Obsessive-compulsive disorder (OCD) is defined as “an anxiety disorder characterized by recurrent and disturbing thoughts (called obsessions) and/or repetitive, ritualized behaviors that the person feels driven to perform (called compulsions). It may manifest in the form of hand washing until skin is red and raw, checking doors multiple times even if the key just turned in the lock, or making certain the stove is turned off even if one has done it a moment ago. It isn’t a memory issue, since the person is aware of having just engaged in the behaviors.

Many years ago, I had the experience of interviewing a world-renowned yoga teacher who had symptoms of OCD. Seane Corn had shared that in childhood she would count in even numbers, have to walk in certain ways, be tapped on the shoulder a particular number of times. Growing up in a secular Jewish family, she had no concept of a protective God, so she took on that role herself, believing that her rituals kept her loved ones safe.

When she began practicing yoga as a young adult that she found the postures exacting enough to satisfy those needs to feel a sense of balance in her life, since it had felt so out of control. Since then, she has taught all around the world, working with those living with HIV and AIDS, as well as with child survivors of sex-trafficking.

A teen whose family immigrated from a predominantly Catholic country presented with symptoms of OCD and anxiety, following a visit to churches and cemeteries on a trip back home with his parents. They took the form of feeling like he was walking through portals while simply entering doorways in his home. They were also connected to the death of a loved one and guilt that he had not been there for him as much as he would have wanted to be. His family didn’t instill those feelings; he took it on himself, as he freely admitted.

A man who was also raised in the Catholic tradition had obsessive thoughts that bordered on self-torment as his perseveration was about punishment for nebulous ill-advised deeds that he couldn’t easily identify. He felt as his every move was being scrutinized and he would glance upward as if checking on God checking on him. He attended Mass and went to confession regularly. He prayed the rosary, and still he felt unforgivable.

Both people could acknowledge that they were kind and compassionate with others, had not committed crimes and yet were left with the message they were sinners. Each of them knew that their feelings were illogical and irrational. By definition, their form of OCD could fit under the category of Scrupulosity, described in this way, “Those suffering with Scrupulosity hold strict standards of religious, moral, and ethical perfection.Joseph Ciarrocci, who is the author of The Doubting Disease says that the origin of the word, comes from the Latin word scrupulum, which is defined as a small sharp stone. For some if may feel as if they are being stabbed by the stone or at walking on it barefoot.

What they have in common is the erroneous belief that they need to be shining examples of virtue in order to be acceptable to God and the people in their lives. They freely admit that their families and friends would view them in a positive light and that God would give them a thumbs up.

As is so for OCD and one of its co-morbid conditions, anxiety, it involves a “what if?” and “if only” mindset. Each one questioned his future which was uncertain. They were reminded that no one’s life is cast in stone and that change is a natural part of the journey. Each one had a pivotal event or series of occurrences that triggered the symptoms. The first person’s experience was the death of his grandparent, coupled with visiting sacred sites. The second person’s experience was a painful injury sustained in childhood, from which he has recovered physically, but clearly not so, emotionally.

As an interfaith minister, as well as social worker, I inform clients that I have no right to tell them what to believe spiritually. Instead, I engage in exploration with them, inquiring about the relationship with the God of their understanding. The work involves Cognitive Behavioral Therapy, Gestalt exercises as they dialogue with deity, their OCD symptoms and the prevailing anxiety that may have triggered the behaviors. It involves relaxation and stress management techniques, using self-chosen mantras and affirmations, as well as hand mudras that are affirming as opposed to becoming a source of stress. It also includes reality testing as they prove that what they most fear is not likely to occur. I remind them that they are works in progress and that perfection doesn’t exist on this human plane.

They come to accept that any skill they now have was once unfamiliar and uncomfortable and that by practicing, they improved. The same is so for any desired behavioral change. An example is folding hands together and asking which thumb naturally falls on top. Once they have provided the answer, I ask them to reverse the position and once they have done so, I ask how it feels. The initial feedback is that it “feels weird” and brings about a sense of uneasiness. Given enough time, they admit that they could get used to it. The same is so for OCD symptoms. When they are viewed as never-ending, they are more fearsome than if the person can imagine living without them. If they are able to tolerate the stress of not practicing the behaviors, they are closer to overcoming them. I remind them that by resisting the symptoms, they are more likely to continue. There is, however, a balance between repressing them and letting them run amok.

Befriending God within them has helped these people to begin to accept their own inherent worthiness and enhances their desire to alleviate their own suffering.