ERP–the bitter pill nobody wants to take. The most uncomfortable form of therapy ever known to mankind. And yet, ERP for scrupulosity is our best way forward.
I won’t spend a lot of time describing scrupulosity, or describing what ERP is. You can find out more about these issues by clicking here or here. What I’d like to do in this article is offer a few suggestions for how a Christian can navigate the bitter waters of having to apply exposure therapy to sensitive topics like our fears of sin, hell, and blasphemy.
ERP for Scrupulosity: A Fast Track
The key to successful exposure therapy is not merely to expose yourself and “do nothing.” I know that’s what it sounds like when you first hear about ERP. The “do nothing” is the “RP” of ERP. No, it doesn’t stand for Rest in Peace, it stands for “Response Prevention.”
ERP is built upon the assumption that the brain will acclimate itself to triggers by repeated exposure. Thus, our therapists guide us through a process of intentional exposure, followed by the do-nothing experience of resisting our compulsions.
Compulsions are the “do something” urges that arise in response to the trigger. Response prevention pushes back and says, “No, I shall sit right here and refuse to do anything at all that will make myself feel better in the presence of this feared thing.”
But honestly, I don’t want to wait twenty years for my brain to “acclimate” to my triggers. I don’t know about you, but my brain is a jumpy little thing. I’ll spook in surprise if a cockroach sneezes two rooms away.
Isn’t there a fast track to getting through these ugly ERP exercises a bit faster?
I do believe there is. But you’re probably not going to like it.
(Here’s where I insert a trigger warning for anyone not prepared to jump off a really crazy cliff with me…)
Making Peace With Our Fears
Here’s my theory: the ERP fast track does require us to do something in the face of our fear. We can’t do our compulsions, because that’s an automatic game-over. But there’s something we absolutely must do when we confront our biggest fears.
We have to make peace with the possibility of them happening.
No, I’m not saying that these feared events WILL happen, and I’m not saying that you have to agree to follow through with them. But if you want to get your money’s worth out of ERP, you’ve got to genuinely, sincerely make peace with the possibility.
Of course, that will look different for every person and for every obsession.
Let’s talk about the hell/loss of salvation obsession. This is one of the top three biggies for scrupulosity. A huge percentage of religious obsessions are variations on this concern. What if I’m not saved? What if, for whatever reason (insert obsession here), I don’t make it and I end up in hell?
The core fear is hell.
ERP says we have to expose ourselves to the idea of hell.
Okay. Can do.
(Close my eyes. Think about fire. Lots of fire. FIRE FIRE FIRE.)
If you’ve done ERP, you know the flooding sensation of ugly emotions that comes over you as you contemplate your worst triggers. It’s horrible. You want emotional relief, so you’re sorely tempted to engage in compulsive behavior, like googling for reassurance, praying for salvation (again), or juggling Bibles.
But, like a good ERP student, you resist. You do nothing. Eventually, through sheer exhaustion of the will, the feelings begin to subside ever so slightly.
Your therapist gives you a sticker on the back of your hand and sends you home to eat a piece of cheesecake. Come back next week and we’ll do that again.
(If you’re a therapist and you’re reading this, we love you. We love all that you do for the OCD community. We don’t exactly love you when you push us through ERP for scrupulosity, but we know you’re helping us get better. So thank you for torturing us for our better good.)
It’s done. You survived ERP. But is that the best we can do? How can we really engage deeply and fast track this (ahem) disgusting process?
By making peace with our fears.
Making Peace with Hell: A Case Study
The inspiration for this blog post actually came through an email discussion I had with one of my clients. He wrote to me about his first ERP session, which went something like I described above, minus the sticker and the cheesecake (as far as I know).
My client, whom I’ll call Mick, struggles with fears of not being saved. His therapist asked him to write out a script of being judged and sentenced to hell. So Mick obediently wrote his script and found himself thinking about, well, hell.
It wasn’t enjoyable, but he made it through without reverting to any compulsive behavior.
But how many more times would he have to do it? Maybe ten times. Maybe a hundred. He would need to keep repeating the process until his brain could learn to cycle down from panic mode and treat the topic in a more reasonable manner. Yes, salvation is important. It’s the most important thing in life, ever. But it’s not something that should spin us into anxiety-driven spirals of insanity that make us unable to operate in daily life. The brain needs to reclassify these concerns, because that’s not how God works. That’s how a mental health disorder works.
How can we help our brain calm down?
By making peace with the possibility.
Getting Rid of Catastrophizing
One of OCD’s major cognitive distortions is catastrophizing. We think of a feared future possibility, and it all but actualizes in our minds. We think and think and think about coming disaster until it seems like it actually exists. But yet, we tell ourselves that we can’t bear it. That we’ll never be able to endure. That it’ll completely destroy us! No, no, no, we just won’t be able to stand it at all!
One of the doctors I worked with during my journey called this the dreaded disease of “I-can’t-stand-it-itis.”
It really is a mental disease to think that I can’t stand something. It’ll drive me to behave compulsively, because if I believe that I can’t stand encountering my fears, I’ll do anything to prevent them.
The truth is that I CAN stand it. I can bear my fears. I can experience them and still be okay.
This is the core truth that will give us a successful journey with ERP for scrupulosity.
We have to make peace with any and all possibilities that are out there. Not that we are going to passively lie down and accept whatever comes to us, but that we’ll stop being controlled by that little voice that tells us we won’t be able to survive XYZ.
Some possibilities in life, naturally, will be more attractive than others. For example, winning a million-dollar house is a more attractive possibility than becoming homeless. But since I do not know the course that my life will take, I must admit it is completely plausible that I might win a house, and it is also plausible that misfortune might strike me hard and I could one day be homeless.
Let’s imagine I have an obsessive fear about homelessness.
I can make peace with this adverse possibility by telling myself that I CAN STAND being homeless.
I would hate it. It would be unpleasant. I would feel frightened and vulnerable every day. But I would make it through.
And little by little, as I make my peace with dreaded possibilities, they lose their power over me.
What to Do With Hell
So how do you do something like this with the idea of hell?
As in, being lost eternally with no hope of ever entering the Kingdom of God?
Well, we begin with the assumption that we can handle things. Even things we hate, things that disappoint us, things that are absolute tragedies in life. It’s not the end until it’s the end. So we’ll keep pushing, we’ll keep finding a way to make it. And even the end itself can finish with a burst of glory and color. We can inject meaning into even the most untimely death, the most tragic loss, the most disappointing crisis.
There are a few ways people with OCD have made peace with the possibility of hell.
(Which reminds me: I say possibility of hell because we are challenging our brain’s insistence on 100% absolute certainty. We aren’t saying we’re going to hell. We are just saying there’s definitely a possibility that things might not turn out the way we expected. It’s a challenge to be ok with uncertainty and a challenge to be ok with whatever that catastrophic, unwanted outcome looks like.)
Making peace with our fears will look different for everyone, depending on your specific denomination, your personality, and your unique experiences with God. But here are a few possibilities:
- Even if I go to hell, I’ll praise God from there. Like Job said, “though He slay me, yet will I trust Him.” I’m going to light up hell with my songs of praise!
- There are some Christian groups that believe the Bible teaches that hell is not forever, and that the words used for “eternal” and “forever” have been misunderstood. If, therefore, hell is not everlasting, I’m going to roast for awhile, as I deserve, and then be phased out of existence. That’s fine.
- I don’t always understand what God does–but I know that I love Him! My heart will never stop beating for Him, even if I go to hell. Like a rejected lover, I’ll gladly accept a place of pain and agony if I cannot be with the lover of my soul.
ERP for Scrupulosity
There are dozens of other ways you could “make peace” with the possibility of hell. As you can see, you do not need to deny your faith. You simply must become creative in finding an intellectual anchor that explains WHY it’s not important for your brain to respond so radically.
Please note: making peace with your fear is NOT the same as giving it reassurance.
You will not progress if you keep making lists of why your fear will not come true. This is about confronting your fear, admitting that you have no way of being absolutely sure that things will turn out the way you anticipate, and figuring out how to be okay with that.
Think about what it would look like to apply ERP for scrupulosity in other themes. How can you make peace with the possibility that:
- You might have ruined someone’s life
- You accidentally lied and can’t find the person to make it right
- You can’t figure out the answer to your doctrinal concerns
- You might have meant to have that blasphemous thought
- You can’t remember when you were saved, which makes you think you might not be
- Your baby could die if you don’t pray just right
- You can’t figure out if something is a sin or not
There are a million possible ways you can make peace with these feared possibilities. But at the end of the day, you CAN stand it. And what’s more, even if you did ruin someone’s life or even if you did curse God in your heart, God still loves you.
God loves everyone. He IS love. He can do nothing other than love. Even His wrath and judgment are expressions of His love–both to protect the innocent and to restrict the wicked from digging themselves an even deeper pit.
Even if we are lost and go to hell, this does not change God’s character of love.
Viktor Frankl, a Jewish Austrian psychologist who endured the horrors of the Holocaust, emerged from the concentration camps to write the book “Man’s Search for Meaning.” While suffering in the work camps, Frankl noted that his labor in sub-freezing temperatures could be made almost sublime by thinking about his wife. I believe the insight he gained can help us in making peace with our religious fears, which always center on eternal loss.
Even if we lose all, God’s love will always go on existing. Peace and truth and goodness will go on.
We stumbled on in the darkness, over big stones and through large puddles, along the one road leading from the camp. The accompanying guards kept shouting at us and driving us with the butts of their rifles. Anyone with very sore feet supported himself on his neighbor’s arm. Hardly a word was spoken; the icy wind did not encourage talk. Hiding his mouth behind his upturned collar, the man marching next to me whispered suddenly: “If our wives could see us now! I do hope they are better off in their camps and don’t know what is happening to us.”
That brought thoughts of my own wife to mind. And as we stumbled on for miles, slipping on icy spots, supporting each other time and again, dragging one another up and onward, nothing was said, but we both knew: each of us was thinking of his wife. Occasionally I looked at the sky, where the stars were fading and the pink light of the morning was beginning to spread behind a dark bank of clouds. But my mind clung to my wife’s image, imagining it with an uncanny acuteness. I heard her answering me, saw her smile, her frank and encouraging look. Real or not, her look was then more luminous than the sun which was beginning to rise.
A thought transfixed me: for the first time in my life I saw the truth as it is set into song by so many poets, proclaimed as the final wisdom by so many thinkers. The truth—that love is the ultimate and the highest goal to which man can aspire. Then I grasped the meaning of the greatest secret that human poetry and human thought and belief have to impart: The salvation of man is through love and in love. I understood how a man who has nothing left in this world still may know bliss, be it only for a brief moment, in the contemplation of his beloved. In a position of utter desolation, when man cannot express himself in positive action, when his only achievement may consist in enduring his sufferings in the right way —an honorable way—in such a position man can, through loving contemplation of the image he carries of his beloved, achieve fulfillment. For the first time in my life I was able to understand the meaning of the words, “The angels are lost in perpetual contemplation of an infinite glory.”Viktor Frankl, Man’s Search for Meaning, pages 37-38
And thus Frankl summarizes the most that I can say about ERP for scrupulosity: it doesn’t really matter what happens to you and me. God will go on forever and ever. Whatever happens to me is okay. Whether I live or die, whether I go to heaven or to hell, God is upon His throne–the greatest Treasure of my soul, my most Beloved.
I do not need to be in a golden city to find bliss in contemplating my Lord.
I’m guessing the topic of ERP for scrupulosity will generate many questions. Please feel free to dialogue in the comments below. If you’ve had a successful time with ERP, we would especially like to hear your success stories. Others who are just beginning the journey will benefit from your encouragement. Or, if you feel confused about this idea of making peace with your fears, write a comment and let’s talk it out.
Ultimately, the bottom line is that we can’t hide from our fears and try to assuage them all day long. That’s what’s keeping us stuck in a rut. But at the same time, I think there’s more to ERP than just facing it and waiting for the bad feelings to go away. In the best cases, it’ll work, but it’ll take a long time for ERP to have it’s positive effect. In the worst cases, you’ll have an emotional shutdown or depersonalize to escape the anxiety.
If we want to jump off the cliff, we need to be able to accept the possibility that bad things will happen to us in life, and that we’ll still be okay. If we can twist our brains around a way to be okay with anything, ERP will win the day.
How does it sound? Clear as mud? 🙂
Let me know in the comments!
Best wishes on the journey,