Religious OCD-Causes and Treatment

By Wasim Kakroo

DO you know what is common between a person who seems very disturbed by sexual thoughts about religious figures? Who is also troubled by the thoughts about the existence of God even when they’re neither agnostic or an atheistic? Someone who avoids looking at religious books such as the Qur’an or avoids visiting mosques out of the fear of getting exposed to anti-religious thoughts and images?

All the people in the above examples are afflicted by a form of a mental health condition known as religious OCD.
There are many kinds of religious obsessions. Fear of lacking sufficient faith, of entering hell, of being “impure” according to the rules of one’s religion, of engaging in unethical/immoral behaviour; all encapsulate religious obsession. A person who offers hundreds of prayers every day to be forgiven for his perceived transgressions or someone who keeps on verbalising abusive remarks against the devil (shaitan) are also examples of religious OCD.
Most obsessive behaviour is driven by fear and it is a characteristic feature of religious OCD. These fears spring up in the form of religious compulsions. For instance, attending religious services considerably more frequently than is customary for one’s particular religion, praying more than 5 times for a muslim with religious OCD to deal with guilt related to antireligious thoughts, seeking out constant confirmation from religious leaders, putting great self-denial or self-sacrifice into practice, obsessive prayers, mantra repetition, or purification practises. (For instance, someone might practise saying a prayer until they get it just right.) These spiritual compulsions, in contrast to ordinary religious engagement, are frequently driven more by fear than by faith. Many times, people understand that giving into temptation won’t stop their concerns from coming true. However, individuals think that these compulsions are the only way to make their fear go away.

Typically, Obsessive compulsive disorder (OCD) is characterised by intrusive, unwanted thoughts and anxiety (obsessions) about certain things, as well as the behaviour (compulsions) that those with the disorder engage in to calm their anxiety. This specific anxiety disorder is a really severe condition that frequently fills the victim’s mind with fear and, in a very real sense, takes control of their lives.

OCD is a broad mental health condition with many subgroups: in the case of religious OCD (also called scrupulosity), the individual is fixated on obsessions that are founded in religion and/or religious beliefs, or around beliefs about morality. This type of OCD is characterised by obsessive religious doubts and fears unwanted blasphemous thoughts and imagery, as well as compulsive religious rituals, avoidance, and reassurance seeking behaviours. When someone has religious OCD, they consistently have unfavourable or worrying thoughts regarding their spiritual life. These obsessions frequently get in the way of daily functioning. People could find it difficult to ignore or conceal these thoughts.

Patients with religious OCD have a strong belief in and fear of divine or deistic punishment. According to experts, between 5% and 33% of OCD sufferers may exhibit scrupulosity and this percentage is likely to increase to between 50% and 60% among those who come from extremely conservative religious environments. Scrupulosity affects even those who are not very religious since they are concerned about compromising their morals or unintentionally offending others. People with scrupulosity believe their thoughts are the same as their acts, therefore they worry not just about what they have thought but also about what they have done.

Scrupulosity rituals involve behaviours such as Compulsive praying. This is the case wherein, someone prays compulsively. They repeat a prayer or restart it if they become distracted or don’t feel like they are paying attention to it or its meaning correctly.

It also involves observing one’s behaviour throughout the day to make sure one is acting “appropriately” or checking with others to see if one is acting appropriately or if one has “done the right thing”

Infact, excessive reading or study of religious works, books, or texts to find answers to various doubts inducing anti religious/blasphemous thoughts; questioning motivations in a variety of circumstances to check the veracity of intentions; or excessively apologising to God and pleading for forgiveness for ones behaviour – are all typical features of religious OCD.

Causes of Religious OCD?

One may wonder what drives one to OCD and what could be the causes of this disorder.

However, there is no specific diagnosis for religious OCD. It is a particular example of OCD. Therefore, those who have OCD that is religious may also have OCD that is not religious. Some individuals with religious OCD discover that their obsessions and compulsions evolve over time.

The causes of religious OCD are not entirely understood, just like those of other types of OCD. According to research, serotonin levels in OCD-affected brains may be unbalanced. This could be caused by genetic, environmental, or a mix of the two sources. For instance, someone with a family history of OCD may be more susceptible to the diagnosis genetically. OCD may manifest when anything in the surroundings causes the person to get anxious.

A person is more likely to have spiritual themes in their obsessions, If:

1. They reside in a neighbourhood where religion plays a significant role in both social life and one’s sense of self.

2. They give transient religious doubts moral weight.

3. They think their moral or religious transgressions will be severely punished by God.

It’s vital to remember that OCD cannot be caused by religion on its own. Members of any religion can be impacted by scrupulosity. Not religion, but anxiety, is the issue. OCD will persist even if a person rejects religion or becomes an atheist (The theme of their obsessions and compulsions may change though).

Treatment of Religious OCD

Treatment for OCD frequently requires therapy. An individual can learn to control their anxiety in therapy in ways that don’t undermine their quality of life. A therapist just addresses a person’s fear about their faith; they do not require that they abandon their beliefs.

The following therapies are effective in treating religious OCD:

1. Exposure and response Prevention Therapy (ERP): ERP involves exposing a person to their fear and then preventing them from acting on their compulsion. One can be asked to picture God being upset with them as an example. The therapist will next assist the patient in learning to relax as they face anxiety. ERP can teach people to cope with their religious anxieties. A person might gradually come to terms with uncertainty and experience less pressure to follow their compulsions.

2. Cognitive behavioral Therapy (CBT): Numerous types of anxiety, including OCD-related anxiety, can be treated with this kind of therapy. People who receive cognitive behavioural therapy are better able to recognise, comprehend, and handle automatic negative thoughts.

3. Acceptance and Commitment Therapy: People can develop greater mental flexibility by using acceptance and choosing behaviours based on values to help people become more flexible in their thinking. Clients are taught to stop denying their thoughts and feelings and to make a commitment to altering their behaviour, even if having mixed feelings about it.

4. Family Therapy: Family therapy can be helpful when religious OCD threatens the stability of the family. A therapist might employ age-appropriate strategies if the patient is a small child. Couples counselling might be beneficial when a marriage is threatened by religious OCD. Therapy may result in quick, long-lasting changes.

5. Medications: Specific Serotonin Reuptake Inhibitors (SSRIs) have been used to treat OCD symptoms. These can take some time to start working and are frequently used in higher doses than for depression. Some persons may benefit from the addition of additional types of drugs, such as certain antipsychotics, if their symptoms are not sufficiently eased by SSRIs.

• The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar) and works as a consultant clinical psychologist at Centre for Mental Health Services at Rambagh Srinagar. He can be reached at 8825067196

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