Written by Patrick McGrath, PhD and Zachary Appenzeller, Psy.D.
It may come as a surprise to you that people who have no faith (atheists, agnostics, secularists) can have scrupulosity Not only is it possible, but it is a lot more common than you might think. Scrupulosity is not a faith problem; it is an OCD problem. Atheists and agnostics can have OCD, so why not have scrupulosity?
But how does that work you might ask?
Just because you do not believe that there is a higher power does not mean that you are 100% confident in that belief, just as no one can be 100% confident in any belief that they have, even if OCD tells you that you can be. So, the lack of belief may be your world view, but there may be that sneaky OCD that is telling you, “Sure, you don’t believe in anything, but what if you are wrong?” That doubt right there, that “what if…” statement, is all that you need to go down the OCD rabbit hole.
Those who do not believe in a god and experience scrupulous thoughts pray more than many of the religious people that we know, and all the while they tell us that there is no higher power to worry about, but in the off chance they are wrong, they compulsively want to cover all their bases, so they pray to every deity that they have ever heard of. By the way, we have also met devout people who have done the same thing – and have every confidence in the world that their higher power is the right one but pray to all the other ones – just in case they are wrong.
The Main Issue: Doubt
The main issue in all the above examples is doubt, which can encompass fear, shame, guilt, disgust, etc. OCD is called “the doubting disorder.” Your beliefs are your beliefs, whatever/whomever you believe in, or do not believe in. Your level of confidence in your beliefs may be the highest that it can be, and your perceived level of doubt may be zero, but OCD just does not care. OCD can interrupt any belief system, even if it is a lack of belief system, and lead people to excessively pray, research, debate, confess, or seek reassurance.
All of this reveals one thing – doubt is doubt, and you can doubt anything. You can doubt your belief in something, and you can doubt your lack of belief in something as well. As a parallel, someone suffering with Hit and Run OCD could not 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.
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, or do not.
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 mercy. At the very least, resigning themselves to eternal damnation, defining themselves as “bad” and their beliefs as “wrong”, put an end to their perpetual internal debate over whether or not their lack of a belief in a higher power is correct. 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 offend a higher power. Some may even have the belief that if they can consistently remind themselves how bad they are, then this may prevent them from doing something bad in the future.
Atheists/Agnostics Feel Shame and Guilt
Atheists and agnostics can, and do, feel shame and guilt without having a higher power or religious doctrine to follow as a moral compass or guide. The bottom line is that they can absolutely experience shame, and their absence of a belief in a higher power does not speak to an absence of morality. An atheist’s moral compass is based less on the fear of retribution that may come to them after they die, and more on their fear that they might offend their fellow human. In the case of atheist scrupulosity, there are fears surrounding religion, spirituality, the supernatural, and concerns of offending a god, and we felt it important to generally distinguish morality from religiosity. While morality and religiosity can certainly be intertwined, one can still be concerned about morality without being religious, and as such, an atheist concerned about their morality can experience shame as a result.
Non-Belief Is Not Belief In The “Other” Power
One other thing to note; a lack of a belief in a higher power does not equate to a belief in the “other” power, if you know what we mean. Sometimes people fear that a lack of belief in a god equals a belief in a demon. This is far from the truth, as a demon to a non-believer would also be a “higher” power due to the supernatural qualities of that being. So, sometimes people who are atheists or agnostics feel a great deal of shame about their scrupulosity out of concern that people will think they are devil worshippers or lovers of the dark forces.
Exposure and response prevention (ERP) is the gold standard treatment for Obsessive Compulsive Disorder.
So, what does ERP look like for atheist 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 their lack of a belief in a god 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 going to hell, disappointing a god, etc.)
In summary, we believe that people can learn that their lack of certainty about their non-belief in a higher power can go unsolved while still being able to live a happy, fulfilling life.