By Kathleen Ririe
What is scrupulosity?
Picture this- you’re out walking on a beautiful path through the woods. The air smells of fresh rain, the trees are extra lush and green, and as the morning light shines through the trees you are filled with a sense of aliveness. UNTIL. You notice a tiny, sharp rock has found its way into your shoe. You try to ignore it, but the more vigilantly you ignore it, the more obnoxious it becomes. No matter how carefully you step, you can’t avoid the rock in your shoe. Soon you become completely engrossed in noticing the pebble and can no longer enjoy anything else the forest has to offer you.
The word scrupulous comes from the Latin word Scrupulum which means a small sharp stone (1), and like the pebble in the shoe- one experiencing Scrupulosity OCD has obsessions and compulsion centered around their religion, their morals, or both that can be annoying at the least and more often, are quite painful. According to scrupulosity expert, Annabella Hagen of Mindset Family Therapy the following are some common obsession and compulsions related to Scrupulosity (1):
Obsessions:
● Fear of offending Deity (deliberately or inadvertently) with blasphemous or sexual thoughts, uncertainty of appropriateness of sexual behaviors, not keeping your religion’s principles perfectly, not serving God or others perfectly.
● Fear of having acted sinfully
● Fear of a punishing God or being condemned
● Fear of religious questions or doubts
● Fear and self-blame for thoughts, feelings, and urges
Compulsions:
● Avoiding anything that triggers unwanted thoughts, feelings, or urges
● Seeking constant reassurance for public or private behaviors
● Repeating religious rituals until you feel God has listened or accepted your offerings
● Washing or bathing to get rid of “sinful” or unwanted thoughts
● Constantly asking or bargaining with God for forgiveness
While these lists are not comprehensive, they help us to appreciate just how insistent the scrupulous mind can be. What can be done to bring relief from Scrupulosity? Studies have shown ACT (Acceptance Commitment Therapy) to be particularly helpful at aiding one from exiting the rumination cycle of thinking and allowing the psychological flexibility to mindfully observe the self and then continue forward in a direction of their values.
Why do Values help?
In ACT therapy, values are defined as guiding principles that govern the way you want to act. As opposed to goals, which insist on tangible achievable outcomes (2), values can be more flexible and allow for success in many different ways. Think about values more like the guiding star on a journey instead of the destination. You can get to the same destination by following many different paths, using the star to guide you. In addition to providing a framework for decision making, studies have shown that giving language to your values has a greater impact on your behavior than merely just thinking about those values in vague terms. (3). What does this mean? It means that speaking or writing your values (or both!) will help you be more motivated to take meaningful action when confronted with obsessive thoughts.
How do I Identify My Values?
Identifying values, therefore, is a key component in moving forward with meaning, but this can be a little tricky. Perhaps you already have a good sense of what matters most to you. Or you may have a more vague sense that you want to “be good” but you aren’t sure exactly what that means. Or you may be having Scrupulosity sneak in to insist that your values are a rigid set of observances or thought patterns that aren’t actually tied to what is intrinsically of worth to you. Try this Values Clarification Exercise from MyBestSelf101.org (5) to help you identify your values. Next, try narrowing your list down to just 3 core values. Russ Harris, a medical practitioner, bestselling author, ACT trainer and psychotherapist, teaches about using “towards moves” and “away moves” in progressing towards our values (see his video here, (4). After identifying your 3 core values, see if you can focus on applying more “towards moves” than “away moves” for one week. Notice how allowing your Scrupulosity-based thoughts to be there (like a pebble in your shoe), but not dictate your actions can actually minimize the discomfort of the stone. Instead of focusing on the pebble, try focusing outward and taking in what the forest has to offer as you travel toward that guiding star.
References
- Hagen, A. (2022). Imperfectly good: Navigating Religious and Moral Anxiety to Release Fear and Find Peace. Mindset Family Therapy.
- Berkout O. V. (2021). Working With Values: An Overview of Approaches and Considerations in Implementation. Behavior analysis in practice, 15(1), 104–114. https://doi.org/10.1007/s40617-021-00589-1Lundgren, T., & Larsson, A. (2018). Values choice and clarification. In S. C. Hayes & S. G. Hofmann (Eds.), Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy (pp. 375–388). New Harbinger Publications.
- Levin, M. E., Hayes, S. C., & Vilardaga, R. (2013). Acceptance and commitment therapy: Applying an iterative translational research strategy in behavior analysis. In G. J. Madden, V. Dube, T. D. Hackenberg, G. P. Hanley, & K. A. Lattal (Eds.), APA handbook of behavior analysis: Vol. 2. Translating principles into practice (pp. 455–479). 10.1037/13938-018
- The Choice Point: A Map for a Meaningful Life. YouTube. Uploaded by Russ Harris, 6 December 2017. https://www.youtube.com/watch?v=OV15x8LvwAQ
- Values Clarification Exercise. MyBestSelf101.Org
Photo by Aaron Burden on Unsplash
