What the Heck is Scrupulosity?
I get this question at least once a week!
Put simply, scrupulosity is one way that OCD manifests, where a person’s obsessions and compulsions are related to moral, ethical, religious, or spiritual concerns. Many individuals with scrupulosity also have unwanted thoughts, images, or urges about these themes. They often show up to therapy chronically doubtful and debilitated by the fear that something they feel, think, or do is immoral. Most painfully, they are terrified of the possibility of punishment—whether that’s damnation, divine disapproval, or other consequences.
“Scrupulosity is seeing sin where there is no sin.”
— Sr. Carole Riley, CDP, PhD
The scrupulous person’s obsessions and compulsions go beyond the normal practice of religion or spirituality. For these folks, the symptoms affect their everyday functioning and cause noticeable distress. The cruel irony is that what feels unbearably wrong to them is often seen as very un-concerning to others—even by those they view as moral authorities.
What Does Scrupulosity Feel Like?
It might help to think of scrupulosity as when someone who cares deeply about being good and moral gets mentally “stuck” on one or more specific concerns. The root of the word, scrupus, is actually Latin for “a small, sharp stone.” Imagine walking around with a tiny, pointy rock in your shoe all the time. It’s a small issue in the grand scheme of things, but it’s enough to cause constant discomfort.
Examples of Scrupulous Obsessions
Some common examples of scrupulous thoughts might include:
“What if I’ve offended God by doing this and can’t be forgiven?”
“What if I performed this prayer or ritual incorrectly and will go to hell?”
“What if this thought or image in my head means I’m an inherently evil person?”
“What if I’m not being completely, 100% honest in my words or actions?”
“What if I’m friends with someone who sinned, and their sin transfers to me?”
Examples of Scrupulous Compulsions
To neutralize their distressing thoughts, scrupulous individuals engage in compulsions such as:
Mentally reviewing past mistakes or sins.
Repeating or redoing prayers, rituals, or confessions excessively.
Seeking reassurance from those they see as moral authorities (e.g., religious leaders).
Trying to replace, neutralize, or check their “immoral” thoughts.
Scanning themselves for their level of “goodness” or morality.
Avoiding situations or content related to their moral fear or trigger.
Healing from Scrupulosity: A Therapist’s Perspective
As a therapist specializing in OCD, I work with many clients struggling with scrupulosity. I want to make it clear that healing from scrupulosity isn’t about leaving one’s faith, morality, or beliefs behind. Instead, it’s about finding a healthy relationship with these areas of life—where clients can maintain their beliefs while building self-compassion, embracing nuance, and getting comfortable with uncertainty.
“Would a loving, compassionate voice ever speak to you the way you are speaking to yourself?”
There is Hope
If you see yourself in these symptoms, know that there is hope beyond the suffering. With the right treatment, you can conquer the doubt, repair your relationship with shame, and live a life based on your values, not your fears.
Sources
- Choosing Therapy (https://www.choosingtherapy.com/scrupulosity-ocd/)
- Faith & OCD Resource Center (https://iocdf.org/faith-ocd)
- “Scrupulosity: When Being Perfect Punishes” by Sr. Carole Riley, CDP, PhD
- “The Doubting Disease: Help for Scrupulosity and Religious Compulsions” by Joseph Ciarrocchi
