I need to go to the Church 16 times a day, or else God will kill my child.
This is the thought that brings 28-year-old Mrs. M to the hospital.
“Every day I have repetitive thoughts about going to the Church 16 different times. If I don’t go, I fear that my children will die a horrible and sudden death at the hands of God. These thoughts have completely stopped me from going about my day and doing my work. In fact, I haven’t been to work at all in the past 3 months. I understand how illogical I sound when I say this, but when I try to resist these thoughts, I start feeling very uneasy and restless. Sometimes I experience difficulty in breathing, and it takes me around 5 minutes to calm down. I really want these thoughts to leave my head. I feel stuck in life.”

Mrs. M is a mother of one child (aged 2 years) and has been married for the past four years. She has been brought up as a Protestant and regularly used to go to the Church every Sunday before her obsessive thoughts began to occur. She was working as a loan officer for three years before quitting her job three months ago.
This is a classic case of Religious Obsessive-Compulsive Disorder (OCD).
Obsessive-Compulsive Disorder is an anxiety disorder characterized by an uncontrollable and irrational idea, impulse or image which is usually followed by some behavior that an individual is compelled to perform repeatedly. When they realize that the thoughts are absurd, they try to resist against it, but when they are unable to do so it leads to anxiety. In severe cases of distress, they may experience a panic attack which can only be overcome by giving in and performing the compulsive behavior.
Religious OCD or Scrupulosity is a subgroup of the disorder where the person is fixated on obsessive thoughts based in religion or religious beliefs. In some cases, the obsessions can also center around moral beliefs. People who encounter such blasphemous obsessions have a strong fear of punishment from a divine being or deity. In the case of Mrs. M, she believes that if she does not go to the Church sixteen times every day, God will punish her and take her child’s life. This thought results in her spending all of her time at the Church, neglecting her family and job. She is aware of the vicious cycle that she is caught in and all of its consequences. However, the anxiety that is caused when she does not go to the Church suppresses any space for rational thinking, which leads to a very time-consuming lifestyle. Mrs. M is also prone to develop depression.
There are simple ways of treating Scrupulosity, one of which is Exposure and Response Prevention therapy. This therapy is based on developing tolerance to the repetitive thoughts that disturbs an individual. Mrs. M will be made to confront her obsessions and act against them. The number of times that she visits the Church is gradually decreased and finally she will be able to resist her urge to go to the Church several times a day.
This therapy can be supported by mindfulness meditation, which is similar to Pranayama in Hatha Yoga. This is, simply put, the act of paying attention to whatever you are experiencing, as you experience it. The key is to find a quiet, comfortable place and focus on becoming aware of your breath. Every time Mrs. M encounters her obsessive thoughts, she needs to sit in a quiet, comfortable place and start focusing on the sensation of air moving in and out of the body during each breath. The breathing is used as an anchor to fight the obsessions that one experiences.
The symptoms of OCD will gradually decrease with consistent therapy. Taking back control of one’s life seems like a far-fetched dream but it can be done with treatment and support from the individual’s family.