What is Religious OCD, and How Can You Have a Healthier Relationship With Your Beliefs?

When people think of OCD, They tend to think of somebody who cleans a lot or likes everything to be perfectly organized. But every person with OCD is unique, and there are as many themes of OCD thoughts as there are people with OCD.

One lesser known type of OCD is called religious OCD, or scrupulosity OCD. People with this subtype of OCD have intrusive obsessions that are religious in nature. Unfortunately, this can cause people with scrupulosity OCD to develop an unhealthy and complicated relationship with their spiritual beliefs.

At The Center • A Place of HOPE, we believe anyone can have a healthy spiritual life, even if you live with scrupulosity OCD. In this article, we’ll explain what religious or scrupulosity OCD is, and outline ways you can overcome it to develop a healthier relationship with your beliefs.

What is religious or scrupulosity OCD?

OCD, or obsessive-compulsive disorder, is a mental health condition that affects 1 to 2% of the population. This disorder causes people to experience:

1. Obsessions: intrusive and unwanted thoughts, urges, images, or sensations that cause a great deal of anxiety and distress
2. Compulsions: ritualistic or repetitive behaviors that are performed in an effort to decrease or eradicate the anxiety these obsessions bring

People can have obsessions about any theme. Some of the most well-known themes of OCD include contamination (about germs or dirtiness) and symmetry (placing objects in linear or organized order).

For some people, their OCD symptoms revolve around religious or moral beliefs. This is commonly referred to as religious OCD or scrupulosity OCD^[1].

Religious OCD is characterized by a fear of sinning or breaking religious or moral codes. People with this type of OCD may fear being punished by God. But not everyone with scrupulosity OCD is religious; some may simply be afraid of making a moral mistake and offending or hurting others.

Religious OCD obsessions

Some obsessions that someone with religious/scrupulosity OCD may have include worrying about things like:

• Offending God or a higher power
• Death
• Being sent to hell
• Going against scripture
• Praying incorrectly
• Not being faithful enough
• Being “dirty” or contaminated based on scripture or religious rules
• Committing an immoral act either intentionally or without knowing
• Being possessed
• Whether or not you’re a “true believer”
• Needing 100% certainty about religious teachings

Religious OCD can happen in people of any religion, but the way OCD obsessions show up may be different based on the religion you identify with. For example, a Catholic person may have obsessions like:

• “Did I cross myself in the right order? Or did I do it in reverse? What if that’s a sign of worshiping Satan?”
• “What if I go to hell for having a blasphemous thought during mass?”
• “I need to know exactly what the Bible says about this, otherwise I might make the wrong move.”
• “What if I should be taking communion twice a day instead of only once a day?”

Again, not everybody with scrupulosity OCD is religious. Someone may have obsessions about morals or ethics, like:

• “Was that the right thing to do? How can I be sure?”
• “Even the smallest actions have consequences. What if I make the wrong choice and cause someone to get hurt?”
• “What if I’m actually a terrible person?”
• “Was that a racist thought? What if I’m actually a racist?”

Religious OCD compulsions

Like every person with OCD, people with religious OCD respond to their obsessions with compulsions. Some common compulsions you might see in someone with religious or scrupulosity OCD include:

• Praying repeatedly or excessively
• Performing acts of extreme self-punishment
• Seeking constant reassurance from religious leaders
• Neutralizing “bad” thoughts by thinking “good” ones (for example, someone might say a prayer every time a religious doubt comes into their head)
• “Cleansing” practices (like fasting) that are excessive for the religion or culture
• Going to religious services much more than is expected for someone of that religion or culture
• Having a need to perform religious acts until they feel “right” (for example, performing a reverence over and over again until they feel like it’s “right”)
• Excessively apologizing to God or another higher power
• Avoiding religious texts or services in an effort to not experience these obsessions

History of religious OCD

Religious beliefs and scrupulosity have had a long relationship with OCD. In fact, this was one of the first presentations of OCD ever recognized.

Back in the 15th and 16th centuries, understanding about psychiatric illness was slim. But there are records of people facing what was called “religious melancholy,” which was when they were suddenly overcome with “blasphemous” or anti-Christian thoughts.

The Bishop of Down and Connor, Jeremy Taylor, wrote in 1660: “[A scruple] is trouble when the trouble is over, doubts when the doubts are resolved.” This is where the term “scrupulosity OCD” comes from. Although OCD was still centuries away from being named at this time, it seems clear that what he described was a form of religious or scrupulosity OCD.

What is the difference between religious OCD and spirituality?

You might be wondering, “Don’t a lot of people pray or go to church? What’s the difference between being very religious or spiritual and having religious OCD? ”

This is an important question because it’s critical to differentiate between OCD and “normal” behavior. Without the right OCD diagnosis, it’s difficult to get access to the right treatment.

Much of what’s considered “normal” religious behavior has to do with cultural context. For example, there are some countries in which almost every person goes to a religious service for prayer at certain times every day – even though people may not do this in other countries. In others, people may fast at certain times in the year. Monastics or other religious figures are expected to practice religious activities much more than laypeople.

These behaviors wouldn’t be diagnosed OCD within the cultural context – because it’s a common and expected behavior.

OCD causes people to behave in overly religious ways seen as excessive within that person’s cultural context.

Another critical difference is the extent to which these behaviors are getting in the way of day-to-day functioning.

For example, let’s take two people who go to mass every day. One person may go to mass and take communion every morning, because spirituality is important to them. After attending mass, they feel mentally refreshed and renewed. They go about the rest of their day. They say prayers before going to bed, and they sleep well. One day, they are feeling ill and they aren’t able to attend mass. They look forward to returning when their illness has passed.

Another person may also go to mass to take communion every morning. While they’re there, they obsessively monitor their thoughts. Whenever they have a doubtful or “blasphemous” thought, they pinch themselves 3 times as self-punishment. They ask the priest to give them communion a second time, because the first time didn’t feel “right.” They may stay behind after the service to ask the priest whether having these thoughts means they’ll go to hell.

After leaving mass, they are plagued with feelings of guilt. They repeat a verse from the Bible continuously in their head to prevent these “bad” thoughts from entering their minds. They are unfocused at work. They may even arrive late (or never arrive at all) to work because they feel stuck performing compulsions.

After work, they may return to mass again, to ask for reassurance or to attend confession. All day and night, they worry about whether or not God is angry with them and if they will go to hell.

One day, they feel ill and aren’t able to attend mass. They become consumed with “what ifs” – “What if I have doomed myself to hell?”; “What if I’m a bad Catholic?”, “What if God will strike me down because of this?”, and so on.

The difference between these two people is clear. Although they both attend religious services daily, the first person has a healthy relationship with their religion. They take fulfillment and energy from it, and it helps them function better in the rest of their life.

The second person is consumed by feelings of guilt. Their religious obsessions and compulsive practices get in the way of their daily life.

How to heal from religious OCD and create a healthier relationship with your spirituality

Luckily, there is effective treatment available for all types of OCD, including religious OCD.

Healing from OCD does not mean changing your religious beliefs. The goal is to help you develop a healthier relationship with your spirituality. Therapy and medication can help you practice your religion in a way that isn’t affected by OCD. You can begin to feel renewed by your religion and spirituality rather than weighed down.

Some proven treatment methods for OCD include a type of cognitive-behavioral therapy called exposure and response prevention (ERP) and psychiatric medication. But you are a unique individual, and you are more than just your OCD. That’s why it’s important to work with a treatment provider who creates an individualized treatment plan that takes your unique needs into account.

Religious OCD isn’t likely to go away on its own. But with the right treatment, you can start to have a healthy and fulfilling relationship with your religion or spiritual beliefs.

At The Center • A Place of HOPE, we use a Whole Person Care approach that helps you heal your physical, mental, spiritual health and more. Our OCD treatment program has helped people recover from this disruptive condition for many years. No matter if you live with religious OCD or another type, our clinical team can help.

Get in touch with us for more information about admissions or to request treatment.

[1] https://iocdf.org/faith-ocd/what-is-ocd-scrupulosity