Helping People in Crisis

Where to Start

As a member of the clergy, you bring comfort to people when their lives are disrupted by the unexpected: emergencies, disasters, sicknesses and the loss of loved ones.  Because you are also the person to whom many people turn when they are overwhelmed by life’s circumstances, it is entirely possible that individuals who are battling OCD – or  symptoms of what may be OCD – will come to you for help.  In some cases, family members or friends of the individual who is suffering may contact you.  Or perhaps someone has already reached out to you for help.  You can be the one to bring hope to individuals in crisis.

Clergy can play an important role in providing guidance, encouragement and recommendations to OCD sufferers.

One of the most important first steps you can take to help someone struggling with OCD or potential OCD is to become knowledgeable about the disorder.  By understanding what OCD is, symptoms of the disorder, and appropriate treatment, you can help guide struggling individuals onto the road to recovery.

What is OCD?

OCD is a disorder that has a neurobiological basis.  The hallmark of OCD is the presence of obsessions and compulsions which take up at least an hour a day – but usually longer – and cause significant distress.

Obsessions are intrusive thoughts, fears, worries, or urges that cause anxiety or discomfort for the individual.  Virtually everyone has intrusive or disturbing thoughts or worries from time to time.  But people who have OCD are unable to stop these unwanted thoughts or urges; they can’t just dismiss them like people who don’t have OCD.  To reduce the anxiety or discomfort created by the obsessions, people with OCD engage in repetitive mental or physical acts (compulsions, or rituals) that make them feel better temporarily.

Researchers have found that functioning in certain areas of the brain is different in individuals who have OCD compared to those who don’t.  Abnormalities in neurotransmitters – the chemical systems that send messages between brain cells – have also been found.  In addition, research has indicated that genetic, behavioral, cognitive, and environmental factors may also play a role in the onset of OCD.

This web site has information that you can use to learn about the disorder and its treatment.  The sections that should be most useful to you are shown below and link directly to those sections for your reference:

You can also refer to the site map to find specific information for family members, parents helping adult children or the sections especially written for teens.

When OCD and Religion Collide

Scrupulosity is a type of OCD that focuses on religion or morality.

One type of OCD that is characterized by obsessions and compulsions related to religious or moral issues is known as Scrupulosity.  People with religious Scrupulosity experience overwhelming obsessions about sinning or not being “holy enough,” as well as fears of committing inappropriate or violent acts that run contrary to their religious beliefs.  To reduce the distress associated with these obsessions, people with this form of Scrupulosity perform rituals such as praying, going to confession or  attending religious services repeatedly.

Scrupulosity may also involve irrational moral obsessions and corresponding compulsions, or rituals.  Individuals with moral Scrupulosity may fear getting in trouble for making an error (which either hasn’t actually happened or is unlikely to happen) for which they would be punished.  Thus, a child who receives help on homework from her parents may feel as if she has cheated and therefore throws the homework away to reduce her anxiety.

As a member of the clergy, you can play a pivotal role in helping to determine whether someone’s behavior is what it appears to be – a truly devout commitment to one’s faith – or whether it’s indicative of a more serious situation: a form of Obsessive Compulsive Disorder.  Learn more about Scrupulosity

Is Effective Treatment Available?

Fortunately, a very effective treatment called Cognitive Behavior Therapy (CBT) is available for OCD.  CBT, which is the treatment of choice for OCD, involves the use of two evidence-based techniques: Exposure and Response Prevention therapy (ERP) and Cognitive Therapy (CT).  ERP is a special therapy in which OCD patients are placed in situations that expose them to their obsessions and gradually prevent them from performing their typical rituals.

Cognitive Therapy, the second technique involved in CBT, helps an individual identify and modify patterns of thought that cause anxiety, distress or negative behavior.  In other words, CT helps patients understand that the brain is sending “error” messages.  Through Cognitive Therapy, the person learns to recognize these errors and confront the obsessions by responding to them in new ways.

In some cases, physicians prescribe medication to ease the symptoms of OCD.  More about CBT therapy can be found in the OCD Facts and Individuals sections of this web site.

Guidance for Those with OCD

A recommendation to undergo CBT therapy for OCD is taken seriously when it comes from a trusted member of clergy.

A religious leader can positively influence the life of someone who has OCD.  Your recommendation and encouragement to undergo Cognitive Behavior Therapy are likely to be taken more seriously by an OCD sufferer than families’ or friends’ suggestions to get treatment.

When you counsel people who have OCD (including Scrupulosity) or their families, your objectivity and compassion will be crucial in terms of helping them determine the right course of action.  People and families affected by OCD are often so consumed and overwhelmed by the disorder that they can’t think clearly about how to approach the situation.  They value the strength, support and insight you can provide to help them overcome OCD.  Learn more about OCD counseling.

Treatment Resistance and Recovery Failure

Getting effective treatment can help most people with OCD achieve substantial relief from their symptoms and regain significant control over their daily lives.  Unfortunately, getting the appropriate treatment, sticking with a treatment plan and maintaining treatment gains can be challenging.  It can be extremely frustrating when a person who suffers with OCD refuses to get treatment, or when treatment fails. You may be called upon to give guidance when these situations occur. Knowing what to expect ahead of time can make a big difference in your ability to provide assistance.

Learn more about treatment resistance and recovery avoidance

When Financial Assistance is Needed

You may find that some people who seek your help are unable to afford treatment for OCD.  Those without health insurance or whose insurance policies do not fully cover mental health care sometimes struggle to get the treatment they need.  Learn more about how to counsel on financial matters concerning OCD.

More Resources for Clergy

As awareness of OCD continues to grow, more resources are becoming available to help professionals, including clergy, understand the disorder and learn how to encourage people to get into proper treatment programs.


A book published specifically for clergy is Obsessive-Compulsive Disorder: A Guide for Family, Friends and Pastors by Robert M. Collie, a pastoral counselor who is also a clinical social worker.  This book includes both therapeutic and pastoral information, and may be especially useful for pastors, pastoral counselors, priests, rabbis, other ministers and lay ministers.

Another helpful book is Understanding Scrupulosity: Questions, Helps and Encouragement by Rev. Thomas Santa C.Ss.R.  It provides specific answers to questions and concerns related to sin, confession, self-worth, sexuality, prayer, God’s forgiveness and other issues.

For OCD sufferers of the Jewish faith, Avigdor Bonchek, Ph.D., an ordained Orthodox rabbi and clinical psychologist, has written Religious Compulsions and Fears: A Guide to Treatment.  It describes the fine line of separation between scrupulous adherence to religious law and finding oneself tethered to obsessions, compulsions and fears, and would be useful to OCD sufferers, family members, rabbis, teachers and therapists.

A book about Scrupulosity for OCD sufferers is The Doubting Disease: Help for Scrupulosity and Religious Compulsions by Joseph W. Ciarrocchi, Ph.D.

Other Resources

We have reviewed web sites and other books that may be helpful to you. These are listed in the More Resources section of this web site.

There are also first-person accounts of living with OCD and gaining relief from CBT in the Personal Stories section of this web site.  These are inspiring stories of success that might help OCD sufferers you counsel realize there is effective treatment and hope for their own recovery or for that of a family member or friend.

In addition, some people benefit from attending support groups to hear of others’ experiences related to gaining control over OCD or to find out how to help a loved one with OCD.  Information about support groups is available in the More Resources section of this web site.

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