What is scrupulosity?

Introducing Religious OCD

Vincent Van Gogh, “Field of Spring Wheat at Sunrise,” 1889.

“But it was important for me to hear OCD and scrupulosity named, so I wanted to name them here, too.”

-Annie B. Jones (Ordinary Time, 158)

I’m reading Annie B. Jones’s Ordinary Time (an amazing book!), and in it she has a chapter about her husband, who was diagnosed with scrupulosity as an adult. She writes that not enough people know about it or discuss it.

I thought, “I’m a writer! I have scrupulosity!” So I decided to introduce scrupulosity and share my story here.

The first section is simply a description of scrupulosity, the second section is a bit of my journey, and the third section is a short biblical reflection.¹

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My goal

I’ve told so many pastors about my scrupulosity, and so far no one has known what it is. My goal is to raise awareness so that others—like Annie’s husband, like myself—don’t have to journey with it unknowingly for years.

If you have scrupulosity, please know you are not alone. I’m with you. And—more importantly—so is the suffering Christ, who cries with us.

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What is scrupulosity?

Scrupulosity—a subtype of OCD focused on moral or religious obsessions and compulsions—is a Latin word that translates to a small stone stuck in a shoe. It is a small thought lodged in the brain that can’t be let go of. Intrusive in nature, it nags and nags and nags until the sufferer (i.e. me) cannot think of anything else but that one thought, that one Big Scary Fear. And that fear can come in many different forms. The International OCD Foundation has the following list of common Big Scary Fears for scrupulosity:

• Fear of committing blasphemy or offending / angering God

• Fear of having committed a sin

• Behaving overly morally

• Excessively starving for purity

• Fear of going to hell or being punished by God

• Fear of being possessed

• Fear of death

• Fear of the loss of impulse control

• Doubting what you truly believe or feel

• Needing to acquire certainty about religious beliefs²

Many of these are fears any “normal” person might hold. Most people, I assume, do not want to go to hell or be punished by God. The difference, however, between most people and those of us with scrupulosity, is that our brains cannot let go of the thought. What if we accidentally commit blasphemy? What if we mistakenly hear a song about the devil and become possessed? What if we cannot be perfectly morally pure—physically, emotionally, or sexually? What if, what if, what if?

The fears look like a thousand radiant suns, any one of them overwhelming the senses and burning the retinas, making us blind with fear.

So we read our Bibles for hours a day. We pray the same verse over and over and over again. We go to confession and confess the same sins—both real and perceived. We find someone to bounce all their Big Scary Fears off of (for me, it’s always been my dad). These coping mechanisms—these compulsions—work for a little bit at providing reassurance. But soon enough the fears return and the loop continues. Over and over and over again, forever afraid.

That’s scrupulosity. That’s religious OCD. That’s me.

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My scrupulosity story

I didn’t know what scrupulosity was until I was twenty-three and sitting in a psychiatrist’s office. It was the first psychiatrist’s office I had ever been in, and it wasn’t as scary as I had imagined it being—just fake oak and curt receptionists. Someone I trusted recommended this psychiatrist to me; they said he was a kind man, Christian, and psychiatrist, so I made an appointment and sat there in his office, not sure what to expect.

I told him about my incessant fear of salvation and shame of sin, the need to be the perfect soldier for Christ. I told him about staring out the window a hundred times a day in elementary school, terrified a tornado might be coming. I told him about being a second grader seriously contemplating my salvation and whether or not it stuck. I told him about the twice-a-day calls to my dad for reassurance.

And—most important—I told him about my Big Scary Fear.

He looked at me—about twenty minutes into our appointment—and casually told me I had this thing called scrupulosity—religious OCD. He said it so simply, as if there was a neon sign above my head blinking my diagnosis.

He said my obsession was religious perfection and my compulsion was confession. I stared at him and then down at the forest green carpet. My hands fidgeted in my lap. I told him I didn’t think I had OCD. I mean, I couldn’t have it. I wasn’t obsessed with germs or cleanliness; I didn’t worry about whether I turned the stove off; I didn’t wash my hands to rid them of invisible stains. Nothing like that.

He calmly took my confusion and offered answers. Slowly, the truth began to sink in; I began to understand.

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The bottom fell out three months before that visit to the psychiatrist. I was working at my alma mater, leading a Bible study for college sophomores.

A new student came up to me afterwards and asked,“Hey Drew, can you talk for a few minutes?”

I told him yes of course, and we stepped into an empty office.

“I’m not sure who to talk to about this,” he began. I sat calmly and smiled, proud of myself for being such a trustworthy person.

He kept talking, and I kept listening. As he shared what he was going through, my anxiety climbed up a mountain and eventually reached the summit, screaming inside my brain.

He shared about a fear he was going through—a fear I had personally carried for years.

This fear—I call it my Big Scary Fear—arrived my freshman year of college. I talked to my dad a bunch, and that kind of calmed me down, but the fear continued to rest at the bottom of my skull in perpetuity. Every once in a while it would pop up, but I’d push it down through prayer or distraction, refusing to let it take control. But still, it sat there, always available, within arm’s reach.

“So I just don’t know what to do.” He finished speaking and looked at me. I did my best to look back at him, but the chaos fomenting in my body made the room tilt.

“I’m so sorry you’re going through that,” I stammered.

I kept stammering, and eventually we came up with a plan for the next day. He left the office, and I stood up. The room spun. I walked outside. I began to gag.

My Big Scary Fear.

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So yeah, that’s the beginning of the spiraling. That’s when that little fear—something I thought was controlled—turned into my Big Scary Fear.

I know my Big Scary Fear is irrational, and I know I am okay, that God is with me. But still, it slinks along with me and begins to take over whenever I put a spotlight on it, when anything triggers it. Only those close to me—family, dear friends, and my therapist—know about it. I just can’t share it with you; I’m sorry. I hope you understand.

But that’s what scrupulosity does. That’s religious OCD.

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That night, after I stopped gagging and went home, I couldn’t go to sleep. I’d wake up every five minutes in a state of panic—shallow breath in, shallow breath out. I moved to the couch even though it was too small for me to stretch out on. That didn’t work either. Finally, I moved to my closet because it was carpeted and felt safe for some reason. I didn’t know what was happening.

I prayed the Psalms countless times, begging God to let me sleep, to rid me of this Big Scary Fear. It didn’t seem to work; the fear, sleeplessness, and panic remained.

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“You have scrupulosity.”

I’m back in that psychiatrist’s office, three months after my Big Scary Fear crash landed into my life—three months of twice daily phone calls to my dad and panic and all kinds of fear.

“Scrupulosity,” the psychiatrist said, “Is the reality of an irrational fear that won’t go away. Everyone gets irrational fears in life. Everyone. But the difference between you and them is that you can’t shake it. Someone else gets the same fear you have, but they’re able to say to themselves, ‘I don’t like that’ and then move on, continuing with their day. You, however, cannot shake the fear, so it begins to define you. It’s like a record scratch that only ever loops around the same two notes in a song. Those notes, for you, are filled with fear.”

Suddenly it felt like cool water was running down my neck and the knots in my stomach began to loosen. Things were beginning to make sense.

I left that office with a prescription in hand and got dinner with a friend. I told her about the diagnosis and she asked me how I felt.

“I want to throw a party,” I said. Finally, I realized I wasn’t alone.

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All of that happened nearly ten years ago now. I’ve spent a decade taking medicine for OCD and partaking in communion each week.³ There have been peaks and valleys, but I can tell you two things: (1) things have gotten easier, and (2) I have learned of God’s goodness to me with scrupulosity.

The downsides of OCD get focused on a lot, but there are also super powers that come with it. I am eerily good at reading a room and understanding what makes a person tic. I am able to exist in the gray areas of life and not get too stressed out because I’ve spent so much time wrestling with faith and doubt and all the things. And I think I have a really high emotional intelligence; my brain is always moving and analyzing, so I am able to empathize and understand people pretty well.

I wouldn’t have that if I didn’t have scrupulosity, and I have seen God’s glory revealed in beautiful ways because of these gifts.

Don’t get me wrong, scrupulosity sucks. But God is still good.

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Biblical text one: The scrupulosity Psalm (aka the mothering arms of God)

Early on in my journey with scrupulosity, I learned about the importance of acceptance. I can’t control that my brain gets hooked on irrational fears, but I can control whether or not I fight them. Fighting them is a losing battle; the more you fight, the bigger the fear will get. Instead, we are taught to accept the thoughts, to say, “Okay, I recognize this fear is here, but I don’t need to do anything about it.”

Like taking a leaf and setting it in a stream, I have learned (and continue to learn) how to accept a fear and then let it go.

Around the time I was learning this, I discovered a Psalm that put the practice of acceptance into spiritual terms. Here it is, Psalm 131 (NRSV):

O LORD, my heart is not lifted up,
     my eyes are not raised too high;
I do not occupy myself with things
     too great and too marvelous for me.
But I have calmed and quieted my soul,
     like a weaned child with its mother;
     my soul is like the weaned child that is with me.

O Israel, hope in the LORD
     from this time forth and forevermore.

Sometimes, in the last stanza, I replace Israel with my name: “O Drew, hope in the LORD / from this time forth and forevermore.”

This chapter, for me, speaks to giving God all my Big Scary Fears; it speaks to a God who is able to hold them for me. I remind myself that I do not need to lift my heart up; I do not need to raise my eyes too high. There is so much that is “too great and too marvelous for me.” Instead, I can calm and quiet my soul in the mothering arms of God—the mothering arms of God are big enough to hold all my Big Scary Fears.⁴

And I have to continually—each day, each hour, sometimes each moment—remind myself of this. It’s not a one-time switch but a continual acceptance and release.

“Oh _____, hope in the LORD / from this time forth and forevermore.”

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Biblical text two: The beauty of weakness

So often I think that only my strengths can display the goodness of God. But the Bible speaks to something very different. It speaks to the power of weakness.

Take 2 Corinthians 12:7-10 as an example (this time in The Message):

“I was given the gift of a handicap to keep me in constant touch with my limitations. Satan’s angel did his best to get me down; what he in fact did was push me to my knees. No danger then of walking around high and mighty! At first I didn’t think of it as a gift, and begged God to remove it. Three times I did that, and then he told me,

‘My grace is enough; it’s all you need.
My strength comes into its own in your weakness.’

Once I heard that, I was glad to let it happen. I quit focusing on the handicap and began appreciating the gift. It was a case of Christ’s strength moving in on my weakness. Now I take limitations in stride, and with good cheer, these limitations that cut me down to size—abuse, accidents, opposition, bad breaks. I just let Christ take over! And so the weaker I get, the stronger I become.”

I don’t have time to tell you about all the amazing God conversations I’ve had about scrupulosity with people. I get random texts from friends wanting to pick my brain about it, and I meet people who have recently been diagnosed, unsure of where to place their feet or how to move forward. Truly, “the weaker I get, the stronger I become.” My scrupulosity has been an amazing display of the goodness of God.

I think of that line Joseph says in Genesis, “Even though you intended to do harm to me, God intended it for good.” Satan intended to draw me further away from God and from community, but God has used this weakness to draw me closer to him and closer to others. Truly, praise God!

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In conclusion

If you are newly diagnosed or know someone who is newly diagnosed, please know that you are deeply loved by a God who longs to draw near to you. This is not the end, I promise. There is so much more I could tell you, but I want you to know that God is enough. It is hard, for sure. But God is a God who mothers and a God who miraculously turns weaknesses into strengths. God will be faithful to do that for you, too.

You are loved.

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1. I promise that someday I will write a short, quippy post that is easy and breezy to read. Today, however, is not that day.

2. https://iocdf.org/faith-ocd/what-is-ocd-scrupulosity/#:~:text=Scrupulosity%20is%20a%20subtype%20of,of%20religious%20or%20moral%20doctrine.

3. I wrote about the beauty of both here:

Communion and Clomipramine

4. Speaking of mothering arms of God, have you read Elizabeth Berget’s beautiful Substack? Or Caroline Williams?