When OCD Gets Religiousالوسواس القهرى الدينى : When OCD Gets Religiousالوسواس القهرى الدينى What is scrupulosity? : What is scrupulosity? Extremely careful to do the precisely right, proper, or correct thing in every last detail; most punctilious متمسّك بالشكليات.
Showing extreme care, precision, and punctiliousness
Full of scruples وساوس-حيرة-تردد, hesitant, doubtful, or uneasy, constantly and obsessively in deciding what is right or wrong Slide 3: The condition of “seeing sin where there is none”
The Roman Catholic and protestant churches
ابن الجوزي What it is like to have scrupulosity : What it is like to have scrupulosity People with religious obsessions and compulsions are ruled by an overly strict and rigid code of religious, moral, or ethnical conduct.
Rather than subscribing to religious precepts النصائح and laws as guides for living a richer, more peaceful and spiritually fulfilled life, people with scrupulosity become victims of their own beliefs. Their scrupulous behavior robs يَسْرقُ them of peace of mind. Slide 5: They live in a relentless عَنيد tortured state of vigilance , always alert to the possibility of committing some immoral or blasphemous act كفرية and being punished harshly for it. Some examples of scrupulosity : Some examples of scrupulosity Repeatedly attending confession to request forgiveness
Excessively worrying about having a sexual thought while looking at another person's spouse, or حتى لطفل
أو نظرة من رجل لرجل
أو من إمرأة لإمرأة .
Repeatedly reciting the Lord's prayer over and over للتأكد من نطق كل كلمة بدقة وتركيز وخشوع وتدبر وبدون سرحان وبدون أي خطأ في التشكيل أو النطق أو التجويد Slide 7: Constantly checking the ground to make sure one has not stepped on an object resembling the sign of the cross and thus desecrating an important sympol
Meticulously avoiding swallowing one's own saliva in order to follow the requirement to abstain from eating or drinking during the Jewish celebration of Yom Kippur. Some examples of scrupulosity Slide 8: عند المسلمين:
البصق طول النهار
الامتناع عن الاستنشاق والمضمضمة في الوضوء
تنشيف الفم دائماً بخرقة أو فوطة
عدم دخول المطبخ أبداً خلال الصيام خوفاً من تعمد الأكل والشرب
عدم الاقتراب مطلقاً من أي مصدر مياه حتى لا تصل أي طرطشة أو نقطة إلى الفم
إعادة أيام الصيام طوال السنة Some examples of scrupulosity Differentiating between strong religious beliefs and scrupulosity : Differentiating between strong religious beliefs and scrupulosity 1.parctices that go far beyond the requirements of religious law and custom, when members act "more Catholic than the Pope." For example, if a ritual requires abstaining from food and drink , the scrupulous person may feel that swallowing saliva is sinful. Differentiating between strong religious beliefs and scrupulosity : Differentiating between strong religious beliefs and scrupulosity 2.Beliefs or practices that have an overly narrow , trivial focus, or excessive attention paid in prayer to "saying it right" or " perfectly" rather than as a way of developing a relationship with God. Differentiating between strong religious beliefs and scrupulosity : Differentiating between strong religious beliefs and scrupulosity 3.Healthy religious beliefs don't interfere with the normal practice of the religion. Scrupulosity OCD, on the other hand , frequently interferes with practice of the religion, for example , when a person with blasphemous thoughts avoids going to church altogether. Differentiating between strong religious beliefs and scrupulosity : Differentiating between strong religious beliefs and scrupulosity 4. the person with scrupulosity spends excessive time and energy on minute, trivial aspects of religious observance, often ignoring more important aspects of spiritual life such as charity for the less fortunate. Differentiating between strong religious beliefs and scrupulosity : Differentiating between strong religious beliefs and scrupulosity 5.The excessive preoccupation with doing religious rituals until they are "just right," repetitive praying, and unnecessary confessing seen in scrupulosity resemble the typical symptoms of OCD, such as checking, repeating, and asking for reassurance. Like the unwanted. Does having strong religious beliefs increaes the likelihood of having scrupulosity OCD? : Does having strong religious beliefs increaes the likelihood of having scrupulosity OCD? OCD is a neurobiologic disorder
there must be a biological predisposition to have OCD
Strong religious believes are not the cause of OCD
There are only the grist for the OCD mill in a person who is biologically predisposed to it
If strong religious believes were not present, the OCD would surely take a different form, such as contamination fears, or checking compulsions Hypermorality and hyperresposibilty : Hypermorality and hyperresposibilty Hypermorality involves an excessive preoccupation with the fear of doing something morally wrong, reprehensibleيستحق التوبيخ and/or condemnable. These individual set excessive, unrealistically rigid and narrow standards in the areas of their lives.
مراجعة فواتير الشراء – السرقة
مراجعة الكلام مع الناس – الكذب Hypermorality and hyperresposibilty : Hypermorality and hyperresposibilty hyperresposibilty
People who are hyperresposible
Have an overly unrealistic sense of accountability,
Such people take on responsibilities that realistically belong to others, or take responsibility for things that are beyond anyone's control. Hyperresposibilty : Hyperresposibilty Examples:
فحص الأرض للتأكد من عدم وجود أي شيء مثل الماء أو أي مادة قد تؤدي للتزحلق(قشرة موز) حتى لا يضر الآخرين(مسمار-زجاج....)
فحص القمامة جيداً للتأكد من عدم وجود شيء يجرح حاملها أو فرزها وتصنيفها إلى زجاج-معادن-ورق-.... حتى يسهل الاستفاده منها لمن يجمعها
جمع الحيوانات في الشوارع والسلالم (قطط- كلاب -..... لحمايتها ورعايتها Slide 18: For example, they are afraid of going to hell, angering God, or living with guilt for their failure to protect others from harm.
They have little time or energy left to concern themselves with the well-being of others because of living in constant fear for their own fate. The Self Directed Program : The Self Directed Program Step 1
Find a spiritual/Religious advisorمرشد.
Keep a daily record of your obsessions
Make a target Obsessions list
Make a target Compulsions list
Devise an Exposure and Ritual prevention Strategy Step 1:Find a spiritual/Religious advisorمرشد.. : Step 1:Find a spiritual/Religious advisorمرشد.. 1-choose a trusted person to serve as your moral , ethical or spiritual advisor
يا سلام لو كان طبيبك النفسى, وهى دى خطتنا القادمة
وأن يكون كل طبيب نفسي هو مرشد كل مريض وسواس
2-This person should have religious beliefs similar to yours with a basic understanding of scrupulosity OCD Step 2-Keep a daily record of your obsessions : Step 2-Keep a daily record of your obsessions Slide 23: Step 3: make a target obsessions list Target obsessions list : Target obsessions list Step 4:Make a target Compulsions list : Step 4:Make a target Compulsions list Step 5-Devise an Exposure and Ritual prevention Strategy : Step 5-Devise an Exposure and Ritual prevention Strategy This strategy is based on yr lists of target obsessions and compulsions,
The first target is to lower the level of distress The ritual prevention works best when: : The ritual prevention works best when: 1-Exposure must be prolonged and repeated 1.5-3 hours per day, for 4-7 days a week.
U must remain in anxiety provoking situation long enough to promote habituation. The ritual prevention works best when: : The ritual prevention works best when: 2-The exposure must be acceptable to u, and not oppose yr core religious beleifs
محاضرة القسم,كلام الأطباء,ترك الصلاة لغاية ما تخف
Remember that OCD behaviors are excessive, unwanted, persistent ,and not based on the true requirements of religious or spiritual practice The ritual prevention works best when : The ritual prevention works best when 3-As U expose yr self to anxiety provoking situations, work to reduce yr compulsive rituals gradually on a day to day , week to week basis.
4-If U r feeling Unsure or Unsafe when blocking a ritual , the general rule is “do the Opposite” of whatever scrupulous idea Yr OCD mind tells U to do. The ritual prevention works best when: : The ritual prevention works best when: 5-Make copies of the scrupulosity Exposure and Ritual prevention planning form and use it to help U plan Yr EPR strategy on day to day or week to week basis. Scrupulosity Exposure and Ritual prevention planning Form : Scrupulosity Exposure and Ritual prevention planning Form Scrupulosity ERP planning Form(Cont..) : Scrupulosity ERP planning Form(Cont..) Exposure & Ritual prevention daily ( weekly)plan : Exposure & Ritual prevention daily ( weekly)plan Imaginal Exposure Plan : Imaginal Exposure Plan Exposure and Ritual prevention Plan : Exposure and Ritual prevention Plan Imaginal Exposure Plan : Imaginal Exposure Plan Key Points : Key Points 1- U r not Planning to act on yr bad thoughts , only to think about them.
Thoughts do Not Equal actions.
2-Daily place Yr self in situations that will trigger symptoms
المسجد,الصلاة,القران,الأذكار، الكنيسة، الترانيم Key Points : Key Points 3-Tell Yr advisor to give U reassurance that U R doing the right thing only once.
rephrasing a question or asking a second person to get another reassuring answer is not helpful
Be honest with yr self , If U ALREADY KNOW THE ANSWER , Don’T ASK. Key Points : Key Points 4-When u want to avoid a situation or activity do it any way .If u feel an urge to do something to alleviate yr anxiety, DON”T DO IT.
5-Allow bad thoughts to pass into yr mind, as if seeing them through a distance Key Points : Key Points Ignoring obsessive thoughts weakens them while fighting against them strengthens them causing them to grow and multiply
الوسواس سؤال لو جاوبته يبقى 100 لو جاوبتهم يبقوا 1000
The standards and beliefs of people with scrupulosity OCD often go beyond those of most devoted members of their own religion. Slide 45: firstname.lastname@example.org