By Taneia Surles, MPH, NOCD
Research shows that Black Americans are more religious than the general U.S. population—being more likely to believe in God or another higher power, attend services regularly, and say religion is “very important” in their lives.
Faith provides deep comfort, resilience, and hope. But for people with obsessive compulsive disorder (OCD), it can also create unique challenges. OCD often latches onto what people love and value most, including faith, leading to scrupulosity, or religious-themed obsessions and compulsions.
When intrusive thoughts and compulsions become entangled, it can be difficult to separate spiritual concerns from OCD symptoms, and some may be hesitant to seek professional help. But healing is possible. With the right support, people can break the cycle of intrusive doubts and compulsions while maintaining—and even strengthening—their faith.
The central role of faith in the Black community
In the Black community, churches and faith leaders are seen as trusted sources of guidance and support. Beyond spiritual direction, they provide a sense of belonging, resilience, and hope during life’s struggles. When mental health challenges arise, many may turn first to prayer, reading the scripture, or fasting—spiritual practices that can be deeply meaningful, but may also delay seeking professional treatment when needed.
This reliance on faith can become especially complex for people with OCD. Because OCD latches onto what matters most, religious beliefs can become the primary focus of intrusive doubts and compulsions—a subtype or theme known as scrupulosity OCD.
When faith and OCD intersect
Scrupulosity OCD, also known as religious OCD, involves intrusive thoughts and compulsions centered on doing something morally or spiritually “wrong.”
People with this OCD subtype may experience obsessive thoughts such as:
- “What if I sinned and don’t remember it?”
- “Did I offend God by thinking that?”
- “Did I pray the right way, or did I leave something out that makes it invalid?”
- “I thought of a bad word during service. Does that mean I committed blasphemy?”
These distressing thoughts often lead to common compulsions, including:
- Excessive prayer, rituals, or confession
- Re-reading or repeating religious texts to “get it right”
- Asking religious leaders or family for reassurance about salvation or forgiveness
- Mentally reviewing actions to check that no sin was committed or offense given
“When I was younger, I would worry that maybe my dad might not come home,” says Saraa Lee, MSW, LCSW, a therapist at NOCD. “I would pray, and eventually it became compulsive. I would turn to spirituality in a compulsive way to keep myself safe from these intrusive thoughts that I didn’t know were intrusive thoughts at the time.”
In many faith-based communities, when people aren’t aware of the signs of OCD, intrusive thoughts and compulsions are often interpreted as “spiritual struggles” rather than a signal for professional help.
“I felt these thoughts were coming from the devil due to already having a spiritual perspective,” says Lee. “It never occurred to me to think that it was anything mental health-related.”
Barriers to seeking help
Despite growing awareness of OCD and the availability of research-backed treatments like exposure and response prevention (ERP) therapy, several barriers keep many Black people from seeking professional help.
Limited awareness of OCD
“When I was a child, the main reason we didn’t go to therapy was because we didn’t know it existed,” says Lee. She adds that while more people now know what therapy is, some may not believe their symptoms are “severe enough” to get care. “Some may think it’s just for those having a psychotic break or who are hospitalized,” she says. “They aren’t aware of what therapy could do for them.”
“Pray it away” mentality and stigma
Church leaders and family members may recommend praying to “get rid” of blasphemous thoughts instead of seeking help, seeing these experiences as a need to strengthen faith rather than a mental health struggle. “If you have anxiety or fear, then that’s seen as a lack of faith,” says Lee. “So the answer is to pray. If someone tells you to go to a therapist, it can feel like you’re undermining God’s authority or power, or you don’t have the faith you say you have.”
Distrust of the healthcare system
Historical exploitation and discrimination, such as the case of Henrietta Lacks’ cells and the Tuskegee Syphilis Study, have fueled long-standing distrust in medical institutions. “In general, Black people do not have a lot of faith in the medical treatment system because it has not been good to us,” says Lee. “Everybody’s got horror stories. We rightfully are very careful with ourselves.”
Limited access to an OCD specialist
“The primary reasons are insurance and not having the money to pay for it,” says Lee. “Even if you do find a therapist, you need someone who knows what OCD is.” OCD is a very complex condition that requires a professional who can identify intrusive thoughts and compulsive behaviors, and respond with methods that break the cycle rather than reinforce it.
Faith as a source of support in recovery
Managing OCD while maintaining faith can feel like a tug-of-war, but there are ways to find healing without sacrificing your mental health or religion—and that can often start with your trusted religious leader. “A religious leader can help the person understand the point at which it’s not about God, but about themselves and their anxiety, and help them tease those things out,” says Lee. “They can help people adhere to spiritual practices and help them understand that doing something an excessive amount of times does not further God’s love for you.”
Lee emphasizes the complementary role of faith leaders alongside therapy. “Yes, we can treat OCD, but in terms of making sure the person can continue to enjoy and experience the benefits of faith, the church leader can do that so much better than we can,” she says.
Guidance for individuals and families
In addition to faith leaders, Black people with OCD can also benefit from having their families’ support in healing. This could involve normalizing the experience of intrusive thoughts, encouraging a balance between spiritual practice and evidence-based treatment like ERP, and listening with compassion and understanding.
Lee adds that when families are involved, their support can make a significant difference in their loved one’s treatment journey. “As mental health professionals, we know that if the family can also be trained and provided psychoeducation on what OCD is and how to identify compulsions and resist them, we can make a big impact,” says Lee.
Seeking help for OCD is not a weakness—it’s an act of bravery that can provide relief while allowing you to maintain your faith.
The journey to relief and healing
Scrupulosity OCD targets what you value the most: your religion. The OCD subtype can make you doubt if you’re a “real believer,” which can be deeply distressing. While it may seem impossible to manage OCD while maintaining your faith, recovery is possible. In fact, proper treatment can help repair—and even strengthen—your relationship with your religion, despite the stigma that sometimes surrounds mental health in Black communities.
Resources
- IOCDF Resource Directory
- NOCD Therapist Directory
- Faith & OCD Resource Center
- African Americans with Obsessive Compulsive Disorder
- Ask the Experts Live Q&A: OCD in the Black Community
Sources
The post Faith, family, and OCD: How religion shapes mental health in the Black community appeared first on International OCD Foundation.
