Description

Scrupulosity is a form of obsessive-compulsive disorder focused on religious, spiritual or moral themes. For individuals associated with the Church of Jesus Christ of Latter-day Saints, common symptoms of scrupulosity involve obsessive feelings on unworthiness, excessive urges to confess to ecclesiastical leaders or repent, overwhelming feelings that they don’t have enough faith, and high levels of anxiety associated with scripture study, prayer, and temple worship. Although some individuals leave the Church to try to escape their symptoms, scrupulosity is a problem of anxiety not of faith. As such, it is critical that affected individuals receive appropriate, evidence-based treatment for obsessive-compulsive disorder, primarily exposure and response prevention (ERP), so that they can deal with their underlying anxiety problem.

This treatment approach supports clients in making a values vs anxiety-based decision about whether or not to remain in the Church. It is especially important to treat this population with exposure because many other treatments, including all forms of talk therapy, that are widely used to support people navigating social and emotional dimensions of faith transitions can make OCD worse by creating unhelpful opportunities for reassurance- seeking behavior that fuels the OCD cycle.

I will provide an overview of the diagnostic criteria for scrupulosity, including assessments that might be helpful for clinicians, and common symptoms of scrupulosity I see in the Latter-day Saint clients with whom I work. I will also explain the fundamentals of ERP and give examples of common exposures used with LDS clients. Finally, I will give clinicians resources and referrals they can use when working with clients with symptoms of scrupulosity.

Speaker

Claire Breedlove