Scrupulosity & OCD: Religious/Moral Symptoms
Treatment of scrupulosity (religious/moral OCD) is based on exposure and response prevention (ERP), but pre-treatment goals often focus on belief clarification.
Question: I have scrupulosity (religious/moral obsessive-compulsive disorder), and I am triggered by religious posts on Facebook.
When I see a religious post, I feel like I have to repost it or God will be mad at me. I also worry about what other people think about these reposts, which then leads me to fear that God will judge me for worrying.
Any suggestions for treating scrupulosity (religious OCD)?
Religious Scrupulosity/OCD
For many people with OCD/scrupulosity, treatment can be especially confusing at first. Every action or inaction can feel potentially dangerous, which is why scrupulosity often goes untreated for so long. The very fact that you recognize that this is related to obsessive-compulsive disorder is excellent. It also sounds like you have insight about your OCD symptoms and the OCD positive feedback loop. Many people with religious obsessions don’t realize that obsessions can target religious/moral topics. Their OCD tells them that it’s impossible to engage in religious practices “too much” or “too frequently.”
Scrupulosity/OCD Belief Clarification
The first step in your recovery is to clarify your religious beliefs. If you don’t do this, exposure and response prevention for your scrupulosity will likely be unhelpful. The types of questions you should ask yourself are:
- Does God expect me to be perfect?
- If I make a mistake or commit a sin, does my religion have procedures for obtaining forgiveness?
- Would God want my behaviors to be largely driven by obsessive-compulsive disorder?
- Would God want my relationship to my religion to be OCD-based or faith-based?
- Would God understand what’s going on in my head and want me to fight my OCD?
- If my treatment involves doing things that might be considered potentially sinful, would God understand?
Although you cannot have complete confidence when answering many of these questions, your answers to these questions will help frame your treatment efforts. For those whose symptoms distort their view of God, these questions can be especially tricky. These individuals sometimes base their answers on how they would like to think about God. When I treat people who have religious scrupulosity in my South Florida (Palm Beach County) psychological practice, my intention is not to change their religion or create more guilt for them…but rather to help them determine if there are aspects of their current relationship to God/religion that are dysfunctional. If this is the case, it’s not the person’s fault; this simply reflects a common symptom of scrupulosity.
Treatment is then designed to help them develop a more functional and healthy relationship with God.
Once you’ve clarified your beliefs, the next step is to define appropriate treatment goals.
Moral/Religious OCD Treatment Goals
For anyone with scrupulosity/OCD, it’s unhelpful to define your goals in terms of impossibilities. You must set achievable treatment goals. For example, it would be unwise to select the goal of knowing for sure that you did the right thing or handled the situation the right way. Moreover, it would also be unhelpful to adopt the goal of trying to be 100% sure that God isn’t mad at you. For other people with scrupulosity, there may be the fear of hell/damnation and the unattainable goal of wanting to know 100% that you are saved. These types of goals just feed obsessive-compulsive symptoms.
No matter what we do, we can never know these things in the ways that OCD tells us we should know them. Perfect certainty about faith and morality just isn’t possible.
If you think about it, you’ll realize that these types of OCD-driven goals take faith completely out of religion.
Obsessive-compulsive disorder (OCD) often tells us that the only acceptable way to practice religion is to practice it with a perfect sense of knowing. This is actually incompatible with the idea that faith involves believing in something that can’t be seen or verified.
Appropriate treatment goals involve learning to live more comfortably in a world that is often gray, muddied, and confusing…to better tolerate OCD doubt, uncertainty, and ambiguity regarding our actions and intentions. This involves accepting yourself as an imperfect person who will inevitably mess up and learning to rely more on faith and less on certainty.
Exposure and Response Prevention (ERP) for Scrupulosity/OCD
Once you’ve set your goals, you then practice exposure and response prevention (ERP) for scrupulosity. You intentionally enter situations that trigger your doubt and uncertainty and resist the urge to escape or perform your rituals. For you, with the symptoms you’ve described, this would involve resisting the urge to cross-post religious topics on Facebook. Although this will feel dangerous at first, the more practice you get, the easier it will become.
There are also a variety of other exposures that might be helpful to you, such as thinking a bad thought on purpose. Again, this likely sounds dangerous if you’ve never done it before. However, after you’ve clarified your beliefs and defined appropriate treatment goals, you might determine that this territory is an important step in your recovery.
Would God understand and support your efforts to fight OCD?
Only you can answer this question.
Scrupulosity & Mental Rituals
It’s also important to note that when people have symptoms like yours, they often have a variety of mental rituals that accompany their obsessions. These include:
- Reviewing/re-analyzing/replaying scenes from the day to figure out if you did the “right” thing.
- Trying to figure out (i.e., questioning) your own motives in various situations.
- Compulsive praying (which often includes repeating/restarting prayers multiple times)
- Repeating prayers or restarting prayers if you get distracted or lose focus.
- Repeating prayers or restarting prayers if you are not concentrating 100% on the words of your prayer.
- Repeating prayers or restarting prayers if you had a bad thought during them.
- Repeating prayers or restarting prayers if you felt they weren’t 100% genuine.
- Reassurance-seeking behaviors.
- Asking others if you did the “right” thing.
- Excessively reading/studying religious texts (e.g., Bible/Torah/Koran) in order to inform current behavior.
- Asking for forgiveness excessively.
It’s important that you resist these rituals, as they will interfere with your progress in treatment. If you have a hard time determining if a certain behavior is problematic (e.g., praying, studying the Bible/Torah/Koran), it can be helpful to consult with a religious professional (e.g., pastor, priest, rabbi) in order to get feedback. Because not all clergy are familiar with OCD/scrupulosity, I would recommend that you have your therapist join you at this meeting.
After this consultation, it may be helpful to set parameters for your prayer. For example, you may decide to pray at specific times, limit the amount of time you spend praying, and resist urges to repeat/restart prayers. If these behaviors reflect symptoms of scrupulosity, they can actually interfere with being able to establish a healthy relationship with your religion.
Just like any form of OCD, scrupulosity can be effectively treated through exposure and response prevention (ERP). Given the complexity of these symptoms, I would recommend getting the assistance of a therapist who specializes in treating OCD. If you live in a remote area and there are no local providers, there are probably providers in your state who would be willing to do therapy by phone or over Skype. If you use a screen-sharing program, you could even do some of the Facebook exposures “together.”
Wishing you the best in your recovery from religious scrupulosity!
Questions? Comments? Experience with recovering from religious obsessive-compulsive disorder? Sound off below.
Related posts:
Scrupulosity
Scrupulosity Exposure Help?
OCD Triggers in Daily Life? Don’t Ritualize. Be Strategic! 3 Tips for Fighting OCD.
OCD Treatment Group Using ERP
Imaginal Exposure vs. In Vivo Exposure for OCD
OCD Treatment: Back to Basics
Treatment for Body-Focused Obsessions & Compulsions in OCD (e.g., Swallowing, Breathing, Blinking)
OCD: Screaming, Blurting Out Obscenities/Cursing/Profanity, & Other Unwanted Impulses
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Hi there,
I am a long term (10+) year member of AA, which has replaced religion for me. I have constant intrusive thought-loops that I have relapsed (based on taking pain medication during back surgery) AND intrusive thoughts about confessing certain behaviors to my AA sponsor — IE, I’m afraid if I don’t tell her I’m afraid of becoming a pedophile, I will relapse. I obsess that my obsession is God’s way of telling me that if I DON’T confess to these obsessions and behaviors, that I will remain sick and relapse. Then if I am honest with someone about my behavior and obsessions, almost immediately I begin obsessing that I wasn’t totally honest, that I didn’t tell them enough, and my brain will dredge up another memory to support whatever the obsession is.
In your opinion, does this fall under scrupulosity?
Hi Rae,
The line between scrupulosity and other forms of OCD is not entirely clear.
Fear about becoming a pedophile is common in OCD. However, based on your description, it sounds like you’re not actually worried about becoming a pedophile but rather the consequences of not confessing (i.e., increasing the possibility of relapse). It would be important to clarify your specific fears about the consequences of losing your sobriety. If you’re concerned about relapse “ruining your life,” this probably isn’t scrupulosity. If you’re concerned about relapse “making you a bad person” or “God getting mad at you,” this would possibly be scrup-related.
It sounds like the general theme, though, is that you don’t want to be “responsible” for relapsing, so you’ve adopted a “better safe than sorry” approach to dealing with your obsessions.
Regardless of whether your symptoms reflect scrup or not, ERP would be an appropriate treatment if your psychologist determines that you have an OCD-spectrum disorder.
Wishing the best in your recovery!
Thanks so much for the wonderful information. I will try to find a therapist who does remote counseling. I’m a little nervous about doing ERP but I know that these doubts and worrying are not the way I was meant to live.
Good luck!
Hi steve, i think i may have Scrupolosity, potentially HOCD, please, if you read this, could you tell me if there is an actual case when a person suddenly have deep affection and unwanted sexual thoughts of blasphemy to the Lord not because of OCD
The most helpful way to proceed here might be to seek out an OCD specialist for consultation. This would allow them to get a good understanding of your situation in order to guide you appropriately.
Thank you for this information. It is very helpful. I have ocd and its the ocd form of complete mental rumination. It’s not the ocd form of performing rituals or tasks but more of plain thinking, for example, if i think of something bad, I have to think of something good then repeating it with the variants of 3 or 5, those are my ocd numbers. I’m a Christian and i do believe in God, and I’m happy. But still, the ocd part is still there. I want that gone and I just want to enjoy God in my true faith. Any tips on how to get rid of this mental rumination OCD?
Hi John,
This sounds like a form of Pure-O OCD, in which individuals use mental rituals (rather than behavioral rituals) to manage their anxiety. I’ve discussed Pure-O in other posts on this website. Mental rituals sustain the OCD cycle and indirectly feed doubt. As long as your rituals continue, your symptoms are likely to continue. Treatment involves learning to resist these rituals and manage your doubt in a more healthy way. It would probably be helpful for you to work with a therapist to address your doubts systematically.
Wishing you the best with this!
It was so wonderful to read about scrupulosity today. I was finally able to let my sister know what she has. It was relieving for her to find out others share in this horrible disease. How does she even begin the ERP though, as her fear is so bad that she will be condemned, because trying not to have these thoughts she ends up purposely making deals with God, and is so worried about the reprercussions that she can’t even begin the ERP.
Hi Janette,
Before beginning the process of ERP, individuals with scrupulosity often benefit from doing some initial belief clarification and/or consultation with religious professionals. If she doesn’t have a therapist, she should find an OCD specialist to help guide her efforts.
Hey sean I feel bad because of my OCD because looking for reassurance or answers from peole or other christians its like IDOLATRY AND I READ REVELATIION IM LIKE UH OH! also I beat myself up over past sisns and i get thoughts of the past like…did i deny christ in fron of the internet or did i do the unpardonaable sin it just makes it worse also when i read the bible it says you cant havve two masters so when i go on the computer i feel guilty also i want to go by faith and not by feelings or thoughts aslo i hate sin on tv like girls in tank tops etc i get mad at the television like self conrol and if a thought comes in its like i need my fix on the unpardonable sin and i want to pray instead of worrying and trust god
I think am suffering from scrupulosity. When i was 14, i was playing with my cousin when i forced myself on her but i had no sex with her. After that i didnt feel any guilt till 4 years later, that incident is now plagueing me with serious guilt of fornication and i just cant convince myself that it wasnt fornication. Please, how do i deal with this?
Hi Steve,
I was wondering about the whole making deals with God thing. I do this a lot and i worry whether a deal is intrusive (i dont mean it, its OCD) and whether it is real. I keep questioning my motive, and just worry that if i did mean a deal, then God would have no reason not to fulfill the deal i broke and hurt me. I feel like he effects my personality for the worse because my worries are mostly about this. Is it better to not talk to religious people as they say that God does make deals etc.?
hi…
i got some strange thoughts about study……for example..if i download some books from sharing sites thn i think that is it sin to download a book which is illegal ? or worrying about books on which i lied with my friend because i don’t want to give those books to my friends and i considered it as a sin…..i think that i have no right to use those books…please tell me IS IT OCD OR OTHER DISORDER?
Thank you for writing this article. I found it very helpful. Because religion varies so such among people, it is probably hard to describe a general treatment plan for scrupulosity, especially when the patient will probably have to engage in something sinful to target their obsession/compulsion so a ERP plan will be effective enough to allow the physiological and neural changes of extinction to occur. This in addition to accepting the uncertainty aspect of not knowing if God will forgave them or not is a hard thing to communicate.
The problem with 75% of the OCD self-help books is that last sentence above. While many of these books tend to be great describing how to setup hierarchy based ERP plans for other OCD symptoms such as l checking, ordering, contamination, etc they lack in substance when it comes to scrupulosity and tend to be too neutral and passive.
This isn’t the doctors fault, because how can he or she possible write about something so vast with many beliefs of rellgion?
Something like scrupulosity usually needs to be individualized as it probably has some faulty beliefs caused by OCD that need reconstructing and put back into reality.
Simply put, this just something that’s hard to write about and you did a very good job.
For someone who suffers from scrupulosity myself, I am happy to have found this page.
Kris,
I agree with everything you’ve said. Because religious beliefs are so individualized and varied (even within a common religious framework), it can be difficult to describe a general process that works across individuals.
RE: hierarchies involving sins, I really like Alec Pollard’s concept of building exposures around potentially immoral or sinful acts (“PISAs”). Faith can give you permission to engage in behaviors that on the surface appear very sinful (e.g., writing out something like, “I love the devil.”). If I believe that God understands my OCD better than I do and that He wouldn’t want my life to revolve around my OCD, writing this out or saying it out loud becomes an act of faith on my part.
Wishing you all the best!
Hi,
I’m interested in reading more on Alec Pollard’s concept of PISA but I’m having trouble finding a reference for it with Google Search. Maybe i’m searching for the wrong terms – I keep getting Pollard’s site but nothing on PISA directly. Could you please provide a reference or link?
Thanks.
DEAR Steven,
i am a hindu boy..I have gone through ur article..I am also suffering this type of obsession. I pray too much near of GOD.this is my very old habbit.When i see a temple I will be emotionally attached. I want to express my full thought correctly near GOD.I cant avoid it.Then I will get a possitive thinking mood and get a enthu that i can do those thing because GOD will help me.But negative thought will come automatically as an obsession and bring negative emotion.As much I want to express my real thought negative thought will also genrated together…I want to utilise positive enthu in my work if the pray will be done according to my thought but if not energy level will be dropped..so i have understood both are vice versa of ocd cycle..and be neutral at the time of praying..so mind can make any type of thought..dont be emotional(possitive or negative)..if there is god,then he/she will be more powerful than be ..so why I have to express myself infront of him or her??????he/she should realize me truly..so I have to do my thing own..I shouldnot think and wait what is the result of my prayer….
Thank you for this article, I found it very helpful.
I’m on a quest to research about scrupulosity because that’s what my brother’s is suffering from. He’s 18, its been going on for 3 years, also he’s currently living overseas with my mother and professional psychological help isn’t that much available/reliable.
My parents tried everything with him, self help books, guidance, help from a religious person, ERP, trying to advise him him in a non-confrontational way, most of the above-mentioned suggestion too, but it never worked, he’s very stubborn and doesnt wanna admit or acknowledge that his behavior is abnormal,he doesnt listen or reply when asked about it, he refuses therapy of any form, he refuses ANY kind of help he’s so deep in this OCD that its ruining his social life and interaction with people ( which he doesnt seem to care about anyways).
His denial and he seems so indifferent towards everything,I think he’s in a state of mind where everything that is enjoyable is a sin,
Nothing motivates him apart from his morals/values/religious beliefs.
His high sense of morality is very annoying, also he’s becoming very naive, not opening up to life,the real world, he’s just retreated in his room most of the time (unless he has classes).
I would like some help or pointers on what to do next. or what to try, maybe some pointers.
Thanks in advance,
I have a 25 year old Asperger son with partial Scrupulosity. He does not have to read the bible, is not compulsive. By reading both bibles, he believes that man is evil from Adam, does not follow G-ds laws, but mans laws, all men are sinners, going to hell. My son said last year that he remembers a dream, where an angel told him ‘You are going to hell and their is nothing you can do about it”. My son accepts this, this is his future. So he is just waiting for this day, has no interested in moving on with this life. He has no passion, no desire to do anything. He does not feel love, empathy or passion. Things in this world are objects to him, with no emotional connection. Medication as not worked, therapy does not work since he wont listen to anyone, believes we are all evil, not following G-ds commandments. CBT and ERT does not work. They want to try ECT. This is for depression, not OCD and Aspergers. I don’t know what to do, neither do the experts.
I am so glad I’m not the only one dealing with this. I’ve had OCD ever since I was a child. I used to rearrange everything and if something wasn’t right, I’d have to start all over. Currently, I wash my hands a lot and I have scrupulosity because of horror movies. I also tend to have bad thoughts about other things too…like pictures or comments on the internet…it just goes from one thing to another, like moral fear or fear of becoming too jealous, etc. It’s mental torture and I just wish it would end! It’s all in my head and I want it out! I know I’m saved, I know God is on my side, I know the kind of person I am and will always be. But in my head, it’s like I fear anything and everything *cries*. It’s like my mind is always searching for a way to make sure everything is ok when everything already is ok. It’s not as bad as it used to be though. When it first started, I got panic attacks, anxiety and restless leg syndrome from all this heightened fear. But it’s really mellowed out over the years. Every now and then I have prayers that are longer than usual and it causes me some frustration at not being able to do it right. But my point is, I still have it and I want it gone. I did get help for it years ago but have since stopped because I’ve learned to live with it. But I don’t want to live with it for the rest of my life.
I want to thank you for this article as well as all the posters before me for sharing their problems & concerns as well as treatments.
I am stressed about what is right or wrong according to god and is unable to take decisions as per my wish. I have been diagnosed with ocd & right now I m on mediaction & therapy. Many a times I have seen god in my dreams & I feel he is indicating me something. I am not able to deny such dreams believing that they are real. Whenever I want to focus on any work these thoughts fully trap me & I am unable to do any kind of work. Pls guide & also tell me what should be my concept of god ?
Hi Dr. Seay. I felt that I had to stop reading the article on scrupulosity. because maybe it was only meant for the person who asked you a question. Is it alright for me to read and learn from the article?
Rob
My daughter is only 15 an going threw this.I have had to to the dr,an have tried to get help for her.This is a very hard thing to go threw.I am meeting with the school today at 11 am.She was an A,B STUDENT NOW SHE Has a very low grade in math,PLEASE HELP US
Hi,
I notice you said she was 15, so you may wish to check into PANDAS. Although be warned now, not everyone is convinced of an autoimmunity disorder linked to OCD. You can check the PANDAS network or The International OCD Foundation’s webpage for more on PANDAS. The National Institute of Health(NIH) has information on it too.
The International OCD Foundation provides a database on their website of doctors who treat OCD. Therefore I would encourage you to search your location and try to find a specialist approved by them in treating OCD.
Lastly, I highly encourage you to read Steven’s blog and become familiar with ERP processes (even for other sub-types of OCD). By familiarizing yourself with the real CBT/ERP, it will prevent you from receiving incorrect treatment. Unfortunately, and despite all the decades of research supporting CBT/ERP and it’s effectiveness, it is still common to end up with a therapist who will fail to implement it correctly. It could be due to inexperience, or lack of education (older dogma). This will only serve to undermining real treatment and slow progress.
Therefore education of this common treatment protocol (CBT/ERP) is required. Buy self-help books from lead researchers, read this blog, and/or attend The International OCD Foundation’s yearly conference and attend a workshops in ERP.
Hi
Have u ever heard of someone who feels depressed and fearful because they can’t decide what philosophy /religion to believe
That is my situation
Do u think this is ocd
I’m afraid I’m going to go to hell if I believe the wrong thing
This has gone on for decades since childhood
Ii ask god to help me with it but I always end up doubting myself