Understanding religious scrupulosity OCD: Causes & treatments

Key Takeaways

While not an official diagnosis, religious scrupulosity OCD is a form of obsessive-compulsive disorder that revolves around religion and morality. People with this condition experience intrusive thoughts (obsessions) and ritualistic behavior (compulsions) related to things like prayer, sin, and purity.

There’s a significant difference between being a religious person and having religious scrupulosity OCD. People with OCD feel trapped within a cycle of obsessive thoughts and distressing behaviors that they struggle to control.

Fortunately, like other forms of OCD, religious scrupulosity OCD is treatable. With therapy and, at times, medication, you can learn to manage your OCD symptoms and regain control of your life.

Experts who study OCD have discovered that peoples’ obsessions and compulsions often revolve around some common themes. One of these themes is religion, and there’s an unofficial subtype of OCD called religious scrupulosity OCD.

People living with this form of OCD live in fear of breaking the rules of their religion, disappointing God, or not practicing their faith the “right” way. Left untreated, this form of OCD can negatively impact many areas of a person’s life. Fortunately, like other forms of OCD, it can be managed with the right support.

What is religious scrupulosity OCD?

All people living with obsessive-compulsive disorder (OCD) experience disturbing, intrusive thoughts called obsessions. In an attempt to quiet or control these upsetting thoughts, they then engage in ritualistic behaviors called compulsions.

For people with religious scrupulosity OCD, their obsessions and compulsions revolve around religion and morality. They constantly worry about sinning or violating their faith’s doctrine in some way. If they make a mistake or do something that is against the rules of their religion, they often experience excessive fear, guilt, or shame. They may worry about what these perceived violations mean about them as a person.

In response to these distressing thoughts, people with religious OCD engage in ritualistic behaviors to reduce their anxiety. These behaviors might include:

Repeatedly touching sacred objects
Viewing holy imagery
Praying for hours
Or making intense mental efforts to cleanse their minds from “bad” or sinful thoughts

What’s the difference between scrupulosity OCD and being religious?

Being a devout person or someone who practices frequent faith-based rituals does not mean that you have a mental health condition. Perhaps you’re a person who prays at certain times each day or regularly attends religious services. Maybe you use this time to contemplate, reflect, and feel connected to your higher power. These experiences might bring you a sense of peace or help you navigate life’s daily stressors and uncertainties.

By contrast, a person living with scrupulosity OCD will have a different relationship with their religious practices. For example, they might feel extremely anxious if they don’t say their nightly prayers “correctly.” If they stumble over a word or make some other error, they feel like they have to start the process over again. They can’t relax or fall asleep until their prayers feel “perfect.”

These compulsive rituals are very different from everyday expressions of faith. In fact, religious scrupulosity OCD has very little to do with religious beliefs. Just like germs aren’t the cause of contamination OCD, religious beliefs are not the cause of religious OCD.

Symptoms of religious scrupulosity OCD

Religious scrupulosity OCD can take many forms, depending on the individual. But some of the common signs and symptoms to be aware of include:

Having constant fears of sinning
Avoiding anything that could lead you to feel impure or immoral
Striving for religious perfection
Worrying that your thoughts or behaviors might signal that you’re a bad person
Being afraid of going to hell or being punished by your higher power
Seeking constant reassurance about your level of religiosity or commitment to your faith
Doubting whether you’re religious enough
Fearing things like demons or becoming possessed
Feeling anxiety about losing control and straying from righteousness
Feeling compelled to confess every sin, even the smallest mistakes
Seeing religious practices (such as attending services) as mandatory or obligatory even when they aren’t
Engaging in acts of self-sacrifice that could compromise your health or well-being
Spending excessive amounts of time on cleansing or purification rituals
Seeking constant reassurance from clergy, religious leaders, or loved ones

What causes religious scrupulosity OCD?

Like other forms of OCD, we don’t fully understand what causes religious scrupulosity OCD. There was a time when it was believed to be linked to a certain level of religiosity or specific faith traditions. But these findings are not well substantiated. Rather, research shows that when religious people develop OCD, their symptoms might be more likely to reflect religious themes.

In addition to these religious influences, some other risk factors for religious scrupulosity OCD include:

Biology: Some research indicates that OCD may be the result of problems with how certain parts of the brain communicate with one another.
Environment: Experiencing chronic or acute stress or trauma can lead to the onset of OCD and other mental health concerns.
Genetics: Having a first-degree relative, like a parent or sibling, who has OCD could increase your risk.

Most effective treatment options for religious scrupulosity OCD

All forms of OCD, including religious scrupulosity OCD, can be managed with the right support. The most common forms of treatment for OCD include:

Cognitive-behavioral therapy (CBT): This form of treatment helps interrupt irrational, unhelpful, or distressing thoughts, like obsessions related to religion. Learning to manage these thoughts through CBT can help you respond to stressful situations differently.
Exposure and response prevention (ERP): Considered the “gold standard” for OCD treatment, ERP is a form of CBT that can help reduce the distress you experience due to your obsessive thoughts. It can be effectively conducted over teletherapy and involves a slow, gradual exposure to stressors under the supervision of a trained therapist.
Medications: Certain medications may be used to reduce OCD symptoms. You can talk with your therapist about getting referred to a psychiatric provider to see if medications are the right option for you.

Find care with Rula

Left untreated, religious scrupulosity can make it difficult to live your daily life, foster healthy relationships, and maintain a healthy connection to your faith. Fortunately, help is available.

With Rula, you can access effective OCD treatment from the comfort of home. In just a few minutes, you can use our therapist-matching program to find a provider who takes your insurance and make your first appointment as early as this week. And if medication ends up being a part of your treatment journey, we can connect you with a psychiatric provider too.