Why Church May Be Difficult For OCD Sufferers
What is OCD?
Obsessive Compulsive Disorder (or OCD), as with most mental health conditions, is incredibly complex and varies significantly from person to person. It is also, I believe, one of the most misunderstood conditions of our time. OCD is a deeply distressing, anxiety-fuelled disorder which can interfere with a person's ability to function on a daily basis and can lead to suicidal thoughts and desires. There are many misconceptions about what OCD actually is. It has become the norm for someone to declare 'oh, I'm a little bit OCD' when really they just like to be organised or enjoy having things arranged nicely. OCD is not simply a case of someone being a 'hand washer' or a 'checker' either. In fact, many people confuse repeated hand washing, excessive cleaning or constant checking as being the obsessive part of the condition. However, these outward behaviours are the compulsions and are fuelled by frightening thoughts. These thoughts are the obsessive part and are really the focus of much of the sufferer's mental anguish and pain. It is the mental torture of their inner thought life which drives the sufferer to perform rituals in order to neutralise the abject fear the thoughts force them to experience. The driving force for many is a fear that a failure to check or clean can result in the serious illness or the death of someone they love. The sufferer overestimates the danger their action or inaction may have on another person and believe that they must be extra vigilant in case they cause harm to another. The sufferer usually asks themselves a series of 'what if' questions - What if I didn't really lock that door? What if the oven isn't clean enough? For many, distressing images accompany the worry - images of loved ones being whisked away to hospital because they failed to clean the oven properly, images of intruders coming in to hurt their family members. The sufferer believes, wholeheartedly, 'If I don't do this then people will die and it will be my fault'. From this cycle of obsessive thoughts and behaviours there can appear to be no freedom or peace. It is relentless and unyielding.
There is also a form of OCD known as 'Pure O' where the sufferer has distressing thoughts but does not appear to perform any outward compulsions or rituals to neutralise these thoughts. However, the 'Pure O' sufferer may be involved in a relentless cycle of mental checking and may develop some avoidance behaviours to minimise the chances of something bad happening as a result of their action or inaction. For example, they fear that they might harm someone with a knife or scissors and so avoid being on their own with one person, do not go into the kitchen whilst people are visiting and check their limbs and body for any signs that they might be out of control. The 'Pure O' sufferer might be frightened that they will become sexually aroused at inappropriate times or in inappropriate places (such as on the bus or in the middle of Tesco) and many are petrified that they become sexually aroused around children. They check their body continuously for signs of arousal and avoid being around children or being alone with children. They are terrified that they might be a murderer or a paedophile and are desperate to find complete reassurance that they are not. Again, this is relentless and in a particularly bad spell the sufferer can be battling with these thoughts every waking minute. It is a form of mental torture and can take days for the sufferer to be released from this mental prison.
Many new mothers can also suffer a spell of OCD as they develop a paralysing fear that they will harm their baby or believe that they actually want to harm their baby. Some new mothers avoid being alone with their child, avoid changing the child's nappy or even avoid walking down the stairs for fear they might throw the child down them.
Everyone experiences those intrusive, strange thoughts that come out of nowhere from time to time. 'What if I slapped that bald man's head for a laugh?' 'What if I just swerve off this bridge into the river below?' 'What if I just stand up in the middle of this wedding ceremony and start swearing?' Many of us have these thoughts and dismiss them immediately as being silly or inconsequential. However, those with OCD fixate on these thoughts and attach a meaning to them. Usually this attached meaning is that they are out of control and that they might be a dangerous person, likely to cause harm to others.
So, why might church be difficult for the OCD sufferer?
Whilst Church can be a place of healing, comfort, joy and peace, for the OCD sufferer it can cause deep distress and fuel their fears. Church may be difficult for the following reasons:
The focus on self examination - At times in Church services we are invited to participate in negative introspection. We are asked to think about what we have done to grieve God or others and to repent of it. Someone without OCD may participate in this kind of activity well. They can humbly confess their wrongdoing, seek God's forgiveness and have full assurance (or a degree of assurance) that they are forgiven and loved. For a person with OCD, who is already constantly mentally checking to reassure themselves that they are not thinking or doing something wrong, this kind of activity triggers alarm bells and heaps fear on top of fear. You see, it is terrifying, horrifying, abhorrent to the OCD sufferer that they are even capable of doing something to grieve God or to harm others. It is deeply disturbing to them that they might be responsible for having done something harmful or neglected to do something helpful.
-- An over-emphasis on the need for forgiveness - OCD never ever provides the sufferer with any reassurance that they are a safe and good person to be around. In asking the suffering person to constantly seek forgiveness can lead to an unhealthy and upsetting cycle. 'Why do I need forgiven? I'm so terrible. I should never have been born. I didn't mean to do wrong. I desperately want to be good and kind. The fact that I need to ask for God's forgiveness is terrifying and terrible. I can never be good enough. I will always need to be forgiven by God. How can I make sure that I don't mess up and hurt Him or other people? I need to be completely sure that I will not hurt or harm anyone. Ever.'
-- A partial explanation of where blame and responsibility lie - When churches sing of, and speak about, what Jesus accomplished on the cross as being predominantly, or even solely, an act of substitution for the personal sins of individual believers, this only serves to increase the OCD sufferer's perception that they are responsible for evil and that the only way to be sure that they are taking this responsibility seriously is to be extra vigilant so as not to cause suffering to another. The OCD sufferer is devastated and ruminates. 'My sin caused him to die? What an awful, worthless person I must be. I should never have been born.'
-- Violent, sexually disturbing parts of the Bible - Many suffering from OCD avoid the news or leave conversations involving any discussion of violence or sexual harm as the thought of these things are a source of deep fear and sadness. The Bible has many difficult stories and passages where instances of sexual abuse, murder and war are recorded. These passages are disturbing to all of us because they are meant to be. They demonstrate the painful, broken and fallen reality of our world. However, the person with OCD is frightened by these events at a deeper level. The sufferer will question what motivates people to perform such heinous acts of violence and fear that this motivation lies somewhere within them too. They will ruminate and obsess over these stories, frightened to death that they may too lose control and murder or sexually assault someone. The church provides no assurance and comfort but only fuels the terror - some preachers have even said 'this evil lies within all of us'.
-- An over-emphasis or under-emphasis on the spiritual realm - To tell the OCD sufferer that what they are experiencing is purely spiritual attack and that they must defend themselves by praying more is deeply unhelpful. Similarly, telling the person that what they are experiencing is legalism (a desire to be good enough for God on their own merit) is also demonstrative of a lack of understanding that OCD is a mental health condition, an illness with which the person is afflicted and not a free choice someone is making to earn God's favour and love. In fact, implying that the sufferer's spiritual action or inaction is in any way to blame for their spiritual anguish and torment is hurtful and damaging. However, to deny the OCD sufferer access to spiritual comfort is equally unhelpful. Reassurance of the love of God as well as the truth and encouragement found in God's Word can bring comfort and peace. God always shows himself to be trustworthy and kind and for us.
-- The specific form of religious OCD - There is also a form of religious OCD where the fear of thinking blasphemous thoughts or disappointing God can overwhelm the sufferer so much that they feel too ashamed and frightened to attend church. Admittedly, I do not know as much about this form of OCD but know that the same obsessive entrapment, checking, fear, lack of reassurance and distress are all present, and even magnified, as a direct result of being in church.
What might the church do to help those in the church suffering with OCD?
Of course, the answer is certainly not to eradicate sin and the need for forgiveness from our Churches! Indeed, there would be no Gospel if we deny their reality. However, I believe there are some things we can begin to consider in order to move forward:
-- Sin as more than personal wrongdoing - A different emphasis and a wider interpretation of what sin is may just help. When sin is presented as the moral failings of individual people and only as personal wrongdoing this is misleading and is a misinterpretation of the fuller definition of what sin is. This narrow focus can be unhelpful for all believers but is particularly alarming and frightening for those with OCD. Sin is an evil, pervasive force that, to a large extent, happens to us and in us without any control or consent. Please do not misunderstand me here. I do not think that we can absolve ourselves of any responsibility and merely claim a victim mentality but our personal choices and failings must be understood in the wider context of the battle we are caught up in. We are born into a sinful world and cannot choose perfection. In a way this seems like a huge injustice. In all honesty, I do not know of a singular solution that will help. The church could perhaps present personal failings as a facet of sin rather than the whole picture and could also deal more sensitively with personal wrongdoing, fully aware that it can be deeply distressing for those with OCD to dwell on it.
-- An unwavering emphasis on God, who He is and what He has done. Assurance of our standing with God comes when we understand what God is like. Many with OCD struggle to believe they are saved and safe with Jesus. Self examination will never provide the assurance needed but an understanding of the faithfulness and goodness of our heavenly Father will. The beautiful truth is that God loves us because He loves us. When we understand the true nature of His heart towards His children we become secure in the knowledge of this love. Indeed, it is 'his perfect love which drives out fear' (1 John 4) and without love it is fear that consumes and destroys the OCD sufferer. Freedom and peace come from Jesus Himself - the Prince of Peace and the one who can set prisoners free.
-- Preacher sensitivity - When preparing a sermon it may be helpful for the preacher to ask themselves one helpful question: How might someone with OCD interpret what I am saying? In some cases it may be helpful to alter or change what might be said and in other cases it may simply be to keep in mind that an obsessive thinker may ruminate and worry over anything that implicates them as being or doing wrong. If you are unsure if someone in your congregation has OCD then it may be time to get to know people more fully, to listen to their fears and struggles and to speak truth, life and encouragement directly into their situation.
-- Whole church education and responsibility - As with any mental health problem it may be helpful for whole church training and education to be prioritised. From there a plan of action can be outlined, implemented and reviewed. A balance can be struck between the implementation of a formal action plan and the conscious nurturing of authentic, vulnerable and reciprocal relationships so that the church learn to take better and better care of one another.
Of course, it must be said that the person with OCD has responsibilities for their own health and wellbeing. They can access talking therapy, medication and specialist help through their own reading and research. They can, where possible, be courageous enough to open up to family members or friends. They can apply strategies learned in therapy and look after themselves by eating well, sleeping well and staying productive. Whilst all of these things require an immense amount of effort and bravery on the part of the sufferer they can only be done by the sufferer. In carrying out these things and accessing help the sufferer is taking back control and power from the OCD and empowering themselves. However, this is monumentally challenging and the sincere encouragement, love and support of close friends or family is an essential part of recovery.
It is impossible to explore the complexities of OCD and all its forms in this short article. However, if you would like to understand and explore this condition more you can visit www.ocduk.org and www.ocdaction.org.uk. Alternatively, talk to someone with OCD and ask them today how you can help them, love them and journey with them as their friend. It is also impossible to solve the difficulties that church poses for those with OCD and nor has this been the intention of this piece. However, an increased awareness and sensitivity towards those struggling is achievable and necessary. So let's love, show compassion and cultivate authentic relationships to bring healing and wholeness to one another.