Understanding and Healing from Religious OCD (Scrupulosity)

Written By Tara Quick

By a Therapist Who’s Been There

By Tara Quick, LCSW

First and foremost, what is Religious OCD?

Funny enough, it wasn’t until years after completing a graduate-level course in the assessment of psychological disorders—and after becoming a licensed clinical social worker—and after quite a bit of therapy—that I began to realize I was experiencing what’s known as scrupulosity, or religious OCD. For a long time, I genuinely believed I was simply being faithful to my Christian convictions. Looking back, it’s no surprise—religious OCD is known for clouding insight, making it incredibly hard to distinguish devotion from obsessional doubt and compulsion.

It was only as I began working more with clients who had OCD, and started specializing in it myself, that I recognized the signs of religious OCD in my own life.

What Is Religious OCD?

Religious OCD is a version of the scrupulous subtype of Obsessive-Compulsive Disorder (OCD). OCD is characterized by:

  • Obsessions: Unwanted, intrusive thoughts, images, or impulses that repeatedly enter a person’s mind and feel outside their control.

  • Compulsions: Repetitive behaviors or mental acts a person performs to reduce the anxiety caused by those obsessions or to prevent a feared outcome.

A diagnosis of OCD typically involves obsessions and/or compulsions that:

  • Take more than one hour per day, or

  • Cause significant distress, or

  • Interfere with important areas of life (e.g., work, relationships, daily functioning)

With religious OCD, obsessions may sound like:

  • “What if I’ve committed an unforgivable sin?”

  • “Do I really believe enough?”

  • “Am I truly saved?”

  • “Have I offended God by not praying the right way?”

  • “How can I be certain this is true?”

There’s often an overwhelming drive toward moral perfection, intense distress over perceived imperfections, and difficulty accepting grace—even when it aligns with the person’s theology.

Individuals may also experience:

  • Unwanted, intrusive sexual or blasphemous thoughts

  • Extreme fear of being “not really saved” or being doomed to hell despite a desire to follow God

  • Doubts that spiral into existential questioning

Common Compulsions in Religious OCD

In response to these obsessions, compulsions may include:

  • Excessive, repetitive prayer—out of fear rather than faith

  • Mentally “rebuking” distressing thoughts or images to avoid divine punishment

  • Compulsive confession of even the smallest infractions

  • Excessive Scripture reading for reassurance

  • Excessive reassurance seeking via blogs, Reddit threads, pastors, or other theological sources

  • Avoiding church, Bible reading, or prayer to escape the anxiety

  • Ruminating constantly on theological questions or salvation

This can overlap with existential OCD, where a person becomes trapped in compulsive and distressing mental loops about the meaning of life, self, and reality.

The “Feared Self” and “OCD Logic”

In Inference-Based Cognitive Behavioral Therapy (I-CBT), we talk about the idea of a "Feared Self"—the person your OCD says you will become if you don’t comply with its rules. Ironically, this Feared Self is usually the opposite of your true self.

For example:

  • Someone afraid of being spiritually negligent is usually deeply conscientious and faithful.

  • Someone terrified of offending God usually has a sincere desire to live a life pleasing to Him.

So, How Do You Heal?

Religious OCD is especially painful because it takes a main source of comfort—your faith—and makes it feel inaccessible.

When I reflect on my healing and how I help clients, there's no one-size-fits-all answer. But here are some approaches I’ve found effective and are empirically validated, especially through Inference-Based Cognitive Behavioral Therapy (I-CBT) and  ERP (Exposure and Response Prevention). 

Here is what a process of healing could look like:

1. Recognize That This Is OCD

This isn’t a spiritual failing—it’s about how your brain processes information. Understanding OCD’s patterns can be incredibly freeing.

In I-CBT, we talk about the OCD “sequence”:

  • A trigger sparks obsessional doubt (i.e. What if I committed an unforgivable sin? What if seeing the number 666 means I am doomed to hell? What if this disturbing, intrusive image or thought about God means that I have blasphemed the Holy Spirit?)

  • The mind enters a “bubble” of imagined fears supported by “reasonings” (i.e. the rabbit hole of catastrophic stories that start with the “What if?” questions)

  • Compulsions follow, trying (and failing) to resolve the doubt

This cycle deepens the obsession instead of solving it. The OCD uses something called inferential confusion—mistaking imagined scenarios (all of the possible “what if’s” and their consequences) for reality (direct evidence in the here and now or common sense). In I-CBT, we learn about our OCD’s flawed reasoning and the tricks it uses to keep us absorbed in an imagined, catastrophic story.

2. Step Out of the “Bubble”

Contrary to instinct, to heal, you don’t fight OCD with more prayer, more rebuking, or trying to “logic” your way out using Scripture. That only feeds it. This is known as thought-action fusion—treating thoughts or images as morally significant or dangerous just because you had them.

Instead, in I-CBT, we start to:

  • Notice when you’re in the bubble (absorbed in fear or imagined scenarios). 

  • Reconnect with the present moment through your senses.

  • Shift focus to the here and now, and re-engage with your values and and present reality

3. Develop Deeper Trust in Yourself and Your Senses: Experiencing the Alternative Story in the Here-and-Now

This journey takes time, and often the support of an OCD therapist, but healing is possible. As obsessional doubt begins to loosen its grip, you may begin to notice signs of a deeper, more grounded trust in yourself and God’s love developing. This can look like:

  1. Trusting that your true intention is to live a life that honors God—and recognizing that the intrusive voice of OCD does not reflect your actual intentions.

  2. Believing that God accepts you as His beloved child. His compassion and grace are for you, and He understands your struggles and limitations—even better than you do. 

  3. Placing your faith in His love, especially in moments of confusion, mistakes, or uncertainty; learning to lean on His grace, ceasing to discredit the scriptures that speak of His mercy, love, and forgiveness.

  4. Grounding yourself in present reality, noticing  how you live out your faith through love, service, generosity, participation in the sacraments, and your care for others; noticing, instead of discounting, the fruit of the Spirit in your everyday life—which offer real evidence of your values and heart.

  5. Considering how others close to you perceive you: how you act, how you treat people, and how you show up in relationships and community; taking into account how other’s might describe you.

  6. Feeling aligned when reflecting on how most people of faith around you practice their beliefs. For example: You ask yourself “Is the thing I’m obsessing over something that at least 80% of my faith community also worries about?”  If not, you begin to let it go.

        

My Personal Experience

In the past, my religious OCD looked like:

  • Spiraling thoughts: “Am I really saved? Am I going to hell?”

  • Constant rumination, compulsive Scripture reading, evangelizing, seeking reassurance

  • Deep fear of moral failure and disconnection from God

  • At times, this contributed to existential OCD, depression, and anxiety

Coincidentally, some unintentional exposure therapy came during the pandemic, after the birth of my daughter and some subsequent health issues, I could no longer maintain rigid religious routines related to my daily quiet times or scripture reading. I was not able to attend church regularly.  My brain was too foggy and tired to form prayers longer than “Lord, have mercy.” I was forced to trust that God knew my heart and my limitations. 

This was distressing at first—but it created space for healing and a deeper understanding of grace. Along the way, as I began to identify my OCD, I was able to untangle it’s voice from my true self. I began to trust that God was a compassionate, gracious Father who invites me to come to Him as a child. I realized that my true self is someone who desires to love God and others, even though I am imperfect and limited, even though I will never have it all figured out and will always be in process, even though I still have doubt. Instead of being absorbed by theological abstractions, needing certainty for every doctrinal point or needing to figure out how to make myself “good enough”, my attention shifted to the here and now, practical aspects of my faith- i.e.  “How can I be kind to my neighbor today?” “How can I be a good steward of what I have today?” I put my faith in God’s love for me. I’ve been able to feel secure in God’s love and cease striving. Interestingly, once I became less fearful, I actually became more Christ-like.

Treatment Options

Every client’s experience with OCD is personal. When I work with clients, I tailor treatment to their needs. This may include:

If you’re struggling with religious OCD, know that healing is possible. If you're in Tennessee or Georgia, I offer free 15-minute consultations. Let’s see if we might be a good fit.

A Practical Christian Tool for Spiritual Discernment

Wherever you are in your faith journey, this simple yet powerful tool can support you—especially if you’re navigating the challenges of religious OCD. Discernment can be difficult when intrusive thoughts blur the lines between fear and faith. This reflective practice offers a grounded way to help you distinguish God’s voice from internal or spiritual distortions.

The tool is built around three core considerations: character, motive, and tone. While I haven’t been able to locate the original source of this particular Listening Prayer framework, versions of it are used widely in Christian spiritual direction. The descriptions below draw from the overarching narrative of Scripture—not isolated verses taken out of context.

God’s Voice

  • Speaks truth in love

  • Encourages, heals, and redeems

  • Motivated by grace, peace, and a desire for relationship

  • Offers hope and freedom

The Enemy

  • Accuses, condemns, and deceives

  • Instills fear, shame, and division

  • Desires destruction, despair, and disconnection

Self-Talk

  • Often shaped by insecurity, perfectionism, comparison or cultural expectations

If you're wrestling with whether a thought is from God or from OCD, consider asking:

Is this message kind, patient, and loving? Does it offer hope and lead me toward peace?
→ It’s likely from God.

Is it harsh, anxious, condemning, or legalistic?
→ It may be OCD or a spiritual distortion.

A Word About Spiritual Communities

As I reflect on my own healing journey, one significant element that stands out is the shifts I made in my church communities. Over time, I began to step away from communities that, in hindsight, fostered an unhealthy relationship with spirituality. I gravitated instead toward spaces—while still imperfect—that promote a more balanced, compassionate, and life-affirming approach to faith. 

This shift can be especially important for those navigating religious OCD. Some spiritual communities offer support that aligns with healing, while others may inadvertently reinforce fear, scrupulosity, or shame. It’s a nuanced topic—one that deserves its own dedicated post (and likely will get one soon). In the meantime, here are a few reflective questions to help you assess the spiritual health of your current community:

  • Does the focus of my spiritual community lean more toward God’s grace, character, and our hope—or is it centered on failure, sin, and personal effort?

  • Does the community nurture justice, peace, and compassion—or does it promote fear, dread, pride, and division?

  • Is there room for me to be authentically myself—to ask questions, express doubt, and explore differing perspectives—or is dissent met with control, manipulation, or shame?

These questions aren’t meant to provide quick answers, but rather to guide a deeper discernment process. If you find yourself resonating with these concerns, know that you’re not alone—and that there are healthy spaces that can support both your faith and your mental health. If you would like to learn more about navigating spirituality and mental health, you can read more here. 

Final Thought

Religious OCD can distort the most sacred parts of your life—but it does not have to have the final word. With awareness, evidence-based treatment, and spiritual support, healing is possible. Please reach out to see if I would be a good support for you.

Tara Quick