Obsessive-compulsive disorder (OCD) is best treated with exposure and response prevention therapy, but faith-based counseling can be incorporated as well. Whatever therapist you use, it’s crucial to make sure your counselors are educated in both OCD and ERP.
Balancing obsessive-compulsive disorder with religious beliefs can be a difficult endeavor—but it’s not impossible. If you’ve already gotten an OCD diagnosis and are weighing your treatment options, you might wonder if your faith leader can help you through recovery. While OCD is best treated with a specialized form of cognitive behavioral therapy (CBT) therapy called exposure response and prevention (ERP) therapy, there are instances when additional faith-based counseling can be beneficial.
Still, you may find it confusing to consider pairing ERP therapy with faith-based support. If your OCD centers on obsessions around morality or religion, you may even fear punishment from God or a higher power, if you try to disrupt intrusive thoughts with ERP exercises. Seeking support from a faith leader can be a helpful way to assuage these fears, but it’s essential that anyone you approach for guidance on your OCD symptoms have training and experience with the condition—as it can easily be misunderstood.
Whether you are Christian, Jewish, Muslim, or a practitioner of a different faith, this article will help you assess the best treatment options for OCD symptoms that center on religion, and show you that it is possible to get supportive, respectful care for your symptoms.
Understanding OCD and religion
OCD is characterized by two primary symptoms: obsessions and compulsions. Obsessions often take the form of intrusive thoughts, feelings, urges, images, and sensations, and can center on religious or moral themes, like accidentally committing an unforgivable sin. In response, people with OCD feel the urge to perform compulsions—repetitive behaviors or mental acts done in an attempt to neutralize these thoughts, or account for fears. For example, if you’re excessively worried about sinning, you may constantly pray as a way of trying to ease your distress.
When OCD interacts with a person’s religion, a lot of questions can come up. “As an OCD therapist, a Christian, and a person who struggles with OCD myself, I know this firsthand,” says NOCD therapist Melanie Dideriksen, MA, LPC. OCD is best treated through ERP therapy, which encourages you to face your fears, while resisting the urge to respond—but this can feel especially hard when anxieties feel related to deep spiritual beliefs. You may worry that ignoring these intrusive thoughts means ignoring signs from a higher power, or that seeking any kind of therapy outside of faith-based counseling will interfere with your devotional life.
In order to address these concerns, we need to explore how OCD seizes on religious themes, and what treatment for OCD actually entails.
What is scrupulosity OCD?
Scrupulosity OCD, sometimes referred to as religious OCD, is a form of OCD involving religious or moral obsessions. If you struggle with this subtype, you might deal with persistent fears that you are a bad or evil person. You might feel constant concern that you will do something to offend God, or commit an “unpardonable” sin—or, that you may have done so in the past.
Common obsessions related to scrupulosity OCD include:
- What if I accidentally use God’s name in vain?
- What if I commit a sin that won’t be forgiven?
- What if I go to hell because I had sex before marriage, looked at pornography as a teenager, or masturbated?
- What if I think evil things in my head about my friends?
- What if I harm someone, or harmed someone in the past?
- What if another religion is the “right” one?
Common compulsions related to scrupulosity OCD include:
- Excessive prayer
- Excessive confession to a priest, family or loved ones
- Bargaining with God
- Seeking reassurance from friends or loved ones that your sins will be forgiven
- Avoidance of anything associated with immorality
- Excessive research about religious topics
- Excessive attendance of religious ceremonies or services
Community discussions
It is important to note that not all repetitive religious rituals are driven by obsessive fears. “One person may attend Mass every day of the week, go to confession twice a week, volunteer in the church soup kitchen, and direct the Christmas pageant because of their devotion to their faith,” says Dideriksen. “They feel good about this, and are driven by devotion, not fear.” Another person with OCD may do all of these things as a way to respond to obsessive concerns about morality, which would not be healthy.
If you’re unsure whether your acts of devotion are compulsive, it can be helpful to reach out to a therapist who is also trained in scrupulosity OCD.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Treating OCD while practicing your faith
A good OCD therapist will be always willing to work with another professional to deliver the best treatment possible. Sometimes, this means collaborating with a faith-based counselor. Healing from OCD and growing in spirituality can occur at the same time when both areas are addressed appropriately.
ERP therapy for scrupulosity OCD
As mentioned earlier, ERP therapy has been found to be effective for the majority of people with OCD. An ERP therapist can work with you to gradually help you learn to tolerate your worries and fears, without engaging in compulsions, like excessive prayer or reassurance seeking. In ERP therapy, you’ll slowly be exposed to situations that trigger your obsessions, and taught new ways to respond. Over time, you’ll build more tolerance for uncertainty and anxiety in the face of your fears, and you won’t feel such a strong urge to engage in compulsions.
Some specific ERP exercises for scrupulosity OCD might include:
- Reducing prayer to once a day.
- Saying “I am not a perfect practitioner of my faith,” and learning to sit with that discomfort.
- Writing the word “Satan” on a piece of paper over and over, until the word no longer frightens you.
- Watching a movie clip about demonic possession, and resisting compulsions to try to cleanse yourself.
Don’t worry if the idea of these activities makes you flinch. A good ERP therapist will understand how important your faith is, and how scary some of these exercises can sound at first. “We know that some exposures may be off the table for some people—and that’s completely okay,” Dideriksen explains. “Therapy is never one size fits all.” An ERP therapist will work to help you face your fears, while upholding the importance of your faith by creating a customized treatment plan.
Can faith-based counseling work with ERP?
Faith-based counseling isn’t a replacement for ERP, but the right faith-based counselor can be an excellent complement to ERP therapy. That being said, it’s important to note that OCD is widely misunderstood, so it can be difficult to find people who know how to help you manage the symptoms you’re experiencing. “There is a need for more education about OCD in the world at large,” says Dideriksen. “This includes the world of faith, and sadly the world of mental healthcare as well.”
When seeking faith-based counseling to complement your ERP therapy, you’ll need to make sure potential counselors have a strong understanding of OCD and how it manifests. It’s possible for people unfamiliar with the condition to become unjustifiably concerned when presented with OCD obsessions. These misunderstandings can unfortunately counteract effective treatment, exacerbating OCD symptoms. “On the other hand, when a faith-based counselor is educated about OCD, they can help a patient to figure out where their faith ends and their OCD begins,” Dideriksen adds.
Bottom line
If your OCD centers on themes around religion, morality, or ethics, you’re not alone, and you don’t have to diverge from your faith to get help. In fact, you can work with both an ERP therapist and an informed faith-based counselor to disrupt the OCD cycle, and regain your time from compulsions. By making sure your therapists are educated in OCD and ERP, you can ensure your journey to recovery will be as smooth as possible.
Key takeaways
- Religious or scrupulosity OCD is a subtype of OCD characterized by intrusive thoughts and compulsive behaviors related to religious, moral, or ethical concerns.
- ERP therapy is the most effective treatment for OCD, and it can be done in tandem with faith-based counseling.
- If you are seeking additional faith-based support outside of ERP therapy, it’s critical to make sure whoever you’re talking to has a good understanding of OCD—as misunderstandings about the condition can inadvertently worsen symptoms.