Authors have given various descriptions of the scrupulous disorder over the years. Many have been helpful and insightful. Some, less so. Others have given sufferers a false sense of relief by inaccurately integrating the disorder’s spiritual, psychological, and moral aspects.
The designation of scrupulosity as “the doubting disease” has been embraced and accurately focuses on an observable condition of the disorder. Those who experience the disorder understand, in one author’s words, that scrupulosity is the experience of doubt resulting in “a thousand frightening fantasies.”
I have used several descriptions over the years.Now, after a few years of dedication to intense counseling sessions and group spiritual direction with the good men and women who struggle with this disorder, I am redirecting my thoughts. I prefer a description of scrupulosity that I believe accurately pinpoints the real suffering that is experienced and endured.
Each sufferer lives through seemingly endless questions, repetitive behaviors, compulsive rituals, shame, guilt, and persistent anxiety. All are symptomatic of the disorder. Shame, guilt, and persistent anxiety are real, not imagined, and the repercussions are real.
The real suffering of the scrupulous disorder stems from the person’s inability to trust the authenticity of his or her feelings, emotions, and sensibilities. Scrupulosity leads to a profound loss of the true self. The inability to routinely trust the feelings associated with a particular action is a real threat. Scrupulosity disassociates people, disconnecting them from the experience of interpreting real and meaningful anxiety, fear, and shame, which can be useful tools for awareness and understanding. Instead, they become obstacles to healthy living.
In short, whatever the feeling might be and the experience of that feeling, the interpretation of why the feeling is generated is not trusted by the scrupulous person. Those who don’t have scrupulosity usually know their feelings are being generated by an authentic experience. A scrupulous person is deprived of the assumption of authenticity. The feeling is real, but the interpretation of the feeling cannot be trusted.
Such is the cruel suffering that the disorder generates. It deprives a person of the ability to evaluate feelings. Without that tool, life turns upside down.
When life goes topsy-turvy, the questions and doubts are numerous and completely understandable. Without anability to judge a feeling, how can a person know what is authentic and what is not? When the “compass for deciding” is malfunctioning, we lose our way. Asking questions and seeking reassurance should be expected. Such needs are cries for help as the scrupulous person seeks to be connected again with the ability to trust.
People with scrupulosity are often perceived as having an unrealistic need for clarity. I do not believe their need is unrealistic. How will they get clarity unless they ask? When a scrupulous person asks for reassurance, that person is really saying, “I sincerely do not know and cannot determine the difference. I am filled with confusion, doubt and fear and I am only seeking relief. I am seeking, if only for a moment, what you have all of the time.”
I understand that the person who does not suffer with scrupulosity may feel peppered by questions and exhausted by the need to constantly reassure another. What is the best response? Refuse reassurance? Deprive another of a need for clarity and assume that it is acceptable for that person to live life on the edge? I am convinced that it is not acceptable, but it is important to understand the context and content of the doubt and the question.
Scrupulosity reveals itself when the person needs to clarify and define what each experience meant or will mean. The result of all of this expenditure of emotional energy is always catastrophe. While scrupulosity can exist in the present and future, it cannot exist in the present moment. It feeds on the past and on the future but is effectively denied any energy or nourishment in the present moment. The present moment can only be experienced. It cannot be judged, evaluated, or graded. It is what it is. Scrupulosity is a barrier to the present. It prefers the past and the future, and it thrives in confusion.
The only way to manage scrupulosity is to radically reorient perception. This is difficult to grasp. Reorienting requires disengagement from the human systems that are anchored in the past or projected into the future. People struggling with religious scrupulosity must be reoriented away from spiritual and religious practices that require examination, anything more than simple presence, and any activity that introduces new content for consideration.
Spiritually, one is reoriented to the Present Now, a classical identification of the presence of God. God only exists in the eternal now. I know that is hard to understand, but perhaps that is why we identify it as a mystery.
Knowing that this is the truth, the most useful response to people suffering with the scrupulous condition is to help them focus on the present moment. In the Catholic tradition, contemplative prayer and practice is the key. Also, good spiritual direction, professional counseling, and targeted medical care can support the management of the disorder.
The real suffering of scrupulosity occurs when one is deprived of his or her true self. The only management skill that is helpful is to embrace the present moment. Every other strategy seems to me to be useless, at best a distraction, no matter how well-meaning it might be.