Everyone is affected by unwanted thoughts. International studies estimate that about 94 per cent of the worldwide human population experience intrusive thoughts. Most people are able to manage them, but there are some, however, who are unable to stop them, bringing about obsessive and repetitive behaviour that disrupts their day-to-day functioning. This is usually diagnosed as a mental health disorder known as OCD, or obsessive compulsive disorder. 
In classical Islamic sources, the nearest equivalent to religious OCD is al-Wiswās al-Qahri, literally meaning “the overwhelming whispers”.
The concept of wiswās (whispering) is mentioned abundantly in the Qur’ān and Sunnah.
وَلَقَدْ خَلَقْنَا الْإِنْسَانَ وَنَعْلَمُ مَا تُوَسْوِسُ بِهِ نَفْسُهُ
“And We have created man and know what his self whispers to him…” 
And speaking about Shaytān, He says,
ٱلَّذِى يُوَسْوِسُ فِى صُدُورِ ٱلنَّاسِ
“…who whispers into the hearts of humankind.” 
However, a clinical qualifier of qahri (overwhelming) is added to wiswās (whispering) in order to differentiate it from the normal experience of whisperings that all people experience, as opposed to the overwhelming ones that compromise psychological functioning.
OCD has many subsets, and when it relates to matters of religion, this is clinically termed OCD of scrupulosity.
This religious OCD or “scrupulosity” is when a worshipper is preoccupied with religious matters beyond normal limits. It is where this impacts the daily functioning of a person.
Some have even defined it as,
“…fearing sin where there is none.” 
Importance of the topic of OCD and scrupulosity
When a practising Muslim repeats certain acts of worship, it is out of longing to draw nearer to Allah and comfort in the warmth of beseeching Him, whereas a practising Muslim who suffers with OCD will repeat their acts of worship to rid themselves of the pain of doubt, anxiety, and obsessive thoughts.
So, rather than comfort being found in worship, worship is carried out to free oneself from hardship. If not addressed, the Muslim can end up despising religion, having created the false link between worship and pain, which can continue to develop until the worst thoughts are assumed about Allah.
This can affect the journey of a Muslim in several departments of life:
Matters of ‘Aqīda
Where you are overwhelmed with negative thoughts about Allah or religion, or are overwhelmed by a fear of accidentally falling out of Islam, causing some to repeat the declaration of faith hundreds of times a day.
Matters of purification
Where you feel that you haven’t carried out wudū correctly, or develop an irrational fear of contamination, or spend hours checking clothes for impurity.
Matters of worship
Where you feel that you’ve recited al-Fatiha incorrectly, or that you’d forgotten an aspect of your Salah, or acted upon a nullifier (that which invalidates).
In the latter two cases, some may spend hours on end carrying out what should only require a few minutes.
Examples of the debilitating nature of scrupulosity
One brother complained that the relationship with his wife was deteriorating because he was spending between five to six hours a day on wudū and prayer, as he found himself repeating the wudū and prayer over and over again.
Another brother who suffered from scrupulosity found himself in constant doubt as to whether he had divorced his wife or not. When he would speak about divorce, he’d avoid using the word — “I fear that it happened” (meaning divorce) — worrying that uttering it would count as a divorce.
In fact, when he would recite from the Qur’ān, he would skip the verses that included the word talāq (divorce) out of fear that it would cause his wife to become impermissible for him.
This condition can truly become debilitating and a genuine cause for misery.
Mental health issues can be looked at from many angles
It goes without saying that topics pertaining to mental health can be approached from a variety of ways, depending on which dimension of the self is being addressed.
Healthcare practitioners often speak about the biopsychosocial model when addressing health-related issues, and it is based on the idea that suffering, disease, and illness are to be addressed at multiple levels. 
A biological approach is where psychiatrists will treat patients primarily by prescribing medication. There is also the psychological approach which mainly relies on providing talking and/ or behavioural therapy to address factors such as attitudes, emotions, personality, behaviour, and so on. Then there is the social approach that addresses peer relationships, social support networks, economic status, family issues, and so on.
In recent times, there have been calls to incorporate spirituality or the higher levels of consciousness into this three-pronged model, such that it becomes a four-dimensional framework termed the biopsychosocial-spiritual model.
Although religious OCD may seem like a purely religious problem, recovery involves co-ordination between two key players: a clinician who will not put your faith in the crosshairs of the treatment; and a Muslim religious figure who is able to help reframe unhealthy spiritual beliefs with healthy ones.
I will be approaching this three-part series from the latter perspective, whilst acknowledging that this is a contribution to a problem that often requires a multi-disciplinary approach.
There is a spectrum on which people may sit
People who suffer from OCD — as is the case with any condition — will sit on a spectrum, some requiring brief pieces of direction and advice, whilst others will require complicated medical intervention.
I will be addressing the milder forms of religious OCD.
OCD is not a religious problem
As mentioned earlier, it is easy to start resenting Islam if religious OCD is not treated, as pain is gradually and falsely associated with Islam.
It is key to note that religion does not cause OCD because:
A small group are affected
It is a minority of religious people who suffer from OCD, whilst there are millions of religious people who practise their faith in an unhindered manner.
Root cause may be due to stressful events
Often, when asked about their history, you’ll find that many of those affected have been suffering from OCD tendencies before their practising years.
In a nine-year study involving 329 patients, 60.8 per cent or 200 respondents reported an occurrence of at least one stressful life event within 12 months prior to the onset of OCD. 
Religion merely colours the underlying OCD
Scrupulosity has been identified among followers of all the major world religions, where symptoms simply take up a religious appearance or a cultural one, depending on what their world view is or what is core to their life. 
A Catholic with OCD may worry about the state of their confession, repeating it again and again. A Protestant may worry about whether or not they are walking in a way that is honouring God, whereas an ultra-Orthodox Jew might worry about mixing milk and meat, cleanliness, and so on.
It is therefore not a Muslim disease. OCD is the underlying issue, whilst religion (in the case of a practising person) is the colouring of that underlying OCD.
In many instances, what a person with OCD fears is his or her perception of Allah and His religion — a perception, however, that does not represent the reality of Allah and Islam.
How to break the cycle?
The vicious cycle of OCD begins with an obsessive (the ‘O’ of the OCD acronym), intrusive, distressing and/ or senseless thought, that generates distress and anxiety.
They then move into action in order to extinguish this anxiety by using compulsive behaviour (the ‘C’ of the OCD acronym).
So, for example, if a person suspects that he has accidentally divorced his wife, he will renew his marriage contract again and again, or if a person doubts their wudū, they will repeat it again and again. This provides them with temporary relief, like the itching of a scab, which exacerbates the obsessive thought.
When this cycle becomes disruptive to your day-to-day activities, it becomes a disorder (the ‘D’ of the OCD acronym).
Tackling religious OCD, therefore, is largely based on breaking this cycle, and I suggest that this can be approached using two interventions in the following two parts to this piece:
- Addressing the mind, which is the birthplace for obsessions (in Part 2)
- Addressing the behaviours, catering for the consequential compulsions (in Part 3).
- Be cautious of obsessive actions that lead to scrupulosity, it may cause an unfounded resentment of Islam.
- Remember that OCD is not a religious issue, religion just shapes how underlying OCD is outwardly presented.
- Check out the second and third parts to this series!
 Adam S. Radomsky, Roz Shafran, A.E. Coughtrey, S. Rachman, Cognitive-Behavior Therapy for Compulsive Checking in OCD, Cognitive and Behavioral Practice, Volume 17, Issue 2, 2010, Pages 119-131, ISSN 1077-7229, https://doi.org/10.1016/j.cbpra.2009.10.002.
 al-Qur’ān, 50:16
 al-Qur’ān, 114:5
 Abramowitz, J., Jacoby R. (2014). Scrupulosity: A cognitive-behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3, 140-149. Retrieved from: http://jonabram.web.unc.edu/files/2014/05/Scrupulosity-model-2014.pdf
 Purdon, C. and Clark, D.A. (2021). Overcoming obsessive thoughts: How to gain control of your OCD. Oakland, CA: New Harbinger Publications, p.94.