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”.
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.
Moral Scrupulosity presents unique challenges that make treatment more ambiguous and difficult in contrast with religious Scrupulosity. For example, religious faiths have codified rules for approved beliefs and behaviors that can be verified via scripture, or by consulting with certain authority figures (priests, rabbis, imams, etc.). Conversely, there are no fixed, objective definitions of “good” and “bad”, or “right” and “wrong”. In times of doubt, individuals with moral Scrupulosity have no specific religious text or church elder to whom they can turn for counsel. Their personal belief system – their “moral compass” – is generally based not on religious scripture or orthodoxy, but rather has developed over time through their upbringing and experience. Thus, for those with moral Scrupulosity, determining precisely what is “right” or “wrong” can be exponentially more difficult. At the same time, those suffering with moral Scrupulosity often have a rigid, perfectionistic belief that they must strictly adhere to their personal moral code in all matters, regardless of the situation or context. Failure to do so is often considered unacceptable, no matter how slight the infraction.
Cognitive Distortions in Moral Scrupulosity
As with all forms of OCD, the most effective treatment for moral Scrupulosity is Cognitive-Behavioral Therapy (CBT). The main cognitive tenet of CBT is that irrational and unreasonable beliefs (known as cognitive distortions) influence subsequent feelings and behaviors. The central tool used in correcting these faulty beliefs is Cognitive Restructuring, which helps the sufferer to gain a more realistic perspective in three ways:
- Building the sufferer’s awareness of their obsessional thought patterns
- Identifying how their obsessional thoughts are distorted and unrealistic
- Challenging these cognitive distortions with thoughts that are more rational and realistic
Some examples of cognitive distortions commonly experienced by those with moral Scrupulosity are:
- All-or-Nothing Thinking (Black and White Thinking)
- “I may have heard someone talking about part of the test yesterday, so I’ll be a cheater if I answer any of those questions.”
- “If I accidentally under-report my income by $100 on my taxes, I’m committing major tax fraud.“
- Discounting/ Minimizing the Positive
- “It doesn’t matter that I often give money to homeless people – I’m a horrible person because I didn’t give any money to a homeless person today.”
- “I am a terrible person because I didn’t prepare as well as I usually do for my team presentation at work.”
- Emotional Reasoning
- “I am a bad wife because I noticed another man who is attractive.”
- “It would be really mean and unforgivable if I gave my classmate constructive criticism about her assignment.”
- Should/ Must Thinking (Perfectionism)
- “I must always tell the truth, no matter what, because it’s the right thing to do.”
- “I should never drive over the speed limit, no matter what.”
- “If I don’t remind my wife to wear her seatbelt, she’ll be in violation of the law and it’ll be my fault.”
- “I cannot watch the movie Free Willy because it’ll mean I’m supporting harm to Killer Whales.”
The goal of cognitive restructuring is to challenge and replace irrational, fear-based beliefs with thoughts that are more reasonable, realistic, and objective. For example, one can challenge the belief that they should never find anyone but their spouse attractive with a more realistic thought that it is normal to find other people attractive, and that what really matters is what one chooses to do in response to those feelings. Likewise, one can challenge the thought that they are a cheater because they heard other students talking about an exam by reminding themselves that they studied hard, and already knew the answers to the questions that were on the test.
It is worth noting that the process of cognitive restructuring has the potential to become a compulsion in its own right. When challenging your distorted thinking, it is important that you not compulsively review either your obsessive thoughts, or your cognitive challenges to those thoughts. The goal is to quickly establish whether a thought is in fact distorted, and if so, to challenge it with a more balanced thought. If you find yourself repeatedly evaluating whether your cognitive challenge is “good” or “right”, it’s a good bet that you are inadvertently using cognitive restructuring as a compulsion.
Ultimately, the long-term goal of cognitive restructuring is to stop blindly accepting the irrational thoughts that present themselves to your mind, and to instead develop a pattern of challenging them. With conscious effort, your mind’s default position will shift from unquestioning acceptance of distorted thoughts to a more realistic way of thinking that is based on reason rather than fear.
Common Challenges in Cognitive Restructuring for Moral Scrupulosity
Of course, this process is not as simple as it sounds. The human mind loves to create disastrous scenarios, and it is likely to take repeated effort over time to change well-established thought patterns. Furthermore, reality is not as cut-and-dried as logic. For example, take the issue of driving no higher than the speed limit. Most people would agree that, as part of being a responsible member of society, it is generally a good idea to follow traffic laws. And if you don’t, you may get a speeding ticket with a hefty fine, or worse, have an avoidable accident.
However, in some situations it may be advisable to break the law and go above the speed limit, such as in the case of exceptionally fast moving freeway traffic. Even the DMV would advise you match the average speed of others on the road. In other situations, such as an emergency drive to the hospital or some other life-threatening scenario, driving faster than the posted speed limit may actually be a matter of life and death.
These exceptions to the rule illustrate the grey-area nature of real life. Simply put, there are some situations where not being entirely “good” or “right” is preferred, or even necessary. It is also worth noting that bringing logic and reason to emotion may not always change a feeling – try to reason your way into, or out of, loving someone. Now imagine the difficulty of challenging a thought for which there are no codified laws, such as being honest with your spouse, or exhibiting responsibility towards others.
As this suggests, given the inherent ambiguity of trying to “live right”, challenging cognitive distortions will only get one so far in managing moral Scrupulosity. As noted above, in contrast to religious Scrupulosity, moral behavior has no standard doctrine for behavior or belief. For example, a common belief is “It is wrong to kill another person”. But in the case of war or self-defense it may be necessary. Likewise, most people believe it is wrong to steal. But if your family is starving to death, stealing may be the most noble option possible.
A more common moral ambiguity faced by many people in America is the matter of “tipping” for services rendered. By American standards, most people consider tipping a “good” thing to do. However, there is no hard and fast rule for the amount one should tip – 10%, 15%, 20%? If you ask ten people, you are likely to get ten different opinions, including variations based on the type of service being rendered, and how well the service was provided.
But a person suffering with moral Scrupulosity may be obsessively concerned with how much to tip, and with the criteria by which that decision is made. Their belief is that they must tip the “right” amount. It is a moral imperative. Furthermore, their anxiety may be exacerbated by their exaggerated fear of harming the person providing the service – “what if the waiter can’t pay his rent because of my tip being inadequate?”. All this concern over a gesture that by all objective measures is optional.
The Role of Values In Cognitive Restructuring for Moral Scrupulosity
Effective management of moral Scrupulosity ultimately comes down to making choices based on one’s motivation for action. In short, are your actions done because you prefer acting a certain way, and prefer a certain outcome, or because you are trying to avoid feelings of distress and anxiety related to your irrational fears. For individuals in the throes of moral Scrupulosity, simple everyday decisions are often based not on choice, but on fear. Do you tip 20% because it makes you feel good to support the hard work of others, or because tipping less would result in your feeling guilty, anxious, or fearful? Since a firm standard does not exist, it seems reasonable that one should act in accordance with their true values, while accepting the potential costs of upholding those values (such as feeling short-term guilt, or worrying that others may possibly think you’re stingy).
In order to guide your choices by your values, you first need to evaluate both the intended action, and the perceived consequences of alternative choices. If you are suffering with moral Scrupulosity, consider asking yourself these questions when faced with a situation in which you are experiencing moral ambiguity:
- What does my OCD say will happen if I don’t do my compulsion?
- What has been the outcome in previous situations in which I have experienced this moral concern?
- Objectively, what is actually the most likely outcome?
- What do I fear it will say about my character if I do something different?
- Who or what suffers if I make my choice based on my fearful obsession?
- What other possible choices can I can make in this situation?
- What about my choice do I actually care about and want in my life?
- Is my choice in this situation based on my true values, or on my fear of experiencing anxiety or discomfort?
- What might I gain by choosing my action based on my true values rather than on fear?
Using these questions to evaluate a fear-based thought can help you decide if that thought is a cognitive distortion. And if your proposed action and its outcome do not align with your life goals and values, you can choose to instead accept the anxiety that comes with experiencing your irrational, distorted thought. The alternative – guiding your life with the goal of anxiety avoidance – will typically lead to an abandonment of the life you actually want.
Integrating Cognitive Restructuring, Values, and Behavioral Change
Taking control over your behaviors can be emotionally difficult, especially when what you have been doing “feels right” (even if it costs you time, money, energy, or relationships). The ultimate aim of treatment for moral Scrupulosity is to accept and tolerate temporary discomfort in order to gain eventual freedom by acting according to your true goals and values. A decision to do something different is entirely up to you, and will be motivated by your evaluation of the costs of avoiding anxiety versus the benefits of going against your fears by making bold, personally valuable choices.
If you determine that your behavioral responses to your irrational thoughts are out of sync with your values and character, the next step is to begin exercises to progressively challenge and change your actions in response to your fears. The best approach to this is a CBT technique called Exposure and Response Prevention (ERP), which is the most effective method of promoting both a tolerance of irrational feelings of anxiety, and a long-term reduction in distress. ERP for Scrupulosity will be discussed in greater detail in a following article. In the meantime, if you are suffering with moral Scrupulosity, remember that your excessive anxiety is an exaggerated response to feared, irrational thoughts. The path to freedom is to challenge these thoughts, accept short-term discomfort, resist giving in to compulsive behaviors, and act in accordance with your true goals and values.
To read part one of this series on Scrupulosity in OCD, click here.
To read part two in this series on Scrupulosity in OCD, click here.
•Kevin Foss, MFT and Tom Corboy, MFT are licensed psychotherapists at the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions. In addition to individual therapy, the center offers five weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.
Thank you, once again, for an excellent article. My son used to give every penny he had to charity (when it should have been used for college:)). While he had always been a charitable person, this was definite black-and-white thinking on his part. And of course he was motivated by fear, not by a genuine desire to give to each and every charity.ERP therapy did wonders!
Thank you for the kind words and support. We hope this series will shed some light on Scrupulosity and give hope to those who feel trapped in their anxiety. I’m so glad to hear that ERP helped your son, and that he was willing to do the work necessary to see progress.
Hi. I’m suffering from OCD with co-morbid OCPD (or is it the other way around?). I don’t believe this is such a rare condition in OCD. Yet with the exception of three articles by Steven Phillipson, PhD (“God Forbid”, “When the Going Gets Tough” and “The Right Stuff”) published on his OCD Online website (I believe intentionally written with many mistakes), I couldn’t find any other on this subject/topic on any other OCD website I know about. Why?
I agree – moral scrupulosity is not all that rare. We see it fairly often in our clinic. The best guess I can come up with as to why there are not more articles online about this topic is that moral scrupulosity is perhaps not as common as other forms of OCD, including religious scrupulosity. As evidence of this, just look at how many comments this article has produced compared to our article on religious scrupulosity.
Hello. Thanks for your reply. Yes, indeed, 98 comments as of now… But this isn’t exactly what I meant by my question. I’m curious to know why there aren’t more articles about anankastic/obsessive-compulsive personality disorder on OCD websites, since, according to Dr Phillipson:
“There is a chance that when a person has this form of OCD [scrupulosity/hyper-responsibility], they also have an accompanying personality disorder, referred to as obsessive-compulsive personality disorder (OCPD).”
As you point out, Dr. Phillipson wrote “there is a chance that when a person has this form of OCD [scrupulosity/hyper-responsibility], they also have an accompanying personality disorder, referred to as obsessive-compulsive personality disorder (OCPD)”. While some people have both OCD and OCPD, it is not that common, and I suggest this is the reason there are not more articles on the overlap between the two conditions. That said, you found three articles, and searching for more may be a compulsion. I doubt you are going to find information that will shed significantly more light on the topic, and encourage you to refrain from spending more time searching for these types of articles.
Hi, I have some questions with ERP therapy with those who have scrupulosity ocd. My friend has recently begun therapy for this but failed to ask his therapist how it really worked. Religion is a large stressor for him so he feels that ERP is making him unfaithful and not fully relying on God, that’s only the first problem. After I convinced him to take part in it, he said he would still only use his faith in ERP but I thought the person was supposed to live with complete uncertainty of the bad things that could possibly happen so he isn’t fully taking part in it and is using his faith as reassurance?? I need help!!! Could someone please explain this more in depth?
I have a simple question: can one still say that he suffers from “moral scrupulosity” by constantly ruminating and feeling an extreme, chronic and almost disabling pathological guilt over the same mistakes/issues even though that he ACTUALLY DID commit these mistakes?
ERP for Scrupulosity is sometimes as much an art as a science. Please know that I do not know the details of your friend’s disorder, nor the nature and course of his treatment, so I can only respond generally.
You are right that the ultimate goal of ERP for all variants of OCD is to accept uncertainty, while moving forward with the option of greatest value. A common problem with treating Scrupulosity is that the sufferer has a distorted view of what qualifies as sin or unfaithfulness, and ERP is designed to expose the sufferer to thoughts, actions, etc., that may make them feel sinful.
It is unreasonable to expect a religious person to not use their faith as a coping skill in times of stress. In fact, giving up responsibility to God for the outcome of the exposure has been argued as a key component for ERP (which by definition, also relies on “faith”). Compulsive prayers, rituals, or confession during or following exposure, however, would be an inappropriate reliance on faith.
I understand you are concerned about your friend’s treatment, but remember that it is his treatment, and it may not be helped by your involvement. If your friend requests your input, you can meet with his therapist to work out an appropriate way to support and encourage your friend without undermining their work.
To discuss your concerns in more detail, our staff would be more than happy to schedule a consultation time for you or your friend if you contact us by phone or email. I hope this has been helpful. Good luck!
OCD is defined as recurrent and persistent thoughts, urges, or impulses causing distress followed by repetitive physical or mental acts aimed at reducing the discomfort. What you described could be considered OCD if it is indeed extreme and focused on just one area of concern. However, it could be part of Generalized Anxiety Disorder (GAD) if the worry is part of a constellation of worries that are all less extreme in persistence and intensity. This would be determined through a thorough clinical assessment, and I would urge you to consider scheduling one with a competent therapist.
One treatment goal for both OCD and GAD would be to accept the presence of unwanted thoughts without a fight, while giving up on any attempt to resolve or neutralize the worry. We cannot change the past, but we can control what we do in response to our present thoughts and feelings. Again, if you are concerned, I would encourage you to consider beginning some therapy to work out your relationship with this worry. Best of luck, and thank you for the comment.
I have a question. While suffering from GAD, pure OCD and depression, I was starting to get better. I stumbled across a website that had a quote boiling down to ‘it is wrong to eat animals when we don’t need to to survive’. This has caused me a month of terror, stopped me eating, made me worry 24/7 about the fact that I want to eat meat and always was fine with it. It was immediately followed by scrupulosity so extreme that I began to think that it’s a terrible crime to even exist, use resources, use trees for fire and houses, and so on. My awesome therapist says this is just another manifestation of my issues, but exposure therapy is difficult – if I went back to eating meat, I’m terrified that one day I will wake up, feel like I have committed a terrible ethical crime, and have a breakdown. During moments of calm and relaxation, it seems like I have a slightly more nuanced view, but the anxiety starts when I think that, because I’m feeling better, I might go back to eating meat, because if that is the wrong choice, it is irrevocable. My therapist and I are working on it, but do you have any ideas? It’s hard to dismiss these thoughts as irrational especially since there are many vegetarians out there who would agree!
A late reply and I hope you’ve done well with working with it… but anyway, some thoughts:
A complementary approach is to look at your values. What’s most important in your life? Being loving with family? Helping people? Something else? Respecting nature? Being healthy?
Now look at your actions- Not eating meat. How does that fit with each value. Do the benefits outweigh the costs, or the other way around. Also, are there different ways you can be a vegetarian/meat eater? Does it have to be all or nothing? Can you be more flexible?
You have a specific fear: One day, the realisation that you have ‘committed a terrible ethical crime’ will cause a breakdown. This may be a key thought to challenge:
Is this thought realistic?
Is meat eating a terrible ethical crime?
Even if it was a terrible ethical crime, would that realisation necessarily to lead to a breakdown?
Sometimes, It’s not the content, but the process. Can you look at what you are doing with humour and kindness something like: ‘thanks mind for showing that I care, I’ll let that thought pass this time’
The bottom line is: is what I’m doing working for me and those I love?
I suffer from ocd, and perhaps hyper responsibility, hyper-morality amongst other things. I am now a vegetarian and I have recently been on UK National Health’s ‘fit4life’ course. The nutritionist there was never concerned about my vegetarian lifestyle so you will probably be healthier so long as you have a balanced diet. If you think you might slip up and eat meat it is certainly not irrevocable. I know some really loving people who happen to eat meat etc. I know some vegetarians who are very mean. Everyone is on their own journey of discovery. The universe is a play of creation preservation and destruction and you are a part of this creation and you are entitled to what you need for your progress in the scheme of things, remember there is enough in this world for everyone’s needs but not for everyone’s greed. You do not sound greedy at all. Keep working with your therapist. Speak to yourself as if you are advising a loved one. I hope this helps.
There is not a therapist in my city that specializes in OCD, I was told sometime ago by one that I had OCD, painful thinking. I now know I have Pure O, religious scrupulosity. I have bought several books including the Mindfullness Workbook, I just don’t know how to use it. I have thoughts that maybe God isn’t even real, that I have not been chosen by God, that I don’t have enough faith, that if I don’t grow closer to God and have more faith God is going to take my grandson who lives with me to draw me closer. When I try to pray I have these thoughts, when I read my Bible I feel like everything in the bible is saying I am not really saved and not really a believer. I am so worn out by all of this and just want to have peace with my salvation. Any help would so be appreciated. Thank you
Unfortunately, it can be difficult to find therapists who specialize in treating OCD outside of major cities. However you do have several options. First, I encourage you to contact the International OCD Foundation at http://www.iocdf.org. They maintain a database of therapists who specialize in OCD and anxiety and could help connect you to the closest professional. Hopefully you can find a qualified therapist who can help you navigate the tools in the Mindfulness Workbook and apply its principles.
Additionally, if you are able to come to California, our center offers an intensive treatment program. Our staff therapists also offer webcam-based teletherapy to people in some states and under specific guidelines. If you have any questions about these options, please feel free to contact us through our website.
I also encourage you to read our article on Religious Scrupulosity, and its followup on cognitive therapy for Scrupulosity, both of which may address your religious concerns more directly. Best of luck.
Hi Rich. My omnivore and OCD therapist side would simply say, “Eat meat, and lots of it.” The reality is there will be religious, non-religious, and moral arguments to eat all sorts of diets, but they will all ultimately come down to how they fit into your world-view, and which diet brings your life meaning and value.
OCD will always find a reason to say how you are living immorally, but we cannot trust all our thoughts or feelings when OCD is at play! If you have a personal conviction to reduce your use of natural resources and eating vegetarian, then great, but doing so out of fear and guilt sounds like a compulsion.
So, work with your therapist on the details, but if your obsessional fear is using natural resources, then drive to the store when you could walk, use plastic bags, stop recycling paper or aluminum cans, give your loved ones flowers at every possible occasion, and eat as much bacon as your cardiologist will allow.
Finally, it is worth noting that, just because vegetarians exist doesn’t mean that they have a corner on what is “right” or “rational”. You can find people that believe all sorts of things, including many who wholeheartedly disagree with vegetarianism. Best of luck.
I suffer from moral/legal scrupolosity. I spend a lot of time worrying about and trying to make sure I comply with tax laws, government ethics rules, confidentiality rules, business regulations, and other complex rules. I don’t know if most other people in my profession follow these rules to the letter, or if they’re even aware of all of them. I’m guessing probably not. I certainly seem to spend a lot more time than most people trying to understand and comply with rules. But I can’t figure out which rules most people take seriously and which ones are routinely bent or broken even by “good” people. Most of the time I don’t have a good idea of what the norms are, and not knowing causes me a huge amount of anxiety. I would love to have some ideas for doing ERP for this kind of issue
You ask a great question! The trick with moral scrupulosity is that there are no hard and fast rules for most of the issues in life.
One way to get an understanding of the typical practices of someone in your field is to simply ask! Find someone in your field who you trust has good ethics and similar professional values and ask them. I know this sounds like a compulsion, and if done repeatedly will most certainly be one. But if we have questions about how something is usually done, it would be reasonable to ask.
For example, hardly anyone drives the speed limit on the freeway, but how much over the speed limit is usually tolerated. Asking someone who has a good driving record but still speeds from time to time is a great person to ask. Once you have your answer, it is up to you to take the risk to follow their advice, or rely on your own sense of caution.
Using mindfulness-based approaches, such as Acceptance and Commitment Therapy (ACT), you can find the balance that acknowledges your scrupulous leanings with a reasonable approach to your professional practices. Thank you for your comment.
I’ve met a person who i really deeply care for and would like to stay connected with. However, i keep getting intrusive thoughts (which i have had in the past) that sounds like a mixture of ROCD and moral scrupulosity. I don’t even want to say what the thoughts are here, because i’m scared that they will trigger off the sharp stabs of anxiety ridden pain i keep getting with each thought. I don’t want to share this with them as i’m afraid i will lose them. I want to cry, because it’s all so exhausting. I am in the UK and there is not as much insight into rocd and moral scrupulosity here. I am also ashamed of people knowing that i may suffer from ocd. Maybe i will seek the online help here. I still feel ashamed and disappointing with myself for having this issue. Kieron
A few thoughts…
1) It is extremely common for people with OCD to have more than one theme, and it is not unusual for people with ROCD to also experience issues with Moral Scrupulosity. We address this issue in our article “ROCD: Relationship OCD and The Myth of “The One”.
2) Not mentioning the specifics of your obsession for fear of triggering more obsessions is an example of an avoidant compulsion. As you can see, avoidance is not working for you (or else the obsession would have gone away by now).
3) There is no shame in having a mental illness. Would you feel ashamed of having an ulcer, or diabetes, or a broken leg? Of course not. I repeat, there is no shame in having mental illness.
4) If you cannot find specialized help close to home, we offer online therapy for OCD. You can contact us via our website at https://ocdla.com/ to learn more.
Thankyou so much.
I am so confused as to what is real and what is doubt with this issue. It’s like i can’t trust my own feelings and i keep analyzing reassuring..analyzing reassuring.. analyzing..reassuring . I hope i can pluck up the courage to face my fears and contact you soon. I don’t want to lose this person 🙁
Your confusion about the difference between “what is real and what is doubt” is just more doubt.
You don’t need to trust your feelings. In fact I would say trusting feelings in general is a bad idea. Feelings are not facts – they are just feelings.
Reassuring yourself and analyzing your thoughts and feelings are compulsions. They will never help you to better manage OCD
Thank you for this article.
I’ve been using this fear based decision making all of my life. Now that I sort of understand why I’ve been behaving this way I think I can fix my behavior.
Thanks for your comment. It’s gratifying to hear that our article has helped you to better understand your behavior. Take care.
Hello I have been receiving CBT for some time now but have never heard of moral scrupulosity, however this sounds just like me on so many levels.
I have a huge fear of telling a lie to my husband, sometimes memories of something from months, years ago come flooding back and I think to myself ‘ did I confess about that? Did I tell him everything? ‘ it has my stomach in knots and me in tears and I have the compulsion to bring it all up but know that it will probably result in arguments and him thinking worse of me.
This week I have been trying to not give in, accept my thoughts but try to move on to other thoughts instead of giving in but it is so so hard, and yet I still question if this is really my OCD or if I am just a bad person trying to use this as an excuse. It is exhausting.
If it sounds like Moral Scrupulosity, then it probably is Moral Scrupulosity. And if you have told your therapist about these thoughts, and they did not identify them as OCD, there is a good chance that they do not really understand OCD and how to treat it with CBT.
Confessing your thoughts and doubts to your husband is a reassurance seeking compulsion that will not reduce your OCD in the long run. Also, as you note, it will likely lead to discord with your husband. Besides, there is no reason that you or anyone needs to tell their partner about their uncertainty. You are not obligated to tell your husband “everything”. Your mind is your own, and not confessing things 100% does not make you a bad person.
I just found this article and i think it might be what i’m looking for.
i have had anxiety and OCD all my life but recently i have become very preoccupied with my Morality. Mainly, how do i feel about bad things happening in the world? I find that i can read a news article about some human rights violation / accident or attack and will end up endlessly analysing my emotional response to that. I have become fixated on the idea that i am morally flawed and that if i don’t feel gut wrenchingly horrid about these events i end up going on a huge emotional/thinking journey, researching articles about empathy / psychopaths etc. I used to be very interested in serial killers and now i won’t read anything about them as i got worried my interest in them wasn’t normal, and that on some level i was titilated by what they did. Its exhausting to be constantly analysing your response to things and worrying that you aren’t normal all the time.
Is this OCD or am i missing a human empathy trait?
Feelings should not always be trusted, especially for the OCD sufferer. Overfocusing on your feelings and expecting them to be one way or another is a compulsion that worsens your OCD. Furthermore, not having strong feelings one way or another isn’t an indication of your personality or true self. For example, we don’t want our police officers weeping and breaking down at every injustice and murder, but rather we want a calm, thoughtful response from them.
As people, we have fluctuating emotions that are sometimes inconsistent with our expressed goals and desires, and any attempt to control them by manipulation or expulsion is almost certainly an OCD compulsion. Engaging in mindfulness and ERP will help you to get back to your interests without applying a judgement on your personality or character. Reading about killers isn’t bad, killing people is bad, and they are not the same thing. Good luck.
Please help my husband has ocd but over the past three years it’s changed he now goes to church every Sunday and wears crosses and bracelets with crosses on he can’t stop giving to charities and the church don’t know how to help him
I’m sorry to hear that your husband is struggling. Unfortunately, therein nothing that can be done unless he seeks treatment. I encourage you to talk to your husband about getting treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD.
I’m so grateful for this because I’ve finally found a description of my experience. I have an obsessive fear that I’m somehow hurting (emotionally / psychologically, not physically) the people around me. Even though I can never pin down what I’ve done that could be hurtful, and even though they tell me they’re fine. I search my thoughts for any moments of anger, contempt, or disrespect for the people I love. On finding any thought like this, I feel I’ve done harm, even if I haven’t acted on it, even if I’ve expressed these feelings in healthy ways, even if my overall attitude is love and respect. I sometimes feel I should leave my husband because he deserves someone who won’t hurt him, even though he tells me that he’s very happy and that our only problem is my irrational belief that I’m harming him. I want to make progress on this because it’s so draining and exhausting. Thank you for this information. I feel that with some sense of what’s going on, maybe I can make progress. But I do feel confused because it seems like I’m supposed to accept the possibility of hurting the people I love, and that feels really wrong to me. It doesn’t seem like I should accept harmfulness.
In short, you are right – you will have to accept the possibility of hurting the people you love in order to appropriately combat these thoughts. The perceived victim would be the one who would verify if harm were actually done, and your husband has explicitly noted that he has not been harmed.
In relationships, we will inevitably harm our loved ones one way or another, just as we will eventually get sick despite our best efforts to avoid illness. So, until your husband acknowledges a specific harm, you must move on with your life as if you have not done harm unless the alleged victim, says otherwise.
Until I read your site, I didn’t know there was a name for what I experience and that there are other people who have the same experience. It’s awful! I’m afraid to show this to my therapist because she’ll think I’m obsessing and to get over myself. I’m incredibly embarrassed, and I keep all this secret.
I’m glad you found this article and that it could validate what you are going through. Yes, there are many people who experience these same thoughts and feelings, and even more who say nothing for fear of judgement. Your therapist is exactly the person with whom you can and should be able to share these thoughts and this article so that you may address the problem.
However, if you feel hesitant to bring up this information with her, then perhaps there is a poor clinical fit between you two and it’s time to find a new therapist. Therapy ought to be a place to share all manner of thoughts in a non-judgemental setting to process their meaning and value. If you aren’t certain, I suggest you take the risk to share this with your therapist– you will either be surprised that your assumption about her reaction is wrong, or you will have reason to confront her pattern of judgement and marginalization of you.
Hey… I just want to say because of all of your dedicated studies on OCD I have a real shot at living in peace and pursing what I actually want to in life. This has been an insane struggle for the last 4 years and I didn’t even know what it was until a few months ago. I just thought I was going crazy and losing my grip on my life. I never knew why I felt guilty for wanting to pursue my dreams… or why I felt guilty for simply existing… or why my heart was always blaring and my head was always racing. It all makes sense now, but it’s still hard. Anyways, I’m working on having the courage to be more true to myself instead of my irrational fears and I think someday i’m going to get there. Thank you so much. You saved my life.
Thank you for your kind words. It is gratifying to hear that our articles have helped you. Take care.
Thanks for this article!
I know I have ‘classic’ moral scrupulousity, but I also often obsess over things which I have done, especially if it relates to loved ones.
I have never harmed anyone in any way that they would be aware of, but sometimes I have been conscious of a legitimate impulse for a particular decision which coincides with a selfish one…if I fear that I made the wrong decision I worry about which factor most influenced it, which can be difficult to remember. Would I have done things differently if I had not had the selfish impulse? Would someone else’s action’s be different? Would the outcome be different?
I know confessing is bad for MY OCD, but I worry if it’s right to remain friends with, or pursue a relationship, with someone whilst ‘concealing’ things which may have wronged them…they would only ever know of it by the confession and it would only seem bad if they knew how much it was influenced by the selfish impulse, which I know even I will never have certainty over, but it was there.
I know mindfulness and ERP would help, but I fear that my joy in being with people I may have wronged will always be undermined.
A few thoughts…
1) You say you have “selfish impulses”, and that sometimes you wish for things to turn out your way. Congratulations, you are human. I challenge you to find me a single person ever born for whom that is not the case.
2) Wanting things your way does not automatically mean that getting your way harms others.
3) Analyzing which factor impacted a decision or outcome is a compulsion. This is making your OCD worse.
4) I am betting that 95% of the things you have done that you think harmed others have been quite minor and not worth 5 seconds of analysis.
5) Mindfulness and ERP do not “undermine” joy. I can’t even imagine where on earth you came up with such a belief.
This has been incredibly helpful. I am going to CBT therapy already but I still thought that OCD was usually about repeated actions (like pressing a button, or washing hands) and the fear of certain bad events — not about something more abstract as moral scrupulosity, so I felt it was a weird form of OCD.
What I’m finding hard to deal with is that for moral matters the irrational fear cannot be “tested” like one could if the fear was about the occurrence of some event (an illness, say, or a death), and this makes it much harder to dismiss it as irrational (and hence apply CBT). I even mentioned to my doctor that it felt a bit similar to religion (e.g. in Christians would only “discover” if they were virtuous or sinful in the afterlife) but at least — as you said — there the rules are written down and authorities can help with interpretation. In my case I feel like I’m prosecutor, judge, jury, executioner and of course defendant. 🙁
I am weary though to suggest to my doctor to do cognitive restructuring: if I ask him, he’ll probably do it, but then I may doubt if, when challenging my believes, he is honest or rather than just playing a role. Thoughts?
The goal is not to test and resolve uncertainty, but rather to accept it. That means not seeking certainty about moral questions. Just live your life according to your values without checking to see if you have done something “wrong”. This will feel uncomfortable, but you are already uncomfortable with your current approach (which, I might add, is not making you any less unsure in the long run).
While focusing on Cognitive Restructuring is a good start, the more important thing to do is Exposure and Response Prevention (ERP). I encourage you to speak to your therapist about this. If they are not experienced in ERP for OCD, find a therapist who is.
Hi! How can you tell the difference between moral scrupulosity and a legitimately guilty conscience? When I was in high school, I cheated on a test. I worried constantly about getting caught. I couldn’t sleep or focus on other anything else. A few days later, I confessed. I think most people would probably say this was a true guilty conscience, not OCD, and confessing and accepting my punishment was the right thing to do – right? These days one of my compulsions is confessing to transgressions and seeking reassurance that what I did wasn’t so bad. I know doing ERP means not confessing or seeking reassurance. But how do you know if your transgression is actually minor, or if you have a true guilty conscience (like I had about the test)? As you mention in this article, there are large gray areas and people might disagree on how serious something is. These are the kinds of transgressions that my OCD focuses on. The fear always feels the same as when I cheated on the test. As with the test, my main fear is getting caught.
A few thoughts…
1) Having a strong moral center is a good thing, and a guilty conscience is an appropriate response to certain behaviors.
2) Everybody who makes it to adulthood has done many things that could be described as “wrong”, and will likely do many more “wrong” things in the future. For example, I am quite confident that I will roll through a stop sign while driving without making a full stop. In fact, I will likely do that sometime this week.
3) Doing the right thing due to the fear of getting caught if you do the wrong thing is not the same as doing the right thing because of your values.
4) If you find yourself questioning whether a transgression is minor or significant, I encourage you to live with the uncertainty instead of seeking an answer to that question. Looking for the answer to that question is a compulsion. People without OCD do not sweat minor transgressions, and they do not torture themselves with doubt about whether their transgressions are minor or significant.
5) The fact that you are questioning whether a particular transgression is “minor” is pretty good evidence that it is a minor transgression. I am confident you would not be questioning yourself about killing someone or robbing a bank or having sex with a 12 year old. In other words, I think in your heart of hearts, you know what is right and wrong, and what is minor and significant, and it is only OCD that makes you doubt.
6) I encourage you to live by your values without doing compulsions in order to feel less guilty. That means not seeking reassurance, not confessing to minor transgressions, and accepting that you will sometimes feel guilty when you fall short of your values.
I have been dealing with moral scrupulosity for a long time but only recently realized what it was through the help of my therapist. I don’t feel like I have anyone to talk to about my thoughts and compulsions aside from my therapist. My husband thinks I’m crazy when I share my worries with him. And many of my worries have caused major contention between us because I worry how his actions (along with mine) will affect our kids. I feel like I’m ruining my marriage but I haven’t figured out how to stop. And I don’t have any close friends that have understood when I try to explain what I’m going through. Are there any support groups available or do you have any suggestions on how to not feel like I’m suffering alone?
If sharing your concerns with your husband leads to conflict, I encourage you to…stop sharing your concerns with your husband. He has made it clear that he is not able to handle your concerns, and further disclosures along these lines will lead to further problems.
Some marriage counselors would argue that couples should always be able to discuss all of their concerns with their partners, but that is unrealistic. Like I said, your husband isn’t up to the task on this issue. Ditto with friends, most of whom will not be well-versed in the subtleties of Moral Scrupulosity.
I encourage you to continue discussing this with your therapist. And if your therapist is not sufficiently experienced in treating Scrupulosity with Cognitive Behavioral Therapy (CBT), find one who is.
Thank you so much for this article!
I have asked therapists about this time and time again. The last time was around 2004. I was told that I was just a moral individual. Haven’t been medicated or had therapy since. Over the years I have done much reading and implementing what I can; however, my many, many issues have only morphed, or remanifested. I have been trying to find scholarly articles on this, but everything I find is strictly religious scrupulosity. Is there any way someone at your center can direct to scholarly writings?
Unfortunately, your experience with your past therapists is not unusual. Most mental health treatment providers are simply clueless about OCD. In fact many (most?) have never even heard of Scrupulosity, and even fewer have ever heard of Moral Scrupulosity. Equally unfortunate is the fact that there has not been much research on Moral Scrupulosity. The best option for you would be searching with Google.
That said, I want to encourage you to NOT search for research. It sounds like you have a pretty good idea of what you are struggling with, and any additional research is likely to be a compulsive search for some sort of “aha” solution. I think you would be better served by seeking qualified treatment with a therapist who specializes in treating OCD, as virtually all OCD specialists are familiar with Moral Scrupulosity and have treated it on multiple occasions.
I also have a severe case of moral scrupulosity and one that has been doing me alot of harm lately is about me having ‘killed’ other living beings by eating meat, another time i drove like 20mph trough a street and hit a bird i thought i would pass right by him but in my rearview i sae all feathers, i was sort of shocked but did not stop the car and drove on.
Te worst thing about all of this is that im feeling like a true murderer, andi feel like ive been putting my own life above dozens maybe hundreds of animals etc by eating them. Hoe many may have died by my cause?
At this point i feel i am not worthy to live angmore. I just dont knos how to turn this mindset around, it almost feels as if the universe already has decided my faith and that is that im not worth and allowed to live here anymore due those things.
I suspect there are many vegetarians and vegans who don’t eat meat precisely (or at least partially) because they are not comfortable eating animals. After all, a common refrain by anti-meat activists is “Meat is Murder!” Of course, there are many people who don’t share this opinion, as well as many wild animals that eat other wild animals (and I assume they do so without guilt).
The bottom line is that you are the only person who can determine your personal moral code, and you are the only person who is responsible for living up to that personal moral code. Live according to your values, and much of this problem disappears.
Hello. I really need help. It’s been so long that i suffer with intrusive thoughts of harming people but i was not diagnosed with ocd because i always feel so ashamed of talking about that with the doctor. I fear they could say that I’m very sick and has no solution. Sometimes it seems like I’m getting crazy. These days i was consumed by the feeling that i have no care or importance about moral, ethic and social laws and its bizarre because it appears to be a feeling or a belief. I feel like i have no anxiety but inside i feel desperate at the same time. It’s a feeling so real! The worst part is that i feel i could be a threat because of that feeling and because i dont care about social rules or laws i could hurt people without remorse but i dont want to feel or think that way. I just want my life to be normal. Please someone can help me? You know if this can be ocd? Is that normal? Im scared that can not recover my feelings like they were. I fear i have become a psychopath and there’s no turn back. Please if you could help me i would be so thankful! The only thing that makes me more calm is to read text about ocd or harm ocd and scrupulosity ocd trying to find an explanation.
This is a presentation of obsessive overevaluation that we frequently see here at OCDLA. You say that you don’t feel the way you used to, thereby evaluating and comparing your feelings to the past, and fear what that may lead into.
Generally speaking, psychopaths are not concerned that they are psychopaths. You expressed you are concerned with eventually being a threat to society because of your current feeling. Because you aren’t in the future, but only in the present moment, you cannot control how you will eventually act. You can only control what you are doing right now — like everyone else.
Try devaluing the importance of how you think you are supposed to feel, and instead acknowledge how you are currently feeling and acting. Like everyone else, you don’t know what the future will hold until you get there, so refocus on how things are going today and how you intend to act and function despite what personally inconsistent thoughts or feelings may come your way.
I struggle with this and have been working on ERP, which has helped. But I frequently get hung up on what exposures would be reasonable to do. To take an example from your article, suppose it occurs to me that I accidentally forgot to report $100 of income on my taxes the last time I filed. Would it be a reasonable exposure not to fix the error and live with the uncertainty that I might get in trouble for it? The rationale would be that everyone makes mistakes sometimes, and this one is pretty small. Plus a mistake like this probably wouldn’t even occur to many people as their brains aren’t as sensitized to this issue as mine. Or is that too much of a risk? This situation – with taxes – isn’t something that’s happened to me, but I’ve been in similar ones. And each time, I start obsessing about what would be a reasonable exposure and what would be taking it too far. I know there’s no right answer and I probably just have to make a quick decision and go with it. But is there some kind of rule of thumb to apply to get past this?
Generally speaking, we know when we are doing something blatantly illegal or unethical, we we don’t need to spend a lot of time and energy analyzing whether our behavior is ok or not. That said, sometimes we’re wrong because we make mistakes. If you find yourself in the grey area between right and wrong, where most decisions lay, notice when you start to go around and around, or go back and fourth, or get stuck on, the same issues. That’s your red flag that there is no right answer. Then, make a decision, execute the choice, and resist the urge to reconsider, go back, or supplement the decision. In short, live with it and remind yourself that you may have made the wrong choice, but you can weather the storm and deal with the consequences if and when they come, and not a second before.
This is the closest info. to what I am dealing with that I have been able to find to date, and I am in active therapy for years now! My question is this : I use to have these symptoms, having to be perfect religiously or else… and I suffer from diagnosed OCD .. then after treatment for other issues with EFMT unrealted to my religous life I thought anyways I now avoid all things religious and I have no control over doing so! Its like a mental and physical block, and the guilt and missing of that life is guilting me to death! I know OCD behaviors can manifest into other behaviours, so is it more likely that the former was more compulsive and now its manifested somewhere else, or the latter and the avoidance behaviour itself is more compulsive??? I know if I had a choice I would take the former over the latter because I feel like a completely different person , and cant seem to find myself and my connection to God anymore!!! Any thoughts???
Thanks for the comment Grace.
Unfortunately, without learning more about you and your history, I’m unable to give you an answer with any real confidence.
That said, faith is a tricky thing. Over the course of our life, faith shifts and takes on different meaning and intensity based on a variety of things. This can even lead some to genuinely lose the faith they once had by either growing into an atheistic spectrum faith, or simply growing out of an active desire for God. Sometimes, people can attempt to suppress their faith in a compulsive manner in order to avoid OCD based obsessions, or avoid having to resolve emotional or intellectual conflicts, but there is still a belief in God and an interest in having some religious/ spiritual connection. Again, I’m unable to conclude anything at this point.
I encourage you to talk about this conflict with a trusted therapist, friend, or even religious leader. Thank you for the question, and I hope you find what you are looking for.
This article sounds like me. I have recently been obsessing on how I can help stop labor trafficking. I found out it is linked to so many foods, clothing, electronics, even tires in cars. I have read horror stories how children are forced to work in these horrible slave like conditons for no pay while we all consume these goods on a daily basis. I can contact local, state and national politicians and email companies my concern but that would only do so much. I think I should try and get other people involved to fight it and the list continues and it makes me cry. I feel responsible to save the world and it’s driving me insane. I don’t want to quit my job and join a nonprofit but I think should I do more? I just want to be normal and not feel compelled to do all these things. What should I do?
Your quandary is similar to that of “Niels” above who obsesses about being complicit in murder because he eats meat. And my suggestion is the same – if your values about this issue are important to you (and I take at face value that they are), then I encourage you to live according to your values. Don’t buy products that you think make you an accessory to labor trafficking and child slavery. This will likely take effort, research, and a change in lifestyle, but I am confident that many other people on the planet are following their heart on this issue.
Another alternative is to devote your life (or a portion of it) to working to end labor practices that you abhor.
Only you can decide how you want to live your life, and only you can actually put your values into practice.
I have been in a wonderful relationship for the past 5 years and began to seriously consider marriage last summer. A few months ago I had a major surge in my OCD symptoms and started obsessing about all sorts of things. Lately I’ve had the nearly constant obsession that I have to become a nun and give up the life I’ve been working on. Do you know if this would be considered Scrupulosity or Religion OCD? I’ve heard plenty about harm OCD which helped me get over mine, but I can’t find anything on “vocational OCD”.
People with OCD can obsess about anything, including their faith and their relationships. Your current obsession seems to combine these two areas of concern – i.e., “What if I shouldn’t marry my partner, but instead should become a nun?” I encourage you to let this thought exist in your mind without assuming that it is important or meaningful, and without responding to it. It is just a thought, and does not merit your attention or response.
Hello Tom and thanks for this great and helpful article. I have both religious and moral scrupulosity and I feel guilt and seek forgiveness and assurance for Salvation. Also, I start having anxiety on small issues and won’t even litter a small thing on a road thinking I might hurt someone by doing it. I want to get out of it and can I use a self help book for CBT to overcome my OCD.
Self-help books related to OCD can be helpful, but therapy is likely to be more helpful. That said, we have a good list of OCD books on our website.
Hi, my name is Jess and I’ve had OCD since I was five. I’ve been on ssri my entire life. I am a Christian and take my faith in Jesus very seriously. It’s important to me. I am currently going through a very bad phase of religious scrupolisty. I have an intense fear of going to hell, for disappointing God with some of my thoughts. I know deep down how much I love Jesus and how I often cry out to Him to help me. I try to rationalize with myself over and over again that if I’m doing that, I must believe in Him and love Him. My thoughts aren’t very loud…they are like sensation thoughts for example…I sometimes get a sensation thought that I am embarrassed of God…or nearly everything that is said about God or that I hear about God, my mind contradicts it with a negative thought about God. How can I be sure these thoughts are not me? When I’m well I have had some of these thoughts before but have been able to brush them aside….but at the moment I’m completely obsessed and going round in circles trying to prove that I am not this person who is embarrassed of God or is a bad Christian. I am tired and just need some kind of answer please.
Hi. Great article – thank you! I’d love to hear your thoughts about my situation. I definitely have moral OCD, and it usually, but not always, extends to things I’ve done YEARS ago. The one that has been recently flaring is 15 years ago in high school – I frequently cheated on math tests, even sneaked into a teachers locked closet with a friend and copied the answers to math tests. I was a different person then. My morals are very different now and I would never do something like that now. But when I think back to that event, I’m gripped with anxiety and the compulsion is to call my high school and confess. My desired outcome is that they’d “forgive” me and my anxiety would be alleviated. It’s hard because I truly believe that what I did was really wrong, and at the same time, I feel that I shouldn’t “give in” to the OCD. I also recognize the compulsion to gain assurance that what I did was “not that big a deal”. But the compulsion to rid myself of the anxiety by confessing is strong. Help?
What you are describing sounds like what is commonly called “Real Event OCD”. You can read more about the variant of OCD at https://themighty.com/2019/10/real-life-ocd-feel-guilty-past-events/.
Real Event OCD frequently has a flavor of Moral Scrupulosity OCD. Keep in mind that these are just slang terms that people have developed in an effort to better describe and understand their OCD. The bottom line is that all of these slang terms actually refer to the same thing, namely OCD.
If you want help with this, I encourage you top seek treatment with a therapist who specializes in treating OCd with a type of Cognitive behavioral Therapy called Exposure and Response Prevention (ERP).
Obsessions about doing the wrong thing in relation to university work are the latest that I am dealing with, I obsess about things I am doing wrong and confess to people. I have now started my masters and am also having problems because I feel like I am always making plagiarism mistakes, or I may be making them, then I confess, then it happens again but a bit different. The mistakes seem to be piling up, and I am considering restarting my masters because I feel terrible. However, I also know it would look a bit crazy to pull out of my course and restart it somewhere else, but I feel like this might be the only thing to do, since I have been so dishonest.
This sounds exactly like Moral Scrupulosity to me. Starting your master’s degree over somewhere else would be one giant compulsion. Furthermore, it likely would not help, as you may experience the same doubts at your new school.
A better solution would be to seek treatment with a therapist who specializes in treating OCD.