Obsessive-compulsive disorder can cause a crisis of faith.
Obsessive Compulsive Disorder (OCD) was formerly classified as an anxiety disorder but is now
categorized separately by the American Psychological Association. OCD is characterized by
obsessive thoughts that lead to compulsive behaviors. The thoughts are invasive and feel
uncontrollable. Furthermore, the thoughts are anxiety-provoking, compelling the person to carry
out certain behaviors to temporarily relieve the anxiety. Both the thoughts and compulsive
routines interfere with daily life to varying degrees. Researchers have not found a cause for
OCD, but they have identified parts of the brain that seem to be involved.
In popular culture, we sometimes use “OCD” to describe people with an A-type personality or
who may have excessive worry. But it is important to distinguish true Obsessive Compulsive
Disorder from a heightened affinity for organization or cleanliness and from chronic worry. OCD
is a real mental illness and is most often helped through specific forms of therapy and
medication. That being said, it is important for those suffering from OCD to look at what the
Bible says about anxiety and the trustworthiness of God.
The root of OCD, or OCD-like behavior in those not actually suffering with the illness, is
anxiety. While OCD is not mentioned by name in Scripture, the word worry occurs 36 times
(NLT). The consistent warning is not to worry. Worry is sin because it ignores the power of
prayer and obstructs faith (Philippians 4:6). Those who have never trusted Jesus as their Savior
are slaves to sin such as worry and cannot free themselves (Romans 6:17–22). Believers who
struggle with chronic worry have yet to understand their freedom in Jesus to have victory over
sin (Ephesians 6:10–18). Once we have received Jesus as our Savior, we are a new creation in
Christ. Christians must walk in the Spirit in order to put off their earthly nature and begin to
think and act like Jesus (Colossians 3:1–10). This is also called having the mind of Christ (1
Corinthians 2:15–16). With the mind of Christ, we can set our minds on things above (2
Corinthians 10:5; Colossians 3:1–3; Philippians 4:8). More importantly, as we grow in Christ, we
begin to understand God’s sovereignty and His character. We come to trust Him more fully and
can therefore give up our worries.
Those suffering with OCD can be greatly helped by recalling the truth of Scripture. When
confronted with an invasive thought, they can combat it with truth. A firm foundation in God’s
Word will prove a reliable base from which to evaluate thoughts and compulsions. Sufferers can
also be helped by therapeutic protocols designed specifically for OCD, through counseling and
the use of pharmaceuticals. There is much hope for those suffering with OCD. Often, it is a
combination of personal Bible study, medication, and discipling with a biblical counselor that
leads to freedom. Regardless of their troubling symptoms, those with OCD can rest in the love of
God and rely on the power of the Holy Spirit to give them grace to walk the path before them (2
Corinthians 12:8–10).
Religious Obsessions in OCD
Obsessive-compulsive disorder can cause a crisis of faith.
Obsessive-compulsive disorder (OCD)Ais a anxiety-related condition that involves recurring,
unwanted obsessions and repetitive compulsions.AObsessionsAare intrusive thoughts that cause
severe distress, despite the fact that the individual realizes that the obsessions represent
exaggerated fears that are not likely to occur. These obsessions are worries that reach beyond
anxiety about everyday problems. So upsetting are the obsessions that the individual attempts to
counteract them with a specific behavior or neutralizing thought called aAcompulsion. The
individual feels as though their compulsions must be performed in response to the obsessions.
Compulsions are performed strictly to reduce anxiety or prevent a feared outcome.
Religious OCD Subtype
Common Obsessions About Religion
oConcerns with sacrilege or blasphemy
oAccidentally omitting any loved ones from their prayers
oWorries about inadvertently offending God
oWorries about accidentally worshipping the devil
oPerforming a religious task or ritual in the wrong way
oHaving committed a sin
oThinking too much about purity
oGoing to hell
oPraying in the wrong way
oPerfectly following scripture or other religious doctrines
oDeath
Religious thoughts can become intrusive and distressing in individuals with OCD. These
thoughts can involve intrusive religious blasphemous thoughts, compulsive prayers,
hypermorality, unwarranted concern about committing a sin, andAcleaning/washing
ritualsA(Himle, Chatters, Taylor & Nguyen, 2001). These thoughts sometimes become
problematic and are referred to as "scrupulosity." Scrupulosity describes the relationship between
religiosity and the symptoms of OCD, and individuals with these obsessions often focus on
certain details of their religion while ignoring others.
One large study found that scrupulous obsessions in OCD were ranked as the fifth most common
obsession, with 6% of participants endorsing it as their primary obsession. Additionally, it has
been estimated that religious obsessions occur in 25% of individuals with OCD (Antony, Dowie,
& Swinson, 1998). One study showed that OCD symptoms presentation can be influenced by
one's religion and culture (Sica, Novara, Sanavio, Dorz & Coradeschi, 2002). Abramowitz and
colleagues (2004) highlighted this point by finding that Protestant individuals with high levels of
religiosity had the highest severity of OCD symptoms.
Individuals with scrupulous obsessions may have anxiety related to their religion, sinning, and
guilt, which can cause religious practices and rituals to become compulsive (Deacon & Nelson,
2008; Gonsalvez et al., 2009). Also, these individuals are often more religious and more likely to
seek out religious counseling and less likely to receive medical treatment (Siev, Baer, &
Minichiello, 2011). It was also found that a negative concept of God was associated with higher
symptom severity, and that one in five did not subscribe to a particular religious affiliation. In
line with the negative God concept, those that believe that their God is punitive will likely
engage in more severe compulsions to make up for minor sins, even though the clergy is aware
that their sins are minor and do not need compulsive actions (Gonsalvez et al., 2010). One in five
think that their OCD symptoms help them in observing their religion.
While it may be easy to assume that people with these types of worries are from very religious or
strict traditions, these worries can strike the very orthodox, non-religious people, or even
atheists. Scrupulosity should not be confused with appreciating religion or being very devout.
People with this type of OCD do not feel more spiritual or fulfilled by performance of OCD-
related rituals, which may include repeating prayers, seeking reassurance, or mental rituals. In
actuality, the OCD interferes with carrying out proper religious duties.
Treatment for Religious-Themed OCD
The most effective treatment for religious-themed OCD is Exposure and Ritual Prevention (ERP
or ExRP) from a skilled therapist. Elliott and Radomsky (2008) suggest that through
collaboration with clergy, counselors, and members of the religious community, psychologists
can provide good support for individuals suffering from scrupulous obsessions. Religious leaders
can determine within their doctrine which rituals are extreme and which are appropriate, and
they may be able to offer guidance and treatment. Additionally, highly religious individuals often
consult their religious leaders rather than clinicians for help (Miller et al., 2008), so providing
OCD education and specialized treatment trainings in religious settings could be beneficial to
bringing therapies that have been shown to be effective to more people suffering from these
obsessions.
Common Obsessions About Morality
People with religious obsessions are also usually worried about morality, but people with
morality worries might or might not be religious. For example, someone with this sort of OCD
may worry excessively about receiving extra change from a cashier, even its just a few cents.
Common obsessions about morality include:
oExcess concern with right and wrong and morality
oWorry about always doing the morally right thing in every circumstance
oHaving made a moral error
oBreaking an unimportant rule
oBehaving immorally
oA loss of control over urges
oWondering if a person is "good enough"
