Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of going to hell

Mar 7, 20237 minute read

A fear of going to Hell is a common obsession in the Scrupulosity subtype of OCD. People with Scrupulosity often fear that they have committed an immoral act that deserves to be punished, often based on their religious beliefs. A person who suffers with this type of OCD may fear the punishment of going to Hell.

Fears about going to Hell related to OCD may involve fears about being punished for an immoral act, not meeting religious expectations or rules, being separated from God, or suffering greatly after death

People who suffer from OCD have obsessions (thoughts, urges, images) that cause intense fear and even panic. These obsessions are intrusive and unwanted, often opposing one’s values. For example, a person who suffers with moral scrupulosity with a specific fear of going to Hell may highly value their spirituality, relationship with God, and faith. 

OCD might tell this person they are not who they think they are, that they are bad, or that they are going to Hell. Someone with this specific fear will respond to these obsessions by engaging in compulsions to quell their fear or anxiety or to prevent themselves from going to Hell. Compulsions are repetitive thoughts or actions a person feels a strong urge to engage in in response to an obsession. Though compulsions can temporarily reduce distress in the moment, they ultimately strengthen the OCD cycle. The brain learns that in order to get rid of or fight against the intrusive thought, urge, or image it needs to engage in this compulsive behavior, thus teaching the brain that the obsessions are indeed dangerous, maintaining and even increasing fear. 

Let’s consider an example: Louis just graduated high school and is planning to attend college in the fall. Louis plans to study theology and would like to eventually teach at a Christian college or university. He was raised in a devout Catholic home and has always valued his faith and traditions. He enjoys going to Mass on Sunday, singing in the choir, and participating in the sacraments of communion and confession. 

Louis is also diagnosed with OCD and has dealt with intrusive thoughts and compulsions since he was a child. His intrusive thoughts have always involved contamination and harming others, and he has done well using his exposure techniques to address his fears. However, Louis has lately noticed intrusive fears about going to Hell. He has found himself hyper-aware of all of the choices he makes daily. He watched a scary movie with his friends in the theater and felt the need to talk about this the next day at confession. After confession he was saying his prayers of penance and messed up the wording, and had the thought “Now you are damned to Hell.” This made him repeat the Hail Mary over and over until he was sure he had said it just right. 

At night he lays in bed recounting all the events of the day to be sure he doesn’t miss anything for which he may need to ask forgiveness. Now most nights he is awake until 2 or 3 in the morning, recounting, remembering, ruminating, and praying because he is afraid if he falls asleep in a “state of sin” he will go to Hell. During the day Louis gets intrusive images of fire, the Devil, torture, and other things associated with Hell. He then feels the need to pray immediately, no matter what. This fear of going to Hell has started to rule Louis’ life, and he knows he needs to get back into ERP to start to deal with this new fear. 

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Common obsessions

  • Intrusive images about what their experience will be like in Hell (images of burning, torture, crying, fear, being alone, being locked up, seeing the Devil, seeing demons)
  • Intrusive thoughts about their morality (I lied to my parents when I was young, so I will go to Hell because I didn’t honor them)
  • I didn’t say the prayer perfectly, so now I am in a state of sin.
  • I may have forgotten to confess something to my priest, which is keeping me from God
  • What if I don’t really believe in God? What if I’m wrong?

Common triggers

People with Scrupulosity OCD centered on the fear of going to Hell may be triggered by situations involving doubts about their faith, perceived unworthiness, situations that cause them to sin, assessing or explaining their beliefs, seeing numbers they associate with Hell or the Devil, or anything else that exacerbates their obsessions. 

  • Seeing a movie with a religious theme
  • Hearing people or a religious leader talk about Hell
  • Reading the Bible
  • Being around people who do not share one’s religion
  • Remembering past events that they fear were sinful
  • Feeling aroused

How can I tell if I’m experiencing OCD focused on a fear of going to Hell and not anxiety, cautiousness, or normal doubts about my faith? 

Somebody who struggles with OCD will meet specific criteria and have certain experiences. You can ask yourself the following questions to learn if you may be suffering from OCD:

Are you experiencing obsessions? These are intrusive thoughts, urges or images related to the fear of going to Hell, that are unwanted, intrusive, and persistent.

Are you engaging in compulsions as a result? These are mental or physical acts that one feels compelled to engage in to escape, lessen, eliminate, avoid, or neutralize the fears or obsessions.

Do your symptoms cause high distress, or significantly interfere in  your daily life, work, school, or relationships? 

If the answer to these questions is yes, then you may want to speak with a qualified therapist for a diagnostic assessment. 

Common compulsions

When people with a fear of going to Hell associated with OCD experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsions in an attempt to suppress their obsessions or assure themselves that they won’t go to Hell. 

Intense fear caused by obsessions may lead the individual to feel they need to repeat rituals, seek reassurance, avoid certain situations, check, and research to make themselves feel better. However, engaging in compulsions will only make the OCD cycle stronger.

Compulsions performed mentally or physically include:

  • Avoiding churches
  • Attending church as frequently as possible
  • Praying excessively or avoiding prayer
  • Avoiding certain numbers, like 666
  • Seeking reassurance from family, friends or religious leaders
  • Reading about near death experiences 

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How to overcome the fear of going to hell 

OCD focused on fears about going to Hell can be debilitating, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with a trained therapist, there is hope for anyone struggling with these themes. 

ERP is the gold standard treatment for all subtypes of OCD and has been shown to be highly effective. A therapist with specialty training in OCD will work with you to build a hierarchy of your fears, then build exercises called exposures to target these fears. The exposure hierarchy allows for graduated exposure to fear and anxiety, all while resisting the urge to engage in compulsions for relief. 

Examples of possible exposures done to treat OCD with Fear of Going to Hell include: 

  • Writing a script about the reasons you could go to Hell
  • Watching a video depicting Hell
  • Reading about Hell in the Bible
  • Writing 666 on a paper
  • Purposely messing up a prayer

Crucially, a trained ERP therapist will work with you to ensure that exposures are appropriate and do not require you to act against your true values and the tenets of your religion.

If you’re struggling with OCD, 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 with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

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