In support of those with OCD, we want you to know that you can practice your religion and seek mental health treatment. OCD experts, religious leaders, and those living with OCD want you to know that you are not alone.
OCD tends to latch onto the things that are most important to an individual, including their faith and morals. Those experiencing immoral or scrupulous thoughts may face unique challenges when seeking treatment and support. This section is designed to provide individuals impacted by OCD with the education and resources needed to seek evidence-based treatment while feeling encouraged to uphold their faith, religious, and/or spiritual traditions.
Differentiating Faith from OCD
How can I tell what is faith and what is OCD?
OCD latches onto the things most important to each individual. For many people, this is their faith, spirituality, and/or religious traditions. Scrupulosity manifests itself in different ways that are unique to an individual’s faith or religious views. When experiencing an intrusive thought containing religious themes, it can feel like a “spiritual problem” that needs to be addressed within a religious community. It can be challenging for these individuals to determine what is driven by “faith” and what is “OCD” for both the sufferer and the wider community. The individual may engage in rituals in an attempt to alleviate the anxiety and/or distress caused by the obsessions. These rituals could mimic religious behaviors, such as excessive prayer or confession, which can become extremely time-consuming and greatly interfere with a person’s religious practices and daily functioning.
In reality, OCD is inherently ego-dystonic (not in alignment with beliefs), while our religious practices, when healthy, are ego-syntonic (in alignment with beliefs). Beliefs stem from values rather than fear. Evidence-based treatment helps individuals live more fully into their faith by teaching them to separate their OCD from their true faith values. It is important to note that while the terrifying content connected to your faith feels important, OCD has nothing to do with faith or religion and treatment is the same for all subtypes of OCD.
Treatment for Scrupulosity
What is the treatment for scrupulosity?
Scrupulosity might seem unique, but it is simply a subtype of OCD that latches onto your value of faith and your faith practices and beliefs. Just like any other subtype of OCD, exposure and response prevention (ERP) and medication are considered the “first-line” treatments for OCD. The basic principles of ERP for OCD is to face your fears without engaging in rituals (exposure + ritual prevention). In the area of faith, ERP could seem both challenging and irresponsible. Going through ERP treatment may feel as if you are going against your core values, when in actuality it is quite the opposite. ERP is helping you break OCD’s rules by changing your relationship with your thoughts, feelings, urges and other internal events. Experiencing fear is not an indication that you are breaking the tenets of your faith but rather an indication that you are fighting your OCD. By engaging in the treatment and sitting with the discomfort, you can return to your value-driven faith as opposed to faith dictated by OCD.
Accepting Uncertainty
How could you possibly accept uncertainty about your faith?
Accepting uncertainty and sitting with discomfort can feel challenging when your OCD tells you it is a matter of life, death, morality, or salvation. Remember, uncertainty isn’t a bad thing (despite what OCD says). Faith actually includes a level of uncertainty. Doing something that is uncertain helps strengthen your faith as you learn to sit with the discomfort while focusing on living into your values. We may not be able to control the negative feelings that arise while accepting uncertainty, but we can control our response by trusting the treatment process and moving towards our true values.
Working with your mental health provider, you will learn skills to begin accepting uncertainty and how to incorporate exposure and response prevention (ERP) in your daily life. Some mental health providers even work with clergy to better understand faith traditions. You will not be told to oppose or disrespect your faith as a part of your treatment, but you will be asked to do things that make you feel uncomfortable. OCD might make you feel like this discomfort means you are opposing your faith, but this is not the case. By embracing uncertainty, you can learn to have faith in your religious practices, faith in the treatment, and faith in yourself.
Bridging the Gap / Overcoming Stigma
Sometimes, individuals experience stigma within their faith communities as they navigate OCD. For instance, you might hear OCD used as an adjective in ways that invalidate your diagnosis within the faith community. Or perhaps your faith leader sees your OCD as a product of lacking assurance of faith, chronic doubt, or not putting your trust in a higher power. Many well-intentioned religious leaders and individuals within faith communities simply do not understand that OCD is not a spiritual issue. They want to be supportive but just don’t have enough information or access to appropriate resources.
As a result of stigma, it can be hard to share your experience of OCD with your inner circle, as you wish to feel validated and understood. You might worry that your struggles with OCD will be seen as a weakness or struggle of faith.Ideally, we need to educate others, especially in our inner circles and faith communities about the reality of OCD, as when the sufferer feels judged or misunderstood it can exacerbate the already uncomfortable doubt and anxiety that comes with having OCD.
As OCD sufferers, we can educate and teach people about mental illness and let them know that it can co-exist with faith. That being said, it can be very uncomfortable to have a conversation about the topic when one does not feel validated or accepted. This is where the collaboration between faith leaders, clinicians, and those with OCD becomes so important. We hope that this resource offers assistance as we seek to bring conversations around faith and mental health together in healthy, value-driven ways.
Above section adapted by Rev. Katie O’Dunne from the work of the Faith & OCD Special Interest Group
Understanding OCD within Different Faith/Religious Traditions
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