ICSA TODAY 6
I inadvertently came to understand the wrongness I had felt
within myself in a new way during a training I attended. Dr.
Edna Foa and her colleagues at the University of Pennsylvania
presented a brief course on obsessive-compulsive disorder
(OCD) and its many subtypes. To my surprise, I recognized
myself in the course materials. What I had deemed to be
wrongness was an obsession about being a terrible person,
unworthy of love or belonging. High-control groups so often
promise to fill voids or vulnerabilities we feel in our lives or
in ourselves. For me, religion had given me compulsions to
soothe the intolerable anxiety that my obsession with being
a bad person caused (Foa &Franklin, 2001). I had been a
licensed mental health professional for six years, and this was
the first time I had ever heard of scrupulosity OCD.
Scrupulosity is a term used to describe a specific manifestation
of OCD. in which the person becomes overwhelmed
(obsessed) by near constant thoughts about right and wrong
or being a good person or a bad person. It is often, but not
always, associated with religion:
...scrupulosity is best regarded as a pattern of beliefs
and behaviors associated with excessive worry about
having committed a sin or engaging in immoral acts.
Concern may focus either on thoughts or actions
already taken or the possibility of committing sins
in the future. This results in significant emotional
distress, guilt, and despair. (Seay, 2012)
This obsession leads the person to engage in specific
behaviors (compulsions) that they hope will help to prove
or solidify their goodness. Depending on the person,
the compulsive behaviors can take the form of excessive
confessing, hours of praying each day, or fixating on details of
specific rituals. They may seem to be the only way the person
can find relief from the anxiety their obsession produces
(Hershfield, 2018). Ultimately, the relief derived from the
compulsion is short-lived. As a defining feature of OCD, the
obsessive thoughts will return, and the person will again be
tormented by the anxiety until they perform the compulsion
perfectly. This is the never-ending cycle that plagues those
with OCD (Foa, 2010).
As I write this, I am worried I have not sufficiently explained
scrupulosity OCD. I fear that those who read it will not
understand or will think I have intentionally confused them.
My anxiety tells me this will lead to people thinking I am
stupid and a bad therapist. All my colleagues will lose respect
for me, and I will lose everything I have worked for. My
anxiety is screaming at me to go back and fix the preceding
paragraph. Surely, this is the only way I can avoid the demise
of my career. If I were to go back, I would inevitably find more
things to fix. This article would never be finished. I take a
breath and remind myself to move on. My war against anxiety
may never be over, but it is getting easier to win the battles,
and I am learning to be okay with that.
High control-groups offer a mirage of relief from anxiety
In retrospect, both as a person who has been treated for OCD,
and as a clinician trained to understand and treat the disorder
in others, I see that the comfort I sought in diving deeper
into my LDS orthodoxy was actually the spurious reassurance
that compulsions often give those plagued by obsessions.
The relief I was seeking was not God’s confirmation that I
was doing enough to overcome the wrongness it was the
temporary relief of anxiety that compulsions provide. It is the
same relief I find in locking the door three times to ensure it is
truly locked.
Locking the door multiple times is a somewhat stereotypical
compulsive behavior associated with OCD (Ladouceur, 1996).
For those with scrupulosity OCD, specifically in regard to
religion, obeying commandments, following authorities, and
doing whatever may be necessary to be good are equally
enticing and necessary compulsions. Failing to do so can
cause tremendous distress and diminished functioning
(Greenberg, 2010).
While I was Mormon, I did not understand my anxiety. I only
knew the desperation I felt to soothe it. People outside of the
LDS Church told me it did not make sense that I was pinching
every penny so I could ensure I was paying a full ten percent
of my income to the LDS Church each month. It also does not
make sense that I was filled with crippling anxiety if someone
did not smile at me at church, and this would cause me to
become convinced that they, and every other person in the
world, hated me. Anxiety does not make sense. It does not
care about logic. When anxiety takes hold, all that matters is
finding relief.
High-demand religious groups often promise relief from
anxiety in the form of everlasting peace. I would sing hymns
such as “Be Still My Soul” and cling to the hope that I could
feel such stillness in my soul.2 Church leaders would tell me
peace was possible if I prayed more, followed commandments
more obediently, and did all I was told to do. When such peace
eluded me, it was always my fault. In reflecting on this now, I
see how a high-control group such as the LDS Church presents
a mirage of relief from anguish that is tantalizing to those
desperately seeking it. High-control groups seem to offer
answers and clear paths. When the group then fails to deliver
on such promises, it is easy to place the blame on the person
who is seeking. The person perpetually feels close to attaining
the comfort they seek, and so they are willing to do yet
another thing, in hopes this might bring them to their goal.
I had been a licensed mental health
professional for six years,
and this was the first time I had
ever heard of scrupulosity OCD.
I inadvertently came to understand the wrongness I had felt
within myself in a new way during a training I attended. Dr.
Edna Foa and her colleagues at the University of Pennsylvania
presented a brief course on obsessive-compulsive disorder
(OCD) and its many subtypes. To my surprise, I recognized
myself in the course materials. What I had deemed to be
wrongness was an obsession about being a terrible person,
unworthy of love or belonging. High-control groups so often
promise to fill voids or vulnerabilities we feel in our lives or
in ourselves. For me, religion had given me compulsions to
soothe the intolerable anxiety that my obsession with being
a bad person caused (Foa &Franklin, 2001). I had been a
licensed mental health professional for six years, and this was
the first time I had ever heard of scrupulosity OCD.
Scrupulosity is a term used to describe a specific manifestation
of OCD. in which the person becomes overwhelmed
(obsessed) by near constant thoughts about right and wrong
or being a good person or a bad person. It is often, but not
always, associated with religion:
...scrupulosity is best regarded as a pattern of beliefs
and behaviors associated with excessive worry about
having committed a sin or engaging in immoral acts.
Concern may focus either on thoughts or actions
already taken or the possibility of committing sins
in the future. This results in significant emotional
distress, guilt, and despair. (Seay, 2012)
This obsession leads the person to engage in specific
behaviors (compulsions) that they hope will help to prove
or solidify their goodness. Depending on the person,
the compulsive behaviors can take the form of excessive
confessing, hours of praying each day, or fixating on details of
specific rituals. They may seem to be the only way the person
can find relief from the anxiety their obsession produces
(Hershfield, 2018). Ultimately, the relief derived from the
compulsion is short-lived. As a defining feature of OCD, the
obsessive thoughts will return, and the person will again be
tormented by the anxiety until they perform the compulsion
perfectly. This is the never-ending cycle that plagues those
with OCD (Foa, 2010).
As I write this, I am worried I have not sufficiently explained
scrupulosity OCD. I fear that those who read it will not
understand or will think I have intentionally confused them.
My anxiety tells me this will lead to people thinking I am
stupid and a bad therapist. All my colleagues will lose respect
for me, and I will lose everything I have worked for. My
anxiety is screaming at me to go back and fix the preceding
paragraph. Surely, this is the only way I can avoid the demise
of my career. If I were to go back, I would inevitably find more
things to fix. This article would never be finished. I take a
breath and remind myself to move on. My war against anxiety
may never be over, but it is getting easier to win the battles,
and I am learning to be okay with that.
High control-groups offer a mirage of relief from anxiety
In retrospect, both as a person who has been treated for OCD,
and as a clinician trained to understand and treat the disorder
in others, I see that the comfort I sought in diving deeper
into my LDS orthodoxy was actually the spurious reassurance
that compulsions often give those plagued by obsessions.
The relief I was seeking was not God’s confirmation that I
was doing enough to overcome the wrongness it was the
temporary relief of anxiety that compulsions provide. It is the
same relief I find in locking the door three times to ensure it is
truly locked.
Locking the door multiple times is a somewhat stereotypical
compulsive behavior associated with OCD (Ladouceur, 1996).
For those with scrupulosity OCD, specifically in regard to
religion, obeying commandments, following authorities, and
doing whatever may be necessary to be good are equally
enticing and necessary compulsions. Failing to do so can
cause tremendous distress and diminished functioning
(Greenberg, 2010).
While I was Mormon, I did not understand my anxiety. I only
knew the desperation I felt to soothe it. People outside of the
LDS Church told me it did not make sense that I was pinching
every penny so I could ensure I was paying a full ten percent
of my income to the LDS Church each month. It also does not
make sense that I was filled with crippling anxiety if someone
did not smile at me at church, and this would cause me to
become convinced that they, and every other person in the
world, hated me. Anxiety does not make sense. It does not
care about logic. When anxiety takes hold, all that matters is
finding relief.
High-demand religious groups often promise relief from
anxiety in the form of everlasting peace. I would sing hymns
such as “Be Still My Soul” and cling to the hope that I could
feel such stillness in my soul.2 Church leaders would tell me
peace was possible if I prayed more, followed commandments
more obediently, and did all I was told to do. When such peace
eluded me, it was always my fault. In reflecting on this now, I
see how a high-control group such as the LDS Church presents
a mirage of relief from anguish that is tantalizing to those
desperately seeking it. High-control groups seem to offer
answers and clear paths. When the group then fails to deliver
on such promises, it is easy to place the blame on the person
who is seeking. The person perpetually feels close to attaining
the comfort they seek, and so they are willing to do yet
another thing, in hopes this might bring them to their goal.
I had been a licensed mental health
professional for six years,
and this was the first time I had
ever heard of scrupulosity OCD.
