Scrupulosity: Religious Obsessions and Compulsions

Written by Carol E. Watkins, MD

In-depth information on scrupulosity, religious obsessions and compulsions, and the treatment of scrupulosity.

What is Scrupulosity?

Religious belief, and membership in a faith community are important factors in the lives of many individuals. In addition to moral and spiritual guidance, they can provide a sense of purpose, structure and community. For a certain individuals, religious beliefs become compulsive, joyless behaviors. The individual may constantly worry that he or she might say or do something blasphemous. He may fear that he has committed sin, forgotten it and then neglected to repent for the sin. He may spend long hours searching his mind to try to ferret out evidence of un-confessed sins. He is unable to feel forgiven. Specific obsessions and compulsions vary according to the individual's religion. An Orthodox Jew might worry that he did not perform a particular ritual correctly. He might obsess about this for hours. A Roman Catholic might go to confession several times a day. Another individual could believe that anything he does might be sinful. This individual might become so paralyzed with doubt, that he or she becomes afraid to do or say anything at all.

Scrupulosity and OCD

Religious faith and religious education are not generally the causes of Scrupulosity. Actually, Scrupulosity is a form of Obsessive-Compulsive Disorder. (OCD) OCD appears to be a biologically based disorder with severe psychological consequences. The disorder occurs in 2-3% of the population (5-7 million sufferers in the U.S.). About 10% of the first-degree relatives of affected persons also have OCD.

Obsessions are recurrent thoughts or impulses that make the person anxious (such as the fear that using a public toilet will make one sick) The obsessions persist despite efforts to control or suppress them. They feel intrusive and disturbing even though the person knows that they come from his own mind. Obsessions may include fear of harming someone, contamination or of doing something embarrassing.

Compulsions are repetitive behaviors or mental acts the person feels driven to perform, often with ritualistic rigidity, to prevent the anxiety connected with the obsessions. These may include urges to wash, count, check or repeat phrases to oneself.

OCD can occur in different forms. There are a variety of different types of obsessions and compulsions. The nature of intensity of these symptoms may vary over time. Aggressive, sexual and religious obsessions sometimes occur together in the same individual.

Differentiating Scrupulosity from Devout Religious Faith and Practice

Because these obsessions and compulsions are intertwined in the individual's religious life, it may be difficult for him or her to recognize that he or she has a psychiatric condition. An individual with religious obsessions often may focus excessively on one particular concern about sin while neglecting other aspects of his or her religion. Most religions place a high priority on compassion and being a good neighbor. The scrupulous individual while focusing excessively on a few specific rules may neglect this more general dictum.

Religious leaders within the Roman Catholic and Jewish community have addressed these issues. Commentators in both of these groups have writings that label scrupulosity as a sin. One rabbi called it idolatry because the excessive devotion to a specific ritual (to the detriment of good acts toward other people) elevated the ritual to a god-like status. In his book, The Doubting Disease, JW Ciarrocchi reviews Roman Catholic pastoral writings over past centuries. He feels that some of the things that priests did to help scrupulous individuals anticipated current treatments for OCD.