Obsessive-Compulsive Disorder is an anxiety disorder that is difficult to cope with on a daily basis. The need to perform an action repeatedly until it feels right or being unable to stop obsessing over irrational fears can interfere with your life, leading to extra stress in both your life and the lives of those closest to you.

When OCD Meets Religion

“Religious OCD” or “scrupulosity” is a form of OCD where the obsessions and compulsions affecting you are centered around religious beliefs and rituals. (2) This can express itself as obsessive thoughts that you are not morally good enough or that when something bad happens, it’s your fault. You may experience compulsions such as repeating a ritual until you get it “right”, repeatedly saying a blessing until you feel you were focused enough, or going outside the norm to make sure you don’t commit a sin.

Religion itself doesn’t lead to OCD; however, those who grow up with religion – and especially those who grow in religious societies and already have OCD – might experience OCD symptoms that are affected by their religion. (4)(5) Those with OCD who grow up with religion have been found to have a 5% to 33% chance of having scrupulosity, which is characterized by pathological guilt about moral or religious issues. For those with OCD who grow up in religious societies, such as Egypt or Saudi Arabia, the chances of scrupulosity being their form of OCD expression rises to 50-60%.

Managing OCD

There are an array of tools and techniques that can help manage religious OCD.

One approach is called Exposure and Response Prevention therapy (ERP). ERP with a trained therapist will help you to gradually learn to ignore the anxiety associated with obsessions and compulsions and stop giving in to them. (6)

Another approach, as a complement to therapy by a qualified professional, is to combine therapy with the guidance of a religious leader who is knowledgeable about OCD. (3) The rabbi or other religious authority can help you learn to balance the need to maintain your mental health with the obligations of your religious practice. This approach with ERP therapy can help make OCD much more manageable. (1)

While there isn’t any known, long-term cure for OCD, it doesn’t have to control your life or your religious practice. By understanding when your concerns are disproportionate to your situation and learning how to manage your symptoms in a healthy way, you can lead a healthier, happier life.

Sources:

(1) Huppert, J. D., Siev, J., & Kushner, E. S. (2007). When religion and obsessive-compulsive disorder collide: Treating scrupulosity in ultra‐orthodox Jews. Journal of Clinical Psychology, 63(10), 925-941.
(2) Greenberg, D., & Huppert, J. D. (2010). Scrupulosity: A unique subtype of obsessive-compulsive disorder. Current Psychiatry Reports, 12(4), 282-289.
(3) Greenberg, D. (2008). Ultra-orthodox rabbinic responses to religious obsessive-compulsive disorder. The Israel journal of psychiatry and related sciences, 45(3), 183.
(4) Wu, M. S., Rozenman, M., Peris, T. S., O’Neill, J., Bergman, R. L., Chang, S., & Piacentini, J. (2018). Comparing OCD-affected youth with and without religious symptoms: Clinical profiles and treatment response. Comprehensive psychiatry, 86, 47-53.
(5) Buchholz, J. L., Abramowitz, J. S., Riemann, B. C., Reuman, L., Blakey, S. M., Leonard, R. C., & Thompson, K. A. (2019). Scrupulosity, Religious Affiliation and Symptom Presentation in Obsessive-Compulsive Disorder. Behavioural and cognitive psychotherapy, 1-15.
(6) Rector, N. A., Richter, M. A., Katz, D., & Leybman, M. (2019). Does the addition of cognitive therapy to exposure and response prevention for obsessive compulsive disorder enhance clinical efficacy? A randomized controlled trial in a community setting. British Journal of Clinical Psychology, 58(1), 1-18.

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