Scrupulosity: when religious practice or matters of morality become an unhealthy obsession

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The Anxiety and Depression Association of America says obsessive-compulsive disorder (OCD) currently affects approximately 1 in 40 adults, and 1 in 100 children in the U.S. OCD causes a person to have uncontrollable, reoccurring thoughts or obsessions with corresponding behaviors known as compulsions.

“Many people think of OCD as excessive handwashing or checking, but it can take many forms,” says Brenda Bailey, PhD, licensed clinical psychologist and clinical supervisor of OCD and anxiety care for adults in Oconomowoc. “Scrupulosity is a type of OCD in which someone becomes mentally and emotionally consumed by matters of religious practice and/or morality. They question whether they are doing the right thing in terms of their religious practice, and for some, whether they are maintaining a high moral standard. They become stuck in their intrusive, obsessive thoughts and decision making,” Dr. Bailey explains. 

Dr. Bailey says scrupulosity is not associated with any particular religion. The specific fear will depend on the person’s specific religious values, and the following signs can indicate someone may be suffering from it:

• Obsessing over whether they have sinned
• Living in constant fear of angering God
• Fearing they are not perfectly following their religion’s doctrine or practices
• Spending excessive time praying and worrying they aren’t praying the right way
• Seeking constant assurance from a religious leader
• Thinking they have blasphemed the Holy Spirit

“Someone who suffers from scrupulosity thinks they should be able to control their intrusive thoughts, and they believe those thoughts reveal their true character,” says Dr. Bailey. “All of us have intrusive thoughts from time to time. For example, some people may get distracted while praying as their minds drift to other things, but then are able to refocus and not worry about it. But people with scrupulosity can have an intrusive thought while praying and think they are going to hell, and that causes them a great deal of distress.”

Rogers’ expertise in OCD

“Rogers is internationally recognized in treating OCD with evidence-based therapy.” explains Dr. Bailey. “Using cognitive behavioral therapy (CBT), we work with patients to change their relationship to their thoughts by helping them recognize, understand, and manage them. We also use exposure and response prevention therapy (ERP) to help patients gradually confront obsessions and compulsions. For example, we will have patients sit with an intrusive thought and work through the anxiety without feeling like they need to do something about it,” Bailey adds.

Rogers’ spiritual care team is also available if a patient desires, at no cost, to help address spiritual or religious concerns.

“The spiritual care team provides an important treatment component when a patient is experiencing moral or religious scrupulosity,” says Christine Dawley, MS, LPC, manager, spiritual care. "The team highlights the positive elements of healthy faith and compares and contrasts that with the limiting, punitive, and negative nature of scrupulosity. The spiritual care team collaborates with the patients’ treatment team as part of the multidisciplinary approach at Rogers. We share the goal of helping the patient return to a balanced, healthy place in their faith journey so they can engage in the spiritual life they desire.” 

Help at Rogers

Rogers offers multiple levels of care for OCD and anxiety for adults, adolescents and children throughout the country. Call 800-767-4411 or request a free screening online.

If you do not feel you need treatment right away, but may be concerned, we offer online quizzes to possibly provide some relief. While these quizzes do not provide a diagnosis, it could be the first step in finding the treatment you may need. Take our online Anxiety or OCD Quiz today.