Katie O’Dunne (adapted from article by Patrick McGrath, PhD & Zachary Appenzeller)
Scrupulosity is not a faith problem; it is an OCD problem. OCD tends to latch onto the things most important to an individual - including faith! For those in the Hindu faith, OCD might impact the way worshippers see themselves, perform puja, or engage in devotion.
The Main Issue: Doubt
All of this reveals one thing – doubt is doubt, and you can doubt anything: including your entire faith tradition. As a parallel, someone suffering with Hit and Run OCD could believe that they ran someone over on their way to work. Their OCD will get them to doubt that and wonder if they did, even to the point of getting into their car and driving around looking for the body at the expense of potentially losing their job.
So, if someone can doubt their belief that they did not hit someone while driving, they can also doubt their core spiritual beliefs. In that doubt, you can seek reassurance by researching to make sure you are performing puja correctly. Or perhaps you might be hyper-obsessed with the pronunciation of slokas and understanding the meaning of the slokas. You may try to avoid driving past religious spaces because they remind you that your beliefs might be wrong or that you might subscribe to the “wrong” faith tradition. You could distract yourself when you are with anyone who starts to talk about their religion, particularly those proselytizing on another faith. You could try to make sure that you are honoring the correct deity or following your dharma appropriately. You might even try to make sure you are setting up rangolis perfectly before festivals.
No Matter What You Believe, OCD Can Wiggle In
No matter what it is that you do, or do not do, believe or not believe, your OCD can wiggle its way in and make everything feel overwhelming. It can amplify doubt to the nth degree. It can cause the best day ever to become the worst day ever, and it can lead to discomfort and pain and anguish - and then punish you for not being 100% confident in whatever it is you do believe. It is important to note that this is not unique to Hinduism. OCD simply latches onto anything that is the most important to the sufferer.
Compulsive Self-Shaming/Self-Criticism
A fairly common and harmful compulsion that cuts across themes of scrupulosity is compulsive self-shaming/self-criticism. This presents as repeated self-defeating statements that serve an avoidant function of sitting with uncertainty. While exchanging anxiety and uncertainty for shame and sadness doesn’t sound like much of a tradeoff, at least shame is “certain.”
This is a maladaptive way by which individuals can put their doubts to rest, albeit temporarily, only for obsessions to inevitably come back. The OCD cycle continues, now with lower mood and decreased self-worth as an added byproduct. It should be noted that self-shaming can also increase with time as individuals engage in ERP, where they begin to disengage from other compulsions and experience a sense of immorality or doubts that they are disappointing a higher power (these feelings are to be expected because you are facing the fear/doubt/uncertainty of these things).
Some individuals believe that if they can at least feel badly about their possible shortcomings, then maybe, just maybe they might receive good karma. When patients engage in consistent self-shaming, it can also act as a constant reminder to be on guard (hypervigilance) to prevent potentially doing something that may impact your progress in dharma. They may feel like they must do everything perfectly in order to reach moksha.
Treatment
Exposure and response prevention (ERP) is the gold standard treatment for Obsessive Compulsive Disorder.
So, what does ERP look like for Hindu scrupulosity?
In short, patients will develop a hierarchy related to their scrupulous concerns and approach these triggers that provoke anxiety and uncertainty without engaging in avoidance or frantic efforts to relieve their doubt. These individuals must accept the way they engage with their faith and tolerate the possibility that they may be wrong. No amount of compulsive reasoning/rumination, prayer, reassurance, analysis, research, avoidance or thought suppression leads to certainty or lasting, long-term relief, and all simply contribute to the maintenance of their anxiety. Imaginal exposures or worst-case scenarios can also be utilized to address feared outcomes that may not be able to be addressed with in-vivo work (Ex. Fears of negative karma, improperly performing puja, negative opinions of others, etc.)
Summary
In summary, we believe that people can learn that their lack of certainty about their beliefs can go unsolved while still being able to live a happy, fulfilling life. We believe that faith and OCD do not have to be mutually exclusive. You can live a beautiful life as a Hindu while accepting uncertainty through treatment for OCD. In fact, your treatment can help you more fully uncover and live into your faith in a value-driven way!