Religious (scrupulosity) OCD is a subtype of OCD that involves religious or moral obsessions and compulsions. People with scrupulosity OCD often experience intense anxiety or guilt about their perceived moral or religious thoughts, which leads them to perform compulsions to “correct” or alleviate that anxiety.
If you’re experiencing religious obsessive-compulsive disorder (OCD), you may have thoughts like: What if I’ve sinned and didn’t realize it? Am I truly devoted, or am I just pretending? What if I have impure thoughts?
For someone experiencing this religious OCD (also known as scrupulosity OCD), the constant fear of being morally “wrong” can make everyday decisions feel like high-stakes moral dilemmas. It’s like every choice feels weighed down by the possibility of making a mistake that could have consequences—whether it’s a religious failure, a moral slip-up, or an action that might anger or disappoint a higher power.
The key is to remember that these thoughts and behaviors are symptoms of religious OCD, not an accurate reflection of one’s true character, faith, or values. Fortunately, religious OCD can be treated using exposure and response prevention (ERP) therapy—a specialized form of cognitive behavioral therapy (CBT) that is particularly effective for OCD.
Read more to learn about signs of religious OCD and how you can treat it.
What is religious or scrupulosity OCD?
Religious (scrupulosity) OCD is a subtype of OCD that involves religious, moral, and/or ethical obsessions. Obsessions are recurrent and intrusive thoughts, sensations, images, feelings, or urges that cause distress. In this case, people with scrupulosity OCD experience frequent worry and feel guilt about violating a religious or ethical code and what it means about them as a person.
They may wonder: “Did I allow myself to have an ‘impure’ thought in church? Does it mean that I’m a sinner and must repent?” The guilt and anxiety drives these people to engage in various compulsions, which are repetitive behaviors or mental acts, aimed to alleviate their distress.
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What are the symptoms of religious (scrupulosity) OCD?
Here’s a list of common obsessions in religious (scrupulosity) OCD:
Religious-focused OCD thoughts:
- Have I prayed correctly? Have I prayed for the correct amount of time? I was a bit distracted. Maybe I should do it again.
- Today I thought my religious leader is ugly. Does that make me a bad person?
- During religious services, I found it hard to concentrate and thought about my to-do list for a few minutes. Is that a sin?
- At the supermarket, I accidentally picked up pork and immediately put it down. Am I contaminated from having touched it? Should I confess?
- I wanted to laugh today during services. Does this mean I don’t take my religion seriously?
- Did I do something that offended or angered God?
- I’m striving for purity and I fear I’ve done something wrong.
Moral/secular OCD obsessions:
- Did I offend my friend without knowing during our conversation yesterday?
- Was the question I asked in class rude? Have I accidentally offended the teacher?
- Is it OK that my friend edited my essay? Does that count as cheating?
- I didn’t say ‘thank you’ to the person who held the door for me. I am a bad person.
- I told my spouse that I am great when they asked how I am. But the truth is I’m upset. Am I deceiving my partner? Do I deserve to be in this relationship?
- I told a prospective tenant that I ended up choosing someone else, but the truth is I let my cousin stay in the apartment. Am I a horrible person for “telling a white lie?”
Scrupulosity OCD compulsions:
- Excessive prayer. You pray longer than the standard for your particular faith, sometimes hundreds of times a day, in order to make sure your prayers have been performed perfectly. If there’s a mistake or hesitation, you may repeat yourself until you believe the prayer is flawless.
- Excessive confession. You repeatedly go to your religious leader/authority to ask about or confess sins you are worried about having committed.You may return multiple times to confess about the same event, for fear that you haven’t communicated the sin properly and may still be guilty.
- Excessive rituals. You develop rituals to calm obsessive thoughts. This may look like coming up with a number of minutes to pray, asking for a higher power’s forgiveness a certain number of times, or performing established religious rituals a certain number of times.
- Reassurance seeking. You repeatedly turn to the people in your life for reassurance. You might ask loved ones if they’ve ever experienced the same thoughts you have, to affirm whether or not it’s sinful. You may also spend hours in online forums asking strangers whether something they’ve done would be considered a sin. You may ask your teacher if it’s okay that a friend helped with your homework, even if the teacher already clarified it is. You may ask a friend if they would consider this cheating.
- Mental checking. You mentally review past experiences and try to evaluate whether you behaved in an immoral or sinful way.
- Avoidance. You avoid your place of worship for fear of behaving in a sinful way. You may avoid certain people who cause you to have thoughts you’ve determined are immoral or sinful.
Community discussions
How can religious (scrupulosity) OCD be distinguished from typical religious practice?
Oftentimes, OCD can masquerade as a religion—especially when the compulsions and certain behaviors become so rigid and structured. People with OCD develop a sense of duty or moral obligation to perform specific actions in a certain way, believing that failing to do so will result in consequences or something bad happening to them or their loved ones. In this way, OCD can distort your perception of normal daily activities, elevating them to a level of significance that mimics rules or practices seen in religion.
For example, spending hours researching religious texts may seem like a way to deepen your understanding, but in the case of OCD, this behavior is often driven by the need to alleviate the anxiety caused by obsessive thoughts.
Another distinction is the functional impairment that OCD causes compared to the role that religion can play in your life. OCD interferes with work, relationships, and well-being, whereas faith-based beliefs and rituals are usually integrated in a way that fosters resilience, emotional stability, and creates community. Having some doubt at times is common, but these periods are typically not disruptive to a person’s overall functioning.
How common is religious (scrupulosity) OCD?
Religion has been recognized as one of the most common themes of obsessions in people with OCD, with its prevalence among people varying widely, from 0% to as high as 93%.
The most common religious obsessions include the fear that you’ve committed a sin, concerns about not being faithful or moral enough, blasphemous thoughts, fears that you didn’t perform a religious prayer or ceremony properly, and worries about being punished by God.
Is religious (scrupulosity) OCD more common for people of a certain religion?
OCD affects all kinds of people, and that’s certainly true for religious (scrupulosity) OCD as well. To date, there’s no evidence that shows people of a particular religion are more likely to experience this form of OCD. Keep in mind, as previously mentioned, that it’s certainly possible to have religious (scrupulosity) OCD and not have any religious affiliation.
Some people may wonder if their faith says anything about having OCD. For instance, they might google “does the bible mention OCD at all?” Licensed therapist, Tracie Ibrahim, MA, LMFT, CST, has seen patients who try to tease this question out through various holy texts, but asserts that there’s no sacred text that explicitly mentions the condition.
“I bet if you ask twenty religious leaders, you’d probably get twenty answers, because there’s nowhere for them to look it up either—it’s an opinion,” Ibrahim says.
People may read certain scriptures through a mental health lens, but remember that all texts are up for personal interpretation.
What does religious OCD look like in different faiths?
Religious OCD can manifest differently based on the themes in your spirituality. It doesn’t matter if you follow an organized religion or a practice with a smaller following. OCD can even attach to beliefs that are unique to an individual. The common thread is the inability to sit with the spiritual doubts that arise.
Let’s examine some common obsessions and compulsions in major belief systems.
Christianity
Example obsessions:
- “I’m bored when I read the bible. Does that mean I don’t care about my faith?”
- “I don’t feel connected to God. Does this mean I’m not a true believer?”
- Worries about sins you don’t remember committing
Example compulsions:
- Penitence rituals aimed at cleansing a contaminated soul
- Monitoring the mind for evidence of sin of blasphemy
- Demanding spiritual leaders share a black-and-white truth rather than accepting gray areas in religion
Judaism
Example obsessions:
- Worries about violating Jewish law
- Perfectionism in prayer, ritual, and study
- Modesty and purity
Example compulsions:
- Excessively checking food to make sure it’s kosher
- Needing constant reassurance from rabbis
- Avoiding all potentially “impure” activities
Islam
Example obsessions:
- “My cleaning ritual was interrupted and therefore I am dirty.”
- Excessive worries about offending Allah
- Constantly wondering if you accidentally ate haram food
Example compulsions:
- Excessive cleaning rituals
- Constantly rereading scriptures to stay in “good standing” with Allah
- Redoing prayers until they feel “just right”
Hinduism
Example obsessions:
- Fears of negative karma
- Excessively worrying about one’s reincarnation
- “Did my actions impact my progress in dharma?”
Example compulsions:
- Repeating a puja over and over again until it’s done “correctly”
- Consistent self-shaming
- Setting up rangolis “perfectly” before festivals
Can you have non-religious scrupulosity OCD?
Yes. Scrupulosity can affect people who are atheist, agnostic, or have no set faith. Moral scrupulosity latches onto how an individual sits with personal beliefs. They may not believe in any higher power, but spend hours ruminating on whether or not their world view is the “correct” one.
For example, someone with non-religious scrupulosity OCD may wonder if it’s “bad” that they don’t have a religion. Their mind keeps circling around all the “what if” scenarios about faith, like “What if I am punished by a higher power for not believing?”, “What if my beliefs are wrong and I regret them?”, or “What if I’m demonic because I’m an atheist?” They might choose to stop attending church, but then be plagued with thoughts about going to hell because of that decision. They have trouble sitting with their own doubts about faith and the uncertainty that comes with all the things you can’t definitely prove.
Ibrahim has seen secular patients who have compulsions that mimic religious rituals. “You could be totally not religious, but always have a little ritual you do or a little prayer that you think somehow protects you,” she says. Or you may avoid people, places, and things that remind you of spiritual doubts.
Non-religious scrupulosity doesn’t have to focus on belief systems at all. With cases of moral OCD, an individual may be overly concerned with how they treat people, animals, or even the planet. They’re obsessions revolve around being a “good” person. They constantly worry what will happen if they do something that doesn’t perfectly line up with their values.
How to get treatment for religious or scrupulosity OCD
Exposure and response prevention (ERP) therapy
As with all forms of OCD, the gold standard treatment for scrupulosity OCD is exposure and response prevention (ERP) therapy. In ERP, you’ll work with a specially-trained therapist to slowly put yourself into situations that bring on your religious, moral, or ethical obsessions and learn ways to prevent responding with compulsions.
Let’s say you’re someone with scrupulosity OCD and excessively concerned about telling the truth. You’ve just told your spouse you’ll be home at 3 p.m., but you actually arrived at 3:30 p.m. Each time this happens, you spiral into obsessive thoughts about being a liar, and the need to know if you’ve done something wrong, and sometimes ask your spouse for confirmation that this isn’t a serious lie and that you are still a good person.
In ERP therapy, the goal is to prevent yourself from acting on compulsions. Instead of asking your spouse for reassurance, a therapist may have you think to yourself, “Maybe I am a liar. Maybe I’m not. It’s impossible to know for sure.” This teaches your brain a new response to your anxiety and begins to help you tolerate the uncertainty fueling your obsessions and compulsions. In order to avoid becoming overwhelmed, you’ll work with your therapist to come up with a hierarchy of anxieties and related exposures and gradually work your way through them.
People with religious OCD may face particular challenges during ERP therapy because they may be convinced certain exposures will make them unfaithful to their religion. Working with a trained therapist who understands your faith may help you feel confident to begin the process of separating your faith from your OCD thoughts about it. However, any therapist who specializes in OCD and ERP will be able to help learn how to manage your symptoms and break the OCD cycle.
Bottom line
Religious or scrupulosity OCD can be a tricky diagnosis to make because many of the behaviors can appear as concern about being faithful or ethical. A religious leader may tell you you’re simply overly concerned and have nothing to worry about, without knowing they are actually helping fill your need for reassurance. However, a mental health professional who specializes in OCD will be able to make an accurate diagnosis.
Key takeaways
- Religious (scrupulosity) OCD is a subtype of obsessive-compulsive disorder (OCD) characterized by intrusive thoughts and compulsive behaviors related to religious, moral, or ethical concerns, causing significant distress and disruption to daily life.
- Religious OCD affects people across all belief systems, including atheism, and involves compulsions like excessive prayer, confession, reassurance-seeking, or mental checking to alleviate anxiety over perceived moral or spiritual failings.
- Exposure and response prevention (ERP) therapy is an effective treatment for religious and scrupulosity OCD.