For most, religious beliefs provide moral and spiritual guidance, a sense of purpose, comfort, structure, and community. However, for those with scrupulosity, religion becomes compulsive, joyless and a source of anxiety and stress.
Scrupulosity, a subtype of obsessive-compulsive disorder (OCD), is an over-concern for doing things correctly or perfectly in order to follow religious practices, to please God, or to avoid disrespect from others or from one’s own self.
This form of over-concern and over-responsibility leads to excessive anxiety and guilt. It has been referred to by some as having an excessively tender conscience. There are historical references to scrupulosity among monastic priests as they struggled to please God.
Scrupulosity can include:
- excessive prayer,
- worry that one might say or do something blasphemous,
- fear of having sinned (forgotten the sin) and not having repented of it,
- fear of having committed “the unpardonable sin”,
- difficulties with doing confession or rituals “correctly”,
- over-analysis of what “moral behavior” entails, and
- intrusive thoughts that the person considers blasphemous or sinful in nature and lead to tremendous uncertainty, anxiety, guilt, disgust, or shame.
Those suffering from OCD are generally aware that their obsessions are irrational and unlikely. With scrupulosity, there is less awareness that the obsessions are of an irrational nature because they are so closely related to their belief system and are intertwined in the individual’s religious life.
This fact can negatively impact the prognosis for treatment success. One’s own well-being and God’s approval are seen as being at stake, thus creating more resistance in the patient. A cooperative effort between a person’s religious leader and therapist sometimes proves to be an effective treatment.
- In The Doubting Disease, clinical psychologist Joseph W. Ciarrocchi discusses current information on religion and scruples, scrupulosity, and obsessive-compulsive disorders. He also helps us to understand the anguish suffered by thousands of people of faith and how to help.
- For Christians seeking a spiritual perspective, I recommend OCD: Freedom for the Obsessive-Compulsive by Michael R. Emlet, M.Div., M.D. as a good place to start. Dr. Emlet offers a balanced perspective by discussing the physiological, psychological and spiritual aspects of OCD. His short booklet includes a discussion about what he calls the “heart issues,” which are the 1) need for certainty, 2) demand for control and mastery, 3) desire for a “black and white” world, and 4) perfectionism, guilt and self-atonement.Dr. Emlet is a counselor and faculty member of the School of Biblical Counseling at Christian Counseling & Educational Foundation (CCEF).