“For as he thinketh in his heart, so is he….” ~ Proverbs 23:7

Grace had grown up in a religious home. She was familiar with the above proverb. She understood it as a reminder to maintain pure thoughts to be a better person. Unfortunately, she was challenged by obsessive-compulsive disorder (OCD), and every time she read verses such as this, her anxiety and guilt would torment her.

Honesty and integrity were often talked about in her home. Impure and blasphemous thoughts were against her religious beliefs. She had learned that if she were to sin, she could take steps to be forgiven. A broken heart, contrite spirit, and confession were essential.

Her troubles began in middle school. She was taking a history test and inadvertently looked at her neighbor’s test. Her guilt drove her to tears. Because of her values, she had to come clean. She did, and failed her test. This seemed to be the beginning of her cascade of constant guilt caused by her thoughts.

When a kid at school would announce someone had stolen his lunch money, she’d quickly look in her pockets, school bag, and desk to ensure she was not the thief. Her thoughts and fears felt real. Once, when she got an A+ on an English essay, she felt remorseful. Her mom had proofread her paper for spelling and grammar errors. She believed she had cheated. Getting rid of her guilt was more important than passing her class. Praying and confessing were a must so she could feel peace.

“Somehow my honesty issues subsided while I was in high school. But before I began college my troubles reappeared. This time my thoughts morphed into something disgusting that drove me crazy,” she told me.

Grace’s thoughts didn’t match her values. She couldn’t accept the thoughts and images in her mind of actually harming someone. She began to miss school and stay in her dorm all day. She’d spend hours “figuring things out.” She questioned her worthiness.

The truth about thoughts is that every single human being — regardless of whether he or she suffers OCD — has intrusive, disturbing thoughts at one time or another. When non-OCD sufferers have a distressing thought, they may be surprised. They may say to themselves, “Whoa! That was a weird thought.” They acknowledge it and move on.

On the other hand, when people who struggle with OCD have “random” perturbing and unpleasant thoughts, they panic. “Why in the world would I think such an awful thought? Where did that come from? What does this thought mean about me? I’m not this terrible person!”

OCD sufferers begin to reassure themselves in many ways to decrease anxiety and guilt. Their thoughts are troublesome because they are incongruous with their moral character. After all, the scriptures tell us to have pure thoughts, don’t they? However, prophets and biblical writers did not have OCD in mind.

OCD is a neurological and behavioral issue. It does not relate to religious beliefs, despite the symptoms. In truth, OCD often attacks whatever matters most to the person. In Grace’s case, as a devout, religious person, her OCD symptoms were related to that area of her life. She believed that thinking hideous thoughts would lead her to frightening actions. She began to question her self-worth. Depression began to surface because she couldn’t get rid of her “sins” despite her repeated repentance and confessions.

Prayers, hymns, and certain words became rituals. She began to avoid situations, places, and people to avoid triggering any tormenting thoughts. Her “OCD mind” kept telling her of the daunting consequences she would face in the future if she were not able to control her thoughts. She could not bear the thought of seeing herself living in eternal damnation.

The guilt Grace experienced was a biological consequence of her “OCD mind.” She had grown up learning “we must resist temptation,” but this wasn’t working for her. She had not learned that the guilt she felt was due not to sinning, but to OCD.

As Grace began treatment, through cognitive-behavioral therapy that included exposure and response prevention therapy, she discovered that finding reassurance and hating her thoughts were the stumbling blocks in her progress. It took some time, but she finally understood that resisting her sinful thoughts was not the answer. She learned that it’s impossible to control one’s thoughts. She learned that some of her thinking errors were contributing to her suffering.

For instance, most people who experience obsessions such as Grace’s have the belief that their thoughts equal their actions. This thinking error is called “thought-action fusion.” She believed that thinking something was just as bad as doing it. Grace had a constant need to assess her behavior and question her thoughts. She would spend hours figuring out the reason for her evil thoughts and how to undo them. She gained the experience and insight that thoughts are just that: thoughts. They come and go, and mean nothing themselves.

The road to modify her thinking habits was not easy. But she knew that what she had been doing all these years hadn’t worked. She realized that OCD had gotten in the way of enjoying her life and religion. For as she thought, she was not.