Skip to content

Defining Scrupulosity Correctly

There many words and phrases that are used to explain what it means to suffer from scrupulosity. Some resemble a book title, like “the doubting disease” or “a thousand frightening fantasies.” Others are phrases that are in the scrupulosity lexicon, including “a sensitive conscience” and the experience of “constant nagging thoughts that will not go away.” 

These are helpful, but I prefer to give scrupulosity a psychological definition: Scrupulosity is a mental disorder. From a psychological standpoint and a moral perspective, a mental disorder is a health problem that affects the way we think about ourselves, relate to others, and interact with the world around us. A mental disorder affects our thoughts, feelings, abilities, and behaviors. Mental disorders, including scrupulosity, can cause significant distress or impairment of personal functioning. The features of a mental disorder may persist, relapse, and remit, or they may occur once.

Defining scrupulosity as it truly is—a mental disorder—has two key benefits. The definition can free sufferers from crippling self-blame when they experience scrupulous feelings. The meaning is also essential to grasp for people who work with sufferers, such as confessors and spiritual directors. 

While spiritual components are present in the disorder—particularly in the way anxiety is experienced and described by the person who suffers from it—spiritual-only remedies are usually ineffective in managing scrupulosity. Behavioral and psychological therapy, including therapeutic drugs, are usually more effective and have greater potential to provide significant relief and management. Unfortunately far too often, therapeutic approaches aren’t used to help the sufferer because of the false belief that scrupulosity is somehow God’s will. 

Notice I refer to the “management” of scrupulosity and not a “cure.” There may well be an ebb and a flow of intensity to the manifestation of the disorder for the sufferer, but seldom is there a complete and total remission. The disorder typically is always present, requiring consistent management in order to achieve a sense of peace and well-being. As with all mental disorders, it can’t be willed or prayed away. Unless there’s a miraculous intervention by the grace of God (which I don’t rule out), scrupulosity must be managed. Thus, it’s far better to work with God-given management gifts than it is to await a miracle.

Once we accept that scrupulosity is a mental disorder, we can try to understand how it’s experienced. The vast majority of sufferers experience scrupulosity through compulsive questions about sin, mostly centered on compulsion over a specific theme, with numerous questions arising. Each question is anxious and frantic, building an explosive energy that the sufferer wrongly thinks can only be moderated by engaging in ritual behavior such as multiple confessions, repeated prayers, or other actions. The process then begins again, each time with more anxiety and fear. The cruel result is an energized manifestation of the disorder and a false promise of peace and resolution, if only temporary.

The experience is further complicated and worsened by a basic misunderstanding of what sin is and, usually, a warped concept of the nature of God. These off-kilter components make the suffering more intense. Unfortunately, a misunderstanding of sin and a warped concept about God can detour the management of the disorder and thus interfere with the effectiveness of correct catechetical understanding and sound behavioral therapy. 

Sufferers and well-meaning caregivers who take  only a spiritual approach to treating scrupulosity can and often do compound the problem. For example, sufferers who are Catholic may wrongly believe that their caregiver is trying to make them sin or is not in step with Catholicism. Uninformed caregivers who don’t understand that scrupulosity is not a spiritual problem but a mental disorder may give incomplete, unhelpful advice and direction.

Caregivers and scrupulosity sufferers may not notice that a continual asking of questions is part of the disorder. After all, everyone poses questions in a spiritual journey. However, when questions, feelings, and interpretations of experiences intrude into a peaceful life and make a person feel trapped into an obsessive, compulsive examination that’s unending and never satisfied, scrupulosity could well be the probable cause. People who exhibit this obsessive and compulsive behavior should seek professional help.

Indeed, a professional diagnosis of obsessive-compulsive disorder (OCD) may help sufferers and their spiritual caregivers by putting the problem in the mental health arena, thus helping ensure that the person with scrupulosity will receive attention that will help lead to greater peace. In addition, for some people, participation in an OCD support group helps manage the disorder. 

And for the scrupulous person to progress, it’s also crucial that his or her confessor or spiritual director understand, support, and never interfere with the directives of mental health professionals. In order to accomplish the goal of peace in the person’s life, everyone must understand what scrupulosity is: a mental disorder, not a spiritual one. 

Published inCover Articles