There are many ways in which scrupulosity hides in the church. By this I don’t mean any particular church, but the church as a whole; not just on Sunday mornings, but through every interaction with other Christians, too.
When I say scrupulosity hides in the church, I’m saying there are things unique to Christian culture and even beliefs that can keep someone from being diagnosed with scrupulosity. It’s a large topic and probably has many different aspects, but here are particulars from my own experience.
Narrow or False View of OCD
First, there’s the reality that OCD in general is so misunderstood. Most people have either too narrow a view or an entirely false view of it, but scrupulosity in particular is even less understood than other forms of OCD. Over the years, very few people whom I have told about my struggle have ever heard of OCD with a religious spin, which just shows how many misunderstandings there are (most perpetuated by the media, sadly). We are told that OCD is about obsessive hand washing, perfectionism, and cleanliness, which is a simplistic, narrow, and false view of the disorder. (Read more about common misconceptions of OCD here.)
Growing up, I knew people who had OCD, but it never once occurred to me that I was trapped in similar cycles of obsessions and compulsions, because they were so very different in theme. I didn’t see how my repetitive praying was related to someone else’s constant checking of the stove or flipping of the light switch. OCD was about outward behaviors, I mistakenly thought.
Confusing Obsessions & Compulsions with Spiritual Issues
Stemming from this misunderstanding is another reason why scrupulosity may evade diagnosis. In Christian circles, the symptoms of scrupulosity are so often confused with normal Christian behavior and thinking or with sin. Scrupulosity is so entwined with one’s faith that it’s hard, especially for the struggler, to see through the fog to discern what is OCD and what is a faith issue.
The dominant, most central doubt in my struggle is Am I really saved? This is something most Christians struggle with at one point or another, and for many years I thought I struggled with “typical” assurance of salvation issues. Even then, I could tell there was something abnormal about my struggle, because the intensity and duration of it didn’t seem to match with the experience of others. But instead of seeing this as a sign of a disorder, I chalked it up to a lack of faith, thus perpetuating the self-condemnatory cycle.
I viewed my obsessions as a failure to trust in Christ’s finished work, instead of largely a faulty wiring in my brain. I viewed my compulsions as temptations and sins instead of knee-jerk responses to reduce anxiety. My intrusive thoughts of blasphemy were temptations versus just that: intrusive thoughts that had nothing to do with the state and desires of my heart.
I also saw my prayer as normal in a sense. Sure, it was dysfunctional, but again, that was a sign of my lack of faith. Aren’t Christians supposed to “pray without ceasing”? I didn’t see the areas where my prayers were compulsive rituals meant to lessen anxiety and ward off obsessions.
From the outside, it may look like any spiritual-themed obsessions or compulsions are typical Christian behaviors: prayer, confession, seeking reassurance from others, etc. But a closer look at these behaviors in people with scrupulosity often reveals excessive, repetitive, and persistent patterns that are not what the Christian life is supposed to be about.
Confusing Suffering with Sin
Particularly in the Reformed tradition, there’s a tendency to view any struggle as sin versus suffering. We see certain patterns and struggles as completely heart issues versus signs of bodily brokenness. When we focus on our “total depravity” and sinfulness—necessary things to consider—to the extreme where we begin to neglect the other parts of our identity, we risk the danger of chalking up even areas of suffering and affliction to our sinful nature. “You just need to have more faith,” we say, implying that the struggle means a lack of one. Or “Just trust God,” suggesting that we are willfully rebelling against him in the struggle.
My default is to view my scrupulosity as a lack of faith, but I struggle to view it in terms of a mental disorder. I don’t know the direct causes of it: there may be brain-based and biological causes that are exaggerated by my personality and environmental/cultural factors. Regardless, it’s hard for me to truly believe that it isn’t sin: I don’t have assurance which must mean I’m not believing.
Those with scrupulosity are already prone to see their struggle through the lens of sin, so even the slightest, most indirect message will seem like confirmation. I think this is a persistent struggle for those of us with scrupulosity. Even after three years of counseling, I continually have the same conversation with my counselor: “Are you sure this is suffering, not sin?” His answer is always the same: “It manifests more as an affliction than a willful choice.”
I don’t think anyone can truly parse out how much of any experience is sin versus suffering. We are sinners, and we tend to respond in unhealthy ways, so that can’t be totally separated from our sufferings. But I feel like the church has the sinner part down. It’s a huge part of our identity, for sure, but it’s not all that the Lord has to say about us. He also acknowledges that we are his beloved children—the most vital part of our identity!—and also that we are victims of a broken world with broken minds and bodies. With OCD, there’s an obvious thread of suffering; we don’t seek out the thoughts, and there is a sense of feeling trapped in them. Compounding this is the fact that many of us struggle to believe this is true; we can logically assent to it, yet our minds still whisper, What if it’s just sin?
Reframing the Struggle
Perhaps it isn’t helpful for you to think of your struggle in terms of obsessive-compulsive disorder. That’s okay. But regardless, I think it’s important that you reframe the struggle not as sin or lack of faith but rather as an affliction. And keep in mind that this reframing will most likely be continual and long-term, not once and done.
Scrupulosity is so deeply entwined with faith, which is one reason why it’s so hard to battle. And that’s why it makes it so hard to recognize, too. But be assured: if you struggle with obsessive doubts, rumination, compulsive confessing or praying, or another other host of symptoms, they indicate a disorder and are not a sign of willful sinning, spiritual danger, or moral issues.
And yet even if the what ifs are true—even if that nagging doubt that says “This is sin” is true—know that God in his mercy stands ready to receive you. Not even our what ifs and maybes can stand in the way.