Catholic and OCD

I’ve mentioned in the past that OCD involves a disordering of the passion of fear/anxiety. As the years have slipped by since my counselor first mentioned this, a further epiphany has slowly dawned on me. The Catholic tradition identifies a specific virtue to regulate the passion of fear: courage.

This puts a positive spin on one of the major goals of OCD treatment. Those of us who have OCD need to grow in our ability to resist our compulsions. However, sometimes it is hard to pursue a negative goal like “not doing” something. If we frame this as taking a courageous stand against disordered fear, it suddenly becomes a positive action. I can choose to identify, acknowledge, and stand firm against my irrational compulsions. I can choose to move forward with my life, rationally and…courageously.

I have mentioned elsewhere that the “gold standard” treatment for OCD is Exposure Response Prevention (ERP), which works by scaffolding exposure to increasingly severe OCD triggers while preventing compulsive responses. I have come to think of this treatment as a structured way of cultivating courage. Ordinarily, in this fallen world, virtue cultivation requires grace and effort, but progress is possible. When emotions are disordered to a pathological extent, the strategies required to regulate them are commensurately more intensive, and may need to involve expert professional support.

This dynamic is analogous to the difference between someone for whom moderate exercise and a balanced diet are sufficient to support continued and improved health, and someone who needs targeted physical and pharmacological therapies, along with a highly specific diet and exercise regime, to achieve health. The end goal is the same: physical health. However, it is clear that some people require more support than others in getting there.

As a Catholic with OCD, I have come to see the virtue of courage as my goal, and the war between fear and courage as the defining challenge to my growth towards wholeness and sanctity. The irony of this is that my OCD often tries to convince me that my compulsions are the “difficult but courageous” choice. This is one of its primary tactics to browbeat my reason into submission. It argues – quite persuasively – that my desire not to fulfill compulsive demands is cowardly, selfish, and worldly. Gripped in terror for my integrity and my soul, I feel that I must immolate my better judgment on the altar of Doing the Hard but Right Thing. This is all a lie, though. Standing up to my fear is just has hard as giving in to it, but far more life-giving.

To put this into concrete terms, I have a long history of scrupulosity which has impacted my use of the sacrament of confession. Disordered fear is the driving force that goads me into scrupulous behaviors like re-confessing old sins, confessing things that aren’t even sins, and scouring my soul until it figuratively bleeds in the confessional. When I am in the grip of that fear, I feel like this painful process is difficult because I am weak, and because I am embarrassed to confess shameful “sins.” Since embarrassment would be a pathetic reason to go to Hell, fear tells me that I must have the “courage” to confess everything.

The truth is that these sins are not actually on my soul, or they are not mortal, or they have already been forgiven. Thus, my deep-seated revulsion towards confessing them is actually reasonable. Courage in this situation looks like not confessing that which I know, deep down, is being dredged up by ungoverned fear rather than by my real conscience. Courage lies in choosing not to give into compulsive confession, acting decisively, and refusing to look back.

This is indescribably counterintuitive for someone with OCD. It is also the path to hope and healing. It is difficult, indeed, because fear is strong; but each courageous action is a blow towards freedom from the tyranny of fear, and a building block towards virtue. It is God’s calling for each of our lives. “Eye has not seen” how great will be the fruit of this obedient submission to His will. It is worth the struggle.