Scrupulousness: the excessive fear of not being good enough

The 16th century theologian Martin Luther was tormented by impulses to curse God and Jesus. When he prayed, he became obsessed with images of the devil.

On the other hand, Santo Inácio, the Portuguese Jesuit of the same century, could not step on two pieces of straw that formed a cross because it would be disrespectful to Christ.

Both suffered from conscientiousness, a form of obsessive-compulsive disorder (OCD) that, although documented for centuries, remains little known. These are people who live in torment, thinking that they are constantly violating their religious, ethical or moral beliefs. They may obsess over not praying well or even punish themselves for being bad people because they didn’t recycle a sheet of paper, for example.

Unfortunately, these intrusive thoughts can flood children’s minds, overwhelming them with feelings of guilt, confusion, and insecurity, unbeknownst to adults. Convinced that they are perverse and have no solution, children do not dare to tell what is happening.

old acquaintance

Historical records of conscientiousness symptoms can be traced back to the 14th and 16th centuries.

At this time, it was often discussed in a religious context, as religion played an important role in everyday life. People were used to sharing their physical and mental sufferings with local religious figures.

“The clerics of the time were the ones who discovered scrupulousness and OCD, when the faithful often approached priests or rabbis to ask if they were doing everything right, to go to confession or when they prayed incessantly, but with a feeling of anxiety,” he told the BBC. American psychologist Patricia Thornton. “It made them think, ‘Something’s wrong, this isn’t what God intends you to feel or think’.”

For Luther, “the devil is the one who puts these ideas in people’s heads and says, ‘…you need to believe better. You need to believe more. Your faith is not very strong, it is insufficient.’ And that makes them desperate.”

In the 17th century, British clergyman Richard Baxter — considered a source of help for people who felt scrupulous or melancholy (another term for obsession) — wrote in detail about this condition. According to him, “some melancholy and meticulous people accuse themselves, out of mere conscientiousness, questioning almost everything they eat, drink, wear or do, whether the quantity is not excessive or if it is not too pleasant.”

“Scrupulousness comes from the Latin word scrupulum, which means ‘sharp stone’. You feel it like a thorn in your shoe, but in this case it’s inside you and it can’t be taken out,” explains Annabella Hagen, Clinical Director at Mindset. Family Therapy, based in Utah, United States.

Thomton pointed out that OCD and conscientiousness have nothing to do with devotion. It’s not about your religious or moral beliefs, or how ethical or religious you are, because “there are a lot of people who are very religious or attached to their moral norms who don’t suffer from conscientiousness. You have to have the anxiety component. It comes into play.” with the conviction that you’re not doing well,” she says.

“And one might not be religious, but still feel very conscientious about things like, am I a good enough citizen? Good enough neighbor, good enough father, son, etc.?” Hagen adds.

What do people feel?

Shay suffers from conscientiousness and was diagnosed in his early 30s — as he only sought help after becoming a father. He explained to the BBC how he feels, so that people who don’t know about the disorder can understand.

“Imagine that you hate the color blue and that it is the worst thing in the world for you. One day, you imagine yourself in a blue outfit. But you hate that color, why would you imagine yourself wearing a blue outfit? does that mean? that you actually like the color blue?”

“Once you see yourself in that circle, all you can think about is the color blue — even when you think for a moment you haven’t thought about it,” he explains. “Will I ever stop thinking about the color blue? Will the color blue control my life for the rest of my days? The only thing I can think about is the color blue?”

Shay goes on: “Then you see other people and all you can do is imagine them dressed in blue. You ask yourself, ‘This is utter nonsense. Why am I so afraid of this?’ But OCD is so powerful that it can override that rational voice and say, ‘No, that’s not bullshit’.”

How does it manifest?

To illustrate the effects of conscientiousness, the Healthline website provides examples, starting with religious afflicted with this disorder, who may fear they are:

• offending God
• committing sins
• praying incorrectly
• Misinterpreting religious teachings
• Doing certain religious practices “incorrectly” (e.g. a Catholic convinced he is not making the sign of the cross correctly)

To alleviate feelings of guilt or anxiety, some people turn to compulsive rituals, such as:

• excessive prayer
• frequent confessions
• Seeking Solace from Religious Leaders
• Avoid situations where immoral acts may occur

Some symptoms of secular conscientiousness include obsessive preoccupation with:

• Lying, even unintentionally (which could include the fear of lying by omission or accidentally deceiving people)
• Unconsciously discriminating against people
• Act ethically out of self-interest rather than motivated by helping people
• Whether the ethical decisions made are really the best for the common good
• Whether you are really a “good” person or not

Rituals related to moral scrupulousness can be:

• Do selfless actions to “prove” to themselves that they are good people
• Sharing too much or repeating information to avoid accidentally lying to people
• Mental ethical debates that last for hours
• Refusing to make decisions because you cannot prove which is the “best” decision

What to do?

An estimated 2% of the world’s population suffers from OCD.

Studies show conscientiousness is the fifth most common form of OCD, after contamination, aggressive thoughts, symmetry and somatic worries, as published in the Journal of Obsessive-Compulsive Related Disorders by Jonathan Abramowitz and Ryan Jacoby, both of Chapel Hill , in the United States.

“People suffer a lot. They try not to make absolutely any mistakes within what they consider right and wrong, and when they fail, they suffer intense anxiety, deep guilt and an immense amount of doubt,” US clinical psychologist Ezra Cowan told the BBC. .

“Getting better with any kind of OCD means accepting uncertainty. That’s what it’s really all about. You have to say ‘I don’t know’ and get on with life,” says Thorton. “But this ‘I don’t know’ is very upsetting because OCD requires you to know and you can never know everything.”

Sometimes identifying conscientiousness can be difficult. The awareness that it exists and the help of the community are essential so that people do not have to suffer in silence.

Common treatments are exposure and response prevention (EPR) and acceptance and commitment therapy (ACT), which help to develop tolerance and acceptance of obsessions and compulsions.

“There are people ready to help and you’re not alone. When you face your fears, you soon learn to treat them as irrelevant. It’s difficult and terrifying. There’s no overnight cure, but it helps,” says Shay.

“OCD is also a very greedy disorder. It wants to be the only thing in your life and the way to beat it is to realize that it is only a small part of your life and that inside you there are many other things. OCD doesn’t define you”, he concludes.