OCD and Christianity

“I’m in a major OCD crisis,” the young homemaker said. She had experienced contamination fears since adolescence. Now, however, obsessional doubts had struck her religious beliefs, and she was in worse shape than ever. It started when she attended a new church. The pastor had preached a sermon in which he forcefully stated, “Anyone who is not certain of their salvation probably isn’t saved at all.” He had stressed the importance of knowing for sure that we are saved, emphasizing that if we can’t say we are with certainty, then something must be wrong. Ever since that day she had been in a state of panic. She thought that since she doubted, she couldn’t be saved. Very simple. Very terrifying. She tried as hard as she could to convince herself that she was saved, to cast our the idea that she was not, and to immerse herself in Bible verses and spiritual readings. Yet her agitation only got worse.

The pastor’s teaching, often heard in Evangelical and Reformed churches, has some excellent points. It encourages people to be confident in God and bold in their beliefs. It forces people to address stumbling blocks to attaining God’s peace, such as unconfessed sins. One major problem with this theological stance, however, is that a subgroup of people exists for whom this message is a major stumbling block. These people are OCD sufferers.

OCD, sometimes called the “doubting disease,” is a disorder in the processing of fears. It involves the agonizing paradox that the more we try to overcome a particular fear, the stronger it becomes. The OCD suffer struck with a fear that her hands are unclean, for instance, is not going to be able to gain certainty that they are clean through trying to convince herself of that fact. Such efforts become compulsions that make her doubt even stronger. Likewise, in the case of an obsessional doubt of salvation, the OCD sufferer is simply not able to gain certainty that she is saved through her own effort. The steps taken by the young woman to bolster her faith were all good in themselves, yet because of her OCD they made matters worse.

The effective psychological treatment for this particular manifestation of OCD is clear: The young woman must expose herself to the fear that she is not saved and do nothing to lessen it. This will lead to habituation to the fear. From the Christian perspective, a helpful way to view this is as a specific trial of faith. It is the working out of salvation in “fear and trembling” (Phil 2:12). What God wants in these unusual cases is not efforts to make ourselves believe more strongly, but patience in enduring the painful cross of fear and uncertainty. When God is ready, he will then make faith stronger than ever.



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