Understanding Scrupulosity OCD

Scrupulosity — sometimes called religious OCD or moral OCD — is a common form of OCD where a person experiences thoughts or urges that may violate their religious or moral beliefs.

For example, religious scrupulosity may manifest as believing you’re going to hell because you thought of something immoral during a church service.

An example of moral scrupulosity may be telling your friends a joke, and if they do not laugh, you stay up all night thinking that you are a cruel person.

Prevalence

The prevalence of scrupulosity OCD depends on cultural factors.

In Western countries, where many are not legally bound to religious rules, as many as a third of people with OCD may also exhibit scrupulous symptoms. An estimated 5% of these people who live with OCD may show signs of scrupulosity.

Although OCD can start at any age, symptoms tend to appear in adolescence. Still, one may experience symptoms in the late teenage years or early adulthood.

The symptoms of scrupulosity may include obsessively worrying about something that goes against your religious or moral beliefs.

Consider these common obsessions or intrusive thoughts in scrupulosity OCD:

• fear of offending a higher being, such as God
• fear of being punished or going to hell
• fear of praying incorrectly
• fear of committing a sin
• fear of behaving too morally
• fear of lacking self-control
• striving for purity
• doubting what you believe

In addition to worrying about religious or moral issues, people living with scrupulous OCD may engage in compulsions in addition to avoiding OCD-triggering situations.

Common behavioral and mental compulsions may include:

• going to confession excessively
• repeatedly seeking reassurance from religious leaders
• repeating cleansing and purifying rituals
• excessive praying
• repeating passages from scriptures
• avoiding religious services where an immoral act may occur
• repeatedly trying to erase or replace bad thoughts

Scrupulosity OCD is treated the same as other subtypes of OCD.

According to the International OCD Foundation (IOCDF), an estimated 7 out of 10 people will benefit from either medication or exposure and response prevention therapy (ERP).

Exposure and response prevention

ERP is a form of cognitive behavioral therapy (CBT) and is the first line of treatment for all OCD forms as well as scrupulosity OCD.

This therapy is a structured process where a trained therapist will expose you to what triggers your OCD, then teach you better coping systems instead of performing your compulsions.

Medication

The primary drug treatments for OCD are called selective serotonin reuptake inhibitors (SSRIs). These antidepressants also can help address OCD symptoms.

Research shows that individuals who take medication see their symptoms reduced by 40–60%.

It’s important to note that treatment focuses on the difficult symptoms of OCD. Neither SSRIs nor therapy tries to change your religious faith or moral convictions.

OCD may make your life feel more difficult. Reducing stress and avoiding situations that trigger your obsessions and compulsions can help you thrive in your daily life. Here are some other ways to cope with religious OCD.

1. Learn your triggers

Study your triggers so you can avoid the situations that bring on your symptoms. If you are unable to avoid certain places or situations, consider asking a mental health professional to help you find coping skills on how to deal with triggers.

2. Try stress management techniques

Practice relaxation techniques such as deep breathing or meditation. Try muscle relaxation or yoga. Choose a technique that will help relax you and ease your mind.

3. Join a support group

Support groups are great because you may find other individuals who are going through the same thing that you are. Meeting with people who have similar situations or diagnoses can be healing, helping you feel more understood and connected.

4. Get moving

There is growing research that suggests exercise may help reduce OCD symptoms.

A 2017 study found that exercise and health-focused interventions may be beneficial as additional factors along with existing OCD treatment.

5. Stay occupied

You may find it easy to become absorbed in your obsessive thoughts and rituals when you have OCD. It may help to stay busy and immerse yourself in activities or hobbies that you enjoy. Doing simple tasks can help keep your mind busy and distracted from your OCD triggers and unwanted thoughts.

Scrupulosity is a form of OCD where you may experience intrusive thoughts or urges that do not align with your religious or moral beliefs.

People living with scrupulous OCD may also engage in behavioral compulsions like going to confession excessively or mental compulsions like repeating scriptures from the Bible over and over in one’s head.

You can cope with scrupulosity OCD by maintaining healthy practices including:

• knowing your triggers
• practicing stress-relieving techniques
• joining a support group
• enjoying regular aerobic exercise
• keeping busy

Scrupulosity OCD is treatable. You can best learn how to manage your symptoms under the supervision of a mental health professional. The support of your loved ones and online information resources can be helpful, too.

You can find a support group in your area using the IOCDF’s find help page and their support group page.

Be patient and kind with yourself as you find more healthy ways to manage symptoms and live out your faith every day.