What Is Religious OCD And Can It Be Treated?

Obsessive-compulsive disorder (OCD) is a mental illness characterized by repeated, unwanted thoughts and fears, often resulting in repetitive and ritualistic behavior to avoid or control these thoughts or fears. 

There are different subtypes of OCD, each based on the nature of the symptoms a person experiences. Religious OCD is one example of how the disorder can manifest, and for those impacted, its symptoms can be upsetting, challenging to manage, and significant enough to affect daily life.

What are the types of OCD?

There are several forms OCD may take. Each type of OCD is often associated with specific underlying fears, including but not limited to contamination, harm, or a loss of control. Below are common manifestations of OCD, along with compulsions and obsessions that can accompany them.

Harm obsessions with checking compulsions

Harm obsessions often involve intense thoughts related to harming oneself or others. This type of OCD may be accompanied by compulsive rituals that involve checking behaviors. Checking gives a person a sense of control and reassurance. However, relief is often short-lived. As a result, the cyclical pattern of fear, response to fear, and compulsive behavior can seem to take over an individual’s life. 

For example, people with harm-related obsessions and checking compulsions might believe they accidentally harmed their partner in their sleep. As a result, they may perform checking compulsions by checking that their partner is safe and going through their kitchen to ensure no dangerous substances or items have been messed with. They may further ask their partner if they slept well and feel safe, as asking for reassurance is another form of a checking compulsion. 

Symmetry obsessions and organization compulsions 

People with symmetry obsessions may experience a strong urge to arrange and rearrange objects. They may put a lot of effort into keeping things “in order,” whatever that standard means to them. Symmetry obsessions may involve repeatedly reorganizing books from tallest to shortest, ensuring pens line up evenly on a desk, or hanging shirts according to type and color in a closet. Often, these obsessions and compulsions are rooted in a fear that something may go wrong if the organization is messed with. For this reason, they may react with extremes if someone changes the order of their organization or tries to control the process for them. 

Contamination obsessions with cleaning or washing compulsions

A person with contamination OCD may focus on discomfort associated with contamination. Those who experience this type of OCD may believe the fear of experiencing disgust is more distressing than the results of contamination, such as getting sick, though specifics can vary. They may wash their hands constantly or clean excessively. Some of these behaviors may be repeated for hours.

What is religious OCD, and what makes it different?

Religious OCD, often called scrupulosity, is not a separate obsessive-compulsive diagnosis. Instead, it is a specific manifestation of obsessive-compulsive disorder that often causes a person to obsess over spiritual and religion-related fears. These fears may prompt compulsions to prevent or control situations. 

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

Like other forms of obsessive-compulsive disorder, the cause of religious OCD is not entirely understood. An imbalance of chemical messengers in the brain may contribute to its development. Genetic and environmental factors may contribute, as well. 

Symptoms of religious OCD 

People with religious OCD often experience persistent negative thoughts about their own spirituality. These intrusive thoughts may be so strong that they can interfere with the person’s daily functioning. These individuals may struggle to ignore these thoughts and think about them constantly throughout the day. 

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

Anything that causes an obsession can cause a desire for obsessive or compulsive behavior.  For instance, seeing a person give an extensive offering could cause the person with religious OCD to worry that they want to steal the money from the other person. In turn, they might perform a compulsion by donating significant amounts of money that are out of their budget and put them in financial disarray.

Religious OCD, morals, and religious leaders

Individuals who experience religious OCD or scrupulosity generally have strict standards of moral, ethical, and religious perfection. They may believe they are condemned by what others consider basic standards or guidelines.

In addition to feeling extreme guilt for “unholy” or “unclean” thoughts and behaviors, a person with religious OCD might often experience symptoms of anxiety and depression. A person with religious OCD may experience an overwhelming urge to engage in compulsive behavior that they believe could lead to forgiveness or restore positive religious standing. They might also seek connection with religious leaders who can reassure them of their “worthiness” or try to become religious leaders in an attempt to be closer to their faith. 

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

• Fear of being possessed

• Fear of other people in their religion “finding out” that they are “imperfect,” “unholy,” or “unclean” 

• Fear of having “sinned” without knowing  

Compulsions related to different types of OCD, including religious OCD, are typically 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 or repeated prayer or religious rituals 

• Performing extreme acts of self-sacrifice or denying oneself the benefit of pleasure or joy

What religion do people with religious OCD practice?

Religious OCD is not specific to any one religion. People of various religious backgrounds can experience religious OCD. It may be more likely to develop in those who belong to stricter religious groups. However, because the root of this disorder is the mind, it has not been proven that one religion is more likely to cause OCD than another. 

Can religious OCD be treated?

Treatment for religious OCD is available and often effective. It may involve several modalities of psychotherapy, which may be focused on helping the person manage anxiety without undermining their quality of life. Below are a few treatment options often used for OCD. 

Cognitive-behavioral therapy

Cognitive behavioral therapy (CBT) is often recommended in treating anxiety, OCD, and many other mental health disorders. It is focused on helping people detect, understand, and divert negative thoughts.

Cognitive restructuring

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

Exposure and response prevention therapy (ERP)

With exposure and response prevention therapy (ERP), a person is intentionally exposed to an anxiety-producing thought or situation that may incite an OCD episode. When exposure occurs, individuals purposefully avoid compulsive behavior and track their anxiety levels. 

Exposure therapy can be difficult, as it may require the affected individual to partake in activities they believe are sacrilegious. In the long term, however, exposure and responsive prevention therapy can help a person reduce the occurrence of unwanted compulsions and begin to practice faith healthily without fear or shame. In addition, studies show that ERP is one of the most effective treatments for OCD, often leading to symptom remission.

Alternative treatment options 

If you or someone you know is experiencing symptoms of religious OCD, alternative forms of treatment are available. For some, meeting someone face-to-face can seem frightening or unsafe. If you want to talk to someone but aren’t comfortable meeting with a counselor or therapist in person, online therapy through a platform like BetterHelp may be beneficial. 

Online therapy allows clients to pick a scheduled time with their therapist that fits their schedule. In addition, clients can meet from home and choose between phone, video, or live chat sessions with their therapist. 

In addition to being convenient and approachable, online therapy can also be effective. Research suggests that online treatment options can be as helpful as in-person therapy for treating symptoms of mental illnesses. One literature review examining the efficacy of online cognitive-behavioral therapy (CBT) found that internet-based treatment could be as successful at decreasing symptoms of anxiety, depression, panic disorder, PTSD, and other conditions.