OCD and Scrupulosity

by david castillo dominic freedigitalphotos.net

by david castillo dominic
freedigitalphotos.net

I just came across this great article on OCD and scrupulosity, and was surprised and pleased to see it included commentary from my good friend Tina over at Bringing Along OCD. According to Dr. Jonathan Abramowitz, who is also quoted in the article, scrupulosity actually means “fearing sin where there is none.”

I have written before about social scrupulosity, or moral scrupulosity, but this article focuses more on religious scrupulosity, where obsessions are connected to religion in some way. Those with scrupulosity typically deal with thought-action fusion, a cognitive distortion where sufferers believe that thinking “bad”  thoughts is just as terrible as performing an action associated with the thought. For example, someone suffering from religious scrupulosity might have what they believe to be “sinful thoughts,” thereby believing they are destined to “go to hell.”

As we know, OCD often attacks what is most important to the sufferer. So it comes as no surprise that obsessions will vary, depending on the sufferer’s religion. In the article, Tina, who is Methodist, talks about her religious scrupulosity:

“First I had to get rid of all my sins, ask forgiveness, do it in the right way, and then I had to pray for protection,” said Barbour, now 50. “Or, if something bad happened to my family, it would be my fault because I had not prayed good enough.”

The article also talks about Jennifer Traig, who is Jewish, and how she became obsessed with the biblical definition of cleanliness, which led to complex rituals to remain clean. She worried if she didn’t practice her religion correctly, she would be punished. “I couldn’t have put my finger on what the punishment would be,” she [Jennifer] said. “Just a sense of doom.”

It’s important to note that not all those who suffer from religious scrupulosity are particularly devout; indeed some OCD sufferers might suffer from scrupulosity pertaining to not being religious enough.

All types of OCD revolve around the need to be certain, to be sure, and scrupulosity is no exception. Overcoming OCD of any kind involves being able to live with uncertainty, and in the case of scrupulosity, that translates into having faith.

Dr. Abramowitz says:

“Faith is about being comfortable with your beliefs even if you can’t have a 100% guarantee about things like hell, whether there is really a God, or what it means to be faithful enough,” Abramowitz said. “You’re taught to have faith, even though you cannot have scientific proof.”

Exposure and response prevention (ERP) therapy, the front line treatment for OCD, requires that OCD sufferers face their fears, and when this is done repeatedly, faith that we can deal with uncertainty is strengthened. Really, faith is needed to recover from all types of OCD; faith in the universe and faith in ourselves that we will be okay with whatever happens to come our way. And once this faith is ingrained in us, OCD doesn’t stand a chance.

 

 

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6 Responses to OCD and Scrupulosity

  1. Thank you so much for sharing the article and writing this, Janet. I learned a lot from the article, too, and you pulled out a great quote from Dr. Abramowitz that was meaningful to me, too. Uncertainty lies at the bottom of OCD, and learning to live with that can take us a long way. I am a work in progress, but I am coming along! 🙂 I was glad, too, that the article talked about the use of exposure therapy.

  2. Great post, Janet. I appreciated what you said about how a person doesn’t have to be especially devout to have scrupulosity obsessions. In fact, a person can even be an avowed atheist and worry about committing sacrilege! It really shows how with OCD a person can be “of two minds.”

  3. 71 & Sunny says:

    Ah thought-action fusion. An oldie, but goodie. Been there myself and it is NOT fun.

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