Think No Evil: Clergy Responses to Religious Obsessive-Compulsive Disorder

Zhang, Annie R.
Obsessive-compulsive disorder with primary religious themes, also known as scrupulosity, is an understudied problem that poses unique clinical challenges owing to the potential conflicts between the requirements of exposure therapy (the standard treatment) and adherence to religious law. Although previous discussions have highlighted the potential role of clergy members in the maintenance and treatment of this problem, empirical research has not examined religious authorities' attitudes and behaviors toward scrupulous parishioners. The study to be presented was a nationwide, online survey of 70 clergy members affiliated with liberal or conservative denominations of the Lutheran church. Pastors affiliated with the more conservative denomination evidenced higher endorsement of the position that a bad thought is equal to a bad action, belief in a micromanaging God, and responses to a scrupulous parishioner that risk reinforcing compulsive rituals and the fear of sin (e.g., admonitions of God's expectations for purity in thought and deed, advising regular confession of sinful thoughts). Moral thought-action fusion fully mediated denominational differences in potentially problematic responses to a scrupulous parishioner. Implications for collaborative efforts between mental health professionals and clergy members to improve the prevention and management of scrupulosity will be discussed.
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