FRIDAY, FEBRUARY 10, 2017
THE BAKER COUNTY PRESS — 5
Local
— SPOTLIGHT ON MENTAL HEALTH —
Scrupulosity: When Obsessive
Compulsive Disorder meets religion
BY KERRY McQUISTEN
News@TheBakerCountyPress.com
“Obsessive-compulsive
disorder (OCD) often tells
us that the only acceptable
way to practice religion is
to practice it with a perfect
sense of knowing. This is
actually incompatible with
the idea that faith involves
believing in something that
can’t be seen or verified,”
says Steven J. Seay, Ph.D.,
a licensed psychologist
who practices in Florida.
OCD is primarily defined
as a malfunctioning of the
decision-making pro-
cess in a person’s brain.
Often called the “doubter’s
disease,” OCD is most
certainly not limited to
obsessions with order or
habitual compulsions such
as hand-washing.
A lesser known subset
of OCD, referred to by
psychologists as scrupulos-
ity, is driven by doubt, fear,
and feelings of guilt—with
emphasis on religion.
A study by C.H. Miller
and D.W. Hedges in the
“Journal of Anxiety Dis-
orders 22,” shows that at
least five percent, and up to
33%, of OCD sufferers are
plagued by scrupulosity.
Father Thomas M. Santa,
author of “Understand-
ing Scrupulosity: Helpful
Answers for Those Who
Experience Nagging Ques-
tions and Doubts,” says
scrupulosity is “a habitual
state of mind that, because
of an unreasonable fear of
sin, inclines a person to
judge certain thoughts or
actions sinful when they
are not, or that they are
more gravely wrong than
they really are.”
The scrupulous mindset
often allows for God’s
forgiveness in theory, but
not in practice.
Up close and outside of
textbooks and interviews,
scrupulosity is painful and
devastating.
In a true story of scru-
pulosity out of northeast
Oregon, John and Jane
(whose real names have
been changed), are in
a long-term marriage.
Bright, funny, and in a
community leadership
position, as John puts it,
he has “no connection
whatsoever” with his wife,
whom he is aware has had
multiple emotional and, he
believes, physical affairs.
John and Jane have no
ability to hold so much as
a conversation, and for a
large part of their marriage,
he has tried to make him-
self fall back in love with
her to no avail. “There is
no physical or emotional
intimacy,” he says. Both
turn to alcohol consump-
tion in order to cope.
Desperately empty and
lonely, for years John has
both desired and attempted
to leave the marriage, but
for religious reasons (John
is Christian) he has repeat-
edly returned to the mar-
riage in attempts to fix it.
An abuse component
also exists wherein Jane,
among many other things,
suggests that if he does
leave her, he will lose
his relationship with his
grandchildren. He calls it,
“Emotional extortion.”
He says when Jane lists
out everything she loses
if he divorces her, all he
can silently think is, “But I
don’t love you…”
John has envisioned a
relationship in which he
can sit holding the hand of
the one he loves on a porch
swing at 80-years-old.
“I’m in a position to
do all these things I want
when I retire, but the
problem is, I’ve never had
the person I want to do it
all with,” he says. John
says this realization struck
home fully when he had
to force himself to buy an
anniversary gift for Jane,
knowing he didn’t want
another empty year.
Later, John met Mary,
with whom he fell deeply
in love. “I want to be mar-
ried to my best friend,” he
says.
John separated from
Jane, but the real Christian
sin of beginning a relation-
ship with another woman
before he was technically
divorced triggered John’s
OCD scrupulosity, creating
so much guilt for that sin
that it ballooned until it
debilitated.
Then, all it took was a
sentence or two from Jane
stating that his love for
Mary was a Satanic decep-
tion, to complicate matters
with a downward spiral of
fear and doubt.
To top it off, John turned
to his fundamentalist
Baptist pastor for advice,
and wound up on his knees
in tears feeling condemned
and “broken by the hand of
God”—not your average
human reaction to asking
for guidance. A week-long
anxiety attack followed.
By then, the scrupulosity
had boiled over.
Father Santa writes,
“Treating scrupulosity
with any type of therapy
is inherently problematic
because scrupulosity is
bound up with the practice
of religion, and religion is
a complex phenomenon.
It is easy for clergy or
one’s spiritual community
inadvertently to reinforce
scrupulous behavior be-
cause the latter so closely
resembles devout religious
behavior.”
Citing the “joy and
completeness” he felt
with Mary, John says he
connected with a woman
spiritually, mentally, physi-
cally and emotionally for
the first time in his life.
So, after more time, he
began to inch forward with
his divorce at a snail’s
pace, separating again,
visiting a divorce attorney,
gathering information for
the attorney, developing an
exit strategy for moving,
packing belongings, etc.
He expressed a hundred
times over his hope that
in the end, he and Mary
would not end up apart,
sounding strangely as if
he had no control over the
outcome of the situation.
Whenever Mary ques-
tioned his intent to divorce
and removed herself from
the situation, John would
beg her to give him more
time and not shut him out.
The fear and doubt
planted in his head by the
pastor and his estranged
wife never really left his
mind, as the OCD loop
continued for months.
At nearly each step of the
way, John said he knew in
his heart what he needed to
do and who he wanted—
that was “never a ques-
tion,” he says.
But at each step a feeling
in his head said “some-
thing just wasn’t right”
with the action. So he
would sit still in the mar-
riage trying not to make
any sudden movements un-
til he could figure out what
that “something” was.
Therapists across the
board state that OCD pits
the heart against the head,
and the battle is to stop the
sufferer from listening to
the OCD-driven thoughts.
What a patient feels in his
heart and in his gut-level
intuition rarely lines up
with what’s in his head
when it comes to a life
change, say psychologists.
John went on to experi-
ence repeated “analysis
paralysis,” ruminating over
the “right” thing to do.
He struggles daily with
parts of scripture that
include almost exclusively
“God hates divorce” and
other text along that theme,
and thinks about them
constantly.
He acknowledges that if
he remains in his marriage,
he will also remain in love
with Mary, re-committing
the sin of adultery in his
heart on a regular basis.
Jane is aware of his feel-
ings, but will not initiate
a divorce herself because
she says his love is clearly
just a deception of Satan,
which plays on his illness.
John acknowledges he
has a Biblical “out clause”
for divorcing his wife due
to adultery—but believes
he has to prove it with
better evidence first, yet
can’t, because he can’t find
scripture supporting one
should look for proof.
He acknowledges there
are Grace and forgiveness
of sin in the Bible, and
that full, healthy lives and
relationships honor Jesus.
However, those parts of
scripture are pushed to the
back of his mind as only
the “God hates divorce”
theme repeats. Jesus’s
encouragement of love
of self and others doesn’t
outweigh “God hates
divorce,” nor do lessons
about compassion and love
trumping legalism.
Seay lists several of the
patterns John exhibits as
scrupulosity: Mental ritu-
als like repeatedly looking
in the Bible for scripture
of the same theme, but
ignoring larger overarch-
ing themes; compulsive
praying; excessive reading
of religious texts; and con-
stantly asking for reassur-
ance from others who will
support his doubt-driven
interpretations.
John has stated time
and again he wants to be
certain of the will of God.
At the risk of making the
slightest mistake in what
God may or may not want,
John continues to sit in an
unhealthy situation.
At last check, John has
doubts about the love he
has in Mary being from
God and thinks it just
might be a deceptive prod-
uct of Satan, though, in
contradiction he’ll always
love her, he says.
He has nearly resigned
himself to a future without
joy, health or love in which
he is externally with Jane
but internally always in
love with Mary, believing
that situation must honor
God in some way since he
wouldn’t be divorced.
He says if Mary is gone,
he will dive into work,
focus on his grandkids and
try to schedule as much
time as possible alone and
away from Jane to survive.
He has immersed himself
in various translations of
the Bible and inspirational
texts to come to this con-
clusion, isolating himself
from feedback that might
contradict it. Doctrine from
every major Christian de-
nomination in the country
on divorce and marriage
falls on deaf ears.
On Christmas, John was
with Mary, joyous and cer-
tain he had finally broken
through his doubt to move
on with life. On December
26th the OCD froze him
again—and he folded like
a house of cards this time.
John’s conclusion? “God
doesn’t want me to di-
vorce.” Because Mary then
represented something God
didn’t want, John began to
shun her without explana-
tion.
Martyrdom, avoidance,
and over-the-top self-
sacrifice are scrupulosity
hallmarks.
John now also plans to
sacrifice the job in which
he’s been a success and
give up his home in the
area he didn’t want to
leave, believing God wants
him to.
John feels the sense of
peace that OCD always
creates when it tricks
the brain out of change
and action. That sense of
peace reinforces the belief
that he must have at last
concretely discerned God’s
will—for a while.
Now, instead of be-
ing 80-years-old with the
love of his life on a porch
swing, John lists avoiding
the “regret” of “disappoint-
ing God” as his main goal.
John may believe for
now he’s discovered God’s
true will, but his despair
is evidenced by a renewed
round of excoriation,
where the anxiety of his
unhappy situation results
in him picking holes in his
skin—another affliction
common to OCD. He ap-
pears as if the warmth and
light have been drained
from him—but that’s
God’s will.
Untreated OCD sufferers
save face by presenting
that their actions spring
from a desire to do the
right thing—and rarely
admit to a problem. With
scrupulosity, the desire to
do right and the problem
are intertwined, though.
Seay points out, “Not
all clergy are familiar
with scrupulosity … If
you think about it, you’ll
realize that these types of
OCD-driven goals take
faith completely out of
religion.”
Christianity Today’s
Katelyn Beaty sums up the
illness by saying, “Scrupu-
losity is an obsession with
one’s sins and ridding them
at all costs.” Even if the
cost is as high as the sacri-
fice of a once-in-a-lifetime
love or one’s own health.
John states that if he
can “get right with God”
(a noble cause when done
healthily) then somehow
his situation will change.
He believes if he just acts
more perfectly according
to scripture than he ever
has in his life before, all
will be well. Of course,
this view completely anni-
hilates the Biblical Chris-
tian view that one cannot
earn one’s way through
acts. It does support his
“God hates divorce”
ruminations and his OCD’s
need not to act.
Stock Photo.
May is Mental Health Awareness Month. Starting
this week and ending in April, The Baker County
Press will run a six-part series on the subject of
mental health, two articles per month leading up to
May. Written in installments by various reporters,
the series will address both well-known and lesser
known mental illnesses, their symptoms, how they
affect individuals and families, and methods for
treatment. We will move into areas like Post Trau-
matic Stress Disorder, Autism, Personality Disor-
ders and more, stressing both tragedies and mental
health successes. Remember, there is always help.
Beaty continues, “For
the believer, an obses-
sion with moral purity can
stifle fruitful relationships
with other Christians, and
perhaps ironically, with
the Lord himself. Instead
of leading a believer to
a deeper trust in God’s
mercy on account of their
sins—a trust that is meant
to bring ‘peace with God
through our Lord Jesus
Christ,’ scrupulosity
focuses the person back
on the efforts of him or
herself, which usually
leads to excessive guilt and
despair.”
In addition to feeling
excessive fear and doubt,
persons with scrupulos-
ity often stew in their
thoughts, display negative
cognitive styles (believing
things will go wrong that
logically won’t), and fixate
excessively on religious
text, write Miller and
Hedges.
They document that suf-
ferers, “have poor insight
or awareness, meaning that
because their life is so gov-
erned by rules (legalese)
they have determined for
themselves that they have
no idea of what it is like to
live a typical person’s life,
let alone practice religion
in the typical fashion.”
In religious terms, they
ignore the spirit of the law
and focus on the letter of it.
John says, “But that’s all
I’ve ever known.”
Seay states that scru-
pulosity can occur in any
background, but more of-
ten appears when an OCD
patient has been raised in
a rigid or fundamentalist
religious setting.
Seay suggests that “iden-
tifying one’s core religious
beliefs ahead of major life
decisions proves helpful.”
Scrupulosity sufferers
should ask themselves
questions that would apply
across the board, such as:
• Does God expect me to
be perfect?
• If I make a mistake or
commit a sin, does my re-
ligion have procedures for
obtaining forgiveness?
• Would God want my be-
haviors to be largely driven
by obsessive-compulsive
disorder?
• Would God want my
relationship to my religion
to be OCD-based or faith-
based?
• Would God understand
what’s going on in my
head and want me to fight
my OCD?
• If my treatment
involves doing things
that might be considered
potentially sinful, would
God understand?
Writes Seay, “For anyone
with scrupulosity/OCD,
it’s unhelpful to define
your goals in terms of im-
possibilities. You must set
achievable treatment goals.
For example, it would be
unwise to select the goal
of knowing for sure that
you did the right thing or
handled the situation the
right way. Moreover, it
would also be unhelpful
to adopt the goal of trying
to be 100% sure that God
isn’t mad at you. For other
people with scrupulosity,
there may be the fear of
hell/damnation and the
unattainable goal of want-
ing to know 100% that you
are saved. These types of
goals just feed obsessive-
compulsive symptoms. No
matter what we do, we can
never know these things
in the ways that OCD tells
us we should know them.
Perfect certainty about
faith and morality just isn’t
possible.”
While in medieval times,
scrupulosity sufferers
were left to incessant
confession, hair shirts and
self-flagellation, in modern
times, Exposure Response
Prevention (ERP) Therapy,
a form of cognitive-behav-
ior therapy that bases its
techniques in the theory
that patients’ thoughts and
emotions, can change lives
as a result of changing
patient behavior.
Specialists exist as near
to Baker County as Boise,
Idaho, and very often ERP
can create controls on the
OCD to the point medica-
tion is not recommended.
When asked to state that
he wants a life with Jane
and doesn’t want a life
with Mary, John cannot get
the words out of his mouth,
but yet feels compelled to
live that way. Last week he
stated he still loves Mary,
“And there’s no connection
there with Jane at all. That
never changes.”
At the time of print,
John still cannot fully
mentally separate his
scrupulosity apart from
true religious devotion in
this situation—and has not
sought help.
Mental illness does not
have to mean tragedy.
911 is available 24/7.
The National Suicide
Prevention Lifeline –
1-800-273-TALK (8255)
or Live Online Chat is also
always there if you are
suicidal or in distress.