OCD and Christianity

God purifies the faith of all Christians; and for OCD sufferers this process involves, more than anything else, enduring tormenting fears and uncertainties (see the last two blogs). On a clinical level, this purification represents a specific treatment for OCD. It’s helpful to see how it works. Such a therapeutic understanding helps us to understand how God, through his purifying process, is working for our good.

In the treatment of OCD with cognitive behavioral therapy, there is just one therapeutic goal and a number of procedures for implementing it. The goal is that the OCD suffer learns to endure obsessional fears and stop performing compulsions. This leads to habituation to the fears. As much as the individual is able to do this, that’s how much OCD is brought under control.

Martin Luther suffered from what we now call OCD. Only a couple of years after he resolved it, he published a work entitled “Comfort When Facing Grave Temptations.” It was directed to people who dreaded the loss of their salvation, which is exactly the tormenting fear that had struck him. In this work, the great reformer offers five bits of advice. They apply not only to the specific fear of loss of salvation, but to all obsessions. It is amazing how Luther’s counsel squares with modern therapeutic advice. Luther tells us:

First, such a person must by no means rely on himself, nor must he be guided by his own feelings.

This is excellent advice. In OCD, obsessional fears become stronger and stronger as a result of the performance of compulsions. As they do, they also become ever more realistic and believable. As a result, we lose our judgment about what appropriate actions should taken in order to deal with the fears. Therefore, we simply cannot rely on ourselves. We can’t be guided by our feelings. We must endure the fears and wait for habituation to take place.

Second, he must not imagine that he is the only one assailed about his salvation.

My OCD group participants have often pointed out that they are greatly helped in tough moments by thinking of how others have dealt with their frightful obsessions. Luther specifically suggests that we should look to Jesus on the cross when overcome by the torment of severe fear and uncertainty. These emotions are exactly what our Lord felt when he uttered the words “Oh, God, why have you forsaken me?” Yet, he did not ask to be taken down from the cross. He endured his suffering and waited in hope for God’s grace. That’s what we must do.

Third, he should by no means insist on deliverance from these trials without yielding to the divine will. He should address God cheerfully and firmly and say, “If I am to drink this cup, dear Father, may your will, not mine, be done”

This is key. Luther is saying that we must allow ourselves to be on the cross. In clinical terms, this is accepting the process of exposure and response prevention. No way around it: We need to drink the cup like Jesus did. Fear and uncertainty is the cup we are asked to drink—nothing more, nothing less.

Fourth, there is no stronger medicine for this than to begin with words such as David used when he said in Psalm 18 [:3], “I will call upon the Lord and praise him.

When, as Christians, we recognize that this trial is for our good, a part of the process of our sanctification, we put OCD in an entirely different light. We can praise God for it.

Fifth…Therefore, we should willingly endure the hand of God in this and in all suffering. Do not be worried; indeed, such a trial is the very best sign of God’s grace and love for man.

What a beautiful conclusion. If we endure on the cross of fear and uncertainty, we will be rewarded with grace. The whole experience of OCD is a sign of God’s love. In the clinical approach, the reward for enduring obsessions is habituation. That’s good, but it doesn’t match up with the love of God. The Christian understanding is sublime.


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