Obsessive compulsive disorder - OCD treatment and therapy from NOCD

OCD as a Christian: How to Understand and Cope With Religion-Based Fears

By Marcio Guzman

Jan 6, 20237 minute read

Reviewed byPatrick McGrath, PhD

If you are a Christian facing OCD, your worldview may feel at odds with your thoughts, fears, and compulsions. 

Many Christians with OCD even report feeling tormented by the condition. They may worry that they will go to hell if they doubt God exists, feel the need to repeat prayers over and over so that they are heard, or struggle to enjoy church services because they trigger these fears. 

Perhaps your Christian values even feel attacked or threatened by your OCD symptoms. Navigating religion with OCD isn’t easy, but with the right treatment, many go on to thrive in their faith. 

First, let’s take a look at what religion-related OCD fear is, and then we can discuss how to treat it. 

What is scrupulosity OCD?

Scrupulosity OCD is a subtype of obsessive-compulsive disorder (OCD) that involves religious or moral obsessions. People with scrupulosity OCD are overly concerned that their thoughts and actions could be sins or other violations of religious or moral doctrine, and have difficulty tolerating the slightest uncertainty or doubt about their faith and actions. 

Intrusive thoughts and obsessions in Christians with OCD: A Guide  

In Christianity OCD, one’s obsessive thoughts or doubts involve their Christian beliefs, teaching, or rules. Many devout Christians with OCD report intrusive thoughts that are religious in nature and that they worry are blasphemous. Some examples of such intrusive thoughts include: 

  • When I pray, I don’t feel connected to Christ. What if this means I don’t believe in my faith?
  • What if I have committed the unpardonable sin?
  • I have bad thoughts about others, and having these thoughts is as bad as doing bad things.
  • What if I have sinned and I don’t remember?
  • I may be practicing my faith in the wrong way.
  • I have done things outside of my church’s tradition. Am I going to suffer as a result?
  • I don’t like all of my fellow churchgoers. Am I unloving? 
  • If I find reading the Bible boring that means I’m not invested in my faith.  

Are intrusive thoughts a sin?

No. Intrusive thoughts are complex and their sources can be anything from trauma or OCD to one’s upbringing or anxiety. In most cases, core Christian values of love, mercy, and justice are at odds with condemning someone for their intrusive thoughts. What matters is getting help for one’s intrusive thoughts.

Does God forgive intrusive thoughts? 

Since intrusive thoughts aren’t a sin, there wouldn’t be a need for forgiveness for having them. That said, engaging in reassuring prayers and readings in a non-compulsive manner, or with the guidance of faith leaders, may help you ease feelings of guilt or shame for having intrusive thoughts. 

Common triggers, and compulsions

Christians with OCD fear punishment (i.e. denied salvation, heaven, etc) for perceived religious violations. These fears may reinforce their desire to avoid such violations, which in turn reinforces fear-based obsessions and compulsions involving sinning. Common obsessions, triggers, and compulsions for Christians with OCD include: 

Common triggers:

  • Praying and not feeling connected to their faith 
  • Having “unacceptable” thoughts 
  • Hearing the words “heaven” or “hell”
  • Attending religious services
  • Speaking with religious friends, relatives, or loved ones
  • Forgetting scriptural passages or prayers
  • Viewing, reading, or listening to media that may be considered sinful or wrong
  • Intrusive images of violent or blasphemous content

Compulsions for people with Christianity OCD include:

Compulsions are actions performed in an attempt to relieve the anxiety that comes from obsessions, or to avoid a feared consequence. For example, maybe you become obsessed with feeling like you have to donate a certain amount of money to your church each week to avoid going to hell, rather than simply giving generously when inspired or able to do so. Other compulsions include: 

  • Excessive displays of devotion 
  • Checking for specific feelings to ensure a genuine connection to faith
  • Avoidance of people, places and things that could create doubt
  • Reassurance-seeking using religious texts, spiritual advisors, family members, etc.
  • Engaging in penitence rituals aimed at cleansing a contaminated soul
  • Excessive or overly mechanized prayer
  • Excessive avoidance of triggers of unwanted thoughts that may run contrary to Christian beliefs
  • Avoidance of religious practice or reminders of religion for fear of being triggered
  • Mental rituals, including monitoring for evidence of sin of blasphemy
  • Excessive religious practices such as feeling the need to attend multiple Bible studies per week 
  • Focus on one area of religious practice such as praying in a certain way rather than building a more holistic practice 
  • Demand for certainty such as asking spiritual leaders for a black-and-white truth rather than accepting gray areas
Many Christians with OCD sometimes struggle to discern between God’s voice and their OCD fears. One simple way to tell the difference is to ask yourself if you need to feel 100% certain about your doubts. Faith can be strong despite feelings of uncertainty, but OCD may try to convince you that you must feel perfectly at ease in order to rely on your faith.

The potential for ERP therapy for Christians with OCD 

The most effective, evidence-based treatment for scrupulosity is exposure and response prevention (ERP) therapy. This type of therapy involves gradually confronting fears, via real-life or imaginal exposures, while resisting the urge to engage in compulsions for short-term relief.

In ERP, a therapist will not ask you to violate a religious belief. Instead, ERP will invite the person to tolerate gray areas and feelings of uncertainty. Exposures will never be imposed on the member and the therapist will never ask a member to do something that they would not be willing to do themselves. 

Over time and with repetition, ERP leads to reduced fear and compulsive urges. Some examples of exposures done to treat OCD themes related to Christianity may include: 

Changing relationship with prayer

If you feel an urgency or intense need to pray often, your therapist may ask you to limit prayers to when you want to pray rather than when you feel you need to. Stacy Quick, a licensed therapist with NOCD, explains: “Feeling a sense of urgency that you are praying in order to relieve anxiety is a telltale sign that it is based on OCD fear versus genuine desire.” 

Doing what you fear 

If, for instance, you worry that you’ve sinned by telling your co-worker you arrived at 8 a.m rather than 8:05 a.m., your therapist may have you intentionally tell “white lies” in a controlled environment, such as playing the game “Two Truths and a Lie” with them. 

As you pursue healing for your OCD journey as a Christian it may be helpful to consider these things: 

There is a Biblical basis for healing

It might not seem like it on the surface but there is a scriptural basis for seeking treatment for mental health. In 2 Timothy 1-7 in the Bible, it says, “for God gave us a spirit not of fear but of power and love and self-control.” 

You can find a therapist who understands you 

You can search for a like-minded therapist who shares your faith or has experience working with religious patients. NOCD has over 300 therapists who specialize in treating OCD, and we’ll work to match you with someone skilled and experienced in treating scrupulosity OCD. You can also find support and compassion in dozens of support groups, which are free to join for members working with a NOCD Therapist. If you’re looking for additional sources of support or other treatment options, the International OCD Foundation is an excellent, credible resource.

Treatment can help deepen your faith 

The word faith implies belief in the unknown, or strength and peace despite uncertainty. ERP therapy can help you cope with the unknown. The potential for ERP therapy to strengthen one’s faith is high. Consider how seeking counsel and accepting uncertainty are strong themes in scripture. Proverbs 24:6 says “for you should wage war with sound guidance—victory comes with many counselors.” NOCD experts find patients go from seeking certainty to accepting uncertainty. They begin to be open to ideas such as “my obsessions may come true,” “some things are out of my control,” and “I can’t ever be sure yet I have faith.” 

Left untreated, OCD results in the person distancing from their values and themselves. Treatment aims to reconnect someone suffering from OCD with their authentic self and values—including their religious faith. 

Christianity OCD can cause significant distress and impairment for those who struggle with it, but it is highly treatable. Seeking treatment for religion-related OCD symptoms can hopefully relate to a renewed relationship with one’s faith where people can experience strength, community, peace, and hope from their religion rather than increased fear or exacerbated obsession. 

If you’re struggling with OCD and are interested in learning about ERP, As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment .All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is.

We specialize in treating Religious OCD

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