Scrupulosity & Religious OCD: Coping Strategies for Faith‑Based Fear | Ep. 491
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In this episode, I sit down with OCD therapist and scrupulosity specialist Justin Hughes to explore how religious OCD can hijack faith, why common attempts to find certainty often make things worse, and what true recovery can look like.
In this episode, I discuss:
- Why intrusive thoughts about God, morality, and faith are often a sign of OCD, not a reflection of your character or beliefs.
- How scrupulosity tricks you into seeking more certainty through prayer, confession, reassurance, and mental review.
- The difference between practicing your faith and engaging in compulsive religious rituals.
- How Exposure and Response Prevention (ERP) can be adapted to honor your values while helping you break free from OCD.
- What to do in the moment when a blasphemous, shame-filled, or unwanted thought shows up during prayer, worship, or religious practice.
- Why recovery from religious OCD isn’t about becoming less faithful, it’s about learning to live with uncertainty and reconnecting with your faith without fear.
Religious OCD (Scrupulosity): When Faith Gets Entangled With Fear
Have you ever found yourself praying over and over again, not because you want to, but because you feel like you have to?
Maybe you’re terrified that you offended God. Maybe you’re worried you had the wrong intention, the wrong thought, or the wrong feeling. Maybe you find yourself repeatedly seeking reassurance, confessing, or mentally reviewing your actions to make sure you didn’t do something spiritually wrong.
If so, you may not be dealing with a faith problem.
You may be dealing with OCD.
Specifically, religious OCD, also known as scrupulosity.
And one of the most heartbreaking things about scrupulosity is that it almost always attacks the people who care most deeply about their faith.
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What Is Religious OCD?
Religious OCD is a subtype of obsessive-compulsive disorder that centers around spiritual, religious, or moral fears.
People with scrupulosity often experience intrusive thoughts such as:
- “What if I offended God?”
- “What if I didn’t pray correctly?”
- “What if my intentions weren’t pure?”
- “What if I secretly reject my faith?”
- “What if I committed an unforgivable sin?”
- “What if this thought means something terrible about me?”
These thoughts can feel incredibly real and urgent.
The problem is that OCD convinces you that certainty is possible, and that you must achieve it before you can move on.
Why These Thoughts Feel So Convincing
One of the biggest misconceptions about intrusive thoughts is that they reflect who you are.
In reality, OCD often attacks what matters most to you.
If your faith is important, OCD may target your relationship with God.
If honesty is important, OCD may convince you that you’ve lied.
If morality matters deeply to you, OCD may constantly question your intentions.
This is why people with scrupulosity often feel devastated by their thoughts. The content directly collides with their values.
The thought feels important because the topic is important.
But importance does not make the thought true.
The Trap of Trying Harder
When people experience religious obsessions, their natural instinct is often to do more.
They pray more.
They confess more.
They seek reassurance more.
They mentally review events more.
They try harder to be certain.
Unfortunately, these efforts usually become compulsions.
Compulsions provide temporary relief, but they teach the brain that the obsession was important and dangerous.
As a result, the cycle continues.
The more you try to solve the obsession, the stronger it becomes.
When Faith and OCD Get Confused
One reason scrupulosity can be so difficult is that faith naturally involves reflection, values, and spiritual practices.
OCD can sneak into those practices and transform them into rituals.
This creates a painful question:
“How do I know whether I’m practicing my faith or performing a compulsion?”
The answer is often found in the function of the behavior.
Are you praying because you genuinely want to connect with your faith?
Or are you praying because you’re desperately trying to eliminate uncertainty, fear, or guilt?
The behavior may look similar on the outside, but the motivation underneath can be very different.
Understanding Thought-Action Fusion
A common cognitive distortion in OCD is something called thought-action fusion.
This is the belief that having a thought is somehow equivalent to acting on it, or that having a thought means something significant about who you are.
For example:
- “If I thought it, maybe I wanted it.”
- “If I imagined it, maybe I did it.”
- “If I had the thought, maybe it reflects my true beliefs.”
But thoughts are not actions.
And having an intrusive thought does not automatically reveal your character, intentions, or spiritual standing.
Learning to loosen OCD’s grip on thoughts is a critical part of recovery.
What To Do When an Intrusive Thought Shows Up
Many people ask:
“What should I do in the moment?”
The answer often begins with doing less than OCD wants you to do.
Instead of trying to figure the thought out, explain it, analyze it, or prove it wrong, practice making room for uncertainty.
You might respond with:
- “Maybe.”
- “Maybe not.”
- “It’s possible.”
- “I don’t know.”
- “I’m willing to live with that uncertainty.”
Notice that these responses are not attempts to convince yourself of anything.
They’re simply a refusal to enter OCD’s argument.
Exposure and Response Prevention (ERP) for Scrupulosity
The gold-standard treatment for OCD is Exposure and Response Prevention (ERP).
ERP involves two parts:
Exposure
You intentionally face the thought, feeling, image, or situation that triggers anxiety.
Response Prevention
You resist the urge to perform compulsions that would normally reduce uncertainty or distress.
For someone with scrupulosity, this might mean:
- Attending church without seeking reassurance afterward
- Allowing uncertainty about intentions
- Sitting with uncomfortable thoughts during prayer
- Participating in religious practices without repeatedly checking whether they were done “correctly”
The goal is not to feel certain.
The goal is to learn that you can tolerate uncertainty.
Recovery Doesn’t Have To Be Perfect
One of the most important messages for people with scrupulosity is this:
Recovery will be messy.
You won’t always respond perfectly.
You won’t always know whether you’re doing ERP correctly.
You won’t always resist every compulsion.
That’s okay.
The goal isn’t perfection.
The goal is willingness.
Every time you choose uncertainty over compulsions, you’re teaching your brain a new lesson.
Can Faith Be Part of Recovery?
Absolutely.
One of the most powerful insights from my conversation with Justin was that faith doesn’t have to be something OCD takes away from you.
In many cases, faith can become a source of healing.
Treatment does not require abandoning your beliefs.
In fact, effective OCD treatment should respect your values while helping you separate genuine faith practices from compulsive behaviors.
Recovery is not about becoming less faithful.
It’s about becoming less controlled by fear.
A Different Question to Ask
Many people with scrupulosity spend years asking:
“What if I’ve done something wrong?”
“What if God is disappointed in me?”
“What if I’m spiritually failing?”
But perhaps a more helpful question is:
What if it’s easier than you think?
What if grace is bigger than OCD says it is?
What if you don’t need to achieve absolute certainty before you can move forward?
Those questions may not provide immediate relief.
But they open the door to something OCD desperately wants to keep closed:
Freedom.
Final Thoughts
If you’ve been suffering with religious OCD, please know that you are not alone.
You are not spiritually broken.
You are not your intrusive thoughts.
And you do not have to continue fighting this battle in silence.
Recovery is possible.
It may involve learning new skills, practicing uncertainty, and facing fears you’ve spent years trying to eliminate.
But freedom is possible.
One small, brave step at a time.
Transcription: Scrupulosity & Religious OCD: Coping Strategies for Faith‑Based Fear
Kimberley: Right now, somebody is praying for the fourth time today, not because they want to, because they have to, because if they don’t, the thought comes back. The one that says they’ve done something unforgivable, the one that says God can’t love them anymore, the one that feels less like anxiety and more like the truth.
Most people call that
a spiritual problem, but it’s not. It’s OCD, and the cruel, devastating irony is that it almost always attacks the people who care the most about their faith. Today, I’m sitting down with Justin Hughes, a wonderful therapist and author who specializes in exactly this, religious OCD, also called scrupulosity.
And what we’re going to talk about today is going to challenge almost everything-
Because the common belief is that if you’re having these dark, blasphemous, or terrifying thoughts about God, something must be really wrong with you. Therefore, you just pray more, you confess more, you seek reassurance, you try harder, but it never works, and there’s a very specific reason why. In this episode, we’re gonna talk about all things scrupulosity, religious OCD, and name the faith-based thoughts that people are too ashamed to say out loud.
We will explain exactly why every strategy you’ve tried has made it worse, and show you exactly what actually leads you through to recovery. Now, if you’ve been suffering with scrupulosity alone in silence, convinced you’re spiritually broken, this episode of the Your Anxiety Toolkit is exactly for you.
And so let’s get to it. Any questions?
Justin: No Straightforward
Kimberley: So thank you, Justin, for coming on again. I love when you share specifically about how people can manage these really painful, shameful intrus- intrusive thoughts. I know you have a book coming out, which I cannot wait to hear and read. Um, but can you first walk me through that moment, maybe someone sitting at church, maybe they’re praying, or maybe they’re just driving their car, and all of a sudden they do have this intrusive thought or feeling.
What’s actually happening in their brain at that point?
Justin: Yes. It’s so great to be here, Kimberly. The common experience of intrusions can come up for a variety of reasons, but some of the most common examples that I hear on the faith side, though I work with a broad range of people, can be thoughts like, “Am I doing this right?”
Uh, maybe it’s a conversation that they’re replaying in their head, a thought about, “Did I mislead that person? Did I say what was truly honest or what I was actually thinking or feeling in the moment?” And they’ll go back and replay those situations or have a thought more directly about faith or morality or responsibility.
Sometimes this shows up in simple reflections on taking a test or a quiz for students, thinking of the moments that they looked over just to rest their eyes from their exam and they remember seeing the paper of somebody else, and other moments too where it’s more direct to their faith, that, “I didn’t have the right heart.
I didn’t have the right posture. What if I was actually angry and rejecting towards God?” Uh, these are all just really tangible day-to-day examples that come up so frequently and so commonly.
Kimberley: Yeah, so what you’re really saying is people who tend to be genuinely moral, good human beings, their intrusive thoughts attack that so directly in these little nuanced ways, like just in the little day-to-day activities, which makes them feel like they have done something really wrong or they are a bad person.
Would you agree?
Justin: Well, yeah. So I’ll give a little bit of a caveat to that. So I think that that’s a great way… It- it’s the important starting points to look at it. Mm-hmm. So when we say that, that it attacks what we love, and oftentimes it’s, it’s the counterpoint of the person’s very heart, yes, absolutely, from the intrusive standpoint.
And so when we pull in faith beliefs and act- uh, teachings of the church, for example, there we would, for Christians particularly, we’re gonna look at no one is good but God alone. Now, here’s the problem. If people rush into some judgmental condemnation, fill-in-the-blank mindset, they’re already on the wrong path with, with these things.
Mm-hmm. Because first of all, that’s not that’s not what the answer would be from a Christian ethic standpoint anyway, is some self-flagellation, beating oneself up. In that, it’s, uh, that’s more reliance on the person rather than God. Um, but then back to the point of the intrusion, that’s just one of the most important things, I think, in early conversations for me to emphasize and to teach that, “Hey, this can be completely against your, your wishes.”
Like, we, we can both uphold the theological teaching and belief, and also that this thing is very much against your wishes. This thing is very much against what your otherwise character would be. And so that, that’s a little bit of how I’d put that, but I think it’s landing at that starting place that’s so essential for the beginning of OCD treatment.
Kimberley: Can you tell me more about that? Like, I really wanna understand more about what you just said. I, I mean, and I’m not someone who I think understands the scriptures like you do. Tell me more about– ’cause, uh, when I see clients who are struggling with scrupulosity, they are trying to be good. They are trying to have good thoughts.
They are trying to have good feelings, pure feelings, pure intentions, good behaviors, like a lot of this good and bad shame, like black and white thinking. But tell me more about what you were talking about in terms of- Mm-hmm … God being The good
Justin: Yes. Yeah. Okay, so some people came up to Jesus when he was teaching, uh, this was recorded Gospels, can’t remember which one, and they said, “Good teacher.”
And it’s interesting ’cause he paused and reflected. He said, “Why do you call me good? No one is good but God alone.” Now, critics of scripture and Christianity will say, “See? Jesus is clearly at this moment saying that’s, uh, he’s, he’s not good or…” Th- that’s a trash reading of that passage. That’s not what that’s all, at all saying.
So it’s… A theologian could put this better, but as, as I read it, a bit of a tongue in cheek, like, “Why would you do this? Why would you call me good?” Because if you see that only God is good, and when we think of Christian teaching, we’re going to teach on topics like sin. We’re gonna talk about separation from God, and I realize that maybe a majority of your listeners may not…
Uh, actually, I, I don’t know necessarily. There’s many listeners that are not gonna be Christian, so by the way, if you’re on here, thank you so much. I hope you’ll bear with me. I’ve got a lot of stuff that applies to, to everybody. But talking about this specific aspect of what, what we believe and teach from a, a Christian doctrine standpoint is that man is not good apart from God, apart from God’s grace, apart from God’s intervention.
And so when clients come into session and they, they talk about these things, it’s one of the things that creates this huge gap if they go to someone who’s not a Christian or doesn’t share their faith because they show up and they say, “Well, I’m such a terrible person. I’m really, really bad.” And then the counselor may say, “Well, no, you’re not.
Like, you’re a wonderful person. You’re a really good person. Look at these intentions. They’re so pure.” Well, automatically that’s actually gonna go against Christian teaching on that topic. But what the counselor who specialized particularly in ERP is trying to get at, and, and KQ, we’re friends, and I have so many friends that have different backgrounds and work with a variety of beliefs.
I really respect my, my colleagues that are doing great work in that. And if a Christian walks in and they’re really, really– If they’re not able to read between the lines of what a person is saying with that, that, “Hey, this is against, intrusive to your values and your wishes,” the person will very quickly dismiss all of it if they get, like, a sense or just, like, a smell, just like, almost like the sniff test of, “Wait a second, that doesn’t line up with what I’m being taught in, in church.”
In Isaiah it says, “All my righteous deeds are as filthy rags,” which the concept is God is holy. And so, like, ultimately I– it’s through God and by God that I can do anything that is good. But also total side note too, there’s, there’s variations in theological teaching. Like, I land really strongly on all of us share, I believe, the image of God, the imago Dei in Latin.
And so that means there’s gonna be amazing, great stuff. And I’m also not gonna bat an eye, however, a lot of my Christian colleagues that are more in the church or ministry realm wouldn’t like wording of it. Like, if, if a person is like, “Yeah, I think I have good intentions,” y- you’re always gonna find that person that’s just the almost the hellfire and brimstone, like, “Nobody has good intent-” No, like, I think that there can be really good things.
But the whole theological point that I want to come back to that so many, uh, so many Christians I think get invalidated when they go to a therapist is that from a belief standpoint, it’s gonna say, “Only God is good,” and it’s but for his grace that, that I have goodness, um, uh, i- in me, so both the general image of God and then also more specific.
So Mm … slide that over to exposures and OCD, what does that look like? I want to talk about that, but I need to pause, ’cause
Kimberley: Wait. Yeah … we’ve
Justin: got,
Kimberley: yes … you have to pause because- … I think you’ve just taught me something I did not know. Like, I feel- Oh, okay … like, it’s very rare when I have a, a guest on where I’m, like, completely gobsmacked, and I’m completely gobsmacked.
Okay. Let’s, let’s roll back. Let’s roll back. To everybody listening, we are learning in real time. Like, Justin, you are-
Justin: Which is the best …
Kimberley: taking me on a journey right now. So wait, I maybe have been making some mistakes with my clients. Let’s address that. So from a compassion standpoint, I think I have made that mistake by restructuring that they are good people, right?
You know, we do it- Mm-hmm … just once. It’s not like we do it repetitively. ‘Cause remember, when we’re doing … For folks listening, and if you’ve taken your OCD toolkit, the course we have for OCD, we’re always talking about your exposures and response prevention should line up with your values, right? It should line up with your faith.
It should line up with what you believe true. But if I, Kimberly the therapist, are coming to restructure, like, your thoughts don’t mean anything about you, does that still ring true in the circumstance? ‘Cause I’m over here teaching thoughts are neither good nor bad, they’re neutral, right? Mm. Mm-hmm. That your feelings are neither good nor bad, and they’re neutral, and your thoughts don’t mean anything about you, and that your OCD will often attack what you value.
Is that correct wording for the person with these obsessions if they are a Christian?
Justin: So a lot of that I think is extraordinarily helpful. Oh, we’re, we’re doing a deep dive here. So-
Kimberley: No, and don’t be afraid to school me here because I feel like this is important for my followers to listen- Mm-hmm … ’cause this is the messaging I give, and I wanna make sure it’s correct.
Justin: And I love, love your perspective and attitude with that. So let’s look at one of the key problems that shows up in, in OCD. Um, it’s known as thought-action fusion or over-significance of thoughts. And, uh, so with that, it is unfairly joining together, uh, fusing. So in ACT terms, there’s that cognitive fusion, but in cognitive distortion terms, over-significance of thoughts, thought-action fusion.
And one of the things the Christian faith teaches is thoughts are important and beliefs are important. And so, uh, oftentimes one of the very first, um, concerns that’s levied in the process by many that, that I work with, and then when I talk to others who are going to other counselors, is yeah, but thoughts, intent, all of these things, uh, matter.
And so I do want to get people to the place quickly, uh, where they can recognize that a thought can just be a thought.
Kimberley: Mm.
Justin: Um, so as to respond to, to some of the thoughts, I think that is the right thing. That is the accurate thing that we all need to be doing. Is it possible that I can have just the thoughts that in the messiness of my brain and this world and fill in the blank, uh, I could just, you know, be having a conversation with somebody, having a great time, and then just have a thought of stabbing them And can it literally mean nothing?
Yes. Nothing other than I have intrusive thoughts or- Yes … OCD or whatever else. It’s so key, and that actually was one of the key hallmarks in my own growth as a therapist in especially the early days. And when I first started to specialize in OCD, it was a necessary hoop to jump through, was to grapple with, okay, what does this mean?
Now, different belief systems and approaches teach some very different things in relation to thoughts and beliefs. And I oftentimes I hear a lot of those fears from people. They’re like, “Oh, but, but we can’t, can’t just dismiss this,” or, “Does this mean that you’re approaching it, you know, from some other religious perspective,” or fancy term is syncretism, that you’re just pulling in all these different things and you’re invalidating faith, and fill in the blank.
So questions, I think that this is one of the absolute hallmark things to get down and get right in the treatment process, and then also from the faith standpoint. So I’ll make a comment and pause. As to thoughts, there, there’s even been some research, Dr. Jonathan Abramowitz has been part of research, uh, Dr.
Jed Siev, all related to what sort of things become more of a struggle for different religious beliefs and, and systems. And so Christians will really, really struggle with the thought-action fusion, uh, very commonly because of this emphasis that thoughts matter. And so as a clinician, w- and by the way, this is going to be true for Muslim clients as well, or multiple different faiths.
But thoughts also matter in Islam. Uh, and so if I’m working with a Muslim client, I’m going to make sure that I’m respecting that as well. So from the Christian teaching standpoint, we, we teach that both worship or sin, wrongdoing, missing the mark, can be at that level of thought and can be of, and certainly relates to belief.
And so it is really, really important to be able to emphasize, “Hey, like, I understand this is actually the teaching,” and, uh, da, da, da. I’ll, I’ll emphasize different, uh, scriptures. And then for me, because I do the integration with- The, the clients who are interested, and, and bless me to do that, I don’t force it on anybody, it’s pretty neat to be able to be like, “Hey, by the way, we, like I think this is important, too.”
Yeah. I’m not here at all to dismiss that. Yeah. So, uh, hopefully that, that makes sense. I, I think that the base level of what you’re getting at is precisely what needs to happen with OCD, but for the, the Christian client particularly, I think that a wording change could help. Hey, like and that’s like the ultimate uncertainty, right?
Like maybe there are some thoughts there that mean something, but can we agree that there could be thoughts that are very against your wishes, against what you want. It’s a false signal, and that’s what I’m also gonna do early on is try to come to some agreement not to necessarily put it in a, a clear box with those things, if that makes sense.
Kimberley: Now, as you know, I have a private practice. I have six amazing therapists in Calabasas, California. However, we do not take insurance. Now, if you are looking for insurance-covered OCD or BFRB treatment, I wanna let you know about NOCD. NOCD provides face-to-face live video sessions with specialized licensed OCD therapists.
Now, their therapists use exposure and response prevention. We know this is the gold standard for OCD, so you can be absolutely confirmed that you’re in the right place there, and they have a clinically proven app that helps you stay connected to your therapist and others who have OCD between sessions, so you’ll always feel supported.
Now, the cool thing is NOCD is available in all 50 US states and even internationally, and they accept most insurance plans, making it affordable and accessible. We love that. Now, if you think you might have OCD or you’re struggling to manage your symptoms, you can book a free call. Just click
the link in the show notes at nocd.com.
I am honored to partner with NOCD. I want to remind you that recovery is possible. Please do not forget that. Now, big hugs, and let’s get back to the show
It does. It does. Okay, so I really appreciate this. I’m constantly thinking through the lens of me supervising my staff, I have six incredible therapists who work with me, and how I can absolutely be the best supervisor for them and a tr- and a teacher for all of my students.
So I would love if you could walk me through, a- and I actually am- would love for you, we can go as deep as you like here, but walk me through and walk us students of yours through what do you do if you have a thought, like in real time, what would you encourage as a Christian ERP therapist, and this could be for Christians specifically or other religions as well, it’s up to you.
But like what do we do in the moment? Can you walk me through some steps on what is helpful for a Christian or religious folks when they have a thought or feeling that completely does not line up with their values?
Justin: Put me in, coach. Uh, I love this.
Kimberley: And we’re in the-
I think- We’re in the dugout and we’re going out onto the, the field, I think is the saying now.
Justin: Uh, yep, absolutely. Uh, so response prevention is a great umbrella, and also, uh, I think there’s things even outside of response prevention proper, so I’ll explain briefly. So the main go-to gold standard treatment for OCD is exposure and response prevention, and it’s now used actually for other things, too.
It’s finding a great basis in the treatment of eating disorders. And so anyway, it’s not just limited to OCD, but it was created for. Interesting enough, it’s the one thing that was created for OCD. Everything else was just kind of incidental- Yeah … like SSRIs and, and so forth. But with that, we have the I’m facing the thing that’s uncomfortable and I’m doing it systematically, intentionally, and I remove or block or keep myself from engaging in the compulsion.
Now, easier said than done. What does it look like to do nothing? Because essentially, that’s what the response prevention is. Uh, there’s a lot of ways to facilitate that. And so, um, I actually have this, I can include it if you would like. It’s my big response prevention guide. In book, uh, I list out tools and skills, but I also have ebook too that I can get you hooked up with for free.
I think just like an obsession, and I may have a different take on this, but I think that it can be pretty much anything. The compulsion could be pretty much anything, and so sometimes the best response prevention is just a really good exposure. Like, did I just swear at God? Maybe. And then- Keep driving that car
Uh, send that text message. Maybe is actually diffusion. So diffusion’s maybe, maybe not, could be. Okay. So cognitive fusion, that, uh, this must be important, giving this attention. If it must not be important , then, uh, diffusion is so great because it’s okay, yeah, sure, definitely, maybe, could be. Now, people will quickly raise their hand or try to leave , uh, if they think that they’re going to be encouraged in having bad thoughts.
Mm. There’s a couple of people that I recommend their resources and their books, but they … And many, many, many of my clients are very scared off by when they get into the middle of their books and they’re just talking about how matter-of-fact one can be with doing an exposure script, for example, uh, facing your fears.
So back to what a person can do instead, it’s technically everything that’s opposite- Yeah … of what one does. Uh, everything that’s different in quality from what one does in the context of fear when they fall into the compulsion. But we have to look out because even exposures themselves can start to become- Yeah
compulsive. Am I feeling lower distress? Did I habituate after the … That would be- Yeah … a great example of, of that. Yeah. So and I can go into more detail of other response prevention techniques.
Kimberley: I have a question. Mm. So we want exposure and response prevention to be in line with their values. So if they have the thought, “Did I just pray to the devil and not to God?”
If that’s their thought. Or-
Mm-hmm …
you know, “Did I want to sin,” or, “Did I sin,” or, “Did I say something out loud,” or, you know, “Did I have a negative thought while taking communion?” Like, it could be any of those thoughts. In that moment, let’s say … Okay, let’s work it out. You’re in church. It’s the holiest of times, or you’re at the temple, wherever you are.
It’s the time you have made in your week to worship God. So it feels intense and purposeful, and there’s a bit of pressure there, right? And let’s say you do have that thought. So you’re s- you’re saying, and this is what we do too, but you can really put your nuance into it. So you’re saying We don’t need to do…
The old school ERP would be like, “Well, no, purposely have a thought against God, or purposely
Justin: have a-” Yeah, exactly.
Kimberley: We don’t do-
Justin: Start tearing up your Bible. Start
Kimberley: Yeah, we don’t do that anymore, but we practice saying maybe or just doing nothing at all, right?
Justin: Okay, so what I do is I default to the plan, and I do use a hierarchy.
It’s a really filled out digital form of this, and I have been using the phrase, I like this recently, we’ll see if it sticks, respect the hierarchy. And so if that person is going to church and it’s the, this special moment, it’s a, a holy moment, uh, maybe it’s right before, uh, receiving communion or the Eucharist, maybe it’s a high holiday, you know, Easter, uh, fill in the blank.
First of all, back to what you were talking about earlier, that, that’s where that really does apply. That of, of course, if we raise the stakes on when is gonna be the worst time for me to have really bad thoughts, it’s probably about now. So it, it makes a lot of sense. Uh, that would be the moment of struggle.
And so I work with what can the person do with quality skill? So if the person gets slammed with their level 10 exposure, then it’s important to say, “Well, what can I do? What have I done so far?” And sometimes it may even be what I– how I practice it is I tell the person, “Hey, this may have happened, but work with the one that we’re working on in session this week.”
So it could be something like, “I feel anger, and maybe that means that I’m against God.” And maybe that’s a level three out of 10, whereas the obsession that they just got in the church service was vile words, swear words, sexual obsessions, you know, something like that. They see a crucifix, and they think of Jesus naked.
Like, maybe they’re slammed with a level 10. I don’t want that pers– I mean, basically people are like, “But what do I do in those situations?” And now I just look at people, and I say, “I’m sorry. It’s gonna be messy.” That’s hard. Do your best. You don’t yet have the skills to pay the bills when it comes to those situations.
So what you can do is go back to what you have. So maybe that’s an exposure script at that point that immediately when that happens, the person shifts to a different exposure, which interestingly enough is actually response prevention in that moment because it’s not trying to figure out, “Why did I think of naked Jesus?”
It’s, “Okay, I’m sitting here,” and i-and it’s, yes, unfortunate in the moment with the suffering. Maybe that person does pass communion or the participation because instead they’re sitting to journal in their notebook. But if it’s intentional and planned, and it-it’s part of it, it’s part of what helps for freedom to say, “You know what?
I’m gonna go ahead and do some business with this. I’m tired of being bossed around by this thing, and I’m going to, uh, work on my skills.” So maybe it’s that level three script, and then, uh, of course, they’re gonna have a harder time. It’s not just gonna magically disappear, but at least they’ve practiced three minutes, five minutes, 10 minutes or whatever of that skill that they know how to do or developing maybe with a therapist or apart from.
And then, uh, it becomes all the more motivation if those things are coming up often or frequently to say, “Hey, now we gotta work quicker to work higher.” And I’m not– I don’t require that people do one, two, three, four, five, six, seven. That, that’s pretty old school also. But I do do that in the early stages where it’s like, “Hey, like, don’t, don’t make a leap from a 3 to a 10, maybe a 3 to a 5.”
Like, if, if you have the skill, if you can do it with lowered compulsions or no compulsions, great. That’s, that’s fine.
Kimberley: Right. So just to add, a client or a student listening is … So they’ve done the script, they’ve, uh, you know, they’ve practiced the thought diffusion, they’re giving themselves permission for it to be messy if they are having a 10 out of 10.
But then it is time to do communion, or it is time to sing a hymn or pray in the community of the church, and then that person struggles to engage back in that faith-based action, let’s say it’s praying, without it becoming compulsive. What would you suggest for those folks who are trying to resist the compulsive behavior?
Maybe it feels very habitual. They’re trying to practice response prevention, but the compulsion is kind of interfering with their faith action, their faith community action.
Justin: Yeah, and this is where a lot of the quick reference points and platitudes are just that. We have to really personalize. And one of the reasons that I’m just such a big believer in doing this in community and frankly getting therapists, like, there’s just something very, very different about the personalized.
And as much as I’m a fan of self-help and books, you’ve written some great ones yourself, KQ, I’ve got one coming out, there’s nothing that quite matches sitting down and being with another who can get it and help guide through it. So that being said, there’s, uh, with a lot of nuance here. The f- on the faith practice side, there are gonna be some things that are threshold items that even if there are compulsions out one’s ears, they may still choose to engage in that.
For example, one of the things that we don’t do with food-related obsessions is tell people to stop eating for 30 days while they get their treatment down and have a non-compulsive relationship to food. It has to be at both end- Yeah … of course. And this is one of the things that is easy to miss. And me too, like, as I’m coming in here talking about these things, I, e- I’m also not highlighting, you know, my own challenges and mistakes along the way.
So I wanna be really, really clear about this, that it’s not like, “Oh man, uh-” That, that Christian dude got the mic and now he’s just on blast with every … No, no, no. Like, I’m making so many mistakes in this process, and not walking congruently or respecting other, you know, things at different points. So we’re all in this boat if, if we’re learning.
Like, if, if you don’t wanna learn, if you don’t wanna grow, well, I have a different issue with you. Yeah. But
Kimberley: Yeah.
Justin: Um, not you, KQ. Um-
Kimberley: No, I’m always so happy for … I always say to people, like, “Challenge me.” Like, that’s where I learn.
Justin: Well, and also, if I can give this validation at this moment, Kimberly, you are the person that has modeled that the most to me in the sphere of therapist, author, podcaster, because I don’t think that that is mirrored very often.
And even just a moment ago, like, I gobsmacked. Yes. I, I love those tr- uh, those, uh … Is that an Australian-ism coming out or? It’s good. I, I don’t usually hear people in the States say gobsmacked, but- Oh,
Kimberley: okay Yeah So no,
that’s … Maybe it is. I’m
so American and I’m, I’m, I’m m- so mixed up with between the
two cultures at this
point.
Justin: Yeah. So- So thank you for- Of
Kimberley: course …
bringing it
to the lighting factor No, I, I love this. So, so you’re saying s- I think we hear what you’re saying, but again, challenge me, is if you came to pray and your OCD is helping you or encouraging you or pushing you to engage in compulsions, don’t not pray out of the wish- Mm-hmm, mm-hmm
to com- response prevention. Pray with- Still try to pray- Mm, mm-hmm … and try not to engage in those, and maybe flip-flop and teeter-totter between your praying and your script and your uncertainty statements or non-engagement in statements-
Justin: Mm-hmm, mm-hmm …
Kimberley: and still engaging in your church. Like, we don’t wanna avoid the church because you might do a compulsion at church.
Justin: Mm-hmm.
Kimberley: Would you agree with that response?
Justin: Largely. It change, the recommendations can change with really high severity.
Kimberley: Yeah.
Justin: And so, actually well before I understood OCD, I, I was trained at a clinic, and they worked with patients who had OCD. They didn’t specialize in it, but it was a lot of, um, general mental health, anxiety, depression, intensive outpatient day programming, day hospital programming.
And I remember that one of the things that kind of shocked me, uh, coming out of seminary, um, but trained as a state licensed therapist as well, was when the head psychiatrist had told somebody to cease a specific spiritual practice for 30 days. They actually told them, “Hey, for part of your treatment, I don’t want you going to church in the next 30 days.”
Now, that’s where a lot of people are like, “See, this is … I told you, these people are the devil. These therapists, these,” you know, fill in the blank, “are, are recommending against.” Well, here’s the thing. There is no singular passage. There’s not, like, a command to follow of, “I need to be actively in church- Mm-hmm
for four weeks straight.” And so this is where we have some flexibility.
Kimberley: Yeah.
Justin: Now, however, we need to be very careful about a prohibition on total prayer. We … Actually, there’s, there’s ways to kind of game it in the sense that sometimes gets people’s buy-in to say, “Hey, I need you to prove to me that you’re not compulsively praying.”
So I would like you to figure out a way that you can do it where you are confident that this is not a compulsion, and then share it with me, and and we’ll just kinda run it past together and I’ll, I’ll share some insights that I have. And the sooner you get there, the more I’m gonna f- and it’s not up to me, it’s up to you, the Lord, but I’m gonna feel good about blessing, so to speak, like your re-engagements with whatever it is that you had to take a pause.
So there are moments to take a pause, especially with higher severity so that a person, much like with addictions, you know, getting, getting space from something that they haven’t yet figured out. Yeah. I don’t know if this home environment is awful for me, but I think I need 30 days, 60 days to- Yeah … kinda figure this out.
I don’t know if, you know, right now there’s actually a faith problem of which I should examine myself and not take communion or Eucharist, but I sure have a lot of reasons to believe the compulsions are kicking my butt. Yeah. So in that case-
Kimberley: Right …
Justin: what, usually it’s kind of a day-by-day thing. It can even just be in traditional outpatient therapy to be like, “Hey, can you pause this for a moment so that you have the space to do the work?
This week, would you actually skip going to church, see what happens there?”
Kimberley: Yes, and I was literally just about to ask you that. So that, and that’s the, the model that I have used is I don’t need you to stop. I need you to have- Mm … practiced not going once so that you- Yeah … can learn that you can tolerate not going once or not getting- That’s right
communion once. So it, it’s not black and white. And I think that- Yeah … that is where religion can get so confused because sometimes it feels like it’s black and white. Sometimes they, clients will say like, “No, it literally says in the Bible, like it has to be this way.” And OCD- Pray
Justin: without ceasing-
Kimberley: Yeah … is a
Justin: great example.
Yeah.
Kimberley: And then OCD will come in and be like, “You cannot,” like, and that- Mm-hmm … gets so confusing, right? And that’s where so much nuance is required in this treatment.
Justin: Yeah. That’s right. Nuance is, is a right, a good word, and I think of how relational it is. I, I’ve been pondering these past couple of years how much even evidence-based practices that are high power, super impactful, really effective, that still the basic building block is relationship.
Like we’ve- Yeah … got to engage and build trust and rapport with clients. If we don’t have that, it’s, we’re gonna clearly run into problems. And that’s, that’s I think where that personalization comes in, where we actually have a relationship with the person who’s sitting before us to really, really get to know them and, and not just parroting something that was on Instagram or- Yes
that I just posted on Instagram. Mm-hmm. Like, there’s, that- that’s the thing, like, I’m so torn sometimes, um, just social media presence because it has to be so pithy. Mm-hmm. It has to be so, like, black and white and- Yeah … thoughts, thoughts are thoughts are thoughts are thoughts. Yes. I agree with that 100%. I dropped that post recently.
And yet, to work with the person, to work with the nuance that’s there, I think it’s so important that people hear, uh, it, and also can just understand the more that they listen to a podcast like yours, for example, and the more they come across great training, OCD SoCal’s got some great stuff going on right now, and then maybe it’s the international conference, uh, in the summer.
Like, to hear that, okay, wait a second. There’s another way to do this, and what’s being suggested doesn’t have to work against my faith, and it also doesn’t have to work against me. I can show up. I can grow both in a, you know, just an emotional, behavioral sense, but I can also grow in my faith, which is a big passion of mine, not just to be like, “Okay.
Well, you got these faith beliefs that are… I’m making a slowdown assessment. Fine. Okay. Whatever. I guess we’ll talk about it.” Yeah. No. Like, to say, hold on. Actually, some of the most successful cases that I’ve seen and treated are very much because of their faith. Uh, and, you know, putting treatment on steroids, as it were, to say, “Let’s go.”
Like, it’s not just some necessity of, “I guess we gotta talk about it ’cause the person won’t shut up.” No. It’s- Yeah … we have this opportunity to get to know the whole person- Yeah … body, mind, spirit. Biopsychosocial, spiritual is, uh, another way of thinking of it. And then obviously, as clinicians who- who work, you know, with state licensures and, and diversity and, uh, which I love, we’re going to also, uh, need to be at that place where a person can say, “That is silly.
That stuff doesn’t have any importance to me.” And the cool thing is the evidence-based treatment is powerful enough to get most people where they need to go with reducing dysfunction, reducing the suffering that’s in their life.
Kimberley: Right. If you, let’s bring this home, if there is one core message you want to give to someone with scrupulosity or religious OCD, what would that be?
Justin: So I think that’s… The… I’ll, I’ll put it this way. What if it’s easier than you think? This… It could be easier. God could be way more gracious in this than you think. God’s ways are not our ways, and so where I have a tendency to beat the crap out of myself, what if He’s smiling kindly? And then what about the areas where I want to go easy on myself and eat that full sleeve of Oreos and God’s not shutting down or throwing down lightning bolts, but also like, “Hey, I’ve got deeper, richer, more beautiful things.”
What if it’s easier? That’s just kinda the thought that comes to me today.
Kimberley: Wow. That’s really beautiful. I love that. I truly love that. That lands for me, so thank you. Not what I was expecting, so thank you.
Justin: Absolutely, and, and same here. Where we’ve gone, and I think it’s just a reflection of and one of the things that you do really well, is to just get into the space of not just following a script.
Like, we don’t have a script here today. That’s that relational piece, and I think that that’s a big part of the answer, no matter which way we look at it- Yeah … and a big part of both in therapy and in community, and it’s showing up. It’s being with people, and I’m just so encouraged by, uh, how you approach these things, uh, as I learn from you as well.
Kimberley: Thank you so much for being here. Tell us about where people can hear more about you.
Justin: Yes. My website is the main hub, justinkhughes.com. Um, so you can go to my /blog, find out about the book, /book, and yeah, just the go-to spot. I’ll send a couple of things that you can send out to your listeners, um, with, uh, free e-books and stuff like that if interested.
Kimberley: Amazing. Thank you so much for being here, truly. What a gift for me on a Tuesday morning to sit with you and be a student, you know? I love it so much, so thank you.
Justin: May we always be in the student role.
Kimberley: Yes. Yes. Yeah. Thank you.
Justin: For real. Thank you.
Kimberley: Please note that this podcast or any other resources from cbtschool.com
should not replace professional mental health care.
If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day, and thank you for supporting cbtschool.com.
