I’ve been surprised at how frequently this question comes up. The main concern is often put like this: “I’m not sure if I have OCD or not. This just doesn’t seem like a mental disorder. I’m not saying that I don’t have a mental disorder, but this doesn’t feel like one. It seems like a real spiritual problem–a struggle that directly involves me and God. It’s just seems different than a physical illness.”

People with such sentiments are likely to have a hard time investing themselves in treatment. I suspect, in fact, that lots of Christians do have what psychiatrists would call OCD; but would reject the diagnosis if they were given it, and of course never get therapy, because they sense they are dealing with a spiritual rather than a physical reality. I don’t blame them, because OCD can feel like that. The truth is, however, that OCD is a spiritual disorder as well as a physical one.

Much could be said about the relationship of physical disorders to the spiritual realm, but let me simply explain how I view the matter as it relates to OCD. This approach doesn’t claim too much, and it works for my patients. At a minimum, we can say the following.

First of all, OCD is a physical disorder. From a medical standpoint, there is no room for doubt on this fact. It is characterized by unique symptoms related to distinct changes in the brain that normalize with treatment. It is as biochemical as diabetes, and like that disorder it involves the dysregulation of a biochemical system. In the case of OCD, the dysregulation is in the brain, affecting how fearful thoughts are processed.

Yet, in no way does that suggest that it is not also a spiritual disorder.  Certainly all physical disorders become spiritual matters to some degree when they affect our relationship with God. And certainly no physical disorder affects our relationship with God more than OCD, a problem consisting solely of fears–often relating to God himself! We’re not captives of our fears–Jesus took care of that. We have the ability to choose what we do when struck with obsessions. The choice we make is all important in the spiritual realm. Do we let fear rule us, or do we turn to God? Do we trust in ourselves, or in God’s power and mercy?

In the physical realm, OCD is effectively treated with cognitive behavioral therapy. This therapeutic technique teaches a person how to make choices that lead to habituation of fears. In the spiritual realm, likewise, there are correct choices to be made when dealing with obsessions—namely  giving to God the responsibility for them. Providentially, the right choices in the spiritual realm cause  the same therapeutic effect as does cognitive-behavioral therapy. For what more could we ask? God is giving us every break. He wants us to turn to him. Surely, that is why God allows us to suffer obsessions in the first place.

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