When my therapist first suggested I could have强迫症（OCD），我感到很多事情。
Mostly, I felt relieved.
但是我也感到害怕。以我的经验，强迫症是最广泛误解的精神疾病之一 - 每个人都认为他们知道这是什么，但实际上很少有人做。
大多数人将OCD与经常洗手和过度整洁相关联，但这不是事实。
Some people with OCD are incredibly concerned with hygiene, but many people aren’t. Like many others, I worried that talking about my OCD would be met with a dismissal —but you’re not obsessively tidy!— instead of understanding, even by people whose intentions were good.
As the name suggests, OCD involves obsessions, which are intrusive, unwanted, persistent thoughts. It also involves compulsions, which are the mental or physical practices used to reduce distress around those thoughts.
Most of us have intrusive, weird thoughts from time to time. We may get to work and think, “Hey, what if I left the gas stove on?” The problem is when we give inflated meaning to these thoughts.
We might return to the thought again and again:如果我把煤气炉留在那里怎么办？如果我把煤气炉留在那里怎么办？如果我把煤气炉留在那里怎么办？
The thoughts then become very distressing to us, so much so that we pick up certain compulsions or change our day-to-day routine to avoid those thoughts.
To someone with OCD, checking the gas stove 10 times each morning might be a compulsion intended to reduce those stressful thoughts, while others might have a prayer they repeat to themselves to cope with the anxiety.
At the heart of OCD is fear or uncertainty, though, so it’s by no means limited to germs or burning down your home.
One way OCD can take form is scrupulosity, often referred to as ‘religious OCD’ or ‘moral OCD.’
“Scrupulosity is an OCD theme in which a person is overly concerned with the fear that they are doing something that goes against their religious beliefs or is immoral,” saysStephanie Woodrow, a counselor who specializes in treating OCD.
Let’s say you’re sitting in church and a blasphemous thought crosses your mind. Most religious people will feel bad, but then move on from that thought.
People with scrupulosity, however, will struggle to let that thought go.
They’ll feel racked with guilt because the thought crossed their mind, and they might worry about offending God. They’ll spend hours trying to ‘make up’ for this by confessing, praying, and reading religious texts. These compulsions or rituals are aimed at reducing their distress.
这意味着宗教充满着他们的焦虑，他们将努力真正享受宗教服务或实践。
在仔细检查方面，痴迷（或持续的，侵入性的思想）可能包括担心：
- 冒犯上帝
- 犯罪
- praying incorrectly
- misinterpreting religious teachings
- going to the “wrong” place of worship
- participating in certain religious practices “incorrectly” (e.g. a Catholic person might worry about not crossing themselves correctly, or a Jewish person might worry about not wearing the Tefillin perfectly in the middle of their forehead)
The compulsions (or rituals) could include:
- excessive praying
- frequent confessing
- seeking reassurance from religious leaders
- avoiding situations where immoral acts might happen
当然,许多宗教人士确实担心me of the above issues to an extent. For example, if you believe in hell, chances are you’ve worried about going there at least once.
So, I asked Woodrow, what’s the difference between non-pathological religious concerns and actual OCD?
她解释说：“关键是[扫描性]的人不享受信仰/宗教的任何方面，因为他们一直都害怕。”“如果有人对某事感到恼火或担心因跳过某事而遇到麻烦，他们可能不喜欢自己的宗教习俗，但他们并不害怕做错事。”
Scrupulosity isn’t just limited to the religious: You can have moral scrupulosity, too.
“When someone has moral scrupulosity, they might be worried about not treating people equally, lying, or having bad motives for doing something,” Woodrow explains.
一些道德审查的症状包括担心：
- lying, even if unintentionally (which could include being afraid of lying by omission or accidentally misleading people)
- unconsciously discriminating against people
- acting ethically out of self-interest, instead of being motivated by helping others
- whether the ethical choices you make are truly better for the greater good
- 无论您是否真正是“好”的人
The rituals relating to moral scrupulosity could look like:
- doing altruistic things to “prove” to yourself that you’re a good person
- oversharing or repeating information so that you don’t accidentally lie to people
- debating ethics for hours in your head
- refusing to make decisions because you can’t figure out the “best” decision
- 试图做“好”的事情来弥补您所做的“坏”事情
如果您熟悉“好地方”中的Chidi，那您会知道我的意思。
Chidi, an ethics professor, is obsessed with weighing the ethics of things — so much so that he struggles to function well, ruins his relationships with others, and gets frequent stomachaches (a common symptom of anxiety!).
While I definitely can’t diagnose a fictional character, Chidi is pretty much what moral OCD can look like.
当然，解决严格性的问题在于，很少有人知道它存在。
Being concerned about ethical or religious issues doesn’t sound bad to everyone. This, coupled with the fact that OCD is often misrepresented and misunderstood, means that people don’t always know what signs to look out for or where to turn for help.
“In my experience, it takes a while for them to realize that what they are experiencing is too much and unnecessary,” Michael Twohig, a psychology professor at Utah State University, tells Healthline.
他说：“对于他们来说，认为这是忠实的一部分是很普遍的。”“外面的人通常会介入，说这太多了。如果该人受到信任或宗教领袖，可能会非常有帮助。”
Fortunately, with the right support, scrupulosity can be treated.
Often, OCD is treated by cognitive behavioral therapy (CBT), specifically exposure and response prevention (ERP).
ERP often involves confronting your obsessive thoughts without engaging in compulsive behavior or rituals. So, if you believe God will hate you if you don’t pray every night, you might intentionally skip one night of prayers and manage your feelings around it.
OCD治疗的另一种形式是接受和承诺疗法（ACT），这是一种涉及接受和正念技术的CBT形式。
Twiphig在治疗强迫症方面拥有广泛的ACT专业知识，最近从事
Another hurdle for people with OCD is that they often fear treatment for scrupulosity will push them away from their faith, according to Twohig. Someone might fear that their therapist will discourage them from praying, going to religious gatherings, or believing in God.
但事实并非如此。
The treatment is meant to focus on treating the紊乱of OCD — it’s not about trying to change your faith or beliefs.
You can maintain your religion or beliefs while treating your OCD.
In fact, treatment might help you enjoy your religion more. “Studies have shown that after completing treatment, people with religious scrupulosity actually enjoy their faith more than prior to treatment,” Woodrow says.
Twohig agrees. He worked on a
“I usually say that our goal as therapists is to help the client do what is most important to them,” Twohig says. “If religion is important to them, we want to help the client make religion more meaningful.”
Your treatment plan might involve talking to religious leaders, who can help you form a healthier relationship with your faith.
伍德罗说：“有一些神职人员也是强迫症治疗师，并且经常在做'应该做的事情上做'应该做的事情之间取得平衡，而不是强迫症说一个人应该做的事情。”“他们都同意，没有任何宗教领袖认为[扫描仪式]仪式是好的或有帮助的。”
好消息是，对任何形式的强迫症的治疗都是可能的。坏消息？除非我们认识到它存在，否则很难对待某些东西。
精神疾病的症状可以以许多意外且令人惊讶的方式出现，以至于我们可以在将其与我们的心理健康联系起来之前会经历大量的困扰。
This is one of the many reasons why we should continue to talk about mental health, our symptoms, and therapy — even and especially if our struggles interfere with our ability to pursue what’s most important to us.
西安·弗格森（Sian Ferguson）是位于南非格雷厄姆斯敦（Grahamstown）的自由作家和记者。她的写作涵盖了与社会正义和健康有关的问题。你可以接触她Twitter.
Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. As someone with multiple anxiety disorders, she’s passionate about using her writing skills to educate and empower readers. She believes that words have the power to change minds, hearts, and lives.
