Why Traditional Talk Therapy is Bad for Scrupulosity and Related Forms of OCD
If you live with obsessive-compulsive disorder (OCD), you may have been encouraged to “talk it through” as a path toward healing. For many mental health concerns, this approach is helpful. But for OCD—particularly religious or moral OCD (scrupulosity)—traditional talk therapy can unintentionally make symptoms more persistent, more distressing, and more confusing.
This can be especially difficult for members of The Church of Jesus Christ of Latter-day Saints. Reflection, contemplation, and study are meaningful parts of the LDS faith. When OCD is involved, however, these same values can become the very material OCD uses to generate fear and doubt. More talking does not lead to peace—when OCD is involved, it leads to more uncertainty and heightened anxiety.
OCD Is Not a Lack of Insight or Understanding
One of the most common misunderstandings about OCD is that it stems from unresolved emotional issues, trauma, or a lack of insight. In reality, people with OCD are often highly conscientious, thoughtful, and morally sensitive. They already understand their fears logically.
OCD is not a thinking problem. It is a certainty problem.
The OCD brain demands absolute certainty—about safety, morality, forgiveness, or worthiness—before allowing a person to feel at ease. Unfortunately, certainty is something the brain can never fully achieve.
How Talk Therapy Reinforces the OCD Cycle
OCD follows a predictable cycle:
An intrusive thought or doubt (“What if I am not worthy?”)
Anxiety, guilt, or fear
A compulsion (rumination, reassurance-seeking, confessing, repeated prayer)
Temporary relief
A return of doubt, usually stronger than before
Traditional talk therapy often becomes part of this cycle.
When therapy focuses on reassurance, emotional processing, or analyzing whether a thought “really counts,” the brain learns that relief comes from figuring it out. This reinforces OCD’s demand for certainty and keeps the loop alive.
Scrupulosity and LDS-Specific Therapy Traps
For Latter-day Saints, scrupulosity often centers on sincere spiritual concerns. This is not about a lack of faith. It is about OCD attaching itself to what matters most.
Common ways talk therapy can unintentionally worsen scrupulosity include:
Over-processing repentance
Clients may repeatedly discuss whether they repented “correctly,” felt enough sorrow, or need to confess again. Each discussion provides reassurance that briefly reduces anxiety—until the doubt returns.
Analyzing intent
OCD often asks, “What if my intent wasn’t pure?” Talk therapy encourages exploring intent, which keeps clients stuck in mental review rather than learning to tolerate uncertainty.
Moral reassurance
Sessions may turn into ongoing discussions about whether someone is a good person, faithful enough, or spiritually safe. These conversations feel comforting but function as compulsions.
Using spiritual truths as reassurance
Statements like “God knows your heart” or “You wouldn’t worry like this if you were doing something wrong” can temporarily soothe anxiety, but OCD quickly demands that reassurance again.
Feeling Better Is Not the Same as Getting Better
Talk therapy often aims to reduce distress in the moment. OCD treatment aims to change how the brain responds to doubt long-term.
When relief comes from explanation, reassurance, or emotional resolution, OCD never learns that uncertainty can be tolerated. Instead, it learns that anxiety must be resolved before life can continue.
Many people with scrupulosity report that traditional therapy:
Increased doubt over time
Made symptoms more complex
Introduced new obsessions
Strengthened fear of “getting it wrong”
This is not a personal failure—and it is not a moral failure. It is a treatment mismatch.
What Actually Helps: Evidence-Based OCD Treatment
Effective OCD treatment does not try to eliminate intrusive thoughts or guarantee certainty. Instead, it teaches the brain to stop responding to OCD demands.
Evidence-based treatments for OCD include:
Inference-Based Cognitive Behavioral Therapy (I-CBT)
Caregiver-based approaches such as SPACE (when appropriate)
These approaches help individuals:
Disengage from compulsive analysis and reassurance-seeking
Act according to values rather than fear
Tolerate uncertainty without resolving it
Separate genuine faith from OCD-driven rituals
For Latter-day Saints with scrupulosity, this often means learning to practice faith without performing behaviors for compulsive behaviors like rumination, reassurance-seeking, and excessive confession.
Why Working With an OCD Therapist Matters
This is one of the most important—and most overlooked—parts of recovery.
OCD is a highly specialized disorder. Even well-trained, compassionate therapists can unintentionally reinforce symptoms if they are not specifically trained in OCD treatment. A therapist who is unfamiliar with scrupulosity may mistake compulsions for healthy spiritual practices or assume that reassurance is helpful.
An OCD specialist understands:
How reassurance fuels symptoms
How scrupulosity differs from healthy faith
How to treat OCD without undermining religious values
How to help clients tolerate doubt without abandoning beliefs
Evidence-based OCD treatment is not about challenging faith. It is about removing OCD from the driver’s seat so faith can exist without fear.
You Don’t Have to Think Your Way Out of OCD
If you’ve tried talk therapy and felt worse—or stuck—you’re not broken, and you’re not doing therapy “wrong.” OCD simply requires a different approach.
With the right, evidence-based treatment from a clinician who specializes in OCD, it is possible to experience relief, regain trust in yourself, and practice faith without constant anxiety.
Start OCD Treatment in Provo, UT
Peace doesn’t come from certainty.
It comes from understanding your OCD and learning how to manage it with the support of specialized, evidence-based treatment. If you’ve tried traditional talk therapy and found yourself feeling more stuck, more anxious, or more unsure, it doesn’t mean you’re broken—it usually means you need a different kind of care. You can take the first step with Mountain Home Center for Religious and Moral OCD by following these simple steps:
Reach out through my contact page or directly at claire@mountainhomeocd.com.
Meet with a compassionate OCD therapist.
Start creating a plan for meaningful, lasting change!
Other Services Offered with Mountain Home Center for Religious and Moral OCD
At Mountain Home Center, I offer more than support for religious OCD. Through evidence-based therapy services—including SPACE treatment—I help individuals work through OCD-related concerns, anxiety disorders, and relationship challenges. I understand the unique experiences of Latter-day Saints and others seeking faith-compatible care, and I provide a compassionate, individualized approach that honors what matters most to you. I am happy to offer support with ERP for OCD, I-CBT, and SPACE treatment. Feel free to visit my blog or FAQ page to learn more!
