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Scrupulosity—Or Obsessive-Compulsive Disorder?

No matter what you call it, it’s no day in the park for believers.

Christianity Today March 31, 2008

The word scrupulosity and its derivatives don’t show up much in today’s language. But the mental state it describes – an obsession with one’s sins and ridding them at all costs – has caused the suffering of many a Christian both past and present. It’s derived from the 14th century Latin word scrupulus, meaning a “sharp stone or pebble,” used figuratively by Cicero to describe that which causes unease or anxiety. Think of it as a jagged pebble lodged firmly in the recesses of the mind, causing Martin Luther, for example, to go through confession marathons with annoyed priests to make sure he hadn’t left one sin unconfessed.

An article on today’s ABC News “Mind & Mood” website, a mental-health forum, shares the story of one modern-day sufferer. Cole M.’s scrupulosity (what psychiatrists have labeled a “religious form of obsessive-compulsive disorder”) manifested as a fixation on counting the number of letters in his sentences to make sure they were multipliers of the number 7 (God, holiness) and not 6 (Satan, sin). He would also go through daily bowing rituals before icons before heading to school, and experienced panic attacks when his fellow classmates used profanity.

Even during conversations, Cole silently counted, multiplied and added letters in words to make a sum of seven. For instance, take the sentence: The cat is gray. In less than a second Cole has an answer: “Cat plus gray equals seven letters. ‘The’ and ‘is’ equals five,” said Cole. “So, in order to get the [second] seven, I’d make the cross of the ‘t’ count and the dot of the ‘i’ count. . . . Nobody would be able to tell that I’m doing this,” Cole said. . . .

Such activities, though seemingly minute, become debilitating due to the excessive amount of mental energy they require. For the believer, an obsession with moral purity can stifle fruitful relationships with other Christians, and perhaps ironically, with the Lord himself. Instead of leading a believer to a deeper trust in God’s mercy on account of their sins – a trust that is meant to bring “peace with God through our Lord Jesus Christ” – scrupulosity focuses the person back on the efforts of him or herself, which usually leads to excessive guilt and despair.

One answer for those who suffer comes from Ian Osborn, a Penn State psychiatrist who has just released Can Christianity Cure Obsessive-Compulsive Disorder?: A Psychiatrist Explores the Role of Faith in Treatment (Brazos Press). Though Osborn makes clear that in most cases, no amount of praying and confession will “cure” someone of OCD (or scrupulosity, whichever you prefer), specifically Christian teaching has significantly reduced the symptoms of OCD in the lives of his patients. Osborn argues his case by examining the lives of three Christian giants who were noted for their scrupulosity: Luther, John Bunyan, and Saint Therese of Lisieux. He traces each’s journey from obsession with sins to eventual freedom in a reclamation of justification by faith alone – or in psychiatric terms, “responsibility modification therapy.” Through the Holy Spirit’s illumination of Scripture, Luther, Bunyan, and Therese came to the realization that they could “transfer responsibility” from themselves to Jesus for being clean before the Lord. Whether this is effective psychology or just really good theology, there is hope for Christians who are trapped in this life-squelching obsession.

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