Perhaps if you have found this website, you already know you have OCD. On the other hand, perhaps you arrived here via some combination of keywords like “scrupulosity,” and “vocational discernment,” and you are surprised to find these concepts connected to OCD.
*Obligatory disclaimer: I am not a psychologist. If you feel that your experience borders on clinical OCD or anxiety, I strongly suggest that you reach out to a mental health professional, preferably one who specializes in OCD/anxiety disorders.
Anyway. According to the DSM-V, which is used to diagnose mental health conditions, Obsessive Compulsive Disorder is:
“…characterized by the presence of obsessions and/or compulsions. Obsessions are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted, whereas compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”[1]
Does that ring a bell, or are you still in the dark? Let me offer some common examples to paint the picture.
Scrupulosity is a common manifestation of OCD that particularly distresses Catholics. The obsessions, or intrusive thoughts/urges/images of this OCD subtype, center around sin and morality. For example, someone with scrupulosity might be plagued by doubts about whether a certain thought or action was a mortal sin, unable to shake that nagging fear even though he and his advisors present convincing intellectual arguments to the contrary.
Scrupulous Catholics are often concerned that past actions might have been mortal sins, and further concerned that their attempts to confess these sins have been ineffective or invalid.
Common subjects of scrupulous obsession include sexual sin, blasphemy, sins pertaining to the reception of Holy Communion, and sins impacting confession, such as lying in confession or lacking a firm purpose of amendment. These doubtful “sins” are generally either fabricated or greatly exaggerated, but the OCD Catholic can’t shake their intrusive doubts about them.
Another common topic of scrupulous obsession pertains to prayers and religious rituals, fixating on fears that if one doesn’t do them “right”, they don’t “count.”
Obsessions usually trigger a high degree of anxiety and distress in the sufferer, who then feels the need to “do something” to either reduce or eliminate that discomfort. This is where compulsions come in. Compulsions are “repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.” They are generally irrational or taken to an irrational extent, i.e. they are not a reasonable response to the concern at hand. Nevertheless, the OCD sufferer feels compelled to engage in them to alleviate his relentless anxiety and distress.
Common compulsions of scrupulosity OCD include excessive confession (overly frequent, painfully detailed confession that dredges up every nagging doubt in excruciating detail, in an attempt to obtain “reliable” absolution and/or reassurance that the doubt was not actually sinful). Other scrupulous compulsions can actually involve avoiding confession for fear that it will trigger intrusive/obsessive thoughts, avoiding other trigger situations (i.e. avoiding the opposite sex if obsessions pertain to a fear of impure thoughts), and seeking excessive degrees of reassurance from anyone who will listen.
If the obsessions pertain to prayers and rituals, the corresponding compulsions might include excessively repeating prayers and rituals, as well as either avoiding them or doing them slowly and carefully to avoid the perceived “need” to repeat them.
Another common manifestation of OCD is contamination OCD, which is one of the classic representations of OCD in the media. Contamination obsessions center around the fear of germs, those elusively invisible enemies that seem so terrifyingly outside of our control. Someone with contamination OCD might fear public bathrooms, raw meat, human waste, blood, or even just human contact in general, for thinking that he will contract a serious illness, or worse, spread a serious illness to loved ones.
Some versions of contamination OCD also center around chemical contaminants, such as bleach, acids, toxins, or “chemicals” found in non-organic food.
Common contamination compulsions include excessive hand washing, body cleaning, home and surface cleaning, and avoidance of trigger situations. This can lead to physical health problems (cracked, bleeding hands, excessive exposure to cleaning chemicals, excessive dieting to avoid “contaminated” food sources, etc.). Notably, these precautions extend far beyond the normal, rational precautions appropriate to maintain a basic standard of cleanliness and safety.
Perfectionism OCD, or “Just-Right” OCD, centers around, well, perfectionism. Its broad-ranging obsessions can attack home organization and chores, such as laundry standards, tidiness, etc. It can also impact decision making (obsessing about whether deliberations have been perfect), personal care (standards of dress/makeup/hairstyle), and a variety of other areas, academics, reading, and professional expectations.
Common perfectionist OCD compulsions include doing and redoing tasks until they have been completed “perfectly,” or doing them slowly the first time in attempt to avoid redoing. This category, too, can involve excessive reassurance seeking, particularly when it comes to decision-making. Counterintuitively, perfectionist OCD can result in task avoidance and procrastination, because it makes ordinary tasks seem overwhelming or impossible. The negative consequences include burnout, overwhelm, and the temptation to quit things one can’t accomplish perfectly.
Some sources combine this subtype with physical and symmetry-based obsessions/compulsions, while others split those into a separate category. In these cases, sometimes the “distress” caused by the obsession is less of an outright fear or an anxiety, and more of a feeling of physical discomfort until symmetry has been restored, by means such as tapping the same number of times with both hands, spinning around in the opposite direction to “even things out,” etc.
Another common and especially upsetting OCD theme centers around violent and sexual obsessions, which are intrusive thoughts of a violent or sexual nature (or both), that the sufferer tries desperately to fight, reject, or escape. Considering the Catholic teaching on sins of thought, OCD Catholics are in danger of conflating these intrusions with temptations or sins, although in fact they are terrifying and unwanted, rather than appealing and tempting. For some people, this theme joins up with scrupulosity, forcing them to examine and reexamine these intrusions to determine whether they were sinful, and/or unnecessarily confess them in painful, embarrassing detail.
As expected, these intrusions can give rise to other compulsions as well: avoidance of potential trigger people/situations, avoidance of potential victims or potential “weapons”, re-analysis of thoughts to “check” that nobody was harmed or affected, checking hazards to prevent future dangers, and external reassurance seeking.
While pathological doubt features prominently in many of these subtypes, some sources split it out into its own subtype. The obsessions/intrusions here pertain to feelings or thoughts of doubt/uncertainty, sensations of incomplete deliberation, fears of a terrible outcome if doubts are not fully resolved, etc.
The corresponding compulsions involve over-analysis, reassurance seeking, and re-deliberation. These are mostly mental compulsions, which are difficult to identify from the outside, but very real and damaging nonetheless.
Relationship OCD fixates on personal relationships, often (but not always) of a romantic nature, causing obsessive doubts and fears about the “rightness” of the relationship and the authenticity of our own sentiments and intentions, and/or the “rightness” of the other party, fixating on their minor or imagined flaws.
Compulsions include “checking” on the relationship, “testing” one’s partner, excessive reassurance seeking, excessive analysis, and more.
Some sources identify other OCD subtypes, or split the divisions differently. The reality is that OCD is one disorder that affects a human being as a whole. Nevertheless, it is normal for a sufferer of OCD to experience one or two primary manifestations at any given time, although these can shift over the course of his lifespan.
It is also clear that, while OCD can fixate on and “spin” anything, it manifests in common identifiable themes and patterns across religions, cultures, and nationalities.
This overview does not get into the self-perpetuating nature of the OCD cycle, nor does it address treatment methods. It is intended as a snapshot of what OCD might look like, so that we can begin to identify the problem.
[1] DSM-5, p. 235
Catholic and OCD 