What are OCD and scrupulosity? Many associate obsessive-compulsive disorder (or OCD) with its outward manifestations: checking, washing, or arranging items in a particular order. But underneath the seemingly harmless veneer lies a crippling anxiety which torments its host. The two components are obsessions and compulsions. Obsessions are the thoughts or thought process in which the sufferer has in mind an extremely undesirable outcome which produces anxiety. These thoughts are not usually voluntary–they invade the mind like a most unwelcome guest. Compulsions are the behaviors (physical or mental) that reduce the anxiety.
Suppose that someone is terrified of catching a deadly disease. Perhaps it’s the thought of dying young; perhaps he had a friend or relative who did; perhaps an image he saw in a movie remains embedded in his mind. He might think that germs or bacteria could cause him to catch such a disease. So, when he is putting on his shoes in the morning, he has the thought that perhaps some germs have come in contact with his shoe. He then experiences great anxiety over this thought and broods over the possibility of disease. To remedy this, he goes and washes his hands. After feeling relieved for a while, he has another thought: “Maybe I didn’t wash all the germs off.” This again produces anxiety and he goes back to wash his hands a second time. This process continues over and over with the man having anxiety built up through a thought (the obsession) and then released through the act of washing his hands (the compulsion). The outward manifestation might seem harmless enough, but inside, this poor soul is plagued with the fear of contracting a disease and his life coming to a premature end.
Religious OCD, or “scrupulosity” as it is commonly called, involves the same process. Rather than fearing disease and death, the scrupulous person would fear something perceived as of eternal value: going to hell, offending or displeasing God, losing his salvation, not being savable, committing a heinous sin, and so on. He or she would obsess about such matters and would seek to assure or relieve himself or herself through compulsions. These can take many forms, and a few examples are confessing one’s sins, seeking out someone to provide assurance, repeating a prayer, or trying to do an extreme act of obedience to restore one’s relationship with God. Throughout the process, the sufferer lacks certainty regarding his concern. He can try to believe he is saved, but he can never quite be sure that he is. There is much anxiety-driven doubt in the process–which is why OCD and scrupulosity have been called the “doubting disease1.”
- See The Doubting Disease by Joseph W. Ciarrocchi ↩