I love being a Christian.

I mean, I love Jesus, but I love all the rest of it too: brunch after church with friends and hylomorphism and late-night Eucharist on Christmas Eve and C.S. Lewis and John Donne and Charles De Koninck. I love Durham Cathedral and the Aksum Empire and Neoplatonism and canon law and candles and martyrs who chose death over denial and countless little communes of monks and Anabaptists and Puritans and Methodists and charismatics who read Acts 2 and 4 and decided to just go ahead and do it.

I love knowing that nothing good will be lost and there are no ordinary people and death has been killed. I love sacred Scripture mysteriously breathed by God through the words of men and that our God and King gave us his body to eat and his blood to drink.

And I also think it’s true, so there’s that.

But there have been times I have found belief to be almost unbearable. And I’ve met enough people who have shared this particular difficulty that my story might be worth sharing.

Walk Away, or Pray for Faith

I was baptized at 16, but didn’t become serious about following Jesus until grad school. And then for the next decade or so, I went through . . . call them “crises.” Times I couldn’t stop thinking, obsessively ruminating on certain things — two in particular.

First: If Calvinism was right, as I then understood it, how could I understand that God is good? Second: How can I live in a world where people I love may be going to hell?

These circling thoughts left me exhausted over my own attempts to make sense of everything, and with a grief-fueled nostalgia for the time when, as a secular person, I didn’t worry about any of this stuff. I felt alienated from non-Christians and even from Christians who didn’t share my intensity and anguish.

During some of my worst moments, I felt like I was presented with a choice: you can cease believing, or you can pray for faith. Ceasing to believe didn’t feel like a choice that would change reality. It felt like choosing to somehow sit on the sidelines, to become a non-player character. Yet apostasy did seem to offer me the psychological comfort of escape.

I prayed for faith.

Obsessive Moral Threats

I’m not sure when I first heard the word scrupulosity. At some point, I probably googled “religious OCD,” which is more or less what it is. And I was very familiar with OCD.

Around age 12, I was diagnosed with “obsessive-compulsive disorder.” If you’re unfamiliar with OCD, it makes threats that feel moral. You feel like you’re both morally wrong and physically unsafe, and what will put you morally and physically right again is obsessively performing various rituals (you’ve heard them: handwashing, not stepping on cracks, etc.). Often, what you care about most is what the disorder “chooses” to threaten you about: “wash your hands just right or your child will die, and it will be your fault.” That kind of thing.

Most people with this disorder are not delusional. They know the threat isn’t real, that it’s irrational, which often makes the disorder profoundly embarrassing. “Don’t mind me, just going to, um . . . wash my hands seven times and then turn off the tap with the backs of my hands, because . . . well, you go ahead and start dinner.”

I ended up receiving various kinds of treatments (medication, cognitive behavioral therapy), which helped enormously. And by the time I was out of high school, my OCD was pretty much dealt with. It proved to be a weird blessing in my life to have experienced this before my adult conversion, unrelated to Christianity.

After college, I started spending time with people who actually believed that Jesus was not at all dead. And then I found that I actually believed that too. And the stakes in life suddenly became much higher.

Enter Scrupulosity

Conversion is always disorienting. But God gave me time to work through the normal confusions of new Christianity: the sense that there is nothing one can hold back; the realization that God makes no guarantees that you won’t, for example, eventually be martyred; all the normal pricks of an awakened conscience; all the joy and amazement that first Christmas when the carols you’ve sung your whole life suddenly come alive and blaze with glory.

Then, sometime within the first two years, I had my first major bout of scrupulosity.

Like OCD, scrupulosity produces an irrational sense that one is in profound danger and has a bad conscience. It’s confusing because it can overlap with one’s “real conscience” and real fear of hell, but it’s distinct enough to recognize once you get to know it. I could discern something “off” about it. It wasn’t “what reality is like,” “what being a sinner and having a bad conscience is like,” or “what Christianity is like.”

Being curious by nature, and also a nerd when it comes to history and historical theology, I started digging and discovered that scrupulosity is a spiritual malady that has caused pastors to say, “Oy, not this again,” for about two thousand years. It’s also a neurological, OCD-related condition that can be treated on that basis. In fact, confessors, spiritual directors, and pastors have been using tools similar to cognitive behavioral therapy for a good portion of church history — long before medications provided additional treatment options.

Christians’ Doubting Disease

There are two pretty distinct versions of scrupulosity. There’s the one that resembles “classic” OCD, which leads sufferers to obsessively perform rituals, like prayer (“If I don’t say these exact words with exactly the right feelings, they won’t count”) or confession (Luther’s poor confessor!) in order to feel like they’ve gotten it “right.” And then there’s the delightful experience of repetitive, racing thoughts, obsessively ruminating over theological questions, which one feels like one must resolve in order to be at peace. Neither makes for a particularly good time. But in my experience, the ruminations are the real bear.

OCD has been called the “doubting disease.” Did I really lock the door? I think I did. I remember doing it. But if I did, why do I doubt so profoundly that I did? Why do I feel in danger? Better check. In other words, subjective uncertainty presents itself as something to pay attention to, something that gives good information.

Now imagine how difficult it might be for those dealing with this disorder to evaluate their subjective assurance of salvation, which in some Christian traditions has been viewed as a necessary mark of true salvation. If one must sit on the “anxious bench” until one receives assurance, a person with an unaddressed scrupulosity disorder can sit there for a long, long time.

As I said earlier, questions I found myself obsessively ruminating over included “Does God want everyone to be saved?” “How can I trust that he wants me to be saved?” The questions can get very refined indeed: “If Calvinistic monergism is true, is God good? Is ‘good’ meant equivocally or analogically when we predicate it of God? Are you sure? But are you sure? How about ‘love’? Better think about this for five hours in the middle of the night to try to solve it.” My scrupulosity demanded that I give attention to these subjective uncertainties until I had subjective certainty, the kind that doesn’t come like that. And during the darkest seasons of such ruminating, I was tempted with apostasy as a palliative for my psychological pain.

But I prayed for faith.

Living with a Trustworthy God

I know this might sound simplistic at first, but one of the most helpful things for me has been simply learning to trust God more. I don’t mean “trusting God” as some immediate mental choice in moments of struggle, though it is that too. Rather, I just mean living with him as my King for longer, and learning that he is trustworthy and that I don’t need to get answers to all my theological questions before I am able to rest in that.

“God’s character is one thing we do not need to doubt.”

In non-religious OCD, one learns to talk back to one’s mind: “Yes, I know you are subjectively uncertain, but that has nothing to do with reality.” As a Christian with religious scrupulosity, I do the same. And more, I’ve learned to get out of my own head. I have a kind of mental box, Susannah’s Big Box of Unanswered Theological Questions. I’ve found it incredibly helpful to realize it’s okay to have such a box, and that there will be items in it until I see God face to face, and probably afterward. The fact that we don’t see how all the data points of Scripture and experience and tradition fit rationally together should not for a moment cause us to discount the data points we do have about God’s character. His character is one thing we do not need to doubt.

In my worst episodes, I didn’t really doubt the truth of the Scriptures. In a sense, that was part of the problem: scary passages felt like chains binding me, guns pointed at my head. But it also meant I could hang on to the passages of God’s unequivocal grace. “God shows his love for us in that while we were still sinners, Christ died for us” (Romans 5:8). “The Lord is good to all; he has compassion on all he has made” (Psalm 145:9). There is nothing original that I can offer here: these are uncompromising promises about God’s character and his love of each of us, and of those we love. I held on to these white-knuckled. And then, gradually, I realized that I didn’t need to hold on that tightly, because I was being held.

Out of the Pit

If you’re wondering whether you or someone you know might be suffering with scrupulosity, it can really help, first, to know that it is a thing. It’s a real neurological disorder, and there are many online resources available from credible medical and Christian ministry sources to begin understanding how it works and how to pursue diagnosis and treatment. It’s also an old thing. I found help reading memoirs and anecdotes of saints from the past who have suffered very similar experiences, like St. Therese of Lisieux, St. Ignatius, or John Bunyan.

“When your own thoughts are a trap, you cannot just think your way out of it. You need the help of others.”

It’s also important that you don’t attempt to figure it out alone. Doubt, anxiety, and fear are common human maladies (Philippians 4:6–7; Hebrews 13:6; James 1:5–8). And of course, some anxiety is good (2 Corinthians 11:28), and some fears are real (Luke 12:5). We all fall somewhere on a spectrum with many kinds of mental distress, so discerning what’s “normal” and “abnormal” can be tricky. A good place to start is talking with your pastor, if possible, and/or trusted, wise counselors (particularly those with some familiarity with scrupulosity). When your own thoughts are a trap, you cannot just think your way out of it. You need the help of others, ideally professionals.

And if you feel tormented by scrupulosity’s obsessive ruminations, and tempted by the psychological comfort that apostasy seems to offer: take the leap. In the face of that choice, pray for the grace of faith to be given to you in abundance. And then throw the whole kit and caboodle, every means of grace, at this thing: prayer, Scripture, saints around you, ancient saints, SSRIs, cognitive behavioral therapy, all of it.

I also say this: dare to hope that you will be okay again one day, that you will again find “joy and peace in believing” (Romans 15:13). God, as it happens, is patient. He is also analogically, though not univocally, good and loving. And the ways in which his patience and goodness and love are not univocally identical to ours, his are more so. Always more, not less.