Martin Luther knew OCD. For ten years he suffered it severely. Sometimes in his writings, he seems to be directly speaking to those affected by this disorder. Such is the case here, in this quote from his Commentary on Isaiah:
“God sends a variety of trials, heresies, and the cross in order to train His own and mortify them in their own righteousness and presumption. He mortifies His own in various ways to the point of despair, and then He lifts us up again, so that by experience we are compelled to say, ‘I did not do this, though I expended all my strength, but the hand of the Lord did it.’ Therefore He thoroughly afflicts us, He purifies us well so that we may learn to rely on Him completely. But this will not happen unless our presumption has been destroyed.”
A good case can be made that people with OCD are more prideful than anyone. Okay, I know that is a hard pill to swallow, because we all like to think of ourselves as extra sensitive and always trying to do good. That’s not completely false, but when we do our compulsions we are demonstrating a monstrous degree of presumption. We relying on our own ability to a completely unreasonable degree. That is presumption, a form of pride. Technically it is a sin, because we are showing a lack of faith in God.
Consider the average person struck by an unlikely or unreasonable fear. She does not wrestle with it for hours. Whether it involves cleanliness, possible harm, blasphemy, or terrible thoughts that jump into the mind, she has a sufficient amount of basic trust in something to let it go. Not so with OCD sufferers. No sort of faith is apparent as they struggle onward performing really stupid compulsions. In the case of Christians, these self serving rituals often include repetitively petitioning God for help.
Luther points out here what God must do in such cases for those that he loves: He must purify them of their excessive self reliance. He must teach them the painful lesson of not trusting in themselves, so that they may learn to depend on him. He purifies us of our presumption, so that he may then give us grace. He does this so that we learn to trust in him.
Our part as Christians is to let the purification happen. When struck by an obsession, we must realize that all our compulsions are prideful and presumptuous. We must allow ourselves to be reduced to simply hoping for God’s grace, while waiting passively in fear and trembling for faith to be revealed. It’s tough, but we must suffer through our fears until God sees fit to give us the peace that passes understanding. In narrower psychological jargon, this represents the key element of therapy for OCD: Exposure and response prevention that leads to habituation.