Dr. Jed Siev talks Religious (scrupulosity) and Moral Obsessions

anxiety depression guest interview mental health ocd

In this episode of Your Anxiety Toolkit Podcast, I was honored to talk with Dr. Jed Siev about Religious and Moral Obsessions. Dr. Jed Siev specializes in the treatment of Obsessive Compulsive Disorder (OCD) and is an Associate Professor in the Psychology Department at Swarthmore College.  He specializes in religious and moral obsessions in particular, which are extremely common among those suffering from OCD.  I’m so excited to share this episode with you!

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Via my Instagram (@kimberleyquinlan), I was able to take some questions from followers for this episode that I asked Dr. Jed Siev.  He brought skill, compassion, and research into the conversation in such a beautiful way.

Some of the questions that were discussed in the interview, with answers by Dr. Jed Siev:

  • What is scrupulosity?
    • The way I describe it is pretty broad. Core obsessional fears in OCD latch onto something religious or moral.
    • This is more of a category of a core fear than a subtype. People can have scrupulosity that looks like any other type of OCD.  You can have scrupulosity that is all about ritual contamination, such as cleaning yourself properly before prayers or keeping Kosher.  One can have scrupulosity with sexual obsessions.  Maybe you have sexual thoughts about doing sexual things with Jesus when you go to church.  You can be scrupulous in any of the symptom subtypes.
  • What are the common obsessions and compulsions for Religious (scrupulosity) and Moral Obsessions? 
    • This differs a lot in manifestation and there can be differences in certain religious groups (Christian, Catholic, Jewish, etc.). Examples are below, but there are a lot of exceptions.
    • Obsession examples: Accidental Satan worship, going to hell, offending God, blasphemy, “Do I love God enough,” contamination, being fundamentally evil
    • Compulsion examples: Overuse or misusing confession, not taking communion because they’re not in a pure state, having to redo a prayer so they have the right intention during prayer or articulate the right words properly, etc.
  • How does Scrupulosity differ from Moral Obsessions? 
  • What does treatment for Religious (scrupulosity) and Moral Obsessions consist of? 
  • Does treatment for Religious and Moral Obsessions differ for different common religions?
    • In many ways, it’s fundamentally the same as typical treatment: Exposure & Response Prevention (ERP), supplemented with cognitive work.Fundamentally, we are trying to help people get to the same place by the same means.  However, there are some modifications that we can make to help people. Some modifications have to do with upfront conceptualization and assessment.  Disentangling OCD from the religion is a big part of it.  Religion is not the problem.  The goal is to cut out the OCD and not the religion.  One of the big tricky areas is figuring out how to violate OCD rules without violating religious rules.  I want people to learn to live a life that matters, which other people do.  Breaking religious rules with OCD as the excuse is not great.

The below questions from listeners are addressed:

  • Is it helpful to involve a member of clergy when treating religious OCD?
    • I have found clergy to be really helpful.  I don't want to be a religious authority with scrupulous patients or get involved with religious debates because that makes the issue about religion.  It's nice to have an expert in religion, an expert in OCD treatment, and an expert in their experience (the patient).  Then, we can figure out ways to effectively execute ERP without violating religious rules.  There are guidelines to work out with the clergy and the patient.
  • Is it common to question whether you are a good person or just do a good thing to prove you are a good person? 
    • I actually think that, to some extent, a lot of people (with or without OCD) think about this a little bit.  People wonder about this to a certain degree.  The key is to accept the uncertainty about this.  You'll never know if you're a good person and you will mess up a lot if you're human.  Every religion has this built in.  There is confession if you're Catholic.  It's a way to make things right.  Many religions have something like this.
  • How do you practice acceptance of thoughts and obsessions even if it feels so against your morals? 
  • When you struggle with religious (scrupulosity) and Moral Obsessions, how do you teach your younger child to pray? 
  • Why is there such a strong feeling of guilt attached to Religious (scrupulosity) and Moral Obsessions? 
  • How do you address the fear of doing things that are disloyal?
  • What to do if you keep judging your actions? 
  • What to do if you keep putting shame on yourself? 

I am so grateful for everyone who submitted questions for this episode.  I learned so much from Jed Siev and I am sure that you will too!

For more information on Dr. Siev, visit:




There are two upcoming events that I want to remind you of!  The TLC Foundation will host their annual conference on Body-Focused Repetitive Behaviors from May 2-4 in Virginia.  Click HERE for more information and to buy tickets.  Also, the IOCDF Annual Conference will be held in Austin, Texas, from July 19-21.  I will be speaking at this event and love seeing you there!  Click HERE for more information and to buy tickets.


About Kimberley Quinlan

Kimberley Quinlan is a Licensed Marriage and Family Therapist who specializes in Anxiety, Obsessive Compulsive Disorder (OCD), Eating Disorders, Panic Disorder and Body Focused Repetitive Behaviors (BFRB’s).  Kimberley is highly trained in Cognitive-Behavioral Therapy (CBT), with a heavy emphasis on Exposure Response Prevention (ERP), and has been practicing meditation and mindfulness for many years.  Kimberley has a special interest in the integration of mindfulness principles with CBT for OCD, Anxiety Disorders, and Eating Disorders.  Kimberley has experience treating adults, adolescents, and children, and tailors each program to suit the age and cognitive development of each client.  Kimberley has a private practice in Calabasas and Westlake Village. 

For more information, you can find Kimberley at the following:

Website: https://kimberleyquinlan-lmft.com

Instagram: https://www.instagram.com/kimberleyquinlan

Facebook: https://www.facebook.com/KimberleyQuinlanCBTschool/