This is the third installment in our ongoing series on Scrupulosity, a sub-type of Obsessive-Compulsive Disorder (OCD) focused on religious or moral perfectionism. This article focuses exclusively on identifying and challenging common cognitive distortions seen in “moral” Scrupulosity.

Moral Scrupulosity

Those struggling with Moral Scrupulosity OCD can
learn to challenge their distorted thinking.

Previous articles in this series have focused on religious Scrupulosity, which is most easily described as a pattern of intrusive, unwanted thoughts related to one’s religious beliefs. These unwanted thoughts are counter to the sufferer’s faith, and lead them to perform compulsive behaviors in an attempt to nullify or extinguish the anxiety they experience related to these thoughts.

Conversely, the obsessions experienced in “moral” Scrupulosity are focused not on matters of faith, but rather on one’s personal sense of morals and ethics. Those suffering with moral Scrupulosity experience commonplace thoughts, feelings and actions that they misinterpret as being evidence that they are ethically flawed or morally bankrupt. As with all sub-types of Obsessive Compulsive Disorder (OCD), those with moral Scrupulosity seek relief from their anxiety through various compulsive and avoidant means in an effort to ensure that their obsessive fears do not come true. In other words, they perform compulsive behaviors that they hope will prevent or eliminate the feeling that they are a “bad” person.

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This is the second installment of a multi-part series on Scrupulosity, a specific variation of Obsessive-Compulsive Disorder (OCD) that focuses on religious and moral perfectionism.  This article focuses on how one can learn to identify and challenge common cognitive distortions seen in Scrupulosity.  Please note that this article will focus exclusively on religiously-focused Scrupulosity, and that future installments will address Moral Scrupulosity.

Scrupulosity in OCD

Cognitive Restructuring can be a valuable component of treatment for Religious Scrupulosity in OCD

Scrupulosity is a type of Obsessive Compulsive Disorder (OCD) rooted in irrational, distorted thoughts (obsessions) related to one’s religious beliefs, morals, or personal ethics.  An individual with Scrupulosity experiences these unwanted thoughts as being at odds with their faith, their relationship with God, or their moral and ethical values.

As with all types of OCD, the individual with Scrupulosity responds to their obsessions with compulsive behaviors that they employ in an effort to reduce, eliminate, or reverse their unwanted thoughts and the anxiety they cause.  Scrupulosity becomes a clinical issue when an individual’s behaviors are motivated by a desire to control anxiety rather than the pursuit of a genuine connection to their faith, morals, or ethics.

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Many people mistakenly think of Obsessive Compulsive Disorder (OCD) solely as a condition in which people wash their hands excessively or check door locks repeatedly.  There are actually many sub-types of OCD.  In this ongoing series, Kevin Foss, MFT of the OCD Center of Los Angeles discusses Scrupulosity, in which an individual’s OCD focuses on issues of religion, morals, and ethics. Part one of a four-part series.

Scrupulosity OCD

Those with Scrupulosity experience profound feelings of anxiety and guilt related to religion, morals, and ethics.

One of the first documented references to Obsessive Compulsive Disorder (OCD) was in a 1691 sermon by Bishop John Moore of Norwich in which he discussed men and women who were overwhelmed with unwanted thoughts, and tormented by feelings of guilt and shame over what he described as “religious melancholy.” Priests had started to notice that some churchgoers were attending confession several times a day, and repeatedly confessing to the same sins and shortcomings that they feared would result in divine judgment and eternal damnation. Their penance and absolution would provide only a fleeting glimpse of peace, and then their fears would come roaring back.

In retrospect, we now know that this obsessive religious fervor is a manifestation of OCD known as Scrupulosity. People of various religions across the world are haunted by feelings of doubt, guilt, and anxiety that torment them by attacking that which they find most dear – their faith. Scrupulosity is a form of OCD in which the sufferer’s primary anxiety is the fear of being guilty of religious, moral, or ethical failure. Those afflicted with Scrupulosity fear that their effort to live according to their spiritual values not only isn’t good enough, but is in direct violation of God.

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