Is There Such a Thing as Religious OCD?

Religious OCD is real. Also known as scrupulosity, it is a form of Obsessive Compulsive Disorder in which the scrupulous person is obsessed by intrusive thoughts. He or she believes they committed a sin or did or thought something blasphemous. This triggers feelings of intense fear and distress that drive him or her to behave in extreme, compulsive religious ways to try and get rid of the obsessions and silence the anxiety.

I just want to know if I can go to Heaven. That’s all I want in life, salvation in the next. – Sarah Gracia

Symptoms Of Religious OCD

Symptoms of religious OCD include a combination of obsessive thoughts and compulsive behaviors.

Obsessions Obsessions are typically centered around fear of angering God by committing a sin or blasphemy and being punished for it. Some common examples include:

• Fear of having committed a sin or done something blasphemous that you don’t remember doing, or may have done by mistake, not realizing you were doing it.
• Confusing feelings with facts, and seeing possible or imaginary sin where there is no sin.
• Irrational, intrusive thoughts of not being devout, moral, or faithful enough, despite all evidence to the contrary.
• Excessive concern over whether you are praying or performing the rites or observations of your religion correctly, and whether or not you are completely following God’s will in every area of your life.
• Sudden, intrusive blasphemous thoughts, such as sexual images about religious leaders, or urges to curse God or sell your soul to the devil. These thoughts pop into your mind even during prayer or worship, and trigger intense guilt and fear as you wonder if you really meant to have them.
• Constant fear of doing something wrong that would jeopardize your soul and cause you to lose your salvation and go to hell.
• Subtle, disturbing feeling that something is not right between you and God despite trying to observe every point of doctrine and righteous living.
• Obsessive need for assurance and certainty about your religious beliefs and whether or not something is a sin. Then you still have doubts and wonder how you can be certain even when you receive this reassurance.
• Intrusive thoughts you may believe are being validated by the voice of the Holy Spirit.
• Trouble accepting God’s mercy and grace, and feeling unworthy to even approach him.
• Fear of being possessed.

Compulsions Compulsions mimic normal religious practices, but are performed out of fear rather than joy. They may become so time-consuming that they interfere with daily life. Some common examples include:

• Writing out your prayers to make sure they are done correctly, or repeating them over and over until you think you have said them perfectly.
• Constantly ruminating on prayers you said or conversations you had, looking for mistakes you may have made that offended God.
• Repeatedly performing cleansing and purifying rituals and engaging in self-punishing behaviors such as flagellation or fasting as a form of penance and atonement.
• Feeling compelled to do things you think God is telling you to do or that are being validated by the voice of the Holy Spirit.
• Endlessly repeating actions to try and get them right, such as reading and rereading Scriptures for fear you may have misunderstood them.
• Constantly repenting and confessing perceived sins even when they are not real sins.
• Placing extra demands on yourself that are not required by your faith or religion.
• Constantly scanning your brain to look for things you may have done wrong but can’t remember.
• Making pacts with God.
• Focusing excessively on one aspect of religious practice while ignoring other, more important ones.
• Avoiding situations such as worship services or religious settings you are afraid might trigger unwanted intrusive thoughts.
• Repeatedly asking for advice or reassurance about the same spiritual issue over and over, as your doubts keep returning.

Differentiating Religious OCD From Normal Religious Practice

Religious OCD is often mistaken for deep piety. The scrupulous person may, on the surface, appear to be devout and dedicated to his or her religious practice. However, it differs from people who feel secure in their relationship with God, whose faith is a source of peace, comfort, and spiritual connection.

Unlike those who feel secure and who do what they do out of love and devotion, he or she feels burdened, stressed, and confused. He or she is driven by an intense, obsessive anxiety and fear of being punished by an angry God whose requirements he or she can never satisfy.

Causes of Religious OCD

To date, there is no definitive consensus among researchers as to what causes OCD. However, the consensus seems to be that it has both a biological and an environmental component.

Biological factors Studies suggest there is a strong genetic link and that having an immediate family member with the same disorder can increase your risk for developing OCD by about 45-65%. They have also found that the brains of people with OCD are underactive in areas that regulate habitual behavior and cause it to cease by sending out a complete message. This makes it hard for them to stop their obsessive thoughts and compulsive behavior.

Environmental factors Environmental factors that may contribute to religious OCD include stressful life events in early childhood; pediatric autoimmune neuropsychiatric disorder brought on by a strep infection (PANDAS); or a rigid, fear-based religious upbringing that creates an image of God as harsh, punishing, and judgmental, rather than merciful and loving.

Treating Religious OCD

The most effective way of treating religious OCD involves addressing it from both a clinical and a spiritual perspective.

Common Clinical Interventions

Exposure and response prevention (ERP) Exposure and response prevention therapy is a modified form of cognitive behavioral therapy that is not only considered the gold standard treatment for religious OCD, but for other forms of OCD as well. Its goal is to help you break the obsession-compulsion cycle by having you gradually confront your feared thoughts while resisting the urge to try to counteract them with compulsive behavior.

Before the actual ERP treatment begins, your therapist will guide you through the process of identifying and listing, in hierarchical order from least to most disturbing, all the things that precipitate your obsessive thoughts. Then, in a safe and controlled way, he or she will gradually expose you to them (starting with the least distressing ones) while having you refrain from reacting to them.

This process helps you see that nothing bad happens when you simply ignore obsessive thoughts and let them fade away without acting on them, and builds your tolerance to them. It also rewires your brain’s automatic response to intrusive thoughts by teaching it that anxiety fades and feared outcomes are manageable.

Acceptance and Commitment Therapy (ACT) Acceptance and commitment therapy is another effective treatment that works on breaking the cycle of repeatedly getting stuck in your head, trying to fix distressing emotions. It uses mindfulness techniques to teach you how to accept anxious thoughts and feelings without judging them or responding to them. Learning to let go of the urge to act on your distressing thoughts divests them of their power.

Eye Movement Desensitization and Reprocessing (EMDR) Eye Movement Desensitization and Reprocessing involves talking with a therapist about intrusive thoughts while he or she uses bilateral stimulation to cause rapid eye movements. These mimic the way your brain processes experiences and memories during sleep, reducing the emotional charge of triggers and desensitizing you to disturbing intrusive thoughts.

Spiritual Interventions

Spiritual interventions are typically conducted by a pastor, priest, religious mentor, faith-based counselor, or spiritual life coach. They involve careful application of religious beliefs and values to help you learn how to disentangle genuine faith from obsessive-compulsive faith, accept uncertainty, set spiritual boundaries, and reassess your view of God’s character and ways. This can be particularly helpful when pursued in tandem with the above clinical interventions.

If you think you may be struggling with religious OCD and would like to set up a risk-free appointment to meet with one of the faith-based counselors at our location, please give us a call. You don’t have to walk this path alone.