Comedian, Jim Carey, once joked about the random thoughts that pop into his head. While sitting across a table from a friend the thought popped into his head, “I could just haul off and punch this guy right in the face.” Of course, the audience laughed, but the comedian hit on a spiritual and mental issue many people struggle with. Intrusive thoughts like the one the comedian mentioned, but often more disturbing or more spiritual in nature, plague many people. These intrusive thoughts can cause them to be racked with guilt, causing a viscous obsessive-compulsive cycle to begin. Many names have been given to this condition including, “Scrupulosity,”[1] “The Doubting Disease,”[2] or more broadly “Obsessive-Compulsive Disorder.”[3]
Definition
Mike Emlet defines this condition this way:
Intrusive (spontaneous, unbidden, unwanted) and obsessive (persistent, recurring) thoughts and doubts about moral-spiritual issues, which produce distressing levels of anxiety and the quest to rid oneself of that anxiety, usually by one or more of the following: performing compulsive behaviors, engaging in mental rituals, or by avoiding triggering situations.[4]
The average person dismisses these thoughts and continues with life. However, the person struggling with scrupulosity evaluates these thoughts with distorted views of God, self, and the Christian life which overly sensitize the conscience and rachet up the significance of the thought.[5] According to Emlet, this leads to a vicious cycle portrayed in the figure[6] below:
The over-scrupulous person is dealing with several distorted views.
First, those struggling with scrupulosity tend to emphasize God’s holiness and justice. It is obviously good to recognize God as holy and just, but doing so while removing a sense of his love and kindness can have a very detrimental effect on a Christian’s spiritual well-being.[7]
Second, they have a distorted view of self in that they tend to obsess over absolute certainty. This often leads to a self-reverential epistemology that can’t trust anyone else’s word over theirs.[8] They also tend toward perfectionism. The scrupulous person is dependent on their own ability to resolve any uncertainty and they are no longer depending on God and his truth.
Third, they have a distorted view of Scripture that causes them to see the Bible as an impersonal moral algorithm rather than a story of redemption.[9]
Lastly, they have a distorted view of the Christian life. They tend to elevate law over grace. They also confuse temptation with sin, thinking that any thought of sin is tantamount to committing that act.[10]
Causes
There can be various causes of scrupulosity. Often trauma can lead to mental defense mechanisms being erected, or strategies implemented. The trauma can be physical or emotional, leading to brain-based or emotional dysfunctions. Relational dynamics such as a legalistic church or family, or societal-cultural factors such as hyper rationalistic or hyper empiricist tendencies can also cause scrupulosity and an obsession over absolute certainty.
What to Do
The scrupulous person must learn to doubt their doubts. This involves recognizing when an intrusive thought is baseless. One person struggling with scrupulosity told his counselor that he and his father learned to identify certain intrusive thoughts as “scrupepoop” and flush it out of their minds.[11]
Second, the scrupulous person needs to learn to live with a healthy level of ambiguity and uncertainty. Unlike the Enlightenment thinkers who taught that human reason was autonomous, we don’t know all things. We need God’s Word to be our supreme authority. The scrupulous person often exhibits self-dependence in their thinking rather than dependence on God in rationality and truth. We should be dependent on God in our thoughts rather than autonomous in our judgments of truth.
Third, focus should be centered on the Lord rather than themselves. The scrupulous person is often lost in their own head. Instead, focus should be placed on God and his unchanging grace and nature.
Fourth, the “scratch-itch” cycle of obsessing over thoughts must be broken. As Emlet notes in the figure shown above, an intrusive thought is introduced, which the scrupulous person inordinately values and then launches into anxiety and obsessing over the thought. This cycle must be stopped. When an intrusive thought pops into the mind it must be valued for what it is and dismissed or flushed as “scrupepoop.” This will take self-control but is crucial in breaking the addictive cycle of scrupulosity.
Fifth, the scrupulous person must look outward toward God and others. This means focusing on God and serving others. It also means trusting God and others God has put around us to show us who we truly are. The scrupulous person relies on their knowledge of themselves and their assessment of their thoughts without any regard for what others and God say. Yet, on our own we are incapable of the best judgment of ourselves and our thoughts, but only see a portion of what there is to know about us. We need God and others to arrive at the greatest self-knowledge possible.
Sixth, it may be helpful to see a Christian counselor. A good, biblical counselor can help identify scrupulosity and apply God’s truth wisely and helpfully.
Lastly, at times medication should be considered. Certain people are able to make progress against scrupulosity without medication, but others are so plagued by anxiety and distress over intrusive thoughts that medication may be useful to provide emotional stability to begin to work through some of the steps above.
Scrupulosity may not be very common in a narrow sense, however, aspects of it are found in many spiritual and mental issues. The church needs to be equipped to help people who are struggling in this way. Many commonly face anxiety, distress and weariness resulting from intrusive thoughts. Christ promises that all who come to him would find rest. May they find rest in Christ and his Word.
[1] Michael R. Emlet, “Scrupulosity: When Doubts Devour,” The Journal of Biblical Counseling 33, no. 3 (2019).
[2] Joseph W. Ciarrocchi, The Doubting Disease: Help for Scrupulosity and Religious Compulsions (Mahwah, N.J.: Paulist Press, 1995).
[3] Diagnostic and Statistical Manual of Mental Disorders, 5th Edition [DSM-5] (Arlington, VA: American Psychiatric Association, 2013).
[4] Emlet, “Scrupulosity: When Doubts Devour.” 12.
[5] Emlet, “Scrupulosity: When Doubts Devour.” 15
[6] Ibid. 16.
[7] Ibid. 17.
[8] Ibid. 18.
[9] Ibid. 20.
[10] Ibid. 21.
[11] Ibid. 30.
Mike McGregor
Mike McGregor (MDiv, Reformed Theological Seminary) is Director of College Ministry at First Baptist Church in Durham, N.C. You can follow him on Twitter at @m5mcgregor.
