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logologologo

 

502-339-2442

 

CONTACT US

  • Home
  • About
    • About Us
    • Our Approach
  • Our Team
    • Expert Care Team
    • Testimonials
  • Services
  • Telehealth
  • Next Step Blog
  • Refill Request
  • Request Appt
    • Current Patients
    • New Patient (Adult)
    • New Patient (Under 18)
  • Contact Us
  • Home
  • About
    • About Us
    • Our Approach
  • Our Team
    • Expert Care Team
    • Testimonials
  • Services
  • Telehealth
  • Next Step Blog
  • Refill Request
  • Request Appt
    • Current Patients
    • New Patient (Adult)
    • New Patient (Under 18)
  • Contact Us
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TMS Treatment for OCD: What It Is and How It Can Help

by nextstep4adhdJune 13, 2025 OCD, Religious OCD Series0 comments

This blog is part of the Religious OCD Series.

For those struggling with Religious OCD, Transcranial Magnetic Stimulation (TMS) offers another promising tool. Understanding how it works can help believers make informed decisions about this treatment as part of God’s provisions for healing.

Introduction

For many Christians with Religious OCD, therapy and medication provide significant help. But for some, these treatments may not bring sufficient relief. When that happens, it’s natural to feel discouraged or even question God’s help.

Yet, God often provides multiple avenues for healing, and for some, TMS can be one of those avenues.
TMS is a safe, non-invasive, FDA-approved treatment that uses magnetic fields to stimulate specific areas of the brain involved in OCD.

It has become a valuable option for individuals whose symptoms have not adequately responded to traditional therapies and medications.

What Is TMS?

Transcranial Magnetic Stimulation is a gentle, non-invasive procedure that involves placing a magnetic coil near the scalp, delivering small, focused magnetic pulses to areas of the brain known to be involved in obsessive-compulsive symptoms.

The treatment is typically given in daily sessions over the course of several weeks and is designed to help the brain function in a more balanced way.

  • Non-Invasive – There are no medications or sedation involved, and patients remain awake during treatment.
  • FDA-Approved for OCD – TMS has been shown to reduce symptoms in patients who have not responded well to first-line treatments.
  • Minimal Side Effects in most cases – The most common side effects are mild scalp discomfort or headaches during or shortly after treatment. The treatment itself is painless; patients simply sit comfortably during the sessions, often reading a book or watching TV during the treatment session.

How Does TMS Help with Religious OCD?

OCD, including scrupulosity, involves hyperactivity in certain brain circuits that process fear, doubt, and uncertainty. TMS targets these areas, helping to reset and calm overactive brain activity.
Improving Thought Regulation – TMS can help reduce the intrusive thoughts and mental noise that often plague those with OCD.

Reducing Compulsive Urges – By calming hyperactive areas, TMS can lessen the strong drive to perform compulsions.
Should Christians Consider TMS?

It’s understandable that some Christians may hesitate to consider brain-based treatments. However, it’s important to recognize that TMS does not alter who you are; rather, it helps restore balance to areas of the brain that are not functioning as they should.

God, in His grace, has allowed advancements in science and medicine. Treatments like TMS can be part of His provision for healing.

Questions to Pray Over and Discuss with Your Doctor

  1. Am I experiencing severe, persistent symptoms that limit my daily life and walk with Christ?
  2. Have I consulted with a qualified healthcare provider to understand the risks and benefits?

Encouragement from Scripture

Philippians 4:6-7

“Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.” 

This reminds us that in all decisions, especially regarding treatment, we can bring our concerns to God and trust Him to provide peace and guidance.

What’s Next?

In the next article, we will look at Exposure and Response Prevention (ERP) therapy—the gold standard for treating OCD—and how it can be thoughtfully adapted for believers with Religious OCD.

More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

  •  nextstep.doctor
  •  502-339-2442
  •  contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.

Learn More
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Biological Treatments for Religious OCD: How Medication and Supplements Can Help

by nextstep4adhdMay 30, 2025 OCD, Religious OCD Series0 comments
Biological factors play a significant role in OCD. Understanding how medication and supplements can help manage Religious OCD symptoms is part of embracing the tools God has made available for healing.

Introduction

For Christians struggling with Religious OCD, the idea of taking medication can feel confusing or even uncomfortable. Some may wonder, “Shouldn’t I just pray harder or have more faith?” But just as we use glasses to help with vision or casts to heal broken bones, medication can be one of God’s provisions to help those struggling with OCD. Recognizing that mental health conditions often have biological components allows us to approach treatment with both wisdom and humility.

The Role of Medication in Treating OCD

Research shows that medications, particularly certain types of antidepressants known as SSRIs (Selective Serotonin Reuptake Inhibitors), can significantly reduce OCD symptoms. These medications help regulate brain chemistry and reduce the intensity and frequency of obsessive thoughts and compulsions.
  • What to Expect – Medications typically reduce symptoms by around 30-40%. Some individuals experience more improvement; others may need additional support through therapy.
  • Patience Is Key – OCD medications often take 8-12 weeks to show full effects and may require adjustments in dosage.
  • Common Medications – Examples include fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and clomipramine (Anafranil).
  • Medication Is Not a Lack of Faith – Taking medication is not about spiritual weakness; it’s using a tool that God has allowed us to discover for physical and mental health.

A Story to Remember

There’s a well-known story of a man caught in a hurricane, standing on his rooftop, praying for God to save him. Soon, a neighbor arrives with a truck and offers help, but the man declines, saying, “I’m waiting for God to save me.” Later, a rescue boat comes by, but again he refuses. Finally, a helicopter arrives, and once more, he turns down the rescue. The man eventually drowns, and when he reaches heaven, he asks God why He didn’t save him. God responds, “I sent you a truck, a boat, and a helicopter.”
In the same way, God often provides help through practical means — doctors, medication, therapy, and community support. Ignoring these tools while hoping for a different form of deliverance can mean missing the very provision God has lovingly placed in front of us.

Supplements That May Help

While supplements should never replace prescribed treatments, some may provide additional support:
  • N-Acetylcysteine (NAC) – Some studies suggest that NAC, an antioxidant, may help reduce obsessive thoughts.
  • Omega-3 Fatty Acids – These have been linked to improved mood and brain health.
Always consult with a healthcare provider before starting any supplements. These supplements have been studied as adjunctive treatments alongside SSRIs, but on their own, they are likely not very effective in treating OCD.

Combining Biological Treatments with Faith and Therapy

Medication and supplements are not standalone cures but part of a broader treatment plan. When combined with therapy—particularly Exposure and Response Prevention (ERP)—and a grace-based understanding of faith, they can make a world of difference.
  • Prayerfully Consider Treatment – Seek wisdom, talk with trusted Christian counselors or medical professionals, and pray for discernment.
  • Lean on Scripture – Remember passages like James 1:5: “If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him.”
  • Trust God’s Provision – Whether it’s medication, therapy, or community support, all good things come from His hand.

What’s Next?

In the next article, we will explore TMS (Transcranial Magnetic Stimulation) and its role in treating OCD, including how it may help those for whom medications and therapy have not provided sufficient relief.
More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

📍 nextstep.doctor

📞 502-339-2442

📧 contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.
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 The Impact of Religious OCD on a Believer’s Walk with Christ

by nextstep4adhdMay 23, 2025 Brian Briscoe Blog, OCD0 comments

This blog is part of the Religious OCD Series.

Religious OCD can turn faith into a source of anxiety rather than peace, leading to avoidance, isolation, and spiritual exhaustion. Understanding these effects can help believers reclaim a grace-filled relationship with God.

For Christians, faith is meant to be a source of comfort and strength. However, for those struggling with Religious OCD, faith can become a battleground of fear, doubt, and relentless self-examination. Instead of experiencing the joy of God’s presence, believers with Religious OCD may find themselves trapped in cycles of compulsive rituals, seeking reassurance, and fearing that they are failing in their faith. Over time, these struggles can lead to avoidance, isolation, and deep spiritual exhaustion.

Recognizing how Religious OCD affects a believer’s walk with Christ is an important step in learning to separate faith from fear and embracing the freedom found in God’s grace.

Avoidance: Fleeing from Triggers Instead of Facing Them

One of the major impacts of Religious OCD is avoidance—avoiding certain Bible passages, church services, conversations about theology, or even prayer itself out of fear that these will trigger intrusive thoughts and anxiety.

Common forms of avoidance include:

  • Avoiding Scripture – Some believers may steer clear of certain Bible passages (such as those about blasphemy, judgment, or salvation) because reading them causes distress.
  • Skipping Church or Worship Services – Fear of encountering triggering messages or being overwhelmed by doubts may lead some to withdraw from their church community.
  • Avoiding Prayer – For some, prayer becomes so wrapped up in compulsive rituals that they stop praying altogether to avoid the stress of “doing it wrong.”
  • Distancing from Christian Fellowship – Some believers may withdraw from conversations about faith, fearing that discussing theological topics will spiral into intrusive doubts or anxieties.

Avoidance can cause a believer to feel disconnected from God and their Christian community, reinforcing the idea that they are somehow failing in their faith or even losing it.

Isolation: The Silent Suffering of Scrupulosity

Religious OCD often creates a deep sense of isolation. Those struggling may feel that no one else understands their distress or that admitting their fears would make them seem spiritually weak or unfaithful.

Ways that isolation manifests include:

  • Keeping Doubts and Fears Private – Many fear that sharing their intrusive thoughts or struggles will lead to judgment or misunderstanding. They may also feel embarrassed to admit the nature of their thoughts, worrying that others will not understand or may react negatively.
  • Feeling Spiritually Alone – Despite being surrounded by fellow believers, someone with Religious OCD may feel utterly alone in their battle.
  • Believing Their Faith Is Inadequate – The persistent anxiety and compulsions can make individuals feel like they are failing where others are thriving.

This isolation can intensify symptoms, making it even harder to break free from the OCD cycle.

Spiritual Exhaustion: When Faith Feels Like a Heavy Burden

The constant cycle of intrusive thoughts, compulsions, and reassurance-seeking can leave a believer feeling spiritually drained. Instead of experiencing peace in Christ, they may feel overwhelmed by the pressure to “get it right” in their faith.

Signs of spiritual exhaustion include:

  • Feeling Overwhelmed by Religious Duties – Reading the Bible, praying, or attending church may feel like impossible tasks due to the fear and anxiety they provoke.
  • Doubting One’s Relationship with God – Constantly questioning salvation or worrying about sin can leave a believer feeling distant from God.
  • Loss of Joy in Worship – Worship and devotion, instead of being acts of love and connection with God, can become fear-driven obligations.

This exhaustion can lead to deep discouragement, making it difficult to engage in faith practices.

What Does the Bible Say About This Struggle?

Jesus Himself addressed the burden of legalism and fear-based faith, offering an invitation to rest in Him:

  • Matthew 11:28-30 – “Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.” This passage reassures believers that faith is meant to be freeing, not an exhausting struggle. However, for those with Religious OCD, experiencing this ‘light burden’ can feel out of reach. It’s important to remember that struggling with fear and anxiety does not mean one is failing in their faith—God’s grace is sufficient even when peace feels distant. Christ is still with you even when peace feels distant.
  • Romans 8:1 – “There is therefore now no condemnation for those who are in Christ Jesus.” A reminder that salvation is secured in Christ, not in perfect thoughts or rituals.

Reclaiming a Grace-Filled Walk with Christ

If you recognize these struggles in your own faith journey, know that there is hope. Here are some steps to begin breaking free:

  1. Recognize That Feelings Do Not Define Faith – Salvation is not based on how you feel but on God’s promises.
  2. Re-engage with Scripture and Prayer Slowly – Instead of avoiding these practices out of fear, take small steps to reconnect with God.
  3. Lean on Trusted Christian Community – Surround yourself with believers who understand and can encourage you with truth and grace.
  4. Seek Professional Help – Christian psychologists, therapists, and psychiatrists can provide evidence based treatments for OCD that can make a world of difference.  

What’s Next?

In the next article, we will explore the role of medication and biological treatments in managing Religious OCD.

More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

📍 nextstep.doctor

📞 502-339-2442

📧 contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.

 

 

 

 

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Understanding Compulsions in Religious OCD: Why They Form and How They Reinforce the OCD Cycle

by nextstep4adhdMay 16, 2025 OCD0 comments
This blog is part of the Religious OCD Series.

Compulsions feel like they offer relief from anxiety, but in reality, they strengthen the cycle of Religious OCD, making fears more intense and causing faith to feel more like a test of performance rather than a relationship of grace.

Introduction

For someone struggling with Religious OCD, certain rituals or mental exercises can feel absolutely necessary to keep their faith intact or prevent spiritual disaster. These compulsions often take the form of compulsive or ritualistic prayer, repeated confessions, or seeking reassurance from pastors or loved ones. While these actions may seem like acts of devotion, they are actually responses to intrusive thoughts—desperate attempts to quiet the anxiety that comes with them. Unfortunately, these compulsions only provide temporary relief and ultimately reinforce the obsessive-compulsive cycle.
Understanding how compulsions work and why they perpetuate Religious OCD is key to breaking free from this exhausting cycle and reclaiming a healthy, grace-filled relationship with God.

What Are Compulsions?

Compulsions are repetitive behaviors or mental acts performed in response to an intrusive thought. In the context of Religious OCD, these compulsions are driven by fear rather than genuine worship or devotion. Some common compulsions in Religious OCD include:
  • Compulsive or ritualistic prayer – Feeling the need to pray repeatedly to ensure God has truly heard or accepted a prayer.
  • Repeated confessions – Continually confessing the same sin out of fear that it wasn’t done “correctly” or sincerely enough.
  • Scripture checking – Repeatedly looking up certain Bible verses to confirm one’s salvation or to counter intrusive thoughts.
  • Seeking reassurance – Asking pastors, friends, or family members for constant confirmation that one is saved or has not committed an unforgivable sin.
  • Avoidance behaviors – Steering clear of certain religious discussions, scriptures, or places out of fear that they will trigger anxiety.
  • Mental review – Replaying past actions or thoughts over and over to ensure that no sin was committed.

Why Do Compulsions Form?

Compulsions are an attempt to neutralize or relieve the anxiety caused by intrusive thoughts. The problem is that while they may provide temporary relief, they actually reinforce the fear. Here’s how the cycle works:
  1. Intrusive Thought – A distressing thought enters the mind (e.g., “What if I didn’t pray sincerely enough?”).
  2. Anxiety Increases – The thought triggers deep fear, leading to distress and uncertainty.
  3. Compulsion Performed – The person engages in a ritual to ease the fear (e.g., repeating the prayer multiple times).
  4. Temporary Relief – Anxiety subsides for a short while, reinforcing the belief that the compulsion “worked.”
  5. Reinforcement of OCD Cycle – Over time, the brain learns that relief only comes from performing the compulsion, making the obsession stronger and more intrusive.
This cycle traps the individual in an ongoing struggle, where compulsions are relied upon more and more to manage anxiety, rather than trust in God’s grace and sufficiency.

What Does the Bible Say About This Struggle?

Scripture encourages believers to trust in God’s grace rather than rely on their own efforts for assurance. Jesus Himself reassures us that following Him should not be an unbearable burden:

Matthew 6:7

“And when you pray, do not heap up empty phrases as the Gentiles do, for they think that they will be heard for their many words.” 
This verse reminds us that endless repetition does not make a prayer more effective or sincere in God’s eyes.

Matthew 11:28-30

“Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.” 
This passage reminds us that Jesus does not intend for His followers to live in constant fear and exhaustion but rather in the peace of His grace. If you struggle with feeling this peace, know that it does not mean you are failing—God’s grace is still at work, even when feelings of anxiety persist.
These passages encourage a trust-based relationship with God rather than one driven by fear and endless attempts at spiritual perfection.

Breaking Free from Compulsions

Recognizing and resisting compulsions is a critical step in overcoming Religious OCD. Some helpful strategies include:
  1. Identifying Compulsions – Pay attention to behaviors done out of fear rather than genuine devotion.
  2. Reducing Rituals Gradually – If you feel the urge to pray multiple times for reassurance, try stopping at one and sitting with the discomfort.
  3. Resisting Reassurance-Seeking – Instead of asking others for constant reassurance, remind yourself of God’s promises in Scripture.
  4. Accepting Uncertainty – Recognizing that faith involves trusting in God’s grace, even when feelings of certainty are absent.
  5. Seeking Professional Help – A Christian counselor or therapist trained in OCD treatment can help guide you through Exposure and Response Prevention (ERP), the gold-standard treatment for OCD.

What’s Next?

In the next article, we will explore how Religious OCD affects a believer’s walk with Christ, including how it can lead to avoidance, isolation, and spiritual exhaustion.
More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

  •  nextstep.doctor
  •  502-339-2442
  •  contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.

 

Learn More
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Understanding Intrusive Thoughts: Why They Occur and How They Take Root

by nextstep4adhdMay 9, 2025 Christian perspectives on Mental Health Psychiatry and Psychology, OCD0 comments
This blog is part of the Religious OCD Series.

Intrusive thoughts are unwanted, distressing ideas or images that seem to come out of nowhere. While everyone experiences them, those with Religious OCD often struggle to let them go, fearing they mean something about their faith or morality.

Have you ever had a shocking or disturbing thought pop into your head seemingly at random? Maybe an offensive thought about God, an irrational fear that you’ve committed a terrible sin, or an image that feels completely out of character for you? Most people experience occasional intrusive thoughts, but for those with Religious OCD, these thoughts can become overwhelming and deeply distressing.

Instead of dismissing them as random mental noise, a person with Religious OCD may believe these thoughts are spiritually significant or revealing of their true nature. This misunderstanding can lead to anxiety, endless rumination, and compulsive behaviors aimed at proving or disproving the thought’s meaning.

What Are Intrusive Thoughts?

Intrusive thoughts are involuntary and unwanted thoughts, images, or urges that enter a person’s mind unexpectedly. They are often distressing because they seem to contradict a person’s values or beliefs.

Some common examples of intrusive thoughts in Religious OCD include:

  • Blasphemous thoughts about God or Jesus
  • Fear of having committed the unforgivable sin
  • Doubts about one’s salvation that feel impossible to resolve
  • Unwanted thoughts of saying or doing something sinful
  • Obsessing that one could or will do something sinful
  • Visions of inappropriate or irreverent actions in a sacred space

It’s important to understand that intrusive thoughts do not reflect a person’s true desires or character. They are simply a byproduct of how the brain processes information and handles uncertainty.

Why Do Intrusive Thoughts Occur?

The human brain is designed to generate thoughts constantly, many of which are irrelevant or nonsensical. However, the brain of a person with OCD tends to attach undue significance to certain thoughts, interpreting them as threats that require immediate attention.

A few key reasons why intrusive thoughts take root in Religious OCD:

  • Hyper-Responsibility – The belief that one must control or eliminate all sinful thoughts to be right with God.
  • Thought-Action Fusion – The mistaken belief that having a thought is morally equivalent to acting on it.
  • Intolerance of Uncertainty – The need for absolute certainty in one’s salvation or spiritual standing.
  • Attempts to Suppress Thoughts – The harder one tries to push intrusive thoughts away, the more persistent they become.

Understanding these mechanisms can help individuals begin to challenge their reactions to intrusive thoughts and reduce their power.

What Does the Bible Say About Intrusive Thoughts?

Scripture acknowledges that believers will face distressing thoughts and temptations but reassures us that these do not define our faith. Consider Paul’s words in Romans 7:19:

“For I do not do the good I want, but the evil I do not want is what I keep on doing.”

Even faithful Christians experience struggles in their thoughts, yet God’s grace remains sufficient.

Additionally, 2 Corinthians 10:5 encourages believers to “take every thought captive to obey Christ.” This does not mean obsessively monitoring or controlling every thought but rather recognizing that intrusive thoughts are not sinful in themselves—they are simply thoughts. While human nature is fallen and imperfect, it is our response to these thoughts that matters spiritually. Through God’s grace, believers can learn to approach unwanted thoughts with wisdom and reliance on His truth.

How to Respond to Intrusive Thoughts

Instead of engaging in compulsions like excessive praying, reassurance-seeking, or avoidance, a healthier response to intrusive thoughts includes:

  • Recognizing Them as Intrusive – Acknowledge that these thoughts are unwanted and do not define you.
  • Allowing Them to Exist – Instead of pushing them away, observe them without reacting.
  • Refusing to Engage – Avoid analyzing or trying to prove or disprove the thought.
  • Trusting God’s Grace – Remind yourself that your faith is not dependent on perfect thought control.

What’s Next?

In the next article, we will explore the nature of compulsions in Religious OCD—why they form, how they reinforce the OCD cycle, and healthier ways to address them.

More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

📍 nextstep.doctor

📞 502-339-2442

📧 contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.

Learn More
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Understanding Religious OCD: What It Is and Why It Matters

by nextstep4adhdMay 1, 2025 Christian perspectives on Mental Health Psychiatry and Psychology, OCD, Religious OCD Series0 comments

This blog is part of the Religious OCD Series by Dr. Brian Briscoe. 

OCD tends to latch onto what a person holds most dear, turning their deepest values—such as faith—into sources of anxiety and distress.

Introduction

Imagine feeling an overwhelming fear that you’ve unknowingly committed a sin, even though you have done nothing wrong. Or obsessing that a past sin you have committed has not been forgiven, even though you have accepted Christ and know that in Him all sins are forgiven. You pray repeatedly, seeking reassurance from God, yet the fear does not go away. You confess the same sin over and over, but relief never lasts. Instead, doubt creeps back in, stronger than before. This is the reality for many individuals suffering from Religious OCD, also known as scrupulosity.

What Is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to relieve distress. These compulsions offer temporary relief but ultimately reinforce the obsessive cycle, making the problem worse over time.

What Is Religious OCD (Scrupulosity)?

OCD obsessions and compulsions tend to center around the things that people care about the most. For some, OCD manifests as overwhelming fears about harm coming to their child. For others, it revolves around fears of contamination or illness. In many cases, OCD latches onto what a person holds most dear. Religious OCD occurs when these obsessive fears and compulsions creep into a person’s religious or spiritual life, distorting their faith experience and turning it into a source of distress rather than peace.

Religious OCD, or scrupulosity, is a subtype of OCD in which a person experiences excessive worry about religious or moral matters. Because faith is so central to a believer’s identity, OCD may distort genuine devotion into an exhausting cycle of fear, doubt, and compulsive reassurance-seeking. Common fears include:

  • Doubting one’s salvation
  • Fear of committing the unforgivable sin
  • Worrying that thoughts themselves are sinful
  • Repeatedly seeking reassurance from pastors or loved ones
  • Feeling compelled to engage in excessive prayer, confession, or ritualistic behaviors

While it is natural for Christians to care about living righteously, scrupulosity takes these concerns to an extreme, leading to distress and interfering with one’s ability to experience God’s love and grace.

A Story of Religious OCD in Action

Let’s take a look at a hypothetical case:

Sarah is a devoted Christian who deeply desires to follow God. Her faith is one of the most important aspects of her life, making it a prime target for OCD-related fears. She begins experiencing persistent thoughts that she might have unknowingly blasphemed the Holy Spirit. These thoughts terrify her. She starts praying compulsively, asking God for forgiveness hundreds of times a day. She seeks reassurance from her pastor, who tells her she hasn’t committed the unforgivable sin, but the doubt returns almost immediately. Instead of feeling peace, Sarah feels trapped in an exhausting cycle of fear and rituals.

Sarah’s story reflects the struggle of many believers with Religious OCD. Instead of drawing closer to God, their faith becomes a battleground of relentless doubt and anxiety. What she values most—her faith—has become a source of distress rather than comfort.

Why This Matters

Scripture reminds us that God’s love is steadfast, and our salvation is secured through faith in Christ:

“For by grace you have been saved through faith, and this is not your own doing; it is the gift of God, not a result of works, so that no one may boast.” (Ephesians 2:8-9)

Recognizing that salvation is based on God’s grace—not our ability to achieve certainty—can help free those trapped in the cycle of Religious OCD.

Many people suffering from scrupulosity believe their distress is a sign of spiritual failure. However, Religious OCD is not a lack of faith—it is a mental health condition. Recognizing this distinction is crucial for those who struggle and for pastors, family members, and church communities who seek to support them. Understanding that OCD preys on what is most important to an individual can help sufferers, and those who support them, approach this struggle with compassion and clarity.

What’s Next?

In the next article, we will dive deeper into the nature of intrusive thoughts, why they occur, and how they take root in the mind.

More on that next week…

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

📍 nextstep.doctor

📞 502-339-2442

📧 contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

Note: This article is for educational purposes only and is not intended as medical advice. Please consult a licensed mental health provider for appropriate care.

Learn More
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Introducing the Religious OCD Blog Series: A Message from Dr. Brian Briscoe

by nextstep4adhdApril 25, 2025 Christian perspectives on Mental Health Psychiatry and Psychology, OCD0 comments

This article is part of the Religious OCD Series.

As a practicing psychiatrist who holds my Christian faith dear to my heart, I have had the privilege of walking alongside patients through some of their most challenging mental health struggles. In addition to my clinical work, I have served as Chair of the Psychiatry Section of the Christian Medical and Dental Association (CMDA), where I have had the opportunity to collaborate with colleagues who share both clinical expertise and a heart for ministry.

Over many years of practice, and through numerous conversations with colleagues from CMDA, I have recognized a significant gap in both academic literature and church resources addressing Religious OCD, also known as scrupulosity. Despite being a deeply impactful condition, Religious OCD remains largely misunderstood and under-discussed. Individuals who struggle with this form of OCD — along with their families and church communities — often find themselves navigating these difficulties in isolation and confusion.

This blog series was created in the hope of helping to change that.

Why This Series?

The goal of this twelve-article series is to provide clear, accessible, and theologically sensitive educational material that can:
  • Support individuals who are personally struggling with Religious OCD — offering them hope, understanding, and practical tools.
  • Equip pastors and church leaders — helping them recognize and respond wisely to congregants facing these struggles.
  • Guide family members and loved ones — enabling them to support their spouses, children, or friends with compassion and understanding.
Disclaimer: Although I am a medical doctor, the content in these articles is not intended to diagnose or treat any medical or mental health condition. These reflections are offered for educational purposes only—to support individuals who are suffering, as well as their families and church communities, in understanding scrupulosity and religious OCD with clarity and compassion.
If you or someone you know may be struggling with OCD or a related condition, please seek care from a licensed mental health provider who can offer appropriate evaluation and support.

My Writing Process

Creating this series has been a careful and deliberate process. I began by developing a detailed outline, organizing the key issues that I believe need to be addressed. Then, I wrote down what I felt needed to be communicated based on my clinical experience and expertise, and fleshed out those ideas in rough form. To help craft the initial drafts of each article, I utilized a large language model (LLM), allowing this tool to assist in generating cohesive, structured drafts based on my outlines, content, and direction.

However, this was just the starting point. I approached each draft from the LLM as a sculptor approaches raw stone — carefully chiseling away, refining, and reshaping the material until I found a final product that struck the right balance between clinical accuracy, theological sensitivity, and readability for a lay audience.

Why Use Large Language Models?

The process of writing is time-intensive, involving multiple drafts, careful word selection, thoughtful phrasing, and attention to grammar. As a busy clinician, I simply don’t have the luxury of dedicating that level of time and focus to each article. Still, I remain committed to educating the public on topics that I believe matter deeply.

Large language models have become valuable tools that help transform complex thoughts into structured drafts, assisting with much of the technical refinement. That said, I approached using this technology with some caution. As a history major from a liberal arts college — and the son of an English teacher — I deeply value the craftsmanship of writing. While I miss the time to fully immerse myself in that process, I’ve found that LLMs can be a tremendous aid for busy clinicians, provided we carefully review, revise, and shape the final product to ensure accuracy and integrity.

A Final Word

I hope this blog series will serve as a resource for those who are suffering, for the pastors who shepherd them, and for the families who love and support them. My prayer is that it will help bring clarity, encouragement, and practical guidance where there has previously been silence or confusion.
Thank you for joining me on this journey.
— Dr. Brian Briscoe

Series Overview

This blog series is designed to be comprehensive and approachable, offering twelve articles that each address a different aspect of Religious OCD. The topics include:

  1. What Religious OCD Is and Why It Happens
  2. Understanding Intrusive Thoughts in a Christian Context
  3. Compulsions in Religious OCD and How They Reinforce Anxiety
  4. How Religious OCD Affects a Believer’s Walk with Christ
  5. Biological Treatments: Medication and Supplements
  6. TMS (Transcranial Magnetic Stimulation) as a Treatment Option
  7. Exposure and Response Prevention (ERP) Therapy and How It Can Be Adapted for Christians
  8. Supporting a Spouse Who Struggles with Religious OCD
  9. How Parents Can Recognize and Support a Child with Religious OCD
  10. Guidance for Pastors: Recognizing and Responding with Wisdom
  11. How Small Groups Can Support Members Struggling with Religious OCD
  12. Moving Forward in Hope: A Final Word

Each article has been crafted to offer clinical accuracy paired with compassionate, faith-sensitive guidance. My hope is that readers will find both clarity and encouragement, whether they are sufferers themselves, loved ones, or church leaders seeking to shepherd well.

For Kentucky Residents

If you live in Kentucky and are seeking support for religious OCD or scrupulosity, our team at Next Step 4 Mental Health in Louisville is here to help. We offer compassionate, evidence-based care—both in-person and through telehealth—for children, teens, and adults.

📍 nextstep.doctor

📞 502-339-2442

📧 contactus@nextstep.doctor

For Those Outside Kentucky

If you’re not a Kentucky resident, we encourage you to seek care from a licensed mental health provider in your area. Professional support can be a vital step toward healing and peace.

 

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Hypomania and Hyperfixation: What’s the Difference?

by nextstep4adhdMarch 26, 2023 ADHD, Anxiety, Bipolar Disorder in Adults, OCD0 comments

Mental health conditions can manifest in various ways, and two related concepts that often come up in discussions about mental health are hyperfixation and hypomania. Hyperfixation is an intense preoccupation with a particular object, activity, or topic, while hypomania is a state of elevated mood and energy that is less severe than full-blown mania.

While both hyperfixation and hypomania can have a significant impact on a person’s life, they are distinct phenomena that are associated with different underlying conditions.

In this blog post, we will explore the similarities and differences between hyperfixation and hypomania, as well as their respective causes, symptoms, and treatments. Whether you or someone you know is struggling with hyperfixation or hypomania, understanding these concepts is an important step in seeking the right help and support for optimal mental health.

Are Hyperfixation and Hypomania the Same Thing?

No, they are not.

Hypomania is a specific syndrome that occurs in patients with bipolar disorder and is characterized by a period of at least four consecutive days during which a person experiences persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy.

Hyperfixation is a phenomenon that can occur in various mental health conditions.  For instance, people with OCD can become hyperfixated on a specific obsession, individuals with generalized anxiety disorder may become hyperfixated on worries about the future, and those with PTSD or complex trauma can become hyperfixated on intrusive memories from the past.

Additionally, people with ADHD may become hyperfixated on projects they are highly interested in, while individuals with severe mental illnesses such as psychosis may become hyperfixated on a specific delusion.

In other words, it is clear that hyperfixation and hypomania are not the same thing.

Similarities between Hyperfixation and Hypomania

Hyperfixation and hypomania share some similarities in that they both involve a heightened state of focus and energy. In both cases, a person may feel driven to pursue a particular interest or activity, often to the point of neglecting other responsibilities or obligations.

Differences between Hyperfixation and Hypomania

However, there are also important differences between the two. Hyperfixation is not necessarily accompanied by changes in mood or energy level, whereas hypomania is a distinct state of elevated mood and activity. Hypomania is also a symptom of bipolar disorder, whereas hyperfixation may be seen in a range of conditions, including ADHD or Obsessive-Compulsive Disorder (OCD).

It is important to note that while hyperfixation may be a symptom of certain conditions, it is not itself a medical diagnosis. Hypomania, on the other hand, is a clinical syndrome that requires immediate evaluation and treatment by a mental health professional.

Hyperfixation refers to a strong and intense fixation on a particular object, activity, or topic, to the point where it becomes difficult to focus on anything else. Hypomania, on the other hand, is a symptom of bipolar disorder and refers to a state of elevated mood, energy, and activity that is less severe than full-blown mania. People experiencing hypomania may feel overly confident, euphoric, and impulsive, and may engage in reckless behavior, such as overspending, gambling, or sexual promiscuity.

How Are They Treated?

If you notice signs of hypomania or hyperfixation in yourself or someone you know, it is important to seek professional help. Here at NextStep2MentalHealth, our multidisciplinary team can assess the situation, provide an accurate diagnosis, and recommend an appropriate course of treatment.

For hypomania, treatment may include medication, therapy, or a combination of both. The specific treatment plan will depend on the severity of the symptoms, the underlying cause, and other individual factors. It is important to note that hypomania can escalate into full-blown mania if left untreated, which can have serious consequences on a person’s life and well-being.

For hyperfixation, treatment will depend on the underlying condition. For example, if hyperfixation is a symptom of ADHD, treatment may involve lifestyle modifications, therapy, medication, or a combination of both to help manage symptoms and improve daily functioning. If hyperfixation is a symptom of OCD, treatment may involve exposure and response prevention therapy, medication, or a combination of both.

It is crucial to seek help as soon as possible if you or someone you know is experiencing symptoms of hypomania or hyperfixation. Early intervention can lead to more effective treatment outcomes and a better quality of life.

We’re Here for You

If you are struggling with any sort of mental health issues — whether that’s signs of hyperfixation or signs of hypomania, seeking help from a mental health professional can make a significant difference in your life. Here at NextStep2MentalHealth, we understand that seeking help can be challenging, but we are here to support you every step of the way.

Our experienced mental health professionals provide a safe and supportive environment for you to explore your thoughts and feelings, develop coping strategies, and work towards your mental health goals. Don’t hesitate to reach out to us for help – we are here for you. Schedule your appointment here.

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7 Things Teens with OCD Need to Know

by nextstep4adhdJune 24, 2022 OCD0 comments

Obsessive-compulsive disorder, more commonly called OCD, is a chronic mental health condition marked by intrusive thoughts and behavioral compulsions.

Here at NextStep2MentalHealth, our multidisciplinary team excel when it comes to diagnosing and treating OCD in teens. If you spot the signs of OCD in your teen, it’s never too early to receive professional help.

Here are seven facts that teens with OCD need to know.

1. OCD Is Common

According to the International OCD Foundation, there are about as many kids with OCD as there are with diabetes. That equates to about 20 teens in every medium-to-large high school who struggle with OCD. OCD is a type of anxiety disorder and can often occur with other anxiety disorders or depression.

2. Doubt and Guilt Are Two Hallmark Signs of OCD

TV shows and movies make it appear as though cleanliness is the only compulsion for people with OCD, but the reality is fear of germs or contamination is just one sub-type of OCD. Other sub-types of OCD include:

Doubt

Doubt is a driving force behind many of the compulsions to check and re-check. Doubt is defined as “doubting that you completed the activity even right after you completed it.” This can lead teens to constantly re-checking locks, homework, etc. Understandably, this can affect time management skills and even academic performance.

Guilt

Guilt is another excruciating aspect of OCD. People with OCD may feel guilty about anything, even if it had nothing to do with them. This can cause thoughts such as:

  • “Did I offend John Doe?”
  • “Did I inadvertently cause XYZ to occur?”
  • “Am I a good person or a bad person?”

Other sub-types include counting, hoarding, contamination, false memory, and harm OCD.

3. Cognitive Behavioral Therapy (CBT) Can Help Treat OCD

Cognitive Behavioral Therapy (CBT) is considered to be a top form of treatment for anxiety disorders, and that includes OCD too.

4. The Goal of Treatment Helps You Learn the Tools to Manage Your Symptoms

Throughout your therapy sessions, you’ll continue to learn strategies and tools for managing the cycles of intrusive thoughts and compulsions.

Does your OCD need treatment? Read this blog: Does OCD Need Treatment?

5. Treatment Isn’t Completed Overnight

Often, when teens start treatment for OCD, one of their first questions is “how long does treatment take?” The short answer is: as long as is necessary for any given individual. Managing symptoms is an individualized process and can be impacted by your teen’s willingness to participate in therapy, the presence of any comorbidities, and how severe your teen’s symptoms are.

Understandably, long-term OCD can take a heavy toll on your teen’s quality of life.  It may have been a long time since your teen socialized comfortably, held a summer job, or felt at ease doing daily chores. Some teens have never done these things without the obstacle of OCD.

6. Know the Signs of Relapse in Teens with OCD

As with many disorders, your teen may go for long periods with his or her symptoms well managed, but a relapse can knock them off track. Relapses are not uncommon with OCD.

Here at NextStep, our therapists know that the best way to deal with a relapse is to get ahead of it. We discuss relapse in our sessions and help you engage in as many relapse prevention strategies as possible.

That being said, if you or your teen notice any signs of a relapse, don’t hesitate to reach out. The quicker you seek help, the quicker you can get back on track.

7. OCD Can Be Managed

The most important fact to remember is that OCD can be managed. As with any anxiety disorder, lifestyle modifications help support mental wellness. This includes getting enough sleep, following a proper diet and exercise routine, engaging in positive social relationships, and engaging in hobbies or productive work of some type.

At NextStep2MentalHealth, we know how profoundly OCD can impact all aspects of your teen’s life, and if your teen is struggling now, you don’t have to wait until it gets worse before reaching out for help. Our compassionate, non-judgmental team offers a variety of OCD treatments, including medication and therapy.

If you have concerns about OCD, schedule an appointment at our Louisville, Kentucky office. Request an appointment online.

 

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Does My Teen Have OCD?

by nextstep4adhdMay 31, 2022 OCD0 comments

Obsessive-compulsive disorder (OCD) is one of the many anxiety disorders that can affect teens. About half a million children have OCD, and unfortunately, it’s often overlooked in teens. In some cases, OCD behaviors may be mislabeled as quirky, but the reality is that OCD causes intrusive thoughts and compulsive behaviors that can interfere with your quality of life.

The types of obsessions or compulsions can vary from person to person. Regardless of which obsessions your teen is struggling with, it’s important to know that OCD is treatable. But the first step is to ask for help. 

If you’re wondering if your teen has OCD, schedule an appointment with a mental health care provider for an OCD evaluation. In the meantime, here are some common signs of OCD in teens.

Tell-tale Signs of OCD to Look For

Tune in to the video below to learn more about OCD symptoms in adolescents, courtesy of the International OCD Foundation.

Other Signs of OCD in Teens

1. Does Your Teen Take a Long Time to Get Ready?

Ritualistic behaviors can add minutes (if not hours) to your teen’s routines. This means that your teen might take a long time to get ready for the day, to finish homework, etc.

If intrusive thoughts and compulsive behaviors interfere with your teen’s daily life or take up more than one hour (per the National Institute of Mental Health (NIMH)), consider reaching out for help.

2. Your Teen Is Concerned with Contamination

Do you notice that your teen uses too much soap or washes their hands obsessively? Fear of germs and contamination is a common subtype of OCD. If your child has this subtype of OCD, your teen may obsess over contracting an illness or spreading germs. 

Your teen may:

  • Avoid doorknobs or pushing buttons in public spaces
  • Continually ask if their food is cooked thoroughly
  • Check (and recheck food expiration dates)
  • Wash hands frequently (more than recommended by the WHO)
  • Encourage other family members to constantly clean their hands

Read: Navigating OCD in Post-Pandemic World

3. Your Teen Has Meltdowns

If your teen has rituals in which certain events must be performed in a specific sequence, and you interrupt this process innocently, your teen may feel compelled to go through the entire process again. This can make your child frustrated and even angry.

4. Your Teen Is Concerned He Did Something Wrong

Another subtype of OCD is morality. Your teen may constantly worry that he’s done something wrong. This is also called moral scrupulosity, and it’s an obsessive concern with whether or not one is being good or bad — and it can occupy a lot of your teen’s mental bandwidth.

5. Your Teen’s Schoolwork Is Suffering

Intrusive thoughts and ritualistic behaviors can suck up a lot of your teen’s time at school. For example, ruminating on obsessions can make it hard for your teen to focus on school lectures or get homework done.  Getting the right OCD treatment can help your teen manage his/her anxiety, which can lead to a more productive day at school.

Perfection is another subtype of OCD, and the desire to constantly deliver perfect work can make it hard to ever finish assignments on time.

6. Your Teen’s Personal Relationships Are Suffering

OCD doesn’t just impact your teen’s academic performance. Unmanaged OCD can start to affect your teen’s relationships with you, your family, and their friends. You might consider OCD treatment for your teen if:

  • Your child’s thoughts make it hard to focus at school
  • Your teen’s compulsions limit his or her ability to enjoy time with friends or family
  • Their OCD is getting in between you and your teen

7. Your Child Continually Asks If He’ll Be Okay

Children and teens may struggle with many of the same intrusive thoughts as adults, including fear of contamination and fear of harm. You might suspect your teen is struggling if he continually asks if “he’ll be okay”. According to the International OCD Foundation, this can be a sign of pediatric OCD.

8. Your Teen Demonstrates Symmetry

Obsessions with symmetry and related compulsions, such as ordering and arranging, have received increased empirical attention in recent years. Analyses of obsessive-compulsive symptomatology in obsessive-compulsive disorder (OCD) have consistently identified a factor characterized by symmetry concerns and related rituals. In OCD, symmetry obsessions are characterized by the need for things to be perfect, exact or “just right,” symmetrical, or correctly aligned, and related compulsions include ordering and arranging, evening up or aligning things, and touching or tapping. 

Source

Here’s an example: If your teen bumps his right knee on the table on accident, he may feel compelled to go back and bump his left knee on the table.

Another example: your teen may spend hours arranging or rearranging items on the shelf in his or her room.

Other signs of OCD in teens include:

  • Excessive checking (re-checking that homework is done, lights are off, the door is locked, etc.)
  • Excessive washing, tidying up,  and/or cleaning
  • Repeating ritualistic behaviors until they are “just right” … or starting over again until they are right
  • Obsessing with rearranging things
  • Mental compulsions which may include excessive praying or mental reviewing
  • Frequent  apologizing
  • Reciting lucky words or numbers or phrases; using lucky items, etc.

If you notice any signs of OCD in your teen, seeking professional treatment can help restore the quality of your child’s life.

How Is OCD Treated?

At NextStep2MentalHealth, we know how profoundly OCD can impact all aspects of your teen’s life, and if your teen is struggling now, you don’t have to wait until it gets worse before reaching out for help. Our compassionate, non-judgmental team offers a variety of OCD treatments, including medication and therapy.

If you have concerns about OCD, schedule an appointment at our Louisville, Kentucky office. Request an appointment online.

 

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