87 Scrupulosity: When OCD Gets Religion

Summary: In this episode, we explore the conventional secular and the traditional spiritual ways of understanding scrupulosity, bringing in the experts to define scrupulosity, tells us the signs of being scrupulous, speculate on the causes of the trouble, discuss that standard remedies in the secular and spiritual realms.  Then I share with you my views on it, looking at scrupulosity through an Internal Family Systems lens, grounded in a Catholic worldview.   We discuss how parts have different God images and the role of shame and anger in the experience of scrupulosity.   Description of Scrupulosity
 Suddenly my stomach tightens up, there’s a choking in my throat, and my torture begins. The bad thoughts come. . . . I want to drive them out, but they keep coming back. . . . It is terrible to be in a struggle like this! To have a head that goes around and around without my being able to stop it; to be a madman and still quite rational, for all that. . . . I am double. . . . at the very time that I am trying to plan what I want to do, another unwanted thought is in my mind. . . . Distracting me and always hindering me from doing what I want to do. 

--  Quoted in Albert Barbaste, “Scrupulosity and the Present Data of Psychiatry,” Theology

Digest, 1.3 (Autumn 1953) 182.

Fr. William Doyle: Around 1900  “My confessions were bad. My confessor does not understand me, he is mistaken in me, not believing that I could be so wicked. I have never had contrition. I am constantly committing sins against faith, against purity. I blaspheme interiorly. I rashly judge, even priests. The oftener I receive Holy Communion, the worse I become,”  Around 1900My story just turned 19 -- terrible bout of scrupulosity.  Around sexualityJust started dating the first woman I might consider marryingPhysical touching -- romantic contact How far was too far?
 Thoughts of sex with her -- plagued me.  
Do I break up with her?  How do I handle this? What was sinful, what was not?  Was I on the road to hell?  Was I putting her on the road to hell? I thought I was going crazy.  
Review: I encourage you to review the last episode, number 86 -- Obsessions, Compulsions, OCD and IFS
 That episode went deep into obsessions and compulsions and  serves as a basis for today's episode.  
Today's episode, number 87 is entitled Scrupulosity:  When OCD Gets Religion and it's released on December 6, 2021, St. Nick's Day. 
I am Dr. Peter Malinoski, clinical psychologist and passionate Catholic and together, we are taking on the tough topics that matter to you.  We bring the best of psychology and human formation and harmonize it with the perennial truths of the Catholic Faith.   Interior Integration for Catholics is part of our broader outreach, Souls and Hearts bringing the best of psychology grounded in a Catholic worldview to you and the rest of the world through our website soulsandhearts.comOverview
 Start out with definitions of scrupulosity both from spiritual and secular sources, really want to wrap our minds around what scrupulosity is and the different types of scrupulosity. We will discuss the connection between scrupulosity and OCD -- discussion of OCD We will then move to the signs of scrupulosity -- how can you tell when there is scrupulosity? Then we will get into the internal experience of scrupulosity.  What is it like to experience intense scruples?  Had a taste in the intro, but we will get much more into that.  
We will discuss what religious and secular experts have to say about the causes of scrupulosity Then what religious and secular experts have to say about the treatment of scrupulosity -- that most recommended therapy approach and the medications typically prescribed.  
After we've discussed the conventional secular and spiritual approaches to treating scrupulosity, I will how I think about scrupulosity, the root causes of scrupulosity, and how scrupulosity develops and how it can be treated.  I will give you an alternative view, grounded in a Catholic understanding of the human person and informed by Internal Family Systems thinking.  
Definitions:  You know how important definitions are to me.  We really want to make sure we understand what we are talking about.  Scruple comes from the Latin word  scrupulum, "small, sharp stone" -- like walking with a stone in your shoe.Ancient Roman weight of 1/24 of an ounce or 1.3 grams.    Something tiny, but that can cause a lot of discomfort.  Definitions from Spiritual Sources
 Fr. William Doyle, SJ.  Scruples and their Treatment  1897: Scrupulosity, in general, is an ill-founded fear of committing sin. Fr. Hugh O'Donnell:   Scrupulosity may be defined as a habitual state of mind that, because of an unreasonable fear of sin, inclines a person to judge certain thoughts or actions sinful when they aren't or that they are more gravely wrong than they really are… Scrupulosity involves an emotional condition that interferes with the proper working of the mind and produces a judgement not in accordance with object truth, but with the emotion of fear. 
Fr. James Jackson, article "On Scrupulosity" A very good definitionScrupulosity is an emotional condition, an ultra-sensitivity to sin, which produces excessive anxiety and fear from the thought of eternal damnation…This condition is a religious, moral and psychological state of anxiety, fear and indecision. It is coupled with extreme guilt, depression and fear of punishment from God. However, each person who suffers from it does so uniquely.
Fr. Marc Foley:  The Context of Holiness: Psychological and Spiritual Reflections on the Life of St. Therese of Lisieux
 Excellent, very psychologically informed study of the Little Flower Not only the best psychological profile of St. Therese of Lisieux, but the best psychobiography of any saint from any author I've read. A very in-depth look at her mother, St. Zelie as well and the limitations and lack of attunement in the Martin family Highly recommended reading -- all of chapter 12 is on The Little Flower's scrupulosity.  
Scrupulosity is an extremely painful anxiety disorder. It consists of annoying fear that one is offended God or could offend God at any moment and that God will cast her into hell. To protect yourself from eternal damnation, the scrupulous person dissects every thought, motive, and action in order to ascertain if she has send. And since she is deathly afraid that she might have sent, the scrupulous person seeks absolute certitude that she hasn’t send in order to assuage her fears. 
Definitions from Secular Sources
 Timothy Sisemore, Catherine Barton, Mary Keeley From Richmont Graduate University   Scrupulosity is a "sin phobia." 
Jaimie Eckert, Scrupulosity Coach:  Scrupulosity is where...