You may see the phrase “religious scrupulosity” and think, “Scrabble jackpot!” But for those who experience an unrelenting and irrational preoccupation with guilt, it is life-altering. Religious scrupulosity is generally defined as, “A pathological guilt about moral or religious issues. It is personally distressing, objectively dysfunctional, and often accompanied by significant impairment in social functioning. It is typically conceptualized as a moral or religious form of obsessive–compulsive disorder (OCD).”
What does that mean? It means, in the same way that individuals who experience OCD can fixate on germs, locked doors, the oven being turned off, or doing tasks in even or odd sets, OCD can fixate on the assurance of salvation. OCD consists of two parts: (a) obsessions – cognitive fixation on a perceived problem, and (b) compulsions – rituals believed to remedy the problem.
For religious scrupulosity, the obsessions might include:
- Belief that one hasn’t been religious enough or must practice their faith perfectly for it to count
- Fears that one is saying their prayers incorrectly or parts have been left out
- Thoughts or fears of having committed the unforgivable sin or having blasphemed the Holy Spirit
- Repeated thoughts of saying something blasphemous during prayer or at church
- Intrusive thoughts (including sexual thoughts) about religious figures or God
For religious scrupulosity, the compulsions might include:
- Continually asking for God’s forgiveness
- Constantly mulling over one’s words or actions, wondering if the words have double meanings of a sacrilegious or blasphemous nature or if the behavior was sinful
- Praying or performing religious rituals for hours to ensure that rituals are performed perfectly
- Saying prayers a certain number of times, perhaps a number with biblical significance, or a multiple of that number
- Repeatedly asking pastors and other church leaders the same question about religious practices to be sure they understand the answer completely
Perhaps you know someone who struggles in this way and have seen your friend begin to be debilitated socially, emotionally, and spiritually. If so, you are likely asking, “What value is gained by placing this kind of struggle in the category of OCD?” We will consider three advantages that emerge.
First, we realize we are facing a neurological challenge, not just a cognition (belief) problem. Brain scans for individuals who experience OCD show key differences from those who do not. The physician and biblical counselor, Michael Emlet, has reviewed the medical literature and encouraged Christians to recognize this reality.
This recognition allows for a both-and approach, and it can help alleviate some of the guilt which is so central to the experience of religious scrupulosity. For a parallel example, consider the person who believed they struggled with the sin of sloth (i.e., laziness). But they later learn they have anemia (i.e., low red blood cell count resulting in a personal feeling weak and fatigued). This medical finding doesn’t erase the problem of low activity. It provides an additional means of addressing the problem.We realize we are facing a neurological challenge, not just a cognition (belief) problem. This allows for a both-and approach, and it can help alleviate some of the guilt which is central to the experience of religious scrupulosity. Click To Tweet
Our friend with anemia could still say, “I believe I would honor God and enjoy life more if I were more active.” Our friend would still be responsible for taking the steps necessary to move in this direction. However, these steps would include a high iron diet and other medical interventions, not just repentance and faith-based actions. Our friend could engage the medical helps with faith and gratitude to God for allowing science to help us understand how these things impact their struggle.
Second, we see more clearly the need to expand the helping team. Having a skilled Christian psychiatrist or counselor experienced with OCD becomes a natural step to take. This does not replace pastoral care, but it ensures that each helper is doing what they do best.
Pastorally, working with a psychiatrist helps the person struggling with religious scrupulosity make necessary distinctions. If a pastor tries to address this struggle on their own, the pastor is inadvertently reinforcing the belief that this struggle is exclusively spiritual. If a pastor just refers and doesn’t remain engaged for pastoral care, he communicates that the problem is only physical. We want to embody, not just advise, a both-and approach. That takes us to the question, “What does pastoral care look like in this kind of situation?”
Third, we identify the kind of care strategies that are most helpful for our friend. We realize that trying to explain key biblical texts that are frequently associated with religious scrupulosity, such as Matthew 12:30-32 and Hebrews 6:4-6, is not productive. This is like taking someone who’s OCD fixates on germ contamination to nursing school. It seems like it might be helpful, but when we realize the fear being battled is irrational, we quit trying to use education to counter the fear.
We want our friend to doubt their fear enough to turn their attention to something else. Imagine your friend as a wild animal caught in a net. The more they fight against the net, the tighter the net gets. If you wanted to help them, what is the first thing you would ask them to do? Relax and quite fighting, so the net can be loosened. What is the religious scrupulosity equivalent of relaxing? Doubting the fear.
How do we help our friend doubt their fear? We help them see the pattern, not just the event. OCD is a pattern consisting of obsessive thoughts and compulsive rituals (see above). Every pattern is a series of events. But the more our friend fixates on a particular event – a troublesome thought or corresponding behavior – the more they despair.
Again, imagine OCD like a washing machine spinning too fast. Imagine the question about the assurance of salvation is a shoe in that washing machine. It makes an awful noise. If you wanted to get the shoe out, what is the first thing you would do? You would slow the spin cycle down. If you reached in while it was spinning full speed, your arm would get beat up and you would be unable to retrieve the shoe. Slowing the machine down is a picture of the strategy of doubting our fears.
The conversation might sound something like this:
“You have proven you are willing to do whatever God asks. Your desire to honor God is exceptional; actually, it’s so strong it can be debilitating. This pattern of thinking has been in place for years. Over the years, how many actions or thoughts have you feared would cost you your salvation? All I am asking is that you consider that the pattern of thought – fixating on losing your salvation – may be the real problem. If so, a loving God – one worth devoting your life to – would want you to stop torturing yourself.”
After conversations like this, you will likely have to help your friend realize you are not minimizing their sin. Instead, you are emphasizing the character of the God who delights in redeeming and freeing his children from sin and any other bondage that impedes their ability to enjoy the full life God intends for them. From there, engagement in any God honoring activity your friend enjoys becomes the goal.
Questions for Reflection
- Look over the list of obsessions and compulsions frequent with religious scrupulosity again. How are these different from normal conviction and legitimate concern for the condition of one’s soul?
- Imagine a friend who is irrationally doubting their salvation, to such a degree that it is impairing their life functioning. How would you have a version of the “doubt your fears” conversation like the vignette above?
 This description is taking from wikipedia.org/wiki/Scrupulosity.
 These lists of obsessions and compulsions are modified and adapted from lists founds at beyondocd.org/information-for-clergy/recognizing-and-counseling-people-who-have-scrupulosity
 For a brief (only 32 pages), readable summary for Dr. Emlet’s work in this area, see the minibook OCD: Freedom for the Obsessive-Compulsive, that contains both his assessment of the medical literature and guidance for pastoral care and counseling.