD Look Like?

One of the hardest things about religious OCD is the difficulty in diagnosing it. The individual suffering from religious OCD is likely someone who is considered to be dedicated to their religious beliefs in the way that many others only wish they could be. It is very hard to distinguish true relational religion from religious OCD. In fact, it is impossible to distinguish the two without spending significant time with the sufferer.

I have coined a term to describe the definitive factor in a person with religious OCD[7], “words of death.” When an individual is suffering from religious OCD it is likely that prolonged interaction with the individual will result in their sharing with you or someone in your presence “words of death.”

Words of Death are Biblical Words meant to bring life to the hearer that are used in such a way as to encourage the destruction and shaming of the hearer. In other words, one cannot oftentimes fault a person with religious OCD for stating something that is unbiblical, because it is meticulously backed by Scripture, rather one can only state that they have used the words of life to cause death. This is not to say, nor should it be taken to say, that anytime an individual speaks harsh words that they are speaking words of death out of words of life. Rather, religious teachings, especially Christian teachings, include many hard sayings. The Christian idea that humans are irreparably sinful (within the scope of natural ability), that they are deserving of punishment, that we cannot escape our punishment, that we are incapable of healing ourselves, that God can heal us – these are hard teachings, but are not in and of themselves words of death. Rather, one cannot look so much at the words themselves as the way in which they are used. Words can either build up or tear down. A rebuking word can lead to change in the rebuked, or to hardening. It is when the result is repeatedly hardening that one may suspect religious OCD.[8]

Do I Have Religious OCD?

How can someone tell if they have religious OCD? The first step is in seeking professional medical help. If you have a question in your mind about whether or not you are suffering from religious OCD, you should see a medical professional who can help you make this decision. I would recommend seeing a psychiatrist or counselor, but a general physician is better than not seeing anyone.[9]

For those who are treating individuals with religious ocd or for sufferers I would suggest the following as introspective questions to help determine whether an individual or oneself suffers from religious ocd:

  • Do I suffer from symptoms of general OCD? These would include hand washing, checking (e.g. oven, locks), and number counting.
  • Do others oftentimes get into debates with me over religious matters? Am I the only one who believes the way I do even within my own church?
  • Do I oftentimes hurt the feelings of others for the sake of “truth” and “biblical correctness”?
  • Do I have thoughts that cause me great amounts of guilt and seem to be unstoppable? About taboo topics? About hurting myself? About hurting others? About others hurting me?
  • What is my picture of God? Is my God a tyrant? Does my belief system about Jesus’ provision of salvation match up with my lifestyle?
  • Ask a friend to honestly tell you if you seem to have dysfunctional ways of thinking.

How Is Religious OCD Treated?

The first step in treating religious OCD is seeking proper care. OCD is largely a biological and genetic disorder which can be treated by medications and cognitive-behavioral therapy (CBT). One of the problems with healing religious OCD is that individuals who suffer it have a tendency to understand that they are ill for a period of time but eventually “forget.”[10] They need outside, consistent, non-biased sources that will help them remember that they are ill and in need of treatment.[11] Family and friends oftentimes cannot bear the extreme burdens that a religious OCD sufferer can place upon them emotionally so a professional psychiatrist or counselor is usually needed.

A second step is beginning a good, steady diet of books that will challenge your theology of God. We oftentimes claim we believe in a certain sort of God but our lifestyle belies our true beliefs. I have included a full list of recommended resources on the Religious OCD Further Resources page.

One may also find healing in watching movies or television shows about OCD. One example of this that is humorous yet revealing is the popular detective show, Monk. I also recommend a steady diet of humorous films and stand-up comedians. Laughter is a good medicine for the soul. You can discover more recommendations by visiting my general page on OCD and its resource page.

Appendix A: Examples of Religious OCD.

One of the most powerful treatments for me throughout my experience with OCD has been hearing others stories of struggling with OCD. I am afraid that there is a very limited number of stories currently expressing the symptoms of religious OCD, so I will here share several of my own.

Finding Forgiveness.

I was reading a book by Charles Finney[12], a famous American Christian revivalist speaking about how to bring revival into one own’s life and the surrounding area. Rev. Finney suggested that one should begin one’s search for revival by confessing one’s sins against others. I took this to mean an exhaustive confession of my sins to all I had offended. I began this long and emotionally destructive process. I apologized to dozens of people dozens of times. Eventually I was apologizing to people for thoughts or emotions that they were not even aware I had. If I couldn’t gauge whether my emotions towards them were positive or negative, I would apologize. This became all the time as I attempted to understand the intricacies of my own emotions with such an analytical nature that I could never say with certainty what my motivations where.

Being Perfect.

I desired to be perfect. I knew that positionally I was cleansed and I believed that I could be perfect, I just had to try hard enough. I avoided all forms of sin, which resulted in a withdrawal from other people. I knew that I could not entirely control myself when around others so I withdrew from them.[13]

Big Issue, Small Mistake

One day I was driving home from my job as a field-stone mason. I got severely lost and turned around in a driveway of gravel. This driveway was on a steep incline and as I pulled out my tires began to spin, some gravel was misplaced. For days afterward I could not ignore the feeling that I had to make things right – go back and rake that gravel exactly as it had been before. Eventually I did go back – but I couldn’t even tell that any gravel had been disturbed![14]

Helping Everyone.

I do not have a problem with sharing the gospel (“good news”) with people who do not believe in it, but at one point during my freshman year at college I joined a street witnessing team. By the end of the first semester I was second-in-command. I felt that anyone who didn’t street witness with us every weekend was slacking in their spiritual walk and that I myself was responsible for saving the entire world. Eventually this burden caused my near mental collapse.

Hearing God.

I felt a great amount of internal unrest. I still oftentimes do. I knew these feelings where from God, so I looked for some issue in my life. I would spend hours and days wondering what was separating my communion with God, what was causing me to feel so disturbed. Great healing came when I recognized that this obsessive feeling that “something is wrong” did not necessarily mean that anything was wrong, rather my brain was simply entering its infinite OCD loop.


  1. [1] This relationship to one’s obsessions/compulsions may change with time. Many do become aware of the disorder, but unlike general OCD sufferers who recognize from the beginning that their obsessions/compulsions are illogical and unreasonable, while still feeling the necessity of them – the religious sufferer usually doesn’t have this insight. Even once we acquire the insight we are still haunted by the thought that perhaps we are wrong…and tend to have relapses back into full-fledged scrupulosity.
  2. [2] I am not attempting to minimize General OCD or the pain experienced by those with General OCD. I believe the pain of this can be as severe as that suffered by the scrupulous, my intent is only to note that without the general symptoms it would have been nigh impossible for me to recognize the scrupulous symptoms as illogical.
  3. [3] I do not know that there is a solely religious form of ocd, I have never seen such. Religious OCD has always been accompanied by General OCD in my personal experience and in that of those I have known. However, individuals with Religious OCD are oftentimes in denial of the General OCD symptoms – their abnormality, etc.
  4. [4] This is not to say that I no longer struggle with OCD, but that I am now cognizant of the struggle and able to take the necessary steps to battle it.
  5. [5] Thankfully, since I first wrote this a number of years ago, the resources for scrupulosity have been expanding significantly.
  6. [6] It is easy to assume that this occurs in other churches but not our own. It is also easy to assume that others would fall prey to mistaking OCD for religious fervor, not ourselves. It is always easy to see the faults of others but not our own. Open minds and open hearts are required.
  7. [7] Over time I will probably need to revise this factor. No DSM diagnosis is given on the basis of a single symptom, neither should this be given. But for the time being, this is the significant symptom of which I am aware.
  8. [8] It is key to note that one may suspect religious OCD when the result is repeatedly hardening. The difference between personality traits and mental disorders is the level to which they interrupt our daily functioning. Oftentimes people tell me, “I think we are all a little obsessive-compulsive” or “I must have that too.” However, one does not have OCD nor any other mental disorder simply because one on occasion exemplifies some symptom of that disorder. Rather, it is evident that one has such a disorder when one repeatedly manifests such symptoms in a way that impairs your daily living. For example, I had a significant fear of being raped in the shower. I would lock the door and place a shampoo bottle on the door (I saw that in a movie) so that I would know if anyone entered. Still, I would spend two to three times as long as necessary in the shower while still not thoroughly washing because of a need to continuously check the door (I have never been raped or sexually abused, I have no context which would cause me to experience this fear rationally). This was interrupting my daily functioning. An individual who doesn’t have OCD might occasionally check the door – but it does not significantly impair their ability to get ready on time or wash effectively.
  9. [9] Medical Doctors are skilled physicians but they mainly deal with treating an individual’s physical body and not their mind. While the brain is part of the physical body it also seems to encompass more than the rest of the body and deserves specialists in this area. Just as we know that seeing a general physician for a heart problem is better than seeing no physician at all, so it is better to see a general physician for OCD than seeing no one at all, at the same time it is better to see a specialist – e.g. a psychiatrist.
  10. [10] When I speak of “forget” I do not mean that the person cannot remember that they ever acknowledged having a problem – or even in most cases that they deny they once had a problem. Rather, they experience some modicum of renewal in their mind and heart and assume they have overcome the issue – quickly descending back into the same old pathways…Oftentimes ending up worse than when one began. It is essential for those seeking or involved in the treatment of the religiously OCD to follow treatment through to the end. Treatment begins with an acknowledgment of needing help, individual’s self-esteem is oftentimes broken by such admittance and the repeated need to acknowledge the need of help without significant visible progress oftentimes results in a wall of protectiveness formed to maintain a level of self-esteem.
  11. [11] We cannot simply say to each other, “You are ill and in need of assistance” and expect healing. Unlike a festering cut, religious OCD leaves no physical marks and while the symptoms may be obvious a blindness occurs in the sufferer at times. Sufferers need people not only to confront them but also to walk with them through the healing process. I will not lie – walking through this process is extremely painful for all involved.
  12. [12] I am not recommending Rev. Finney for reading, there are many authors who I feel are much better and especially for anyone struggling with OCD.
  13. [13] The religiously OCD individual tries with all their might not to sin. Unfortunately, in attempting (and accomplishing) a lack of sin in active action (commission) we end up committing great sins of inaction (omission). We are no longer capable of loving our neighbors or enemies in any true sense, rather we exemplify a rigid and dead love. We need the assistance of a community of Christians to help us balance our thoughts in this area.
  14. [14] If one resists the temptation to act on one’s obsession for a long enough period of time it will generally dissipate. I had one instance in which an obsession (even while resisted) remained constant for a number of years. While it is theoretically practical to battle on our own, realistically we must enlist the assistance of others – and oftentimes medication. I know I must sound like a broken record, but all my suggestions apart from appropriate professional assistance will provide minimal long-term relief.

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