Obsessive Compulsive Disoder (OCD) is well known to interact with pre-existing cultural and religious beliefs and practices. I was interested in coming at it from the other direction- is there evidence that culture, particularly religious culture, has been shaped by OCD?

Although I can’t prove it absolutely, I believe I there is enough evidence to make the idea intriguing, and worthy of further study by someone better suited than me. The idea that mental illness might be linked to the origins of religion is not new, but I have rarely seen the idea in the context of OCD specifically. However, I suspect that the effect has been profound.

It is worth stating categorically that a link between religion and OCD is not intended to denigrate religion, nor OCD. As a lifelong sufferer of OCD myself, such an intention is the furthest thing from my mind. OCD is associated with many positive traits and traits which can be positive in some situations- caution, concern for our impact on others, cleanliness, seeking certainty, aiming to systematise etc. Although these traits tend to get out of control in OCD, at other times and parts of life they can be profoundly useful. If there is a relationship between OCD and the development of religion, the contribution of OCD could well be positive.

Nor does saying that OCD played a role in the formation of religion imply that great religious figures all had OCD (though many may have). Rather, ambient forms of OCD might have influenced religious thinkers and their interpreters. One might also believe that even people without clinical OCD can tap into an OCD like mindset, especially when concerns as vast as salvation and divinity are on the line.



Personally I the link between OCD and religion as one of OCD and certain aspects of religion utilising the same ‘circuitry’, although outright cases of OCD most likely play a role in the development as religion as well.

The idea of a link between religion and OCD is far older than my poor thoughts (notably, Sigmund Freud championed it, although there is surprisingly little development in later literature), but I wanted to explore it in a more contemporary way. I’ve gone looking for information on people who have tried to develop a connection, but as best I can determine, most of the literature tends to be practical and epidemiological, with little of it coming from a studies-of-religion perspective.

What follows is my attempt to trace what I see as shared themes between OCD and religion. The exact role, if any, that OCD, and OCD-like mental states, played in the formation of religious beliefs is probably in most cases lost to time now, yet as we will see there may be grounds to suspect it was a rather large one.

Themes that OCD might have contributed to the development of religion:

In what follows we examine five parallels between OCD and religious thinking, and speculate about the possibility that OCD-like modes of thinking may have contributed to their development in religion- concerns about purity, fear of offending the sacred, rituals and ritualistic behaviour, complex, detailed and guilt driven forms moral reasoning, and ideas of demonic or external possession. While many of the parallels we discuss are not entirely unique to obsessive compulsive disorder, the overall picture is of a striking resonance between the focused but fearful reasoning of OCD, and similar trends within religion.

OCD and similar mental states as an explanation for the origin of religious fears around contamination and purity

A common concept in OCD is the fear of contamination, although today this fear is often expressed in terms of the germ theory of disease, prior to the development of such it would likely have taken different forms.

Religious categories of ritual and dietary purity are often worked out with a logic that is at once incredibly rigorous and dreamlike, very much mimicking the ‘style’ of OCD thinking. This overlap in content (concern about purity) and style of thinking (internally coherent, deeply elaborate) is quite striking. There is a deep concern form how various unclean things might infect various clean things, of what is capable of ‘carrying’ or ‘transmitting’ uncleaniness, about making sharp rulings in unusual and borderline cases and so on.

The book says do not mix a kid goat in it’s mother’s milk. Easy enough. But the book says don’t do it three times? There must be something extra here. Better not mix meat and milk, and keep a four hour gap between eating one and the other, just in case.



2. Fear of offending the sacred, blasphemy, scrupulosity and the origins of sacredness

A very common form of OCD is scrupulosity, a fear of offending the divine through uncontrollable sacrilegious thoughts, words, mental images etc, or through very small lapses in action or words that would seem unimportant to many. It seems at first glance that the idea of scrupulosity presupposes the prior existence of a concept of the sacred, yet I can imagine ways in which symptoms of scrupulosity and a sense of the absolute sacred might co-develop. The belief that one must not even think- let alone say- certain things about a being, even in jest or illustration, elevates it to a higher level of sacredness. For sacredness to exist, the possibility of blasphemy must exist.

The constant guilty struggle with one’s own thoughts and micro-behaviours about the sacred can further drive greater religious engagement, and the development of cycles of repentance, perhaps contributing to the often dramatic rituals of self-abasing penance and the purging of sin common to so many religions.

3. OCD and the origins of religious ritual and ritual magic

Numerous OCD behaviours are rituals, in the sense of stereotyped series of actions intended to influence seemingly unrelated actions. Tapping a spoon three times to make sure your husband does not die on a ship, for example. Or Saying the Lord’s Prayer 27 times to make sure that your children do not die of a horrible disease.

It is easy to see how, in a society which did not necessarily dismiss such rituals like ours tends to, someone might develop a belief about a necessary series of actions and this might be adopted by the society at large, especially if the ritual ‘worked’ several times.

OCD even comes with a ready-made explanation of why rituals sometimes fail, since there is an overwhelming concern that one will slightly mess up one of the innumerable complex parts. Ritual failure is itself an important theme in many religions.

4. OCD, guilt and the development of categories of moral reasoning

A common form of OCD is a supreme concern that one will, or that one already has, acted in a way entirely dissonant with one’s moral values. One form in particular is the fear of negligently or actively causing others harm, or violating the moral order of the universe, with actions that would, to most outside observers, look absolutely harmless.

Replaying past actions for evidence that one did the wrong thing in one’s mind constantly, and endlessly vetting possible actions, could drive the creation of new categories used in moral and religious thinking.

To choose a few examples, categories of Islamic jurisprudence, Catholic moral philosophy and- perhaps above all- the Jewish Halakha- display an exemplary combination of deep caution, deep concern, deep subtlety and exceptional systemation. Relatively harmless or even completely harmless behaviours are condemned in the strictest language. St Thomas Aquinas claimed that masturbation was worse than murder, Jesus said that thinking about another woman sexually was a form of adultery and that calling one’s brother a fool was worthy of the fires of hell, the Talmud says that it is better to be burned alive than to embarrass someone in public. The fusion of intense anxieties with careful legalistic thinking bears an uncanny resemblance to OCD, and the longer one reads the texts, the stronger the parallels seem.

Neurological evidence suggests that OCD may be a disease of hypermoralism, and is deeply implicated in the over activity of neural pathways associated with moral reasoning and thinking (forming a possible inverse to antisocial personality disorder). It seems to me very plausible that inclinations towards hypermoralism may well be one of the motors driving the development of moral thought in a religious context.

But unreasonable rules give rise to resistance, and religion is no exception. Resistance to hypermoralism, by OCD sufferers who had become sick of it might form another motor driving moral development within religious traditions. An ongoing dialectic, sometimes creative and sometimes destructive, between the spirit and the letter of the law, is a theme in every religious tradition I have ever studied. I’m not just trying to have it both ways here- there’s a least one very good case study of this kind of ‘bending in the opposite way’ reaction to hypermoralism by an OCD sufferer with a profound effect on the history of religion: Martin Luther, leader of the protestant reformation. Martin Luther is fairly well established to have suffered from scrupulosity, a religious form of OCD. Luther’s continual sufferings, and deep fear that his behaviour was inadequate almost certainly contributed to the theological views which caused him to propose that belief in god alone was enough for salvation, thus attempting to cut the cycle of fearful hypermoralism.

5. OCD and demonic possession

While many mental illnesses can be seen as ‘demonic possession’ by those without a psychological background, the potential for OCD to be perceived in this way is often forgotten. While I don’t think the majority of cases of ‘demonic possession’ are really OCD in disguise, I suspect a substantial minority may be.



I would argue that many forms of OCD- such as uncontrollable thoughts of the violent, sexual or sacrilegious which go against the values of the sufferer could be seen in some societies as a sign of mental demonic harassment. Many sufferers of OCD (falsely) believe that they are experiencing barely controllable urges to do violence. Such feelings could very easily be mistaken for a sign of demonic activity, either by the sufferer, or by society at large.

6. Religious (Self)-Consciousness and internal struggle



But more importantly than extreme cases like demon possession there is the form of self-consciousness associated with many (though not all) forms of religious life, the sense of oneself as a tempted being- a being who is constantly in an unwilling dialogue with dark forces that wish one to sin. Whether these be conceived of as as internal, external (like a demonic tempter) or something ambiguous and intermediate (like the Yetzer Hara) the effect is the same, the self is seen as divided, and torn between obedience and sin.

The parallel in OCD is found mostly in cases of morally charged OCD- scrupulosity, harm obsessions and sexuality obsessions. The sufferer can be confronted with a sense of division about themselves, about who one is, what one has done and what one might do- a kind of fragmentary consciousness in which parts of one’s consciousness sometimes seem work with a vicious semblance of autonomy in order to perversely thwart the whole is fundamental. Many sufferers of OCD begin to conceptualise their OCD thoughts and impulses as a cruel and bizarre stranger living in their mind.

We might also point to the internal struggle between doubt and belief that plays such a role in the life of the believer, and such a role in OCD. Certainly there’s a parallel in concepts here, although whether there’s a deeper or historically important parallel is harder to say.

Summing up the historical case

You’re a psychologist, someone comes to you and pitches a hypothetical. There’a a patient who keeps strict rules regarding bathing, refuses to mix certain foods, repeats certain words at certain precise intervals throughout the day, regards certain behaviours as absolutely taboo for reasons which they either cannot articulate, or which seem bizarre, will only dress in certain specific ways, is afraid that they are a deeply wicked person and struggles with questions about their moral identity.

If you had to take a guess at the diagnosis, what would it be?

Evidence of an association today

To bolster our historical associations, let us take a brief look at the very large literature suggesting that religion and OCD remain linked today. Degree of religiosity is linked to likelihood of developing OCD, this has been validated for a wide variety of monotheistic religions including:

Judaism,

Christianity

and Islam.

While formal research has focused on these religions (largely because of their popularity in the regions where research has been conducted) the internet is full of heartrending stories of people struggling with these problems in all kinds of religious contexts including Buddhism, Hinduism and Jainism.

There is little doubt that membership in at least some religious communities is associated with OCD. The direction of causation remains unclear.

Conclusions

What we’ve presented here is very partial and tentative. The idea of a strong connection is far from certain, but many individually modest pieces of evidence can form a greater image.

I want to reiterate that it is not my intention to contribute to a crass reductionism here. We are not saying that major religious figures were all OCD sufferers. We’re not making an argument that religion is a disease. Reasoning of the form “OCD might have contributed to religion, OCD is a pathology, therefore religion is pathological” is lazy and dangerous.

A more fruitful approach, and what I’d like to see, is greater investigation of the link between OCD, mental states which parallel OCD, and the development and survival of religions over time.

Rather than denigrate religion, I would hope such a study might deepen our appreciation of the social role of both religion and obsessive compulsive disorder.

A final quotation:

“Luther’s first years in the priory were thus a time of interior tension, spiritual struggle and suffering. The hopeless feeling that he was not numbered among the elect but among the reprobate overcame him and grew stronger as he grew more and more conscious that he did not fulfil God’s commandments in all things. Since he began early to condemn as sin every movement of natural appetite, even though unwilling, and since, with his exuberant vitality, such movements kept recurring, he supposed himself to be full of sin, and no prayer, fasting or confession could free him of this terror.”

Karl Adam, Roots of the Reformation, as quoted here, itself an invaluable resource.