Untangling Faith and Fear: The Relationship Between Religion and Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) can be characterized by preoccupying and often distressing thoughts, accompanied by compulsive acts or routines performed in an attempt to neutralize those thoughts. The media often portrays OCD in a singular way: a character must either count to a specific number or check something a specific number of times to prevent something horrible from happening. However, there are numerous “themes" involved in OCD, meaning numerous categories of both thoughts and compulsions that people experience. 

An overlooked theme that someone with OCD can experience is religiosity OCD and/or moral scrupulosity OCD. These themes often interact, involving obsessive thoughts about being a “good person,” being morally correct, adhering strictly to religious teachings, utilizing prayer as a compulsion, etc. It can be severely overlooked due to its overlap with standard and non-clinical behaviors. Other experiences of someone experiencing religious OCD may include intrusive thoughts that violate their religious or moral beliefs, or obsessions around eternal damnation and the “afterlife” (when applicable). 

So how does this differ from religious conviction? Don’t many of us strive to be a good and moral person? This is precisely why many people can live unknowingly with religiosity and moral scrupulosity OCD themes. One question you can pose is whether these thoughts are based in fear of wrongdoing or being a bad person, or whether they are based in your beliefs and values. We can also evaluate whether these thoughts are more pervasive in nature and disruptive to our lives. 

Most notably, we can determine whether or not these thoughts are seeking reassurance or wanting to be soothed by some compulsion. Compulsive responses in these OCD themes may include seeking forgiveness in the church, asking others for reassurance on your morality, or engaging in mental rituals that comb through evidence of you being a good person. For individuals struggling with OCD, these compulsions will provide only short-term relief and will ultimately exacerbate the fears or intrusive thoughts when they return,

It may seem difficult to understand how therapy can be utilized with religiosity themes of OCD, especially knowing a client and clinician’s religious background and beliefs are likely to differ. However, more than sharing similarities, we know the single most important predictor of therapeutic outcomes to be the strength and safety of the therapeutic relationship. 

Once this has been established, psychoeducation becomes crucial. Understanding how OCD functions, and how your religion may fit into its cycles and desires for certainty, are imperative for treatment. Being able to parse out moments when the brain and body are seeking ways to soothe their discomfort versus engaging in one’s religion in a regulated way is essential. Ultimately, the more the body learns to not rely on the certainty and reassurance it has been receiving from compulsions, the more it will learn to feel regulated on its own. The ultimate goal and hope is that addressing religiosity and moral OCD can allow people to exist in their faith in a way that feels safe, supported, and unadulterated versus out of fear of punishment and catastrophe.