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Thu Dec 13, 2007

Religious Scrupulosity in OCD

One type of compulsion that I tend to see quite a bit is religious scrupulosity, in which the person is compelled to pray repeatedly or to worry about whether they have prayed as correctly or completely as possible. There is often an obsessive fear that fuels the compulsion, perhaps of going to hell or about being punished by God.

With these symptoms, I often find myself in the ironic position of trying to help someone to pray less. This is a great example of the yin-yang of therapy: Where someone is too extreme, the goal is to decrease; where they are too lax, the goal is too increase. Similar strategies that are used to combat other obsessions and compulsions, such as turning light switches on and off, remain extremely useful here. A typical bottom line is to help the person experience the fear and not run from it.

However, an important addition is usually helpful. This is to address the person's image of God. If the person is constantly fearing being smited by the Almighty for forgetting one Hail Mary in their 20 rosaries, then there is an image of an extremely harsh, punishing God at the root. It can be helpful to explore where this comes from, and why there is such an underemphasis on the idea of God's mercy, particulary if there is a prayer specifically appealing to God's mercy being said by the person after each of their Rosary decates.

I believe that the ability to meet the client deep within their own Christian framework and discuss the cognitive distortions within that context is critical in addressing scrupulosity, and this is one case where Christian psychology has an edge over a secular approach.

posted at: 17:43 | path: /ocd | link