OCDers spend a lot of time hoping. What they hope for is that their obsessional fears are not realized. Take the example (not uncommon) of a new and loving mother with the gut wrenching obsession that she is a pedophile and wants to molest her baby. She has an image in her mind of doing it, and sometimes even an inexplicable urge to do so. Of course, she is not a pedophile, and she does not want to do anything like that to her baby. The disturbing thoughts are OCD pure and simple. That is very clear. Yet, although this may be clear to everyone else, it is far from clear to her. “Okay, I have OCD,” she says, “but maybe I’m also a pedophile!” She hopes she is not, desperately.
There is an excellent psychological treatment for obsessional fears, and we encourage OCD sufferers to put their hope in it. At its core is the therapeutic modality referred to as “exposure and response prevention.” If a person purposefully exposes herself to an obsessional fear, tolerating its presence in mind, and prevents herself from responding to the fear through the performance of compulsions, the result is a lessening of the fear (“habituation”). This treatment really works. For the OCD sufferer, a significant risk is involved in engaging the treatment, because tolerating fears and doing nothing about them appears to invite disaster. The risk still seems worthwhile, however, because of genuine hope that is based on scientific understanding.
There is also a Christian approach to OCD that should not be ignored. In this approach, we put our hope in God rather than scientific understanding. We give to God all the responsibility for dealing with an obsessional concern and everything about it. We do nothing to lessen the fear, or the anxiety, or the uncertainty associated with it—rather, we allow God to be in charge of all of that. There is plenty of risk involved here, too, because God does allow bad things to happen to good people. God even allows some people who call themselves Christians to turn into pedophiles. Yet here the risk is also worthwhile, because God is merciful, and he arranges such trials for our spiritual good.
It is through such trials that we grow in hope, and that is what God wants. As Saint Therese of Lisieux says, “What pleases God is the blind hope I have in his mercy.” (And hope is never so blind as when taken in the midst of a severe obsession!). Further, it is when we are most fearful that we hope the most. So fear, in that sense, is good. Martin Luther expresses this nicely: “Fear and hope go hand in hand. And just as the judgment of God produces fear, so fear results in crying out, and the cry brings mercy.” Thus the highest degree of hope is found when we fear. As a 9th century Catholic saint observed, “Holy fear guards the summit of hope.”
To approach the terrible fears of OCD from a Christian perspective means to take a risk. The risk is to allow God to have complete control over all aspects of the fear: its occurrence, its outcome; and the anxiety, uncertainty, guilt that accompanies it. If we take the risk and put our hope in God, our Christian faith assures us that that we will be rewarded; we will find peace.
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