Photo credit: Praying-CraigSunter-Flickr.Jpg
Scrupulosity OCD is overwhelming for anyone going through the torment of what is most important to them – their faith. The sufferer’s primary anxiety is the fear of being proved guilty of religious, moral, or ethical failure and facing spiritual rejection.
Treatment includes cognitive behavioural therapy (CBT) and exposure response prevention (ERP). In CBT cognitive strategies help to alter faulty interpretations. For example:
“I feel guilty; therefore, I must have sinned” to “My guilt is misplaced; therefore, because my thoughts are intrusive and therefore unwanted, I can allow these to come and go without feeling that I have sinned”.
Since compulsions negatively reinforce the person’s fears, ERP has them agree to face these fears whilst tolerating associated anxiety. So if the compulsion is to pray for forgiveness and/or to seek reassurance for doing a perceived wrong doing, they would resist doing these rituals in graded steps. This way they learn to build disterss tolerance.
How does this happen?
Giving into rituals associated with the obsession relieves anxiety momentarily, and so the behaviour is repeated to find relief again; however, by learning to resist these an initial increase in anxiety becomes noticeably less the more the obsession is faced and the corresponding compulsions are not carried out.
What is another benefit when doing CBT and ERP?
A person learns to see that they can live with uncertainty, which is better than living with never-ending doubts about their religious, moral or ethical conduct. When doing CBT/ERP bear in mind that a paradoxical conclusion arises from an incompatible clarification that forms the basis of an original belief (e.g., “I am a true believer and am saved”). So when the paradox is of OCD’s tormenting its victim with conflicting ideas about their religious belief (e.g., “What if don’t truly believe, it means I won’t be saved?”) it is the inconsistency of defining the problem to which the person, following remission, sees its absurdity.
“OCD dedicates itself in tormenting those susceptible to the disorder. Identify its paradox, resist unnecessary compulsions, and it will loosen its grip…” Carol Edwards
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