Religious OCD Understanding the Nuances of This Challenging OCD Subtype

Religious OCD can be a particularly challenging type of OCD. This is because the obsessive thoughts often involve the wrath of an all-powerful God and the fear of being doomed to an eternal hell. Individuals with this disorder are consumed with obsessive thoughts that are religious or moral in nature.

The term "scrupulosity" is often used in reference to this little-known and often misunderstood OCD subtype. Scrupulosity involves obsessive thoughts that center around behaving morally. Since God judges immoral behaviors, if you have done something that might be construed as immoral, then you may fear – obsessively – that you have angered God and must reap the consequences, unless you can somehow "undo" the wrong or make it right with some sort of ritual.

For example, with scrupulosity, if you forgot to say grace before dinner, didn’t come to a 100% complete stop at the intersection, or had a sexual thought about an attractive but married coworker, you might obsess about it for quite some time.

However, religious OCD (ROCD for short) often involves more than obsessing about immoral behaviors. The following story is a perfect example of the gut-wrenching terror that irrational religious obsessions can elicit.

Jenny’s story…

Jenny, a successful businesswoman in her late 30s, struggled with severe anxiety off and on over the years. Although no one – including her – knew it at the time, she clearly battled religious OCD when she was just a young girl. She describes her ordeal below:

I grew up in a non-religious home. I started going to a Christian youth group at the invitation of a friend when I was about 12 years old. I remember, vividly, the first time I heard Mrs. Jensen (one of the group leaders) talk about how you’d go to hell forever if you hadn’t accepted Jesus as your savior. I’d never heard anything like that before, but the thought of an eternity in hell absolutely terrified me.

Not long after that, I prayed the "sinner’s prayer" one day with Mrs. Jensen to become a Christian. Although I initially felt a sense of relief, I always struggled with nagging doubts about not really being saved or that I would somehow lose my salvation. The fear of hell constantly fueled those anxious thoughts.

To make matters worse, one day I came across a verse in the Bible that talked about the "unpardonable sin", otherwise known as blasphemy against the Holy Spirit. Even though I didn’t understand what blasphemy meant, a strange (and in retrospect, nonsensical) thought suddenly popped into my head. I quickly began to believe that, because of that thought (which I feared might be "blasphemous" in some way), I’d committed this unforgivable sin. I was terrified that I was forever doomed to hell.

The thought was relentless – constantly invading my mind and causing severe anxiety and panic. I know now that these were symptoms of OCD, but way back then I’d never heard of the disorder.

Although I never revealed the actual thought to anyone, I talked to Mrs. Jensen many, many times about my fear. She would always gently reassure me that I hadn’t committed the unpardonable sin. Talking to her would provide temporary relief, but then the anxiety (and the intrusive thought) would quickly return.

I struggled with this for several years – this silly, meaningless obsessive thought plaguing me and causing me severe anxiety. I would pray and pray, begging God to forgive me, but there was no peace.

Fortunately, even though I never went to therapy (nobody did back then – at least not anyone I knew) the obsessive thought and subsequent anxiety gradually became less frequent and intense. When I was about 20 years old, I was finally able to let it go; recognizing that it was a ridiculous, meaningless thought and that God knew that too.

Common Obsessive Themes in ROCD

The types of obsessive thoughts that are often found in individuals with ROCD tend to center around one of the following:

  • Incorrectly performing a religious ritual or duty
  • Fearing that you have done something unforgiveable and will go to hell
  • Fearing that you have lost your salvation or were never really saved
  • Fearing that you have done something blasphemous or sacrilegious
  • Obsessing about whether or not you did the right or moral thing

Common Rituals (or Compulsions) in ROCD

With all types of OCD, rituals – or compulsive behaviors – are performed to alleviate anxiety. With ROCD, these often include:

  • Constantly seeking reassurance (e.g. that you’re saved, forgiven, not an immoral person)
  • Praying for forgiveness for the same thing over and over
  • Praying for other things repetitively
  • Looking for "signs" that God heard your prayer, forgave you, etc.
  • Engaging in nonsensical mental rituals (e.g. counting things)


While ROCD can certainly strike highly religious individuals, like Jenny, it is not limited to that. Anyone – even an atheist or totally non-religious individual – can develop ROCD as well.

Treatment for ROCD

As a general rule, the most effective type of treatment for ROCD is Cognitive Behavioral Therapy (CBT). This type of therapy addresses the irrational thought patterns and helps you develop healthier ones. Many people with various types of OCD have found this type of therapy to be very beneficial.

Medication may be warranted in some cases, particularly if your day-to-day functioning is impaired, or if you have significant symptoms of depression. The medications most often used to treat OCD are Anafranil, a tricyclic antidepressant, and SSRIs (selective serotonin reuptake inhibitors) such as Paxil and Zoloft.

It’s important to seek treatment as soon as possible if you are experiencing symptoms of ROCD. Rather than suffer for years, like Jenny (who was fortunate in that her symptoms did eventually subside on their own), start working with a skilled therapist. The right treatment can help significantly reduce your symptoms, and in some cases, eliminate them altogether.