bigstock-123151913Most people associate scrupulosity with religion, and indeed religious scrupulosity is often an issue for some people with obsessive-compulsive disorder. Those with this type of OCD have unreasonable religious expectations of themselves. But scrupulosity can be seen in other areas as well. For example, social scrupulosity occurs when the person with OCD has an obsessive fear of harming the feelings of others. This can be extremely distressing and can significantly interfere with daily life.

My son Dan is a good example. When his OCD became severe in college, he totally isolated himself from his friends. I’ve previously written about his sense of hyper-responsibility, and as I understand it, social scrupulosity is a type of hyper-responsibility. Those with social scrupulosity might believe that giving their opinion, negotiating, or being assertive in any way, will bring harm to others. In Dan’s case, one of the ways he dealt with his social scrupulosity was through the avoidance of his friends. By avoiding them, he wouldn’t have to deal with the anxiety and fear of saying the wrong thing, or of expressing the wrong thoughts. Other common ways of dealing with social scrupulosity include engaging in compulsions such as constantly apologizing for saying something wrong or “checking” to make sure the person you think you might have harmed is okay. It is not unusual for those with social scrupulosity to become extremely inhibited — never asking for help or voicing concerns. Indeed they often will not express themselves in any way.

As I’ve written before, the thoughts and behaviors of those with obsessive-compulsive disorder are often no different from those who do not have the disorder. It is the severity that sets them apart. I don’t have OCD but I can easily relate to social scrupulosity. For example, I was traveling recently and had to take a shuttle from the airport to my hotel. The air-conditioning was on full force and blowing right on me. I was so cold! But did I say anything to the driver? Nope! I felt that being assertive in this particular situation would be a negative thing. Maybe even selfish. What if everyone else was comfortable? I didn’t want to ruin the ride for the other passengers. As it turned out, somebody else eventually asked the driver to warm things up a bit, and of course, nobody was offended. My guess is, they were all as pleased as I was. Of course this example is on the mild end of the social scrupulosity continuum, and had more to do with not being assertive than anything else. But I frequently act this way, and now that I’m aware of it, I am trying to be more assertive and voice my opinion more often, without being so concerned about how I will appear to others, or if they will be negatively affected by my thoughts or actions.

Cognitive Behavioral Therapy (CBT), specifically exposure and response prevention (ERP) therapy, can help those with OCD (or even those without OCD) who deal with social scrupulosity. A good therapist can also help you recognize and deal with any cognitive distortions that might come into play. The good news is that this type of OCD, like all types of OCD, is absolutely treatable.