There are a lot of misconceptions about OCD, including what it is, who it affects, and how debilitating or impairing it is. Oftentimes, OCD is mistakenly and harmfully described as being a character quirk or a preference, or that it only picks on contamination, germs, symmetry and orderliness. This is far from the truth as OCD is a diverse and complex mental health condition that preys on uncertainty and loss of control. This post will explore moral and religious scrupulosity.

What is Scrupulosity?

Scrupulosity is a subtype of OCD where individuals are often consumed by debilitating fears around moral or religious wrongdoings. The obsessions are accompanied by compulsions (repetitive behaviors or mental acts) that are meant to take away the intense anxiety, guilt, shame, disgust or distress caused by these thoughts. The fears related to being morally or spiritually wrong can be debilitating and overwhelming.

Moral Scrupulosity: When Conscience Becomes an Obsession

Moral scrupulosity involves intense fears around doing something immoral or unethical. Common obsessions include (but are not limited to):

• What if I lied or did something deceptive?
• What if I hurt someone through my actions?
• What if I made a mistake?
• What if I’m a bad person?
• What if I’m not being 100% honest?

Common compulsions include (but are not limited to):

• Repeatedly confessing to others
• Seeking reassurance of giving self-reassurance
• Mentally reviewing actions to ensure nothing bad or harmful was done

The constant need for certainty leads to significant distress, as the person is trapped in a cycle of doubt and compulsions. Even the smallest perceived moral lapse or mistake can trigger intense distress and leave one feeling like they’re a “bad” person.

Religious Scrupulosity: When Faith Becomes a Source of Fear

Religious scrupulosity involves fears and obsessions around sinning or offending God or a higher power. Common obsessions include (but are not limited to):

• What if I committed a sin or offended God?
• What if I did something blasphemous?
• What if I am damned to Hell?
• What if I’m possessed?

Common compulsions include (but are not limited to):

• Excessive prayer or having to pray the “right” way
• Confession or seeking excessive consultation with religious leaders
• Seeking reassurance or giving self-reassurance
• Mental review to make sure no sins were committed
• Asking for forgiveness repeatedly

The key differences between a healthy relationship with religion and scrupulosity are the presence of distress and impairment in functioning. Faith and spirituality are meant to bring comfort and meaning and help one with their moral compass. Scrupulosity takes these principles, distorts them and turns them into a source of fear and anxiety, and a never-ending quest for certainty and control. This usually leads to the person feeling spiritually lost, questioning their faith and worthiness in the eyes of their higher power, and this often perpetuates the OCD cycle.

Common Misconceptions About Scrupulosity

There are several misconceptions about scrupulosity that can add to the guilt and shame individuals experience and can contribute to the stigma of having OCD.

Misconception 1: “It’s just being devout or having strong morals.”

Reality: While it’s natural to have a strong moral compass or deep religious faith, scrupulosity is different. It is driven by anxiety and fear and leads to distress, rather than peace or fulfillment. By nature, the obsessions in OCD are ego-dystonic, meaning that they go against one’s values, morals and character. The individual’s actions are not rooted in genuine belief or devotion but in a compulsive need to neutralize their fears.

Misconception 2: “They’re just overthinking.”

Reality: Scrupulosity goes beyond normal worry or overthinking. The obsessions are intrusive, persistent and unwanted, and the compulsions are attempts to neutralize the anxiety these thoughts create. This cycle can be incredibly exhausting and isolating.

How to Support Someone with Scrupulosity

If you know someone who might be struggling with moral or religious scrupulosity, it’s important to approach the situation with empathy and understanding. Here are a few ways you can offer support:

1. Educate Yourself: Do your research on what scrupulosity is and what it isn’t. By learning more about this subtype, you can better help to support and validate your loved one and help reduce some of the shame or stigma they may feel.
2. Seek Support for Yourself: Oftentimes, family or friends inadvertently accommodate OCD by allowing compulsions or engaging in compulsive behaviors with their loved ones. Reducing these is a necessary part of OCD recovery, but they can feel really challenging without support. There are resources online on supporting loved ones with OCD and even some support groups specifically for caregivers. The IOCDF has some helpful resources for families to check out.
3. Encourage Treatment: The good news is that effective treatment is available. Exposure and Response Prevention (ERP) therapy is a highly effective treatment for scrupulosity. ERP helps individuals learn to live with uncertainty and reduce compulsive behaviors, allowing them to reclaim their lives from OCD.

Final Thoughts

Moral and religious scrupulosity can be an incredibly isolating and distressing experience, but it’s important to remember that those affected are not alone. With the right support and treatment, individuals can find relief and begin to live more freely, without the constant burden of doubt and fear. 

If you or someone you know is struggling with scrupulosity, don’t hesitate to reach out for help. Breaking the silence is the first step toward healing.