“Understanding Scrupulosity (Religious OCD)” Ensign, September 2019

Don’t let this anxiety disorder hijack your gospel experience. Here are some ways to identify the problem and get help.

Editors’ note: Obsessive-compulsive disorder (OCD) can manifest itself in a variety of ways. If you or someone you love is experiencing distress or loss of function because of unwanted thoughts or behaviors such as those described below, seeing a qualified mental health professional for help is recommended.

Do you constantly obsess about living the gospel the “right” way? Do you feel an urgency to repent for the same mistake or sin over and over again because you doubt whether you have repented “properly”? Do you feel perpetually guilty? If so, you might be struggling with a form of obsessive-compulsive disorder (OCD) known as scrupulosity.

What Is Obsessive-Compulsive Disorder? With OCD, anxiety takes on an extreme nature that differs from the kind of anxiety experienced in everyday life. Obsessions (unwanted, repetitive, and distressing thoughts) and compulsions (repetitive behaviors or mental acts that are done to try to relieve the anxiety caused by the distressing thoughts) create a very powerful, destructive cycle of anxiety. They can play out in a variety of ways, such as being concerned about germs and contamination, requiring symmetry, or checking for safety.1 Those with a religious background may also experience religious obsessions and compulsions2 where a “person judges personal behavior as immoral that one’s faith community would see as blameless.”3 This type of religious OCD is called scrupulosity.

Understanding Scrupulosity For members of the Church with scrupulosity, obsessive-compulsive anxiety bullies its way into their religious life by relentlessly plaguing them with pathological, toxic guilt and inducing them to believe that this guilt comes from the Spirit. As a result, elements of personal worship get hijacked by the anxiety. Prayer, scripture study, and church and temple attendance often no longer bring feelings of peace or a connection with the Spirit because they are generally done out of fear of punishment and create feelings of condemnation. Religious focus tends to become narrow and trivial; religious practice gets extreme; and behaviors such as praying and confessing become repetitive, persistent, and unwanted compulsions that cause a lot of distress.4 For example, confession tends to become chronic, generally connected to minute indiscretions or behavior that is misperceived as sinful; it becomes impulsive and repetitive because of fear that it hasn’t been done quite the “right way.” In other words, with scrupulosity, the big picture of the gospel plan of happiness gets distorted and corrupted by anxiety. Perhaps this is your struggle. Perhaps you relate to some of these struggles but to a lesser degree. Consider this perspective from Elder Jeffrey R. Holland of the Quorum of the Twelve Apostles: “Our only hope for true perfection is in receiving it as a gift from heaven﻿—we can’t ‘earn’ it. Thus, the grace of Christ offers us not only salvation from sorrow and sin and death but also salvation from our own persistent self-criticism.”5 We all have weaknesses and “have sinned, and come short of the glory of God” (Romans 3:23). This is a given in our current mortal condition. Yet, Christ can remove our stumbling blocks (see 1 Nephi 14:1), and through His grace He can “make weak things become strong” (Ether 12:27). But these blessings don’t come to us by following anxiety’s mandates. Scrupulosity masquerades as a desirable, higher standard of righteousness and personal worthiness﻿—but it’s not! Instead, it actually denies Christ and His gospel. Scrupulosity replaces our loving, merciful Father and His Spirit with punishing, crippling anxiety and guilt, creating a rigid, demanding checklist approach to gospel living. This is because scrupulosity isn’t about faith; it’s about obsessive anxiety.

Recognizing Symptoms In my work as a psychologist, my clients, who are members of the Church struggling with scrupulosity, have helped me understand the differences between scrupulosity and pure religion, as outlined in the chart below:

SCRUPULOSITY PURE RELIGION Condemning Ennobling; uplifting Damning Exalting; to help us be like God Critical; demeaning Loving Fear-inducing; afraid of God Peaceful Overwhelming Hopeful Restricting, with focus stuck in the past Conducive to personal and eternal progress Discouraging Uplifting Demanding: “Religious practice must be 100-percent perfect or it’s worthless”; “I must perfect myself” Flexible and forgiving “I am perpetually guilty” “I can be worthy, while not being perfect” “Christ’s Atonement doesn’t apply to me.” “Christ is my Savior, and His Atonement applies to me personally.”

Recognizing the qualities of pure religion listed above can help those struggling with scrupulosity to dispute its harsh messages and find health and freedom.

Where to Turn for Help Individuals struggling with scrupulosity feel perpetually guilty. They commonly make repeated confessions to their bishops, even confessing things they have previously confessed. They may go to a member of their stake presidency to confess something they already confessed to their bishop, just in case they didn’t confess “properly” or their bishop didn’t have “enough authority.” They confess everything from minor indiscretions to more blatant sins, either from their recent life or from their very distant past. As Church members, we are taught the importance of confession to our ecclesiastical leaders. So, how does someone who cannot clearly discern between the promptings of the Spirit and their own anxiety know whether they should meet with their bishop or a therapist?

Meeting with Your Bishop When we are guilty of sin, the Lord requires us to repent. Confession is one part of the repentance process. But we are required to confess to an ecclesiastical leader only for certain issues. The Bible Dictionary clarifies: “Confession to a church official (in most cases the bishop) is necessary whenever one’s transgression is of a nature for which the Church might impose loss of membership or other disciplinary action” (“Confession”). This is an important distinction because those with scrupulosity experience such intense, unbearable anxiety that they often find themselves confessing minor indiscretions or non-issues to their bishops because the anxiety makes them feel like every issue is a major issue. If you have worked with your bishop to resolve a serious sin and he has confirmed that you have done what was required by the Lord for your repentance process, then you have “done it properly” and there is no need to return to him or to other ecclesiastical leaders for additional confessions. If you feel the urge to confess again, that is, in most cases, driven by anxiety, not religious sensitivities. If you give in to the anxiety and choose to confess again to your ecclesiastical leader, you may feel some relief by his reassurances that you have fully repented, but this will last only temporarily. When you engage in compulsions to relieve anxiety (in this case, repeated confessions to get reassurance), those compulsions work﻿—that’s why you do them﻿—but they work only temporarily. The soothing you experience is short-lived and then the anxiety returns, usually in greater force, which then prompts more confessions and so on.

Meeting with a Therapist Elder Alexander B. Morrison (1930–2018) of the Seventy taught: “We must understand … that ecclesiastical leaders are spiritual leaders and not mental health professionals. Most of them lack the professional skills and training to deal effectively with deep-seated mental illnesses and are well advised to seek competent professional assistance for those in their charge who are in need of it. Remember that God has given us wondrous knowledge and technology that can help us overcome grievous problems such as mental illness.”6 Scrupulosity is not within your bishop’s realm, even though you might think that it is because of the religious backdrop for your obsessions and compulsions. But obsessions and compulsions are the domain of a trained mental health professional. This is not to say that your bishop has no role to play; as your ecclesiastical leader, he can continue to counsel, reassure, bless, and receive inspiration in your behalf.

You Can Find Peace It is only through our Savior Jesus Christ that we will be saved. His mercy and His grace come as the gift of a loving Heavenly Father. Our Father is not interested in finding reasons to condemn us; He wants to exalt us! Elder Ronald A. Rasband of the Quorum of the Twelve Apostles said: “When our Father in Heaven said, ‘This is my work and my glory﻿—to bring to pass the immortality and eternal life of man’ [Moses 1:39], He was talking about all of His children﻿—you in particular.”7 If you struggle with scrupulosity (or any anxiety that interferes with the quality of your daily life), please seek professional help with a trained and licensed mental health provider. A therapist can help you learn to work through the anxiety in a healthy, adaptive manner so you can learn to avoid succumbing to the obsessive-compulsive cycle. In time, the thoughts will no longer be a trigger to anxiety and inappropriate guilt. By learning to manage anxiety and focusing on the tenets of pure religion, as outlined here, you can learn to dismiss anxiety’s efforts to hijack your religious worship and keep proper perspective on God’s plan of happiness. In so doing, you may be able to once again feel His Spirit without anxiety’s distortion and to fully experience the true peace and joy that come from living the gospel.