A little while ago, I wrote a brief, non-exhaustive post on scrupulosity. I had a great comment on that post asking for a little bit more about how I deal with scrupulosity as a member of the Church and how we can determine whether or not it’s “really OCD” or just our morality and conscience kicking in (albeit a bit aggressively).
The sly OCD…
First of all, as I mentioned before, I didn’t connect my scrupulosity with OCD until about a year ago. There are some “types” of OCD that, to me, seem like they make more sense logically than others: contamination or fear of sickness or harm that are connected to things that actually could make you sick or do you harm, for instance. Isn’t it good to clean the house after an illness? Isn’t it wise to wash hands thoroughly after you use the bathroom? Wouldn’t it make sense to sanitize after being in a doctor’s office with sick people or a hospital? These concerns have some basis in fact and precaution, right?
Scrupulosity, to me, is another OCD that has a basis in something that can be agreed upon as being or making some sense. It’s good to be honest. Doing the right thing, following laws, obeying commandments and rules—these things are valued in our society (or should be). Being LDS, following the Word of Wisdom, paying a full tithing, not lying, repenting properly—these things are drilled into us as being so important and essential to our happiness and exaltation (to some extent). Because of this, I think those of us who deal with scrupulosity OCD think, “No, it’s not wrong to be overly concerned about these things. This is my soul we are talking about. I can’t be too careful. It’s not really OCD. It’s just about being good and righteous.”
Because of these thoughts, scrupulosity is not an easy problem to have. It is so difficult and can be so hard. Even still I have a hard time talking casually to people because my personality tends toward sarcasm and exaggeration—but my scrupulosity/OCD has told me so often that I have to be “honest” all the time and “not lie.” If my brain equates my use of sarcasm or manner of speech as not being completely honest, then I feel like I’m “sinning” and not righteous enough.
Where is the line?
But how do we determine the line between an effective moral compass and obsessive compulsive disorder? It’s tough, and I’m not sure I have the penultimate answer or guide. I guess it goes back to the old, “What would a normal person do? How would a normal person think or believe? Do other people or Church members worry about this?” If so, maybe it’s the moral compass working appropriately. If not, maybe your scrupulosity is taking over. Of course, be a good person. But don’t try to be a perfect person. That’s not possible. Even if your mind tells you it is or should be.
The challenge of CBT and ERP
Connecting this all to cognitive behavioral therapy and a psychologist can also difficult. Usually our doctors want us to go overboard in doing exposures and standing up to the OCD. But when it comes to things that are morally or spiritually important, it’s not totally possible to go overboard. For instance, take an obsession with worrying about consuming alcohol in food. I have this one. I wouldn’t purposefully order a chicken marsala at a restaurant (though I know other Mormons who would without even thinking about it, and that’s fine). So, for an exposure, maybe I would order something with red sauce without asking the waiter if the sauce was made with wine. Or get a salad with vinaigrette dressing and not worry about if it’s a wine or balsamic vinegar. I could also get something that I know has an extract (vanilla, mint, lemon, almond, etc.) in it. Those would be exposures for me without my feeling like I’m breaking the Word of Wisdom.
I guess the goal with CBT and scrupulosity is to push yourself to the limit without feeling like you’re actually breaking any commandment or religious rule. Do what “normal” people do. And, as Dr. Bob told me at my last session, if you have problems with your psychologist not respecting your religious beliefs, making you feel uncomfortable, or trying to get you to do something that you feel is morally compromising for you, then change doctors.
Good luck, scrupulosity battlers! It is not easy, but it can get better.