Scrupulosity OCD

Common compulsions may include:

• Repeated and ritualized confessing (to religious figures such as priests, church elders, and/or to friends and family)
• Reassurance seeking about behaviors and thoughts related to religion, morals, ethics, or values
• Excessive, ritualized praying and/or reading of the bible or other religious texts
• Repeating specific verses from the bible or other religious texts (either out loud or silently)
• Mentally reviewing past acts and/or thoughts in an effort to prove to one’s self that one has not committed a sin or acted in a manner thy construe to be immoral or unethical or counter to one’s faith
• Ritualized “undoing” behaviors to counteract perceived sins and transgressions
• Excessive acts of self-sacrifice (i.e., giving away relatively large amounts of money or earthly possessions)
• Avoidance of situations in which one fears the onset of obsessions related to issues of faith (i.e., church, temple, mosque, prayers, movies with devil themes, dating)
• Avoidance of certain objects that one associates with immorality or sin (i.e., certain clothes, certain numbers)
• Making deals with God to avoid eternal damnation (or merely to reduce current anxiety and discomfort)

Why Scrupulosity is Different From Other Forms of OCD

Some variations of OCD, while painful and confusing to those suffering their effects, focus on thoughts that are far removed from the individual’s values, beliefs and character. For example, the teacher with Harm OCD who fears he will somehow become a mass murderer, or the student with Gay OCD (also known as HOCD or Sexual Orientation OCD) who constantly questions her sexual orientation, can at some point recognize that the focus of their obsessions is totally at odds with who they are – with their true values and beliefs.

But this is not the same for those with Scrupulosity OCD, as they would argue that there is nothing more central to them, indeed nothing that more clearly defines the main purpose of their life, than their spiritual beliefs and religious practices. For those suffering with Scrupulosity, the content of their thoughts hits painfully close to home. To make things worse, in many religions, challenging the doctrine or body of belief can be viewed as challenging the faith itself and an act of apostasy.

One question that repeatedly comes up when assessing clients for Scrupulosity goes something like this: “How do I know that what I am experiencing is Scrupulosity, and not an actual sin, or lack of faith, or even a demonic attack?” The answer to this question lies in the client’s intensity of focus on perfectionism. There is a significant difference between feeling convicted in your faith and pursuing your beliefs, as opposed to focusing enormous amounts of time and energy on perfectly following a few specific rules or doctrines, while turning a blind eye to others that may actually be more important.

Why Scrupulosity is the Same as Other Forms of OCD

While Scrupulosity may at first appear vastly different from the traditional presentation of OCD, those with religious, moral, and ethical obsessions experience the same Obsessive Compulsive Cycle as others with OCD – obsession, anxiety, compulsion, and relief / reinforcement.

Triggers for Scrupulosity can be any thought, image, feeling, place, person, etc., that cues an obsession. For example, seeing an attractive person at church may result in sexual thoughts, which in turn trigger an obsessive desire to “undo” that thought in an effort to be pure, holy, and clean. If the scrupulous individual upholds an exaggerated belief that lustful thoughts in and of themselves will automatically result in eternal condemnation, the cycle begins.

As in all forms of OCD, the obsessive thoughts in Scrupulosity often take the form of “What if…?” questions, such as “What if I just sinned?” or “What if I don’t actually believe in God?” In some cases, the thoughts may be somewhat more irrational in nature, such as “what if just by looking at that woman, I accidentally fondled her breasts?” Instead of recognizing the thought for what it is (just a thought), the sufferer responds to it as if it is a fact.