Schizophrenia and Scrupulosity

Many schizophrenics are familiar with obsession.  Obsessive compulsive disorder is in fact an anxiety disorder and is oftentimes comorbid with schizophrenia.  The two can become intertwined as delusion fuels obsession and vice versa.  However, I want to speak exclusively of a certain type of obsession.

Scrupulosity refers directly to a negative religious obsession.  Schizophrenia usually has spiritual and mystical undertones, so it’s no wonder that one might find themselves obsessed with concerns of religious matters.  The word scrupulosity is derived from the word ‘scrupulum’ in Latin, which is a stone with a sharp edge.

The name fits, because this stone stabs in the schizophrenic mind that is overly sensitive and conscientious, struggling internally with abstract concepts such as sin and guilt.  The obsession with these philosophical objects can impact the individual so deeply that it causes great interference in normal functioning.  The daily life and especially the religious life of the sufferer is affected to the point of causing even greater distress, following the downward spiral as described by so many.

The spiritual practitioner will notice a change in his practice.  He will no longer feel the desirous pull towards a higher experience of good, but will become pushed away from the bad by a pathological anxiety surrounding these issues or morality and spirituality.  There is a subtle difference here that alters the experience for the devotee completely.  The individual is likely to suffer silently while attempting to conquer their own negative obsession.  They will begin by attempting to rationalize through the issues, and then by forcibly trying to deny the thoughts altogether.  This only seems to strengthen them.  They are too ashamed of the nature of their thoughts and will remain alone in this struggle.

Examples of Scrupulosity

The world famous Martin Luther spoke of his own struggles with this imp of the mind.  For no reason at all, he would experience compulsions to curse his god and his savior.  He was be urged by some unknown force to imagine the hind region of the devil while praying.  It was as if he was pushed to think of the most inappropriate thing he could imagine at the most inappropriate times.

St. Ignatius was overly conscientious and hyper aware of his environment.  He was threatened by an obsessive fear of stepping on two pieces of straw that crossed perpendicularly in the form of a cross.  He felt this would be a great disrespect to his Christ crucified.

Other highly attained adepts suffered from scrupulosity during the length of their spiritual achievements.  Some were urged to desecrate the eucharist.  Some had thoughts of molesting the Mother Mary and removing her virginity.  Some were compulsively pushed towards destroying religious iconography, spouting indecent phrases during the most compassionate sermon, or even considering Jesus in a sexual manner.  Others found themselves overly concerned with facing the precise direction, to a matter of degrees, towards Mecca as they prayed.

A Deeper Look at Scrupulosity

Negative obsessive thoughts are specifically focused on the worst fear possible.  This could surround inappropriate actions towards family members or envisioning horrible accidents.  For the schizophrenic, it is often surrounding spiritual topics.  This specific kind of obsessive thought, regarding religion, is called ‘scrupulosity’.

The unfortunate thing about obsessing about religious ideas is due to the nature of the foundational and fundamental beliefs involved.  This can amplify the confusion, fear, anxiety, and need for privacy.  This is the trap of scrupulosity, in that the secret will be kept and sometimes the problem is not even recognized for what it is, a psychological issue.  A believer may call it sin, or may believe they are truly possessed by an evil demonic entity.  So then, they try to conquer their mind alone through suppression, which only fuels the fire and inspires more negative religious thoughts.

The classic example of type of thinking is the command to try not to think of pink elephants.  The first thing you will do is envision a pink elephant. The act of denial and suppression is the creative force behind this illness.

Recovering from Negative Obsessive Religious Thought

The extent of this obsession can grow beyond the help of medication alone to manage.  Counseling in the form of cognitive behavioral therapy must be used in tandem with medication to achieve a full recovery.  Exposure therapy is not suggested as it would expose them to behaviors and actions they would deem sacrilegious.

The main reason cognitive behavioral therapy is the best bet is the ability to correct, or at least soften, some anthropomorphic projections people place upon their conceptions of god.  Most of what people think is not theological.  The scriptures themselves can’t even back it the beliefs, and yet people want to consider their god as an angry and vengeful person who will retaliate and bring forth his wrath on anyone who steps out of line.  This creates a fear of being damned.  Damnation and the anxiety surrounding this frightening possibility only further incites the thoughts to occur.

It should also be noted that obsessives, including us schizophrenics, probably place too much emphasis on certain ideas.  We also tend want to be in total control of our thoughts and have an extreme intolerance to not being able to control them.  It is also intolerable to the religious aspirant to not know fully the consequences of these thoughts.

Eventually in some doctrines, thought was equated to action.  If you had a bad thought, that was as bad as having performed the action.  We all clearly know this is not true, yet we still will feel the guilt and fear associated with it and the possible punishment and judgment awaiting us.  This happens due to the inability to know anything surrounding ethics or metaphysical realities.  If we can become okay with knowing that we can’t know, and nobody else can either, then we can dismiss much of the fear and guilt.  Then, medication can help us get the scrupulous thoughts under control to a reasonable level.


Scrupulosity is a baseless fear of sinning that is derived from faulty ideas, errors regarding metaphysical concepts.  The combination of three factors lead to the problem of obsessive religious thought: conscientiousness, spiritual sensitivity, and unfortunate neurochemical composition.  Any fundamentalist believer of their holy scriptures is also subject to a possible spiral down this obsessive path.  The obsession is the thought, and the compulsion is the thought.  It is a self-reinforcing illness related to impulse control.  Cognitive behavioral counseling and medication should be used together to put an end to this suffering.