In this episode John Dehlin discusses his Masters thesis research on Scrupulosity (religious/moral Obsessive-Compulsive Disorder). This presentation covers: 1) an overview of obsessive-compulsive disorder, 2) an overview of scrupulosity, 3) a review of the most common treatments for OCD/Scrupulosity, and 4) the results of John’s recent study of Acceptance and Commitment Therapy as a treatment for Scrupulosity.
20 Responses
I’m about halfway through the podcast. I suddenly have realized that my “Scrupulosity” is entirely linked to Mormon Stories Podcasts. I can’t sleep, I can’t eat, I sit with beady eyes and burning ears and listen hour after hour after hour. I want to yell (scream) at John Dehlin, please make these go away…
Just kidding John. I loved this episode. I still only embrace the podcasts I have a real interest in. I wake up every morning loving another day under California skies. Tomorrow will be my second week attending Friendship Baptist Church, a mostly black congregation with the most amazing choir in the whole county. The church sits directly across the street from my former ward house (I wonder if there is a psychological basis to that?) Friendship has 5,000 members, it’s parking lots overflow. At the close of last weeks service a couple dozen people came up to welcome me, but none asked for my complete name, address or phone number. They simply invited me back in the future… Nirvana! Shalom! Hallelujah!
Thank you for your work in this area, John. What advice do you have for family members of someone with scrupulosity but who is adverse to therapeutic intervention?
Lisa – Loving patience? Persistence? Will they read books? Will they listen to a podcast? What are they willing to do?
I don’t know at this point–I think we’re all so afraid that bringing it up with our family member will act as a trigger that we avoid the subject altogether. I have mentioned the previous podcast you did on scrupulosity to my family member in what I believed to be a non-threatening manner, but it was met with a lot of anxiety/avoidance due to what I perceived as an incredible amount of shame. It’s hard to know whether my attempts at normalizing or recommending resources will lead to an improved situation or only make matters worse. I don’t expect you to be able to provide specific recommendations to my situation, as you don’t have adequate information on our family system to work with, but are there reading materials/general principles you can point to that might be helpful for family members trying to assess how best they can help?
Can you email me the paper
Great work, John!
Just a couple of comments about OCD. Let me preface them by saying that I am not a medical professional, and I am just spouting my own opinion.
Readers should always depend on their physician for research conclusions regarding OCD, or any disorder.
Many medical professionals who read this will likely see errors in my below presentation.
I was a pharmaceutical rep. and called on psychiatrists with drugs which were indicated for OCD.
I’m sure that your research will add to the overall knowledge of this disorder, particularly in regards to it’s expression in all religions.
Also, I’ts likely that every orthodox family – Jewish, Mormon,Catholic has a family member whom they believe should be under the care of a medical doctor for this disorder.
OCD also presents itself in non-religious ways, of course.
In talking with physicians about OCD, I found that each believed that every human has OCD tendencies. Human brains, by nature, are programmed to consider the entire range of – let’s say righteousness. Accordingly, evil (very evil) and righteous (and very rightious) thoughts (and actions) run through or pop-up in the most normal of minds, according to physicians.
Those who love those under the care of a physician for this disorder should take heart in knowing that the medical community deeply cares for you and your loved ones.
Sufferers of OCD will engage in behaviors which – to them – are connected with their obsession, and these in turn will lessen their anxiety, so they hope and believe.
Unfortunately, if compulsions/behaviors worked (washing hands, pulling hair, other repetitive behavior) they would satisfy the obsession, and the behavior would then end. This is not the case for most.
I believe that the early apostles suffered from a degree of OCD, and Joseph Smith even more.
In most OCD cases, the disorder comprises only one element of a constellation of co-morbid CNS disorders, anxiety and depression for example. The underlying cause for most of them rooted to certain CNS transmitters.
Joseph Smith – IMHO – suffered from several CNS disorders simultaneously, which expressed themselves as morbid self absorption – narcissism, bi-polar disorder and schizophrenia, and maybe epilepsy, which I tend to doubt. Mental illness form and severity is typically is associated with an age of onset, and Smith’s profile suggests just this. I believe that he was depressed as a child and young adult, and in the absence of therapeutic and pharmaceutical interventions, Smith engaged in behaviors meant to lessen it – narcissism. As he grew older, his depression continued and his dna allowed for schizophrenia in his late teens and early 20s.
Narcissism explains his treasure hunting – only he could find treasure.
His schizophrenia – hearing voices – explains his revelations.
His bi-polar explains his surrender to answer Expositor charges. He normally went into hiding during periods of stress when the law was after him, and then during these would “flip” into mania – a “high”. These highs would help explain his creativity in coming up with revelations like baptism for the dead.
Unfortunately for Mormonism, the form of christian science he developed – beginning with the Book of Mormon and ending in the very mysterious collection of self naming appellations for himself and Cowdery in the D&C – provide a unique – Mormon – algorithmic way of thought.
His OCD is observed by prescribing compulsions to satisfy an obsession to invoke the blessings of God.
You have to keep the commandments to merit a blessing. He went on to say that when we receive any blessing, it is by obedience to the laws and ordinances of the gospel.
That’s great, except when he starts blaming Zion – the collective church body – for the absence of blessings or as an explanation for persecution.
His members bought his accusation of sin, and the need for more obedience (compulsive behavior). The need to be obedient to Smith’s outbursts brought about compliance to polygamy, and pass/fail tests for Emma. “Emma, you need to let my servant Joseph have his women”. If you don’t, then……..you just wait!
Smith’s mental illness has been transferred to a member of my family who pays 11% tithing. He/She engages in behavior – repetitive every paycheck – to be more obedient. He/she would live polygamy if so instructed.
This is wrong, and many LDS members will recognize it as such.
Nevertheless, Smith’s CNS disorders will be forever woven into LDS fabric and will be seen as normal by them.
Thanks for the informational back ground on your findings on scrupulosity. One point of interest to me stood out was at the end in a question from a fellow at the 1:19:50 mark about a note being passed to a girl about modesty. I did not find that particular event to be so much scrupulous as it was in the Acting In rather than Acting Out by a person caught in their own mental maze of addiction. I would like to see more information on the differences bewteen Acting In versus Acting Out layed out described and studied more in depth.
Oh and you were more than enabling kind in referring to how church leadership could improve their style of teaching that creates Scrupulosity behaviors by requiring singing or other thought control devices. Maybe truth in all things would alleviate personal distress for people to not develop tendencies and circular traps in the first place. Religious hypocrisy is entwined in the temple recommend interview questions themself. How can a religion ask a person if they are honest in their dealings with their fellow man when the religion itself hides and distorts facts, challenges duty and obedience to the organization over personal revelation and being true to one’s self? The inner conflicts do arise from people being taught that the church is God and the church is perfect. Pre-emptive or proactive steps go further into causation rather than treatment alone.
Great research. I learned a lot.
I appreciate your making the point that religion shouldn’t be considered a cause of OCD. But it did remind me of this document:
https://www.i4m.com/think/photos/mormon-oral-sex.jpg
Statements like “If a person is engaged in a practice which troubles him enough to ask about it, he should discontinue it.” certainly can’t help a person who is already compelled to ask and confess everything.
I’ve avoided commenting but feel I need to share a bit of my own story as this podcast and discussion have been very helpful to me as I reflect on my experience.
I developed a scrupulosity-like condition toward the end of my mission – 22+ years ago. I’m sure some of this was due to my own personality and genetics, but much of it also had roots in the constant striving to be “worthy” and never feeling like I measured up. Messages like those contained in “The Miracle of Forgiveness” made things worse. Combined with the extreme stress and anxiety of a Type-A introvert thrust into public proselyting, something finally just broke and I began to experience uncontrollable, irrational thoughts and fears about sin and worthiness that lasted, with variable intensity, for some years. Sometimes it was very bad and very dark.
This story has a somewhat happy ending though. A kind-hearted and liberal-minded singles ward bishop, modern meds, a wonderful marriage of 20 years thus far, and a very carefully managed relationship with the church (I only do what I am comfortable with) have allowed me to come to a place of considerable peace.
To anyone who might be struggling – hang on, seek help from someone truly knowledgeable, qualified, and trustworthy. It is not your fault and you can overcome this in time.
Yeah, Miracle of Forgiveness is ironically named. It does not facilitate an experience of forgiveness. The best mainstream Mormon antidote I have come across is the book “Believing Christ.” I’d highly recommend it if you haven’t read it. Anyway, I can very much relate to your comments. Thanks for sharing.
Your podcast was very interesting.
Can religious OCD take on the
following characteristics, and if so, what would it be called:
1. Life’s obsession is to seek for new spiritual
knowledge and teaching others (carefully chooses who is ready to be taught)
2. Discovering new spiritual knowledge is
thrilling
3. Heroes are fundamentalist-types (Joseph Smith/Brigham
Young/Orson Hyde) Believes that Joseph Smith was even more consistent in his
behavior than Christ was.
4. Clings
to early fundamentalist teachings
5. Accepts weird doctrines
6. Teaches
a new spin on doctrines
7. Believes he has the answer to all problems
through his spiritual knowledge
8. Is
blind to most of his own flaws. When it’s
a matter of spiritual knowledge of discernment of someone’s character he has to be right.
9. When
there is conflict, he attributes the fault to the other person (who he believes must be
under the influence of the adversary)
10. Calls family members to
repentance over small problems or a lack of spiritual growth / ends up pushing them away
11. Obsessed with teaching
others
12. Believes he is favored by
God because of his desires to advance
spiritually / is God-like or perhaps
already has reached God status in mortality and
that others can do this too
13 Believes he has a
God-given calling to teach others and help them during
latter-day calamities
This describes a close family member.
I’m sorry that the formatting of my comment got scrambled. I don’t know what happened to it.
A few months ago, there was a missionary assigned to my stake. He did a lot of damage with members and investigators because of his strong, zealous approach. It got to the point that a member of the mission presidency actually had to accompany him to every appointment. His behavior was really quite shocking (calling members and investigators to repentance; always strongly pushing baptism; telling everyone of his high-number goals, etc.)
Listening to this podcast has helped me understand this condition (I was never even aware of this before), and I view this young missionary with much better understanding and sympathy now. I didn’t think he should be out as a missionary, and it gives me a bit of comfort knowing that this is part of an OCD condition which can be treated.
Thanks. I’ve learned something.
I appreciate your work in bringing this into focus. I am LDS form the UK and have had some interesting times. I was first identified as having OCD around a decade ago but listening to some of your scrupulosity podcasts has been good for me. I note that in the past there was some chat about a scrupulosity stories podcast. I would like to hear some of this. I have started blogging about my experiences (www.mormon-ocd.blogspot.com) and hope that it would be of value to let folks know about my experiences as they happen.
I have lived with OCD since the age of 17, just never knew what it was. It all started when I went in for an interview with my bishop to serve a mission. He told me that if I didn’t confess every sin in my life, I would “burn up’ with guilt in the mission field. From that day forward, I never let myself stop searching my memory for sins I may have committed yet forgotten about. It was on my mind everyday of my mission and for most of my adult life. I’d even ‘invent’ potential sins that I may have committed in many particular instances. The ‘driver’ of my OCD, bottom-line, has always been the belief that if I don’t confess every sin I’m going to hell, especially sexual and serious sins. I believe the mind can create ‘false memories’ and ignite an unquenchable flame of anxiety regarding one’s eternal state. I’ve had to tell myself that God will forgive me, even if I did bad things I forgot about. The God I learned to worship, though my Mormon experience, was a God of harsh, black & white, confess-it-or-burn kind of God.
I’ve been treated for twenty years now but I must add that my leaving the church helped me to lower my worries, change the focus of my life to the ‘now’ rather than obsessing about eternity in hell. My compulsions were mostly mental (pure “O”) checking, which caused me to lose out on a lot of great opportunities due to the impact on my self-concept.
I hope anyone who reads this shares the importance of focusing on ‘behavior change’ and not clean-it-all-out confessions that never seem to be enough. Too much emphasis has been placed on confession to bishops and a ‘behavioral’ paradigm of living. We need a holistic perspective including the psycho dynamic and cognitive/social issues that contribute to sin. We don’t just choose sin because it makes us happy, we choose sin as a maladaptive method of dealing with pain. If the root of that pain is caused by scrupulous self-examination and never ‘measuring up’ to the high standards of the church, maybe we need to stop the perfection-type thinking and let ourselves be human.
doctor –
Your post sounds almost like I had written it myself. This is exactly how my OCD struggle began – with the whole “complete confession” mantra in preparing for a mission. Now that I look back on my youth experience, I realize just how generally good and “worthy” (hate that term) I really was, but still came to feel like I was horrible due to all the sexual desire I struggled to keep bottled up. The MTC experience amplified the whole thing and I “confessed” several times during my mission “just in case” I had forgotten something – even though there was very little to remember in the first place. The confession process itself led to a temporary reduction in anxiety so it was desirable in many ways. I feel a bit sorry for my mission president now…
With medication, I was mostly well until a BKP general conference talk about 10 years ago. Had to go back on the meds but am now doing very well again. But that was the beginning of the end for me as a TBM – the church just never looked the same again after that episode. Everyone means well in preaching the “tough love” gospel, but there seems to be a lot more “tough” than “love.”
Thank you for this and the other podcast on scrupulocity. I was diagnosed with OCD about 14 years ago. It wasn’t until later that I found out about what scrupulocity was and that it was a large part of my obsessions. I came back to the LDS church about a year ago and have been through quite the repentence process, including multiple confesses, a displinary counsel, and then more confession. I have tried to find some rules for confession to no avail, such as do I need to reconfessess sins of a previously confessessed nature, or ones that may naturely be part of leading up to that greater sin? For example knecking, light petting, are pretty much on the way to fornication. Does one, having confessed fornication, really need to go back in “fill in all the blanks” of less-serious sins? And what if another instance of fornication is remembered after that meeting, does that separate incident need to also be confessed? I’m beginning to feel like I’m ticking down a list of Law of Moses rules when I’m trying to do is get things behind me.
When I ask my Bishop, he simply says if you feel like you need to come and talk to me, then do it. That may work great for people without OCD, but for me it’s an open invitation to search every memory and dig up even some previously confessed ones from over a decade ago and take them to him. I, of course, see the vicious cycle in this, but the anxiety of wondering if I’ll be met with surprise and denied the Celestial Kingdom is so strong. I actually took today off work because I have a monthly meeting with the Bishop and I felt too distracted and ill to work. Thank you for any insight or comments.
Scruples,
I feel so much of your pain. I have been dealing with intense scrupulosity for the past 5 years. Some days are more manageable than others, but rarely do I feel good. There’s always something looming in my mind to confess if I search for it. Recently I went back and thought upon and reread my confessions that I have made through the years. Many of these confessions I had to start writing down and giving because I would forget afterwards if I had confessed everything and confessed it right. I found myself splitting hairs over wording, and having to reword everything over and over again. The more I thought about it, the more the list grew. What started out as a small list grew to three pages of confessions. I gave it to my bishop and upon returning he told me that he only read a part and could see that it was clearly OCD. I know I have scrupulosity, but it was so difficult to hear that he didn’t read everything I wrote, essentially making all that writing and confession useless.
I have begun to take a new outlook on things. As I look back I can see that I have been robbed of five years of my life, completely robbed. I have passed through hell on earth as I call it. I’m sure much of this you relate to. I have days where going to work and associating with people honestly makes me sick. The Lord can’t possibly desire this for his children. I have to believe the Christ’s atonement makes up for our imperfections, including our imperfect confessions. I can’t imagine meeting the Lord as a polished individual through so much innocent suffering (although in our minds the thoughts and worries seem valid), and having him not love us and deny us his kingdom for a checklist of words and details that we didn’t confess. The hardest part of this is to have that faith in Christ and trust in his mercy.
All this being said, I still fight everyday with this. It always helps to find strength from others and I pray for all others that suffer like I do. Feel free to contact me.
I have only recently been diagnosed with OCD. I have spent the last 13 years being told it was Anxiety and Depression. This may be because I never told my doctor what my thoughts were, scupulous thoughts, as I was embarassed or thought he wouldn’t get the religious aspect. Having then found information online that described my symptoms better than anything has before, I went to the doctor and told him my thoughts. He said the subject of thoughts were just as important as the physical symptoms and told me I had OCD and changed my medication straight away. Now I am feeling better than I have for a long time, though still struggling and getting my head around the fact it’s OCD and not generalised anxiety. To offload my thoughts I’ve started a blog at http://www.ldsruminations.blogspot.co.uk. If you want to follow, please do so. I can ramble on a bit though. I have found in the last few weeks that writing down thoughts is really helpful and thats the reason behind the blog.