Therapy for Scrupulosity (Religious and Moral OCD) in San Antonio and Across Texas

scrupulosity

This Isn't a Lack of Faith. It's Often Scrupulosity, and It's Very Treatable.

When your faith or conscience becomes a source of constant fear, it can feel like you're failing at the very thing that matters most. You confess again and again. You repeat prayers until they feel "right." You can't shake the fear that you've sinned, offended God, or done something unforgivable. Scrupulosity is a recognized form of OCD [1, 2]. At Integratus Counseling, we treat it with evidence-based care that respects your faith, in person in San Antonio and virtually across Texas.

Luke Mayeux, LPC, scrupulosity therapist in San Antonio, smiling outdoors

Scrupulosity is OCD that focuses on religious or moral themes.

OCD attaches to what you value most, which is why it so often targets faith and conscience [1, 4]. Religious scrupulosity centers on sin, prayer, worship, or your relationship with God. Moral scrupulosity centers on honesty, fairness, or fear of being a bad person. It affects religious and non-religious people alike [4].

Schedule a free 15 minute consultation

A free 15-minute call. No forms, no commitment. Just a conversation about what you're facing.

Flowering plants on a wooden bench in a sunlit greenhouse
Scrupulosity or a sensitive conscience?

A healthy conscience finds peace. Scrupulosity never lets you rest.

With a healthy conscience, a concern comes up, you respond, and you find peace. With scrupulosity, the relief from confessing or checking fades quickly, the doubt returns, and the cycle starts over, often about things others would see as minor or unlikely. The Church has recognized scruples for centuries. St. Ignatius of Loyola wrote about them in his Spiritual Exercises [7], and St. Alphonsus Liguori struggled with them himself [8]. You're in good company, and you don't have to carry this alone.

How we treat scrupulosity: the two leading OCD treatments, adapted with care for your faith.

Exposure and Response Prevention (ERP) helps you face OCD's doubts without the compulsions that keep the cycle going [5]. Inference-Based CBT (I-CBT) helps you see how OCD builds its case against you, so you can trust your conscience and your relationship with God again [6].

  • We never ask you to act against your beliefs. Exposures target what OCD demands, not what your faith teaches [3, 4].
  • Faith integration is always your choice.
  • With your written consent, we can coordinate with your priest, pastor, or spiritual director so your spiritual guidance and therapy support each other [3].
Schedule a free 15 minute consultation

A free 15-minute call. No forms, no commitment. Just a conversation about what you're facing.

why integratus counseling

OCD specialists who respect your faith.

OCD and anxiety are our focus, not one item on a long list. We offer both ERP and I-CBT, with Catholic-sensitive, faith-informed care for clients who want their faith to be part of healing, and we're listed with CatholicTherapists.com. We welcome clients of all faiths, and those with moral scrupulosity and no religious practice. We see clients in person at 16607 Blanco Rd, Ste 1308, San Antonio, and by telehealth anywhere in Texas.

Meet our team →
Integratus Counseling therapist working on a laptop on a shaded porch

Common signs of scrupulosity

Obsessions (the doubts)Compulsions (what you do to relieve them)
Fear that you've sinned, or sinned without realizing itRepeated or excessive confession
Unwanted blasphemous or sacrilegious thoughtsRepeating prayers until they feel "perfect"
Worry that you're damned or can't be forgivenSeeking reassurance from clergy, family, or online
Doubts about whether you received a sacrament worthilyAvoiding church, Mass, or the sacraments out of fear
Fear of lying, cheating, or being secretly immoralMentally reviewing past actions for hours

Learn more about our approaches: ERP therapy, I-CBT, and faith-based integration. Many clients also find The Doubting Disease helpful, listed on our Resources page.

Related types of OCD

Harm OCD
Unwanted thoughts about causing harm
Contamination OCD
Germs, illness, and feeling "dirty"
Just Right OCD
Symmetry, order, and perfectionism
Relationship OCD
Doubts about your partner or relationship
Perinatal & Postpartum OCD
Intrusive thoughts during pregnancy or after birth
Unwanted Sexual & Taboo Thoughts
Including Sexual Orientation OCD (SO-OCD)

Back to OCD therapy at Integratus.

Frequently asked questions

Do I have to be Catholic or Christian to work with you?

No. We have particular experience with Catholic and Christian clients, but we treat scrupulosity in people of every faith and none.

Will therapy challenge my faith?

No. Our goal is to separate your OCD from your faith, not to change what you believe [4]. Many clients find that treatment helps them experience their faith with more peace and less fear.

Can you work with my priest or spiritual director?

Yes, with your written consent. Coordinating care can help you and your spiritual guide respond to OCD in the same way.

Is scrupulosity really OCD?

Yes. Scrupulosity is a well-recognized presentation of obsessive-compulsive disorder [1, 2]. It responds to the same evidence-based treatments as other forms of OCD [1, 4].

Do you offer scrupulosity treatment virtually?

Yes. We see clients in person in San Antonio and by secure telehealth anywhere in Texas. You need to be physically in Texas during each session.

How much does it cost?

Individual sessions are $150 for 50 minutes. We're a private-pay practice, and clients working with Luke Mayeux, LPC, can request a superbill for possible out-of-network reimbursement.

References

  1. Abramowitz, J. S., & Jacoby, R. J. (2014). Scrupulosity: A cognitive–behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 140–149. https://doi.org/10.1016/j.jocrd.2013.12.007
  2. Nelson, E. A., Abramowitz, J. S., Whiteside, S. P., & Deacon, B. J. (2006). Scrupulosity in patients with obsessive-compulsive disorder: Relationship to clinical and cognitive phenomena. Journal of Anxiety Disorders, 20(8), 1071–1086. https://pubmed.ncbi.nlm.nih.gov/16524696/
  3. Huppert, J. D., & Siev, J. (2010). Treating scrupulosity in religious individuals using cognitive-behavioral therapy. Cognitive and Behavioral Practice, 17(4), 382–392. https://www.sciencedirect.com/science/article/pii/S1077722910000490
  4. Siev, J., Huppert, J. D., & Zuckerman, S. E. (2017). Understanding and treating scrupulosity. In The Wiley Handbook of Obsessive Compulsive Disorders (Vol. 1, pp. 527–546). Wiley. https://doi.org/10.1002/9781118890233.ch29
  5. Öst, L.-G., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive–compulsive disorder: A systematic review and meta-analysis of studies published 1993–2014. Clinical Psychology Review, 40, 156–169. https://doi.org/10.1016/j.cpr.2015.06.003
  6. Aardema, F., Bouchard, S., Koszycki, D., Lavoie, M. E., Audet, J.-S., & O'Connor, K. (2022). Evaluation of inference-based cognitive-behavioral therapy for obsessive-compulsive disorder: A multicenter randomized controlled trial with three treatment modalities. Psychotherapy and Psychosomatics, 91(5), 348–359. https://doi.org/10.1159/000524425
  7. Ignatius of Loyola. The Spiritual Exercises, "Notes concerning scruples" (nos. 345–351).
  8. Jones, F. M. (1998). Alphonsus de Liguori. Liguori Publications.

Ready to Feel More in Control and Less Overwhelmed by OCD and Anxiety?

You don’t have to face OCD and anxiety alone. Let’s work together to help you feel more calm, confident, and in control.

Schedule a free 15 minute consultation
Sunlit indoor garden with various green leafy plants, some with variegated leaves, growing along a brick wall and window, with sunlight filtering through large windows.