What is Scrupulosity?

Scrupulosity is a subtype of Obsessive Compulsive Disorder in which obsessions and compulsions become intertwined with one's religious beliefs and/or morals. Although scrupulosity can affect a person of any religion, here I will use Christianity to demonstrate the meaning. A scrupulous Christian may:

- constantly question if they are really saved

- obsess over whether or not they have committed the unpardonable sin

- feel they haven't repented correctly

- sometimes have intrusive sexual thoughts about God, Jesus, the Holy Spirit or other religious figures

- feel they may have sinned, even when they haven't

In order to cope with these disturbing thoughts and feelings, the Christian may do such compulsions as:

- pray a certain prayer repetitively

- confess the same sin over and over

- ask God for forgiveness about a certain sin over and over

- constantly seek reassurance from trusted pastors or persons of faith

- obsessively research in order to find the answers to their spiritual/moral questions

- enforce upon themselves far stricter rules than their belief system actually demands

This creates a great amount of distress for the sufferer as what they value, love, and have devoted their lives to is being turned against them. The distress may cripple the sufferer enough to cause them to avoid practicing their beliefs (such as praying, reading the Bible, or going to church). Through the avoidance, the sufferer strives to prevent the painful thoughts, feelings, and rituals that OCD inflicts upon them.

How Can a Person Struggling with Scrupulosity Receive Help?

Scrupulosity is treated using the same evidence-based treatment methods that are used to treat any type of OCD: Exposure and Response Prevention, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy. However, when treating scrupulosity using ERP, extra care needs to be taken to avoid violating a person's religious values and beliefs. This is one reason why being knowledgable about that particular client's belief system is a must. If the clinician is not familiar with a client's belief system, then it may be necessary to involve a respected leader from that client's faith community in the treatment. This will help the therapist gain a better understanding of the religious norms of that community and it will help the client have confidence that their beliefs will be respected as they participate in therapy.

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