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Scrupulosity

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What is Scrupulosity? Scrupulosity is a form of obsessive-compulsive disorder (OCD) characterized by religious and/or moral obsessions. Scrupulosity can sometimes be difficult to recognize because even within a single faith community, religious beliefs and practices vary widely. There is no singular belief or behavior that is diagnostic for scrupulosity. Instead, scrupulosity is best regarded as a pattern of beliefs and behaviors associated with excessive worry about having committed a sin or engaging in immoral acts. Concern may focus either on thoughts or actions already taken or the possibility of committing sins in the future. This results in significant emotional distress, guilt, and despair. Scrupulous individuals also worry about the sinfulness of having bad thoughts. This experience is very similar to individuals with OCD who experience harm-related obsessions (e.g., the fear of harming a child or loved one). People with...

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Reassurance Seeking in OCD

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Although contamination OCD and washing rituals often go hand-in-hand, many rituals in this domain do not actually involve cleaning or disinfecting. These more subtle rituals are often based around reassurance seeking behaviors that become ingrained in everyday habit. In the context of exposure and response prevention (ERP), reassurance seeking OCD rituals are just as important to address as washing rituals. If you resist washing rituals but continue to engage in reassurance seeking rituals, your recovery will eventually stall (or perhaps never get started at all). Do you believe that knowledge is power? Do you aspire to optimum health? Do you believe that an ounce of prevention is worth a pound of cure? If so, you may be vulnerable to reassurance seeking rituals. Information-Seeking vs. Reassurance Seeking Reassurance seeking rituals involve mentally preparing for potential threats. These compulsions are often...

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OCD & Contamination: Washing & Cleaning Compulsions/Rituals

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OCD: Common Compulsions In my last post about OCD, I discussed reasons why people do rituals. This time, I’ll identify specific rituals that are common in obsessive-compulsive disorder (OCD) characterized by a fear of germs, contamination, diseases, and other health-related ills. OCD: Hand-washing Rituals/Compulsions Hand-washing is a very common ritual and typically involves prolonged and frequent hand-washing behaviors. These washing behaviors may involve a particular sequence, order, or rhythm. Some individuals count while washing or wash in multiples of particular numbers. If these washes are interrupted, the individual may feel the need to repeat the entire sequence to make sure that the wash has been performed “properly.” Although people with OCD may think that their washing rituals are primarily for hygienic reasons, the true function of washing rituals is to reduce feelings of distress, anxiety, doubt, and vulnerability. The...

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OCD & Contamination: Reasons Why People Do Rituals/Compulsions

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In my last post, I identified several idiosyncratic feared outcomes in OCD that are associated with contamination/health-related obsessive-compulsive disorder (OCD). Obsessions are intrusive, recurrent, and distressing thoughts, impulses, or images related to these feared outcomes. Today, I’ll discuss the function of compulsions. Why do people with OCD do rituals? Compulsions, or rituals, are the other main feature of OCD. These physical and/or mental behaviors reduce the anxiety brought on by obsessions and reflect one’s attempt to avoid, reduce, or prevent certain feared outcomes from occurring. Ask someone with a fear of contamination, disease, illness, or germs why they ritualize; and they will likely tell you that rituals serve as a means to destroy, neutralize, or escape from potential pathogens. As a consequence, rituals common to health-related OCD often incorporate washing, cleaning, disinfecting, and sanitizing behaviors. Excessively long OCD-driven shower...

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OCD: Screaming, Blurting Out Obscenities/Cursing/Profanity, & Other Unwanted Impulses

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Question: I’m a teenager and keep having OCD symptoms related to impulse control. I often worry that I’ll lose control and scream or blurt out obscenities. I am especially triggered in quiet public places like classrooms, churches, and movie theaters. I have never actually acted on my impulses and cursed in public, but I still feel very anxious whenever these thoughts occur. Do you have any tips for me? These types of symptoms are very similar to other OCD symptoms in which people worry about losing control and acting on unwanted impulses. Most typically, these types of thoughts attach to situations that are considered morally or socially taboo. Related OCD symptoms include fears about losing control and: Harming a loved one (most often fear of harming a child, spouse, or parent). Killing a loved one (i.e., stabbing, shooting, suffocating,...

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