Scrupulosity, sometimes called “religious OCD,” is essentially an excessive and debilitating concern with morality. Paranoid Schizophrenia, Delusional Disorder, and similar psychological illnesses may accompany obsessive religious thoughts or delusions of a religious nature. And sometimes religious eccentricities appear in other personality disorders. Scrupulosity is considered a psychological illness in modern psychology.
Often, those suffering from scrupulosity will focus on one particular aspect of morality, such as sexual purity or blasphemy. Someone with scrupulosity might continually doubt his salvation or go to extreme measures to ensure she is forgiven. He may attend religious services compulsively, pray repetitive prayers for salvation, perform religious rituals until she feels she has done so perfectly, require constant assurance from clergy members, make frequent pacts with God, or obsess over fears of moral compromise.
It is important to note that scrupulosity is distinct from the observance of one’s religion; those of similar religious faith will recognize the behavior of the scrupulous as obsessive. Scrupulosity is certainly distinct from living the Christian life. Christians are called to obey God, and we must be concerned with morality. However, we have freedom in Christ and complete assurance of our salvation. Ours is not a works-based faith but a life transformation empowered by God. Ours is not a faith characterized by anxiety but one established in peace (John 14; 16:33). So, how should Christians respond to scrupulosity?
First, it is important to understand the truth about God. He is perfect in His justice, lavish in His grace, and acts in love because He is love (1 John 4:8). God does not treat us as our works deserve (Romans 3:23; 6:23) but offers us a way of salvation (John 3:16). We are saved not by our own works but through placing our faith in Jesus (Ephesians 2:8–9). And, just as we did nothing to earn God’s love or merit His gift of salvation, we do nothing to maintain God’s favor. Second Corinthians 5:17–21 says, “Therefore, if anyone is in Christ, the new creation has come: The old has gone, the new is here! All this is from God, who reconciled us to himself through Christ and gave us the ministry of reconciliation: that God was reconciling the world to himself in Christ, not counting people’s sins against them. . . . God made him who had no sin to be sin for us, so that in him we might become the righteousness of God.” The truth of Scripture is that the behaviors associated with scrupulosity are unnecessary, and the fears of the scrupulous are unfounded.
However, for those suffering with scrupulosity, the solution is not always as easy as being reminded of the truth. Doubt still creeps in. Sometimes this doubt can be addressed through waging spiritual warfare, reminding oneself of the truth, and praying for God’s assurance. But, given the nature of the illness, sometimes such religious acts feed the scrupulous behavior and confound the problem. Those who suffer from scrupulosity should seek professional help from pastors, biblical counselors, and medical doctors. There are special therapy protocols that have proven helpful in treating Obsessive-Compulsive Disorder that may also address scrupulosity. Certain medications may also help.