This is a brief recap of one of our Mental Health Monday Live with Dr. David Rosmarin about OCD (Obsessive Compulsive Disorder) and moral or religious scrupulosity. Recap written by Arielle Jacobowitz
To watch the whole interview with a lot more details click here:
It’s fascinating that we can live our lives following society’s general beliefs, but when we learn a more educated perspective it can instantly bring newfound clarity into that aspect of life.
When we sat down with Dr. Rosmarin, he defined and specified the difference between OCD and religion and explained why they are often confused, giving clarity to many of us. When we take a deeper look and understand the different nuances, we will no longer confuse the two.
OCD is purely driven by fear, while religion is driven by the desire to connect to something sacred.
At times, certain practices in religion look similar to OCD because of the required laws. For instance, in the Catholic religion, people pray with the rosary and follow a very particular series of steps. In the Buddhist tradition, people pray with the prayer wheel - also in a specific manner. In Judaism - upon waking up in the morning, people wash their hands in a precise order with a minimum amount of water. The day follows with a series of meticulous prayer rituals that can easily appear to be “OCD behaviours”.
People who suffer from OCD and people who practice religion both engage in rituals on a daily basis. Perhaps this is why the two are often confused.
OCD is made up of obsessions and compulsions. Obsessions are recurrent, unwanted thoughts which brings distress to the one experiencing it. Compulsions are the actions that a person does repeatedly in an attempt to quiet or get rid of those obsessive thoughts. In this case, the rituals are driven by fear.
On the other hand, performing religious rituals stems from yearning to connect with something greater than the physical world and people practice those rituals because they have a shared culture with other people. When Jewish people put on Tefillin in a very specific manner it is done to connect to a Higher Being, as opposed to engaging in an OCD behaviour which would be to calm down one’s anxiety and obsessive thoughts.
There is another misconception that religion can actually cause people to have OCD, but statistics show otherwise. About 78% of Americans have some form of religious affiliation, over 50% of Americans pray once per day, but only 1.2% of Americans have OCD on a given day. If religion was actually a risk factor, the OCD rates would presumably be higher. Many studies have proven that there is no relationship whatsoever between OCD and religion and Dr. Rosmarin sees this in his practice as well. When you compare religious to nonreligious patients, religious patients have religious symptoms because religion is an important aspect of their lives, and non-religious patient’s OCD manifests in other areas. It is common for people to attach OCD to things which are important to them. Dr. Rosmarin often tells his religious patients with OCD, that if you weren't religious you would have OCD anyway, it would just be about something else!
We treat religious OCD the same way we’d treat any other OCD. In treating OCD, exposure and response prevention (ERP) is practiced, which entails encouraging patients to expose themselves to the fear and then work to prevent their response. When someone is afraid of germs, we have them touch doorknobs or things in public. If a patient is afraid of fire, we have them turn on the stove and leave the house (after making sure there is nothing flammable near the stove, of course). Similarly, when someone avoids religious activity because of their OCD, we encourage them to engage more in religious practice.
When someone has OCD and refuses to admit it, many times clinicians will work with their loved ones instead. The first step is to stop accommodating the person. For instance, if a child is scared to open the car door because of germs, a parent's instinct might be to continuously open the door for them. The parents need to learn when accommodations are appropriate and when they must force the child to open the door himself. It’s not necessary to make a war out of everything, but sometimes tough love to benefit the child is necessary. Therapy really helps differentiate this.
The biggest take-home was the importance of hope. It's so important to give those who suffer with OCD the sense that they are capable and can overcome anything with effort. Because they truly can!