Scrupulosity, the religious form of obsessive-compulsive disorder, is both a spiritual thorn in the flesh and a legitimately biological problem. Many people yearn to find a book, a pill, or a therapy for scrupulosity’s intense emotional-spiritual pain. However, just as many people worry that getting help for scrupulosity would be a denial of faith or would lead down a slippery slope to harmful secular psychology.

Thankfully, there are effective therapies that can help with scrupulosity–therapies that are biblically safe for Christians. But there are also some types of therapy that may do more harm than good.

Whether you’re afraid of therapy for scrupulosity, are just looking to start, or have been going faithfully but feel like your OCD is getting worse, I hope this brief guide will help you know what to do next.

Getting Therapy for Scrupulosity

I have worked with hundreds of clients with scrupulosity (almost 400, according to my file), and I have noticed a trend among scrupulous sufferers: a peculiar aversion to therapy.

Not everyone is anti-therapy, but many, many, many people with religious OCD won’t touch a psychologist with a ten foot pole.

Part of this aversion comes from deeply entrenched anthropological beliefs–that the “soul” is more important than the mind and body, and that if this etherial, wispy soul (wherever and whatever it may be) is right with God, than we wouldn’t experience psychological suffering.

However, the Bible describes human beings as a holistic unit. Biblical authors used various terms to describe the elements that make up a whole person, such as body, spirit, soul, breath, mind, heart, and strength.

Genesis 2:7 says that God formed man of the dust of the ground, then breathed into his nostrils the breath of life. When this holistic combination came to be–that is, the physical flesh of Adam with the spiritual, animating life force of God–the Bible says that “man became a living soul.”

Yes, there is a spiritual aspect to our existence–but the soul doesn’t exist separately from our biological reality as a wispy ghost that deserves care while our body deserves neglect and punishment. Job spoke to God, saying,

“Your hands have made me and fashioned me,
An intricate unity…”

Job 10:8

Christians began quite early to denigrate the needs of the body. This stemmed from a gnostic belief that the flesh is evil and that if we live an ascetic life, we can help the “divine spark” within us to escape and be with God. But this is not what biblical anthropology teaches. God created us good–body, soul, and spirit. He affirms the worth and importance of our bodies just as much as the mind and heart.

Paul wrote about false teachings which

…indeed have an appearance of wisdom in self-imposed religion, false humility, and neglect of the body, but are of no value against the indulgence of the flesh.

Colossians 2:23

There is no virtue in neglecting the body (our physiological needs) in a vain attempt to be more spiritual. The most spiritual thing you and I can do is to recognize that in Genesis God made us “very good.” He made us strong and healthy and mentally stable. Today, we may not feel strong and healthy and mentally stable, but every attempt we make to restore that Edenic ideal in our lives is an act of worship.

Thus, visiting a doctor, getting therapy for scrupulosity, going to the gym regularly, and learning to eat healthy are practical ways that we may give God glory.

How Can Christians Get the Best Therapy for Scrupulosity?

The regular readers on my blog know this already, but for anyone new, let me remind you that I’m not a medical professional. I write as a humble student of the Bible, not as a medical doctor. Nevertheless, as a person with my own OCD diagnosis and experience with therapists, specialists, and inpatient care, I do my best to share what I’ve learned along the way.

When it comes to finding the right therapy for scrupulosity, there are at least two major considerations: what kind of therapy to choose, and who to work with.

The Best and Worst Therapies for Religious OCD

For our purposes as OCD strugglers, let’s say that all psychotherapies exist in one of two categories:

1. ERP
2. Talk Therapy

I know, I know…therapists, forgive me for being overly reductionistic. I know that ERP is “technically” a form of talk therapy, and “talk therapy” covers a wide spectrum of very helpful methods like CBT, DBT, and ACT.

But my point here is that if you’re not doing ERP, or the work that builds up to ERP, you’re probably doing talk therapy of some kind. And that is usually not good.

So they say, and so I experienced.

“But what do you mean when you say ‘talk therapy,’ Jaimie?” You may be asking.

What I mean by “talk therapy” (in my very loose and reductionistic usage of the term) is any form of therapy in which your counselor talks through your problems with you and tries to help you “solve” them. This is in contrast to ERP, which asks you to face your problems and accept their presence without arguing or solving anything.

Talk therapy is awesome for things like depression, generalized anxiety, PTSD, and so on. But if you have a disorder like OCD, in which your brain insists on analyzing and arguing with every thought that passes through your mind, it’s not good to encourage MORE analysis.

Here are a few ways to identify a potentially non-helpful counseling experience:

• You notice yourself getting worse and more wound-up from your counseling sessions*
• Your counselor asks you to go back in time and bring up issues from the past that might be influencing your current spiritual anxieties**
• Your counselor asks you to analyze your thoughts and perhaps gives you worksheets that help you argue against them
• Your counselor works hard to show you how your thoughts are incorrect
• Your counselor urges you to employ “thought stopping” methods, but you can never seem to do it successfully
• Your counselor seems baffled about why you don’t seem to be “getting it”

*Note that any kind of discussion under the sun can trigger a person with OCD and make them feel worse. Furthermore, proper treatment of OCD and especially ERP can initially create huge spikes of anxiety that can make it seem like the OCD is getting worse. But what I’m referring to here is a long-term spiraling and worsening of symptoms that you think might be related to your counselor’s request that you argue with your thoughts.

**Note also that discussing the past is not always a bad thing. I have myself spoken to a number of clients who have OCD + past spiritual traumas + severe doctrinal misunderstandings stemming from those traumas. We are complex creatures, and sometimes may need multiple types of intervention to help us heal. However, if this is the only thing you are doing in your counseling sessions, just know that you will probably need more than this in order to make good progress with the OCD side of things.

Therapy for scrupulosity works, as long as we don’t get caught in the wrong kind. The wrong kind is the talk therapy which asks us to argue with our thoughts.

But Aren’t Christians Supposed to “Take Our Thoughts Captive?”

One of the most common objections to the “ignore your obsessions” approach is the belief that Christians are biblically obliged to argue with their bad thoughts. This is based on a simplistic and selective reading of 2 Corinthians 10:3-5.

For though we walk in the flesh, we do not war according to the flesh. For the weapons of our warfare are not carnal but mighty in God for pulling down strongholds, casting down arguments and every high thing that exalts itself against the knowledge of God, bringing every thought into captivity to the obedience of Christ.

2 Corinthians 10:3-5

Before Paul speaks about casting down arguments and bringing our thoughts into captivity, he begins with a brief exposition on the flesh and the spirit.

The flesh-spirit dichotomy is one of Paul’s favorite themes. You can read about it chiefly in Romans and Galatians, but he speaks of it in almost all his epistles. In 2 Corinthians 10, he reminds us that we “walk in the flesh”–that is, we literally, physically, ontologically exist in fleshly bodies–but we do not “war according to the flesh.” We operate in a way that transcends the flesh. We exist in fleshly bodies, but our mode of action is spiritual.

Paul goes on to say that the weapons of our warfare are also not of the flesh. They are “mighty in God.”

This is key.

The weapons of warfare that make me successful in overcoming bad thoughts, evil imaginations, and every other stronghold in my life are spiritual weapons that emphasize God’s might, not my own might.

If we state the flesh-spirit dichotomy another way, we might say it is the radical difference between self-dependence and God-dependence. In this sense, what would it look like to have “weapons of warfare” that are “mighty in God?”

This would look like any spiritual method that gets me to lay down my own sword and let God handle my problems.

Enter the concept of not arguing with our thoughts and trusting God to fix what needs fixin.’

This is fundamental to my belief that therapy for scrupulosity, which asks me to not argue with my obsessions, is valid and biblically permissible for Christians.

What Kind of Counselor Should We Find?

Many people with scrupulosity feel that they must find a Christian counselor–preferably someone from their own denomination–so that they won’t have to explain themselves too much.

And I get it.

If we’re sitting in a puddle of our own tears over the concept of maybe, possibly having committed the unpardonable sin, it would be a little strange to confide in some random atheist dude who doesn’t even believe God exists.

Some people have expressed to me that they don’t feel comfortable opening up about their scrupulosity with their therapist because they don’t want to “be a bad witness for Christ.” Others have said they will talk with their therapist about anything other than scrupulosity because they don’t want to be “led astray” by false teachings.

I have another article about the “myth of the evil therapist” that might be a good read if you find yourself in this category. I believe that the vast majority of licensed therapists–even secular or atheist ones–have gone into the helping profession because they want to help people. One of my recent clients, who worked with me for spiritual support and his secular therapist for ERP, told me that it was actually beneficial for him to explain his beliefs to someone who had never heard about them before. His therapist was extremely supportive, despite not sharing his beliefs, and helped him to successfully complete several months of ERP. This individual is now doing very well with his OCD.

I would suggest that the most important aspect is not whether a person shares your religious beliefs, but whether they are a competent and kindhearted professional. You could try checking iocdf.com/find-help/ to browse listings of OCD professionals in your area, or try the widely-used NOCD app.

There are people out there who have the skills to help you.

Once, I worked with a licensed therapist who claimed to be a “Christian counselor.” I was deeply disappointed and quit after a few sessions. Her questions were undirected and shallow. She seemed to be blacking out for much of our time together. And at the end, when I asked if she could close our session in prayer, she seemed immensely startled by the request and stumbled through a prayer so awkward and distant that it seemed she hadn’t prayed in years.

Lesson learned: not everyone labeled as a “Christian counselor” will get you where you need to go. But sometimes a secular therapist can do just the trick. Look for professional expertise more than denominational similarity.

Conclusion

I believe it is biblical for Christians to get therapy for scrupulosity.

Yes, it might be difficult to find the right fit. You may need to try two or three counselors before you find the right one. I have seen a total of six therapists, some Christian and some not. Most of these were people I only saw a few times before realizing it wouldn’t be a good fit.

Maybe you need to try three or four therapists before you find someone you really connect with. Nothing wrong with that. But don’t be afraid to try. Therapists are there to help you.

As you continue moving forward in your journey to better mental and spiritual health, keep looking up. Keep trusting that God has divine oversight over every part of your life–that He numbers the hairs on your head and catches your tears in a bottle. He will help you find what you need for recovery. Trust Him and keep moving forward.

Best wishes on the journey,