How to Treat Scrupulosity OCD and Chronic Guilt – 5 effective recovery tips


how to overcome scrupulosity ocd

How to recover from moral scrupulosity OCD in 5 steps:

1. Recognise that your brain works differently

OCD is a serious brain circuit disorder. In fact, medical imaging shows that in OCD sufferers, the brain circuit that generates guilt and anxiety is abnormally hyperactive.

This results in OCD sufferers experiencing significantly higher levels of these negative emotions (when compared to healthy people). These emotions get more intense and long-lasting, in response to triggers such as intrusive thoughts, real-life events, false memories or moral uncertainty.

Because people with OCD are more susceptible to high levels of anxiety and guilt, they can’t afford to have rigid beliefs which cause these emotions to amplify.

People with OCD also tend to have lower levels of serotonin (natural mood stabilizer). Physicians may prescribe medications such as Sertraline in order to stabilize serotonin levels.

It’s important to note that understanding every detail of the neural basis of OCD is not necessary for recovery, however, for people that are still not convinced that OCD is a brain disorder, I cover this topic in my article that explains why OCD sufferers are more prone to chronic guilt and anxiety.

2. Get rid of unhealthy beliefs and adopt a mindset of unconditional acceptance

The problem with conditional acceptance is that it’s not realistic. Humans are flawed and fallible. Valuing yourself based on your work performance, popularity or actions leaves you vulnerable to real-life events or circumstances in the future.

In contrast, healthy beliefs (eg unconditional acceptance) are more flexible and do not provoke these negative emotions. For scrupulosity OCD, it’s essential to get rid of the deserving mindset.

Because people with OCD have a heightened threat, danger and guilt response, they can’t afford to adopt unhealthy conventional beliefs such as people’s deservingness and conditional life and other acceptance. For scrupulosity OCD, it’s essential to continuously work on challenging and changing these beliefs.

Healthy and rational beliefs:

  • People are flawed and fallible which results in mistakes or negative behaviour patterns
  • People’s actions are a result of their genetics, upbringing, environment, beliefs and thought processes
  • Deservingness in an unhealthy made-up social construct
  • I can unconditionally accept my situation even if I lost everything (job, friends, health, money etc)
  • My self-worth is not based on my work performance, relationship status, number of friends or income level
  • I can accept that the world is full of grey areas, flaws, imperfections, uncertainties, contradictions, inconsistencies and hypocrisies
  • To achieve inner peace you don’t need anyone to think a certain way about you
  • I can unconditionally accept myself and carry on with my daily routine regardless of any scenario
  • Every single person should do what it takes to make the most out of their life
  • I have the ability and mental strength to resist the urge to engage in a compulsion

Unhealthy and irrational beliefs

  • People deserve x amount of happiness, success and health based on their actions
  • I could never accept myself or others if they did this action
  • I could never accept myself if this blurred memory was true
  • This person deserves to be written off based on something they’ve done
  • My self-worth is based on others’ opinions of me

The key to recovery from chronic guilt and morality-related OCD is to get rid of the deserving mindset. The more deservingness beliefs that you can get rid of, the better your mental health will be.

3. Break down core fears and make peace with worst-case scenarios

Breaking down core fears and being able to accept worst-case scenarios is a helpful long-term strategy to dampen these negative emotions.

Common core fears in relation to moral scrupulosity OCD include the fear of not deserving to be healthy, happy or successful as well as the fear of deserving to be negatively judged by others.

To see more examples of core fears please read this useful article on 7 core fears to work on for scrupulosity OCD recovery

4. Exposure and response prevention – work on cutting out compulsions

Exposure and response prevention is a highly effective strategy for recovering from OCD themes. For scrupulosity and harm OCD, exposure therapy involves gradually putting yourself in situations that usually invoke anxiety, in order to desensitise yourself to the trigger over time. If you’re interested in using exposure therapy to recover from OCD, please read our complete guide on how to do ERP at home.

Important: many OCD sufferers with chronic guilt in relation to real events have reported that ERP therapy alone, is not enough – it needs to be combined with the strategies above for effective OCD recovery.

5. Track progress and have an accountability partner

From my own first-hand experience, I’ve found that tracking my progress has been crucial for recovering from OCD. You can track your progress by using a therapist as an accountability partner or by using a mental health journal.

Metrics to track include your anxiety and guilt levels, your obsessive-compulsive behaviour, how judgemental you are towards yourself or others and how flexible your belief system is on a scale of 0-10.

6. Trust in the process

Hope is a key factor that helps facilitate recovery from scrupulosity, false memory and real-event OCD. There’s comfort in knowing that if you get rid of deservingness beliefs and instead adopt a radical mindset and belief system of non-judgement and unconditional acceptance of worst-case scenarios, your fear will be dampened down and as a result of this you will feel less compelled to engage in the neutralising compulsions.

What is scrupulosity OCD?

Scrupulosity is a variation of OCD characterized by excessive preoccupation with religious or moral beliefs, resulting in feelings of guilt or anxiety. This leads the individual to engage in compulsive behaviors to alleviate these feelings.

If you are more affected by religious OCD, please read this useful guide on religion and obsessive compulsive disorder.

What are some examples of moral scrupulosity-related compulsions?

  • Checking if blurred memories are real
  • Ruminating about whether you deserve to be miserable
  • Engaging in compulsive acts of charity or self-sacrifice to atone for perceived sins
  • Excessively confessing to others or seeking forgiveness
  • Seeking reassurance from others to make sure they are not a bad person
  • Feeling guilty or anxious about their thoughts
  • Self-harm

How does morality OCD interact with other themes?

Moral scrupulosity OCD can combine with magical thinking to cause considerable distress in individuals. For example, someone may worry that if an object is not placed in a certain position then harm will come to their loved one. They may experience excessive guilt and anxiety if they resist the neutralising compulsion. If you’re interested in learning more about magical thinking, please read this informative article.

Unhealthy beliefs about morality and conditional acceptance, create a sense of low self-worth, especially in individuals that feel compelled to be perfect in every aspect of their life. To learn more about maladaptive OCD perfectionism please this article about perfectionism in OCD.

How can I help someone with OCD scrupulosity recover?

Encourage them to take the healthy recovery steps that are outlined in this article. If you are caring for someone with OCD, then you can work on changing your own beliefs to be more non-judgemental and understanding and accepting of life circumstances and other people. If they do open up to you it’s important to not jump to conclusions. You can help them organise therapy sessions or act as an accountability partner as previously mentioned, to help the keep track of their progress.

Free resources for OCD sufferers 

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