What is scrupulosity? The simplest answer, and perhaps the traditional answer, is that it’s an age-old problem that was long understood as a “tender conscience.” Great saints have spoken about it and have counseled their followers about it. Still others, such as St. Alphonsus Liguori and St. Ignatius of Loyola, had it. Many people understand scrupulosity to be a religious problem, and others see it specifically as a Catholic problem.
For many years, mental-health professionals dismissed scrupulosity as a symptom of neurotic behavior, but scrupulosity has been long recognized by priests, rabbis, and spiritual directors. Only recently has it been understood as a possible subtype of obsessive-compulsive disorder (OCD). Recent studies suggest that approximately 3 million people in the United States have OCD; about 6% of this group (about 180,000 people) have religious scrupulosity.
People with scrupulosity describe it as “thoughts that cannot be shaken,” being possessed by “a thousand frightening fantasies,” or being unrelentingly “pricked by a pin.”
Joseph Ciarrocchi, PhD, author of The Doubting Disease (Mahwah, NJ: Paulist Press, 1995), identified the core experience of scrupulosity as “an intrusive idea, often associated with a sinful impulse, which the person abhors but cannot shake.” Good people from all walks of life find themselves possessed by a thought or desire that won’t go away. Even when they realize they’re obsessing, they can’t summon the logic or rational argument that would help. The thought continues to disturb them through no fault of their own.
Since their obsessive thoughts are associated with faith and spirituality, their entire experience of faith is marked with anxiety and fear instead of peace and strength. People with scrupulosity are doing all they can to believe and be hopeful, but they just can’t shake the sense of impending doom, disappointment, or eventual condemnation.
But not all is gloom. Prescription medicines and behavioral therapy have proved quite helpful. St. Alphonsus said, “Obey in all things your spiritual Father, for by the practice of obedience you will always be secure. And doubt not that if you practice it you will be saved, and will become a saint.”