Scrupulosity OCD
Faith and spirituality are deeply personal for everyone. For some, however, these beliefs can become a source of intense anxiety and doubt. Scrupulosity OCD causes obsessive fears and compulsions around more or religious matters. It can affect people from various religious backgrounds.
What is Scrupulosity OCD?
Scrupulosity, also known as Religious OCD, is a subtype of obsessive-compulsive disorder (OCD) that is defined by religious or moral obsessions. People with scrupulosity experience excessive concern over whether their thoughts or actions may violate religious or moral principles. They may continuously worry that they have committed a sin or acted against their values, even in situations where no wrongdoing has occurred. This leads to an ongoing fear about what their thoughts or behaviors may mean regarding their character.
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Risk Factors for Scrupulosity
The exact cause of scrupulosity is not fully understood; however, it is thought to come from a combination of genetic, biological, and environmental factors, similar to other types of OCD. Because OCD often manifests in areas that hold significant personal meaning, people who are deeply religious or spiritual and have a predisposition to OCD may be more likely to experience symptoms related to their faith or moral beliefs.
That being said, there are some factors that may increase the likelihood of developing scrupulosity, including:
- A strong sense of religiosity or moral conviction, which can make spiritual practices more vulnerable to OCD symptoms.
- Exposure to stressful or traumatic events, which can trigger or amplify OCD symptoms.
Scrupulosity OCD in Children and Teens vs. Adults
In children and teens, scrupulosity is often influenced by their family’s religious practices. They may feel pressure to meet moral expectations or fear that their thoughts could lead to severe consequences for themselves or their loved ones. With little control over their choices, this anxiety can grow. Children and teens may experience:
- Fear of spiritual consequences from impure thoughts
- Lack of control over religious participation
- For adults, scrupulosity may involve repetitive behaviors or avoidance of religious settings. They often look for reassurance through prayer or confessions, but struggle to find lasting relief. These behaviors are common in adults:
- Frequent contact with spiritual leaders for validation
- Obsessive focus on specific religious aspects while neglecting others
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Symptoms of Religious OCD
People who experience Religious OCD, or scrupulosity, may feel constant anxiety about whether their thoughts, actions, or beliefs are pure or morally correct. These symptoms often lead to compulsive behaviors meant to relieve the anxiety caused by their doubts and fears.
Common Obsessions in Scrupulosity OCD
Those with scrupulosity may experience a range of religious or moral obsessions. Common obsessions may include:
- Fear or offending God or committing blasphemy
- Worry about having committed a sin, even without clear evidence
- Feeling the need to behave in a perfect way
- An obsession with achieving purity in thoughts and actions
- Fear of being punished by God or going to hell
- Anxiety about being possessed or spiritually unclean
- Preoccupation with death or the afterlife
- Fear of losing control over impulses
- Doubting personal religious beliefs or feelings
- A need for certainty about religious doctrines
Behavioral Compulsions
In response to the obsessions above, people often demonstrate repetitive behaviors intended to ease their fears. These compulsions may include:
- Writing out or repeating prayers repeatedly to make sure they are done “correctly”
- Repenting constantly, either through prayer or by going to confession repeatedly
- Constantly seeking reassurance from others about their moral standing
- Performing cleansing or purifying rituals multiple times
- Making personal sacrifices in an attempt to relieve guilt or anxiety
- Treating attendance at religious services as mandatory, even if it isn’t required
- Performing religious rituals or prayers according to specific “magical numbers,” feeling compelled to repeat the actions a set number of times before stopping
Mental Compulsions
In addition to behavioral compulsions, those with scrupulosity often struggle with mental compulsions as well. These may include:
- Repeating prayers over and over again
- Mentally envisioning sacred images or reciting religious phrases
- Compulsively repeating passages from sacred texts
- Making mental pacts or promises to God to counteract “bad” thoughts
- Trying to erase, neutralize, or replace negative or sinful thoughts
- Repeatedly scanning their mind to assess their level or faith or purity
- Avoidance
Some people with religious OCD may try to avoid situations that trigger their obsessions. This may include:
- Steering clear of religious services where they fear making a moral error
- Avoiding religious texts or scriptures that could cause anxiety
- Refraining from participating in religious discussions or activities that increase their fear of being judged or of offending religious standards
Treating Scrupulosity OCD
Medication such as SSRIs are commonly prescribed to help manage OCD symptoms
