“His thoughts are completely irrational and bizarre. They are not from God, but he just doesn’t understand that.”
“She does these weird rituals and thinks she’s following God’s instructions by doing so. I’ve tried to explain the Biblical viewpoint to her, but it makes absolutely no difference.”
“I’ve tried to tell him that he’s got scrupulosity, but he doesn’t believe me. He thinks he’s just being a good believer and all the rest of us are lukewarm.”
If you’ve ever said something like this about one of your loved ones, it could be that he or she has poor insight into religious OCD.
Or maybe your own loved ones said this about you not too long ago.
Our level of insight in our obsessive-compulsive journey is a crucial component for many reasons. Let’s talk a bit about this concept of insight, discuss how to help a suffering family member with poor insight, and celebrate our victory at developing better insight (note: if you’re reading this blog post and even entertaining the idea that you have scrupulosity, yay! It means you have at least some insight!)
What Is Poor Insight into Religious OCD?
Back in the day, psychologists said that obsessive-compulsive disorder is a condition that we know is irrational.
Touching the doorknob ten times before exiting? Yep, we keep touching it whilst knowing it makes no sense to do so.
Washing our hands a dozen times? Certainly, we know it’s excessive–but we just can’t stop.
Praying without ceasing–like, literally without ceasing? Um, well, it’s kinda sorta irrational, but it’s also kinda Biblical, isn’t it?!
Ugh. Cue the 428 people who have told me, “I feel like my brain is on fire.”
At some point, psychologists realized that “rationality” or “irrationality” is a very fluid concept. Some people with obsessive-compulsive disorder are completely convinced that their actions are irrational. Others can recognize the irrationality of their compulsions only when they are sitting in their therapist’s office. Once they go home and face the real-life triggers, the compulsions suddenly seem to make more sense. Others have very little ability to see their behavior as inappropriate.
This led to the concept of “insight” in the field of OCD recovery. All of us can be classified somewhere on a continuum stretching from “absent insight” to “poor insight” to “moderate insight” to “good insight.” (Note: the following chart is not from any fancy DSM-5 manual, since I’m not a therapist–these are just my chaplain-style observations from working with lots of people.)
As you can imagine, having good insight is…well, good. But what does it actually look like to have good or poor insight into religious OCD? Let’s find out.
Poor Insight into Religious OCD: Some Case Studies
Jane’s Scrupulous Hoarding
“Jane” had been given several pallets of Bible translations in an East Asian language. The donor believed that an influx of immigrants from this country would soon be coming to the United States and that American believers should be ready to evangelize them. He gave the pallets of Bibles to Jane and asked her to store them in her house. Dutifully, believing it to be “the Lord’s work,” Jane took thousands of Bibles into her home–filling up two spare bedrooms, the attic, and the hallways.
Jane’s family learned to cope with squeezing through narrow hallways stacked with boxes of Bibles.
Her children grew up and went away to college. Jane was still waiting for the wave of immigrants so she could give the Bibles away.
No one came.
Jane and her husband grew older. They had long ago lost touch with the donor, and the boxes of Bibles, now more than two decades old, were decaying. Silverfish crept in and out of the boxes as they ate the paper inside. Black mold grew on the wall behind boxes that hadn’t been moved in 20 years.
One day, Jane’s husband fell and broke his hip. He needed a wheelchair, but that wasn’t feasible because of the boxes of Bibles. Jane adamantly refused to get rid of them.
Storing the Bibles was her duty before God.
Except that by now, it had become a hoarding compulsion. If anyone dared touch her boxes of Bibles, Jane became severely anxious, but she couldn’t explain why.
The simplest explanation seemed to be that this was her duty before God.
Her husband, unable to take a wheelchair to the bathroom because of the boxes everywhere, stayed in bed and wore adult diapers. He developed a rash and bedsores, but Jane refused to change.
Keeping the boxes of donated Bibles soothed her own anxiety, but at what cost to her loved ones?
Unfortunately for Jane, she didn’t see anything wrong with her scrupulous hoarding compulsions. After all, wasn’t she doing her duty before God? Wasn’t she “having faith” that these Bibles would be used for His glory? Anyone who told her otherwise was certainly not following the Lord.
Ralph and the Demons
“Ralph” had been anxious most of his life. Now, in his middle-aged years, it seemed like everything came to a head. After a period of intense personal stress, he had a cataclysmic spiritual event. He encountered what he thought was a demon.
When it happened, he had a thought pass rapidly through his mind that he agreed to worship the devil.
In a flash, the thought was gone, and Ralph spent all night repenting from the thought. But he couldn’t get it out of his mind that he had just sold his soul to the devil.
Ralph felt convinced that he had sold his soul.
His wife tried to take him to see a therapist. At first he wasn’t willing–after all, he had a spiritual problem, not a mental one. But finally, after much prodding, he agreed to go. His wife made an appointment, and soon he found himself sitting in front of a friendly therapist.
“Tell me what’s been going on,” she asked.
Ralph didn’t know what to say, but finally blurted out something to the effect of, “There’s demons…and I sold my soul…and now I have no emotions…”
The therapist listened carefully and took notes. Later, Ralph heard her speaking to his wife, something about “psychosis” and “long-term medication.”
Ralph felt a sense of despair. He didn’t realize it at the time, but he had poor insight into his religious OCD and had now been misdiagnosed. (Religious OCD can have up to a 37.5% misdiagnosis rate.) It would be a long time before he would come to see his obsessions in their true light.
Daniel Shows His Devotion
Daniel’s father contacted me from the hospital. The religious obsessions had become so bad that Daniel could neither eat nor function normally. He had been placed on a feeding tube and felt hopeless.
Still, he insisted that his concerns were valid.
Daniel believed that God was testing his devotion by micromanaging the tiniest aspects of life. “God” would tell him whether or not he could eat, whether or not he was allowed to look at screens, and whether or not he could blink. Anything that produced the vaguest sensation of enjoyment was off-limits, and Daniel would wake up spontaneously at night to pray compulsively.
When the hospital staff spoke to him about religious OCD, he reacted fiercely.
“They can’t tell me to disobey God,” he grumbled to father. “They all got their degrees from secular institutions, anyways. They aren’t even Christian. How can they tell me anything about my faith?”
Daniel’s father felt a deep sense of despair. His son clearly had poor insight into religious OCD. He was a strong Christian himself and knew that God would never torture a poor soul the way his son was being tortured. But how could he convince his son that his troubles were the result of a mental health disorder, not a ceaseless string of divine tests?
Poor Insight into Religious OCD: The Way Out
In order for spiritual recovery to take place, we need good insight. We need to know what’s happening.
So how can we go from bad insight to good insight?
Often this occurs through crisis.
You’ll remember the Apostle Paul, before he was Paul. He was Saul the Persecutor. He had all the right “information” in his mind, but it wasn’t arranged properly. He had all the verses memorized and all the devotional practices down pat. But it wasn’t enough. He needed all that data to be rearranged in a different pattern–a different paradigm–so that the gospel would make sense.
Saul’s crisis moment on the Road to Damascus left him blind and utterly astonished. But it gave him piercing insight into the Truth. This new insight helped him reorganize his knowledge bank and rethink his identity–as we must do.
On the Road to Damascus, Saul came face to face with the reality that his beliefs didn’t fit anymore. It was like trying to put a round peg into a square hole.
He had all these ideas about who and what the Messiah was supposed to be, but as the blinding light of heaven and the voice of Jesus threw him to the ground, it just couldn’t make sense anymore.
There had to be another explanation.
There had to be a better way to understand reality.
Thus, Saul embarked on the journey that would turn him into a powerful apostle. He laid aside his preconceived notions and allowed for the possibility that Jesus actually was the Messiah, and that the truth about about Yahweh might be stranger and more glorious than he’d expected.
With this spiritual openness came greater insight…and Truth.
But he had to go through crisis to experience it.
How Crisis Leads to Insight
One of the issues that I see in the scrupulosity world is that family members act as crutches so that their loved ones never have to go through crisis.
For example, in Jane’s case, her family went through considerable inconvenience so that she never had to face her scrupulous hoarding issue. Even though her husband needed better medical care, her family helped by donating adult diapers so he could stay in a crowded, unsafe house while recovering.
But what if her family insisted that the boxes needed to be removed and bulldozed?
Jane would have gone into major panic mode.
(I’ve changed the details and names, but in principle these are all true stories. I’m sad to say that Jane’s scrupulous hoarding has not been challenged. She is still doing her “duty before God,” much to the suffering and inconvenience of others.)
In other cases, when family members step back and allow the natural consequences of scrupulosity to fall upon people with poor insight, it can lead to a very uncomfortable experience.
Did I say, “very uncomfortable?”
Those of you who are regular followers of this blog can probably remember your own moment of insight–when things got so bad that you began wondering if this is really the way God works (if you remember your dawning of OCD insight, please share in the comments below so that others can read more examples of how that works).
Somewhere deep in the underworld of anxiety-induced pseudo-spirituality, we come to our senses and wonder if this is how it’s meant to be.
Remember the Prodigal Son when he was yearning for the empty pods the swine were eating? I love how the Bible phrases it:
And he would gladly have filled his stomach with the pods that the swine ate, and no one gave him anything. But when he came to himself, he said, ‘How many of my father’s hired servants have bread enough and to spare, and I perish with hunger!’Luke 15:16-17
Just like the Prodigal son “came to himself” in a moment of hungry crisis, we also must “come to ourselves.” It’s an antiquated phrase that means something along the lines of, “he suddenly had the dawning of reason about the true situation he was in.”
This is the birth of healthy insight.
Common Pitfalls with Growing Insight
There are a few common pitfalls as we move from having poor insight into religious OCD to having more robust conviction about what’s going on.
First of all, we may vacillate about our diagnosis.
After you’ve gone to an OCD specialist and received a diagnosis of religious OCD, you may initially have a “light bulb moment” where everything seems to make sense. But some weeks or months later, you begin to question whether you actually have OCD or not.
This is incredibly common.
I’d say the majority of people with OCD have, at some point or another, doubted whether they really have OCD.
(Alternative interpretations for these anxious spiritual urges may include God, more severe mental health conditions, or just having a bad “season” of life.)
Chalk it up to the chronic doubt of OCD, but you’ll most likely doubt the diagnosis. Wait for it! 🙂
A second common pitfall is self-loathing and self-blame.
As we begin to understand our anxiety disorder, we wonder,
- Why do I have this?
- Why am I the only one in my church that struggles with this?
- Why can’t I just read my Bible and pray normally?
- What’s wrong with me?
- Will God accept me like this?
And so on.
We exchange the rod of God (which wasn’t really from God anyways) for the rod of self-blame. It’s not pretty. People with scrupulosity are some of the most self-downers I’ve ever met, yet are some of the most kind, creative, and sensitive people in the world.
As you develop deeper insight into your religious OCD, try to be kind to yourself and recognize that God loves you even if you have an anxiety disorder. I like 1 Corinthians 12 because it reminds us that the weaker members of God’s church are not “bad” or “wrong” because we struggle–on the contrary, those with struggles and weaknesses require extra love and support.
But now indeed there are many members, yet one body. And the eye cannot say to the hand, “I have no need of you”; nor again the head to the feet, “I have no need of you.” No, much rather, those members of the body which seem to be weaker are necessary. And those members of the body which we think to be less honorable, on these we bestow greater honor; and our unpresentable parts have greater modesty, but our presentable parts have no need. But God composed the body, having given greater honor to that part which lacks it, that there should be no schism in the body, but that the members should have the same care for one another. And if one member suffers, all the members suffer with it; or if one member is honored, all the members rejoice with it.1 Corinthians 12:20-26
Don’t be hard on yourself! God loves strugglers like you and me!
A third important pitfall is the desire to fixate on causes.
As Dr. Monnica Williams notes, there can be a tendency for treatment providers and patients to focus on supposed “causes” of the OCD (trauma, childhood experiences, etc.). This can lead us to obsess over the reason why we ended up this way (which is not helpful).
We are already predisposed to overthinking things, so why would we want to feed ourselves a bigger diet of overthinking?
When we talk about healthy insight into religious OCD, what matters is that you know what you’ve got. It doesn’t matter too much how you got it (in most cases we can’t be sure, anyways). Healthy insight just means the ability to look in the mirror and say, “I have religious OCD, and I’m committed to working on it.”
No need to obsess about whether Aunt Eleanor’s Christmas fruitcake back in 1992 might have had O. C. Deelobacter bacteria in it.
Having poor insight into religious OCD can create one of the biggest blockages to effective treatment. However, it’s entirely possible to grow into a deeper level of self-understanding.
If you can look back on your scrupulosity journey and see a crisis moment when you suddenly realized, “aha, this is not God making these demands on me! I think it’s an anxiety disorder!” You can actually celebrate that moment. It was probably the most significant turning point in your recovery. Maybe you look back and think your crisis was horrible-terrible-good-for-nothing. Maybe you regret that your crisis cost you your job or a year of schooling.
Don’t think glass-half-empty.
“Insight” into religious OCD is something that you can’t buy. It’s something your family can’t force down your throat. And yet you desperately need insight in order to get better.
So if you had a crisis, rejoice. Hold it like a trophy.
Maybe you never had an actual crisis period but you’ve just known about OCD since childhood. That’s also a trophy. Having parents who diagnosed you early and tried to help you get treatment means insight is much easier to come by.
And maybe you’re still in the investigative stage where you’re wondering if you actually have religious OCD. Unfortunately, I can’t tell you whether you have OCD or not. On this website you’ll be able to find lots of articles and even some quizzes to give you some clues and support, but ultimately you’ll have to be the one to meet with your therapist and figure out the details.
And if you’re the family member of someone with poor insight into religious OCD, I’d encourage you to take three steps:
- Don’t force or pressure them into admitting they have OCD. It won’t work.
- Don’t let yourself be a spiritual crutch. Do not come short nor go beyond the requirements of the Bible. If this causes distress and anxiety to your loved one (that is, if you do not support their spiritual extremism), keep right on going forward with your own balanced spiritual lifestyle. Do not bail them out of spiritual crisis, but be there for them when it happens so you can lovingly suggest a different explanation (i.e. “maybe this is religious OCD”).
- Educate yourself on religious OCD so that you can be the best support partner possible.
Wherever you are on the scrupulosity recovery journey, please remember that God is there to cheer you on. I wish you greater insight every day and a consistently closer relationship with our Lord and Savior.
Best wishes on the journey,