What Is Religious OCD, And Can It Be Treated?

Updated August 28, 2020

Medically Reviewed By: Laura Angers

Obsessive-compulsive disorder, commonly referred to as OCD, is a mental health issue that causes repeated, unwanted thoughts or sensations that result in the urge to do something repeatedly.  Obsessions are unwanted thoughts or sensations and compulsions are the urge to repeat activities.

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There are different types of obsessive-compulsive disorder and each is based on the nature of the symptoms a person experiences.  Some examples of obsessive-compulsive disorders include the following.

Harm Obsessions with Checking Compulsions

Harm obsessions with checking compulsions involve intense thoughts related to harming oneself or others.  It is usually accompanied by rituals of checking things to relieve stress.  For instance, a person with a checking compulsion may constantly lock and unlock doors to make sure the locks are working correctly to prevent a break-in.

Symmetry Obsessions

People with symmetry obsessions experience a strong urge or need to arrange and rearrange objects.  A great deal of detail goes into making sure that everything is in order.  Symmetry obsessions may involve moving books on a shelf repeatedly to make sure they go in order from tallest to shortest or vice versa, making sure that pens line up evenly on a desk or hanging shirts according to type and color in a closet.

Contamination Obsessions with Cleaning/Washing Compulsions

A person who has this subtype of OCD will generally focus on feelings of discomfort that are associated with contamination.  He/she may wash hands constantly or clean excessively.  Some of these behaviors may be repeated for hours.

Obsession without visible compulsions is a subtype of OCD that relates to having unwanted obsessions involving sexual, religious, or aggressive themes.  A person with this type of OCD may have intrusive thoughts about what it would feel like to murder someone or have a constant fear that he/she is going to attack someone.

What is Religious OCD and What Makes It Different?

Religious OCD, often referred to as Scrupulosity, is not a separate obsessive-compulsive diagnosis.  Rather, it is a specific manifestation of obsessive-compulsive disorder that causes a person to obsess over spiritual fears.  These fears generally involve compulsions related to things that the person is trying to prevent happening.

For example, if a person with religious OCD is afraid of going to hell, he or she may pray constantly to become worthy of salvation.  While religion is a source of comfort for many people, those who experience religious OCD often feel fear and overwhelming emotional pain related to their perceived religious shortcomings.

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Like other forms of obsessive-compulsive disorder, the cause of religious OCD is not completely understood.  Some research suggests that an imbalance of chemical messengers in the brain may contribute to its development.  Further, genetic and environmental factors may also be contributing factors.

People with religious OCD have persistent negative thoughts about their own spirituality.  These thoughts are so strong that they can interfere with the person’s daily functioning.  For many, it is difficult to suppress or ignore these thoughts or obsessions.

Although scrupulosity may appear different from other manifestations of obsessive-compulsive disorder at first, people who experience religious OCD do experience the same obsessive-compulsive cycles as people with other forms of OCD.

Obsessive thoughts associated with religious OCD often manifest with the affected person asking “What if” questions.  For example, “What if God is real and I go to hell because I didn’t believe it?” or “What if I accidentally commit adultery by thinking of someone else?”  In fact, triggers for scrupulosity can be an image, thought, place, person, or feeling.  Anything that cues an obsession can cause the need for obsessive or compulsive behavior.  For instance, seeing a person give a large offering could cause the person with religious OCD to have thoughts of taking money from the other person.  This, in turn, could result in an obsessive desire to undo the negative thought with the hope of being redeemed.

Symptoms of Religious OCD

Individuals who suffer from religious OCD or scrupulosity generally have strict standards of moral, ethical, and religious perfection.  They feel easily condemned by what others may consider the simplest standards or guidelines of religion.

In addition to feeling extreme guilt for “unholy” or “unclean” thoughts and behaviors, a person with religious OCD will often experience symptoms of anxiety and depression which can be traced to their fear of eternal damnation.  A person with religious OCD will have an overwhelming urge to engage in any compulsive behavior that may lead to forgiveness or that will restore good religious standing.

Some examples of religious obsessions include:

  • Fear of going to hell
  • Fear of committing immoral or sinful behavior
  • Fear of being unclean or spiritually contaminated
  • Fear of not having enough faith

Compulsions are defined as any intentional thought or behavior that is done in an effort to reduce or neutralize a person’s sense of pain, guilt, or anxiety.  Compulsions are usually repetitive and time-consuming.  Further, the person will not experience gratification by performing these acts.  Performing compulsions is a way of relieving stress and if a person is not allowed to engage in the compulsive act, a rapid escalation in anxiety or stress is likely to occur.

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Compulsions related to OCD are categorized as avoidance behaviors, reassurance-seeking behaviors, mental compulsions, or overt behavioral compulsions.

Examples of religious compulsions include:

  • Seeking constant approval or reassurance from religious leaders or authority figures
  • Going to religious or church services more than what is typically scheduled in a person’s religion
  • Engaging in excessive prayer: The person may repeat a prayer dozens of times or more until he/she gets is right
  • Performing extreme acts of self-sacrifice or denying oneself the benefit of things that bring pleasure or joy

What Religion Do People with Religious OCD Practice?

Religious OCD or Scrupulosity is not specific to any one religion.  In fact, people of various religious backgrounds experience religious OCD.

A few examples of how religion may affect feelings of Scrupulosity include:

Protestant Christians and Catholics generally practice adherence to doctrines that are difficult for some people to understand.  For example, a Scripture in the New Testament tells readers that if a person looks at a woman with lust, he has already committed adultery in his heart.  Although the person has not committed the physical act of adultery, the guilt that comes with a perceived flaw of religious submission may lead to compulsive prayer or fasting until the person feels they have been forgiven.

Muslims believe that a devilish character called “Shaytan” whispers doubting thoughts to men and women and encourages them to sin.  Although most people believe that intrusive thoughts are a normal part of life, asking a devout Muslim to believe that the whispers from Shaytan should be accepted is an insult to their faith.

Can Religious OCD Be Treated?

Treatment of religious OCD can be helpful, but it requires the affected individual to challenge his/her fears.  Therapy is generally focused on helping the person manage anxiety without undermining their quality of life.  Several types of therapy can be helpful in treating religious OCD.

Therapists will not ask a person to give up or consider his faith but will attempt to treat the person’s anxiety related to religious fears.  In fact, debating religious beliefs can have negative impacts on treatment and could result in alienating the person who is in therapy.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is a type of therapy that is helpful in treating anxiety.  It is focused on helping people detect, understand, and divert negative thoughts.  Cognitive Behavioral Therapy is believed to be more helpful when addressing concrete concerns, such as when a person fears she said a prayer wrong or didn’t dress according to her religion’s requirements.

Family Counseling

If religious OCD affects a family unit, family counseling may be helpful.  Age-appropriate counseling sessions can be implemented for children who are affected by scrupulosity.  Additionally, couples therapy may be indicated for people whose relationship is affected by religious OCD.

Cognitive Restructuring

With this type of therapy, individuals are taught ways to effectively challenge the accuracy of their unwanted thoughts and behaviors.  Cognitive restructuring focuses on teaching healthy ways to identify and address obsessions and compulsions while preserving one’s faith.

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Exposure and Response Prevention Therapy (ERP)

In ERP, a person is intentionally exposed to an anxiety-producing thought or situation that triggers an OCD episode.  When the trigger occurs, the individual purposefully avoids any compulsive behavior.  This type of therapy can be difficult as it requires the affected individual to feel as if they are doing something that is sacrilegious.  In the long-term, however, exposure and responsive prevention therapy can help a person reduce the occurrence of unwanted compulsions and begin to function and practice faith more freely without the risk of guilt or shame.

The main goal of therapy for any form of OCD, including religious Scrupulosity, is for the affected individual to learn that they can co-exist with unwanted thoughts without having to indulge in compulsions.  Therapy sessions include attempted to convey that obsessive thoughts are possibilities, but that they are not likely or even probably.

Seeking Help for Religious OCD

If you or someone you know is experiencing symptoms of Scrupulosity, it is important to seek help.  You may choose to consult a pastor or religious advisor for help.

On the other hand, talking with a counselor or therapist who specializes in obsessive and compulsive behaviors can also be beneficial.  Many communities have a local mental health clinic where services are available without a referral.

For some, the thought of meeting someone face-to-face can feel frightening or even unsafe.  If you need to talk to someone but aren’t comfortable meeting with a counselor or therapist in-person, online counseling is an effective alternative to find help.  One example of online counseling services is provided by BetterHelp.

At BetterHelp, licensed, trained, experienced mental health care will work with you to develop a plan of care that is tailored to your needs.  You can connect with BetterHelp from home or anywhere else that you feel safe and comfortable.  If you are a practicing Christian and prefer faith-based counseling, you may want to consider BetterHelp’s sister platform, Faithful Counseling.

Remember, you are not alone.  Reach out today and find help to deal with religious OCD and to help find peace.


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