There are many characteristics common amongst those with OCD. While not every struggler may identify with every characteristic, or they may identify with some more than others, I have generally found these helpful in identifying patterns in my own struggle.
1. Inflated Sense of Responsibility
We feel like we are ultimately responsible. I need to say the sinner’s prayer again because it’s up to me and how I approach God that determines if he will receive me. I need to wash my hands again because if I don’t, I could get my family sick. The weight of the world falls on my shoulders, and OCD is never satisfied until I take every possible measure to secure myself and those I love.
I know (theologically speaking) the truth that Jesus alone is sovereign and in control, and yet I live as though I am the one responsible for my eternal state, my health, etc. I’m the one who can sin too far beyond repentance, I think, or I’m the one who needs to accept Jesus. My actions and heart take center-stage, and God’s mercy and justice are less significant. I live as though I will only be safe if I can control my own world.
2. Need for Certainty
Then of course there’s the need for certainty. OCD is a swirl of “what ifs,” thriving in the ambiguity and demanding certainty. I’m caught in this middle-ground, not assured of my salvation, but then, not sure of my damnation, either. I just don’t know, and that’s what I hate.
Many things are black and white, and yet so much of the Christian life is lived in gray areas. I don’t usually think in black-and-white. However, when it comes to OCD, I can be very black-and-white. I want to know one way or the other, not live in this in-between. And yet, all of faith is lived in the in-between, because faith itself is not an absolute but is mixed with doubt and uncertainty. The scrupulous person—not to mention every person!—needs to get used to the ambiguity.
3. Intolerance of Anxiety
Along with the need for certainty is an intolerance of anxiety. Exposure and response prevention is most effective for fighting OCD, and yet it requires living in the anxiety. For me, even the presence of anxiety itself feels like evidence that I’m in danger. I will do anything to get rid of the anxiety, giving in to compulsion after compulsion just to make it subside (but of course, it never does in the long run). I assume my anxiety is an alarm alerting me of danger, when really it’s more like a faulty smoke detector, blaring in the absence of fire. I feel like anxiety is incompatible with faith, or that I can’t live my life fully until all of the anxiety is eradicated, versus the reality that I need to learn to live with it (as with the uncertainty).
We are perfectionists. By this I don’t mean we keep our houses tidy; our perfectionism comes out in other ways. For me, it’s in how I treat myself. I don’t allow for any error. I don’t like the fact that the Christian life is a journey, but I want sanctification to be immediate. Any sin on my part seems like a huge backslide from which I can never return, versus another opportunity to turn to God in repentance.
If you listen for any length of time to someone who has scrupulosity, you may notice words like “should” and “must” dominating their vocabulary. I should be able to do this without getting anxiety; I shouldn’t have said/done that; I should be at X stage in the journey, etc. This is another form of the perfectionism, by which I hold myself to an impossibly high standard.
5. Over-Importance of Thoughts & Feelings
Another common trait is an over-importance of thoughts. I often pay careful attention to the thoughts that come into my mind. One common example is an intrusive thought such as, “I hate Jesus.” Many people may think this at some point, but most are able to sum it up as a bizarre and random thought—unrelated to how they actually feel—let it go, and carry on with their day.
For the person with OCD, the thought is sticky. Once it appears in the mind, it latches on. It causes us fear—Why did I think that? How horrible! Does this mean I am the kind of person who would say that? Is that really how I feel? There is no desire in us to say such horrible words about the Lord, but we can’t shake the thought, and fear mounts within us as we obsess over the thought and why we even had the thought.
We put value in the thought. We believe that even thinking it means it must be a desire of our heart. I know it’s not logical, but it doesn’t feel that way, and when all my emotions are swirling in a storm of anxiety, it’s going to take a lot more than logic to persuade me otherwise.
Closely tied to this is overvaluing my emotions. It’s like emotional reasoning: my emotional reaction (or lack of) proves something is true. If I feel uncomfortable, anxious, or panicky when reading the Bible, I assume it must mean my heart is hard. If I feel guilt or shame, it must mean that action was sin (even in cases when it’s not sin). If my anxiety lessens and I’m not as scared of my intrusive thoughts, that must mean I like and welcome them.
We tend to put too much meaning into our thoughts and feelings, neither of which are completely reliable and accurate representations of our hearts. Instead, every thought or emotion seems to scream, “You’re in danger! Something’s wrong!”
6. Mountains & Molehills
I once heard someone say that those with OCD can make mountains out of molehills and molehills out of mountains.
In other words, insignificant things are exaggerated (and they’re usually negative!). For instance, I feel that if I don’t wash my hands enough times I am sinning. Or, perhaps the thing is important but is blown completely out of proportion. An example is the many Bible verses about judgment, which are absolutely important but which I obsess over to the neglect of the rest of Scripture.
On the other hand, the actually significant things (which usually end up being positive) are downplayed. The primary way God reveals himself to humankind—as a merciful and loving God—becomes swallowed up in this other view of God as wrathful. Another example is I tend to minimize any fruit that others point out in my life; I am all sinner and no saint.
Then there’s the question of when exactly I became saved. This can become the whole question I focus on. Meanwhile, the more significant question (Where am I today?) barely comes to mind. If it does, I focus on the negative aspects of my relationship with the Lord and completely overlook all the positive aspects.
Of course, all of these traits provide descriptions, not solutions, and they represent fluid facets of the struggle versus distinct categories. And yet, they encourage both the struggler and their helper to begin to identify patterns and be aware of how their particular struggle may manifest. An understanding of these common characteristics can be a helpful starting point!