Scrupulosity: Understanding Religious OCD and How to Treat It

I’ve asked God to forgive my sins. I believe that Christ died on the cross and rose from the grave. I’ve invited Jesus to be my Savior. And I try to live a good Christian life. But I have no peace. I always feel guilty. I have constant, intense doubt and anxiety about my faith. Things like whether God loves me. If I’m truly saved. If I’m praying the right way. If I have unconfessed sin. If my commitment to Christ is real. (My list of religious fears is long.) I know the Bible tells us to trust and not doubt. So what’s wrong with me? Why is my faith so weak?

ANSWER: 

NOTE: This article comes alongside people who have already asked Jesus to be their Lord and Savior but are hurting from obsessive spiritual doubts. If you have questions about what it means to have a personal relationship with God and the promise of eternal life with Him, we encourage you to read our free online booklet Coming Home: How to Know God.

Also, this article can only offer a brief overview of a complex topic. If you or someone you know is struggling with signs of obsessive-compulsive disorder, don’t try to self-diagnose. Instead, call our Counseling team at 1-855-771-HELP (4357) for a free over-the-phone consultation. They can give you a list of referrals to licensed therapists in your area who specialize in treating OCD. You can also find resources through the website of the International OCD Foundation at iocdf.org*

Before anything else, we want you to know that God understands the sincerity of your heart and your desire to follow Him. If you have trusted what the Bible says about your own sinfulness and Jesus’ perfect holiness, you are saved — and there is no condemnation (Romans 8:1).

Every Christian needs to wrestle with doubt and disbelief to a certain extent. A faith unquestioned and untested isn’t true faith. Even Jesus’ disciples had to find their way through this dark, discouraging tunnel. (At the very moment when belief might have come easiest — when the risen Christ stood in front of them — Matthew records that “some doubted” (Matthew 28:16-17.)

However, the unrelenting, extreme distress you described is causing you anxiety that God never intended. We’re glad you reached out for help.

When doubt is about mental health, not a lack of faith

You’re right: The Bible tells us to pray “in faith, with no doubting” (James 1:6-8). At the same time, we must take all of Scripture into account. Remember that Jesus does not condemn anyone who follows Him. Nothing can separate us from His love (Romans 8:1).

Also, consider the biblical account in Mark 9 of the father whose son was suffering. The man cries out to Jesus, “I believe; help my unbelief!” Jesus doesn’t scold him. Our tender, compassionate heavenly Father “knows our frame; he remembers that we are dust” (Psalm 103:14). God understands our human condition and that even Christians will struggle in this world.

Having repetitive, unwanted thoughts, worries, and doubts about salvation or other topics of faith doesn’t mean you are spiritually “weak.” Instead, those symptoms could point to a psychological condition called scrupulosity (also called religious scrupulosity, religious OCD, or scrupulosity OCD).

Scrupulosity is a subtype of obsessive-compulsive disorder (OCD). So, to best answer your question about how to break the cycle of severe doubt and fear, let’s first look at a basic overview of obsessive-compulsive disorder.

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder is an anxiety disorder that usually has two parts: thoughts and behaviors. (However, a person with OCD can sometimes have obsessions without compulsions, and they can have compulsions without obsessions. This makes the disorder complicated.)

• Obsessions are persistent, unwanted thoughts about specific topics.
• Compulsions are behaviors a person uses to try to get obsessive thoughts out of their mind.

In short, someone with OCD often has intrusive, anxiety-producing obsessive thoughts. And to try to get rid of these unwanted thoughts, an individual with OCD often acts on compulsive behaviors (repetitive actions or rituals). They could also be gripped by a thought (urge) that they should do something — even if they don’t follow through.

For example, excessive handwashing is one of the best-known examples of a compulsion. The initial obsession that can lead to such behavior is ongoing, anxious thoughts about germs.

How does OCD impact thoughts about faith?

It’s normal to think about faith. However, people with OCD take personal responsibility for every thought they have. Additionally, they believe every thought has deep, important meaning. (This is true even for random thoughts.)

An individual who has unwanted and persistent thoughts that fixate on spiritual topics might have a form of OCD called scrupulosity.

What is scrupulosity?

An individual with scrupulosity lives in constant distress about their faith. Their doubts and questions attack what they hold most dear and most strongly believe. In a sense, OCD thoughts are telling the person the opposite of who they truly are and what they believe.

They might feel afraid they never do enough to “prove” their faithfulness. They often are afraid they’re not practicing faith in a “correct” way. They might feel as though they have unknowingly offended God. They may have a constant desire (compulsion) to compensate (atone, make amends, pay) for what they believe are sins or shortcomings.

The International OCD Foundation offers this definition of scrupulosity:

Scrupulosity is a subtype of obsessive-compulsive disorder (OCD) involving religious or moral obsessions. Scrupulous individuals hold a high moral or ethical standard that acts as a restraining force or inhibits certain actions. They’re overly concerned that something they thought or did might be a sin or other violation of their religious or moral doctrine.

In other words, someone who suffers from scrupulosity can deeply love the Lord and sincerely want to live life according to His teachings. That person’s pain is not the result of moral failings or lack of faith. Rather, people with scrupulosity suffer from debilitating anxiety and a never-ending sense of doubt that can negatively impact everyday life.

What are the symptoms of scrupulosity?

As we mentioned before, symptoms of general OCD usually include thoughts (obsessions), and behaviors/rituals (compulsions). Similarly, these two elements can be seen in symptoms of religious OCD.

Obsessive thoughts common to scrupulosity can include:

• Intrusive negative thoughts about religion or moral issues.
• Needless guilt and fear about offending God or committing sin.
• Fear of God’s punishment.
• Worry about praying “incorrectly.”
• Concern about misinterpreting religious teachings.
• Fear of going to the “wrong” place of worship.
• Constant self-examination.
• Doubt about whether your ethical choices truly are for the greater good.
• Fixation over whether you’re a “good” person.

Compulsive behaviors common to scrupulosity can include:

• Perfectionism (the need to get your thoughts and spiritual life “right”).
• Refusing to make decisions because you can’t figure out the “best” choice.
• Seeking reassurance to an excessive degree from religious leaders.
• Avoiding any situation where immoral acts might happen.
• Trying to do “good” things to make up for “bad” things.
• Being afraid of lying by omission or accidentally misleading someone.
• Acting generously to “prove” to yourself that you’re a good person.
• Unconsciously discriminating against people.
• Debating ethics for hours in your head.
• Acting out of self-interest instead of being motivated by helping others.
• Repetitive praying (fixating on certain prayer topics) or frequent confessing. (Prayer and confession are encouraged in Scripture; see 1 Thess. 5:16-18 and 1 John 1:9. However, they can become compulsive when pursued in unhealthy ways.)

How can I overcome scrupulosity?

You can overcome religious OCD. Scrupulosity can be treated. OCD thinking might lead you to question your sincerity in the Christian faith. But your commitment to follow the Lord is not defined by doubts you cannot control.

However, we urge you not to self-diagnose. And don’t listen to friends or family who try to shame you for having doubts, obsessions, compulsions, or the need for professional help. Religious OCD is a complex mental health issue that requires compassionate, competent care.

The most important step is to get help from a licensed, professional therapist.

Call our Counseling team at 1-855-771-HELP (4357) for a free over-the-phone consultation. They can give you a list of referrals to licensed therapists in your area who specialize in treating OCD. (You can also find resources through the website of the International OCD Foundation at iocdf.org*)

Connect with a licensed Christian counselor who has expertise in dealing with OCD and is trained to address scrupulosity. That individual might recommend exposure and response prevention (ERP) and cognitive behavioral therapy (CBT), two of the best therapeutic options for overcoming scrupulosity. They might also recommend medication if your symptoms are severe.

In the meantime, here are a few FAQs to help jumpstart your journey to overcome religious OCD.