Christianity and Scrupulosity — Fear of Sin and Salvation
Series Introduction: Faith, Doubt, and OCD — Scrupulosity Across Traditions
Article 1: - When Faith Meets Fear — Understanding Scrupulosity in OCD
Article 2: Judaism and Scrupulosity: When OCD Becomes Entangled with Faith
Article 3 in a 5 Part Series
Christianity and Scrupulosity — Fear of Sin and Salvation
In Christian contexts, scrupulosity often centers on fears related to sin, salvation, and eternal consequences. Rev. Dr. Katie O’Dunne, an interfaith chaplain and OCD specialist, described some of the most common themes as “fear of going to hell, fear of sinning against God, fear of committing the unpardonable sin, [and] fear of even accidentally being spiritual contamination.” Even a stray thought during prayer can, for some individuals, become a source of anxiety.
A Life of Confession and Fear
For James, a Catholic high school student, weekly confession was supposed to bring relief. Instead, it became the epicenter of his anxiety. He would go back again and again — sometimes two or three times in a single day — convinced he had left something out or not confessed “the right way.”
“I know God forgives me,” he said. “But what if I didn’t say it with enough sincerity? What if I forgot one detail?”
What should have been a ritual of grace became a loop of doubt. Similar patterns can appear across Christian denominations — for example, fears about having committed an “unpardonable sin,” worries about intrusive thoughts during prayer, or uncertainty about whether one’s faith is sincere enough. Over time, experiences that once felt spiritually grounding may become closely tied to anxiety rather than comfort.
The Double-Edged Sword of Devotion
At times, compulsions can resemble devotion. Attending extra services, repeating confessions, or policing “bad thoughts” can appear holy to others. But O’Dunne cautioned, “[O]n the flip side, individuals who might be engaging in compulsions that look like they are really devout in practice . . . they might be encouraged by clergy to continue to do things in a really rigid way, when, in fact, it's actually making their OCD worse,”
For many people, including Christians, OCD feeds not only on rituals but on morality itself. “It can make someone feel like they aren’t enough — in terms of their morality, in terms of their faith, in terms of who they are,” O’Dunne said. The result is a cycle of guilt, shame, fear, and anxiety. Over time, this can shift from specific fears to a deeper question of identity—whether one is fundamentally good, worthy, or acceptable.
Young adults are particularly vulnerable. “I think most individuals that I work with [who live with] scrupulosity, particularly adolescents and young adults, definitely hold themselves to a higher standard than everyone else,” O’Dunne said. “[They] feel like they have to be moral or religious—like the pinnacle of everything. And that can be really tough for folks who are going to high school or [ ] college, where it feels like [they]need to be on some moral hill above the rest of [their] friends.”
When Devotion Becomes Fear
According to O’Dunne, scrupulosity often traces back to a core fear. For some, it centers on eternal consequences: “I just want to make sure I don’t go to hell and didn’t commit the unpardonable sin.” For others, the anxiety focuses more on moral identity — persistent doubts about whether they are truly good, safe, or worthy of acceptance.
O’Dunne also noted that even when individuals recognize their pattern as OCD, the uncertainty can remain powerful. People may feel a sense of urgency—“it feels like I have to do this or God is going to be upset with me”—alongside persistent doubt: “I know that this is probably OCD, but in the small case that it’s not, I want to make sure that I’m doing the right things.” She added that this can be especially difficult for young adults, who are trying to move forward in their lives while feeling pulled back by these fears.
O’Dunne emphasized that the challenge is not religion itself, but the way OCD can distort and intensify religious concerns. In supportive environments, faith communities can offer purpose, structure, and connection. At the same time, because religion often carries deep emotional meaning, it can become a powerful focus for obsessive fears. Practices intended to bring fulfillment, grounding, and hope may instead become associated with guilt, insecurity, or a sense of not being “good enough.”
In some cases, this distress may lead people to step away from religious life altogether. However, leaving faith does not necessarily resolve the underlying anxiety; symptoms may simply shift to new concerns, and individuals may also lose sources of community, identity, and meaning that could support recovery.
Evidence from Research
Clinical studies support O’Dunne’s observations. Scrupulosity has been well-documented in Catholic and Protestant populations, with estimates that up to 25–33% of religiously observant individuals with OCD present primarily with scrupulosity symptoms (Abramowitz et al., 2002; Miller & Hedges, 2008). Common features include:
Repetitive confession and reassurance-seeking.
Excessive prayer or ritual.
Intrusive, blasphemous thoughts that cause shame.
Fear of committing “unpardonable” sins.
Treatment, however, shows promise. Exposure and response prevention (ERP), the gold-standard therapy, has been shown to reduce religious compulsions while preserving genuine faith. Studies also suggest that collaboration between therapists and clergy improves outcomes, preventing well-meaning pastors from reinforcing compulsions.
Reclaiming Faith
For Christians with scrupulosity, healing is not necessarily about stepping away from faith, but about learning to live it without fear dictating every thought and ritual. O’Dunne said treatment helps people face intrusive fears without giving in to compulsions, whether that means resisting the urge to repeat a prayer, seek repeated confession, or search for certainty.
Over time, that work can help restore a healthier relationship with religion — one rooted less in panic and punishment, and more in meaning, connection, and trust. Instead of letting OCD define what faith must look like, treatment can help people reclaim spiritual practices as sources of grounding rather than distress.
As O’Dunne emphasizes, “never let OCD take something away from you that’s meaningful.” While this can be challenging — and at times painful — she encourages individuals not to step away from what matters simply because OCD demands it. With the right support, faith can remain not a source of fear, but a foundation for meaning, connection, and trust.
Looking Ahead
In this five-part series, the articles that follow look more closely at how scrupulosity appears in specific religious contexts and how faith communities can support healing alongside clinical care.
Interviews Conducted by Abby Shapiro
Scrupulosity Blog Series - The following sources informed the content of the Scrupulosity Blog and provide additional context on OCD, scrupulosity, and evidence-based treatment approaches. See HERE. Key Terms Appendix - HERE.
Coming soon: A clear, practical guide to understanding OCD — and what helps.