New York – Jewish Rituals And Obsessive Compulsive Disorder


    New York – Scrupulosity is a term given birth to in the 1600s. Today, it is a well-documented form of Obsessive Compulsive Disorder (OCD). It is typically evident in people who believe that their religious behavior is in some way displeasing or disrespectful to Hashem. This preoccupation is often accompanied by the emotional experience of anxiety, common to all forms of OCD, as well as a presence of guilt which exacerbates the pain. The guilt in displeasing Hashem and the feeling that one can never “do it right” often contribute to an associated depressive quality in this OCD subtype. One of the great Chassidishe Rebbes, Rabbi Nahum of Stephanesht described the intertwining of these elements in Scrupulosity: “Scrupulosity is a cloak made of pride, lined with guilt and sewn with melancholia.” As a result, many engage in repetitive and excessive prayer or other religious behavior to correct the pain, as part of the disorder.

    Consider the following:

    * A 17-year-old yeshiva bachur worries that he cannot concentrate fully during Kriyas Shema. He repeats each word over and over in order to make sure that he pronounced it correctly. And despite his constant review of the words, he fears that he didn’t daven with the proper kavanna. He spends 50 minutes a day saying Shema and, he views the mitzva as a burden he cannot manage.

    * A 22-year-old kalla from a prestigious Jewish family is tortured by thoughts of religious doubt that pervade her mind during the day. She meditates about the thoughts constantly, repeating to herself over and over that she is a Baalas Emunah, and spends hours during the day trying to prove her religious commitment.

    * A 21-year-old kollel yungerman wonders if his Tefillin are on straight. He puts on the Shel Yad and readjusts it 18 times before attempting to put on the Shel Rosh. He constantly rechecks and re-examines the Shel Rosh to be sure that it is EXACTLY between his eyes, using a ruler to measure the precise space between them and the equidistant placement of his Tefillin between his eyes. The process of putting on Tefillin takes so much of his time that he often misses Tefillah B’Tzibbur due to the pressure of “getting it right.”

    Although these cases seem extreme, they are some of the examples of Scrupulosity cited by the Divrei Chaim of Sanz (Shut Divrei Chaim II: 6) and the Steipler Gaon (Kriyna D’Igrisa). To the outsider, these behaviors appear to be nothing more than frumkeit. But to the person afflicted with this condition, Scrupulosity OCD takes Ahavas Hashem out of mitzva observance, leaving the individual anxious, depressed and often fearful about doing mitzvos. These Gedolim recognized the difference between healthy religious Shmiras HaMitzvos and Scrupulosity and were able to advise those who sought their wise counsel.

    How can one tell when observance is standard frumkeit and when it is Scrupulosity? Psychologists have noted five key features that distinguish frumkeit from Scrupulosity:

    1. When practices go further than the requirements of religious law, one might be mistaking Scrupulosity for frumkeit. For instance, if a ritual requires washing Netilas Yadim twice on each hand, the person with Scrupulosity will repeatedly wash to be sure that he covered each hand twice until the wrist, often washing twenty times or more.

    2. When the person becomes overly preoccupied with a focus on a seemingly trivial part of the ritual instead of the whole picture, s/he is likely to be expressing behavior more akin to Scrupulosity. When a religious patient is more focused in prayer on “pronouncing it perfectly” instead of developing a sense of proper kavanna, the focus is more like Scrupulosity than fervent behavior.

    3. Healthy and scrupulous religious beliefs do not interfere with the normal practice of the religion. Scrupulosity frequently interferes with the proper practice of religion. For instance, when a person with Scrupulosity OCD does not attend Minyan because of the fear that s/he cannot control intrusive thoughts, s/he is suffering from Scrupulosity.

    4. The person with Scrupulosity spends excessive time and energy on minute, trivial aspects of spiritual life while ignoring more important aspects of spiritual life including Mitzvos Bein Adam L’chaveiro, Gemilas Chessed, Tzedaka and Ahavas Hashem.

    5. The pre-occupation with doing rituals until they are “perfect,” the repetitive praying, unnecessary penance-seeking found in Scrupulosity closely resemble the typical OCD symptoms of checking, repeating and asking for reassurance. The person with Scrupulosity often demonstrates behaviors that are persistent, unwanted and repetitive.

    Remember: Strong religious convictions do not cause or imply Scrupulosity. Rav Yisroel Salanter (Ohr Yisroel, Letter 25) recognized the difference between Zehirus and Scrupulosity. Scrupulosity is a type of OCD, which is a psychological disorder. In these cases, a person’s religious convictions are merely one aspect of his or her being that OCD uses to cultivate doubt and create anxiety. It is not connected to Torah observance or religious life at all. If OCD didn’t attack a person’s religious beliefs, it would surely take on a different form, whether that would be a contamination fear or a checking compulsion or another arena for OCD to unleash anxiety. Scrupulosity takes strong religious ideals and blows them out of proportion, making them distorted and corrupt.

    Treatment Considerations:

    One of the most successful approaches to treating Scrupulosity is with cognitive behavioral therapy (CBT). CBT therapists encourage their patients to see that their behaviors can vary and that one’s sense of self is better off being accepted rather than always being constantly critically evaluated. Given our religious culture that is constantly encouraging us to become or “be” better persons, it is easy to see how patients find it hard to navigate these new ideas.

    It is not unusual for therapist and patient to consult with a patient’s Rav during this initial phase of therapy in order to sanction and help navigate this apparently “irreverent” therapy. The Rav and patient need to be assured that the treatment course is not designed to adversely impact one’s religious beliefs. Rather, they should know that treatment is solely targeting a disruptive anxiety disorder which produces seemingly devout behavior that is actually unrelated to one’s genuine degree of religious commitment. In fact, often the ability to distinguish real religiously fervent behavior from Scrupulosity often helps enhance one’s devotion to Yiddishkeit.

    Often, patients balk at the idea of cognitive therapy for OCD. In the case of Scrupulosity, especially of a religious subtype, many opt for medication therapy instead. Although medication is a very powerful frontline treatment for OCD in general, it can have limited benefit for people with Scrupulosity. The medication can help reduce the experience of the anxiety but it cannot help someone change his way of thinking. This is where the cognitive therapy is most necessary and effective.

    The actual treatment course for Scrupulosity does not deviate significantly from other types of OCD. Generally, a hierarchy is constructed, in which persons are gradually exposed to accelerating levels of risk. This is in accord with the concept expressed by the Chovos Halevavos that one of the principles of Zeheirus is not to be too Zahir where improper to do so.

    This is an excerpt from “Mind, Body and Soul” a mental health magazine, a collaboration of Nefesh International and the Jewish Press in this weeks Jewish Press on Newsstands now.

    Jonathan Schwartz, PsyD is a practicing Rav in NJ and Senior Clinical Psychologist at the Center for Cognitive Behavioral Psychotherapy ( in Manhattan. He can be reached at

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    1. this is largely thanks to the modern culture invented by the holier / frummer than thou chuma macher society that has made people so nuts that crazy insanity like microcopically inspecting every centimeter of every lettuce leaf under a translucent ultra violet light box trumps all things key to simchas hachag and simchas yom tov and the most important more than all the chumras combined SHALOM BAYIS.
      people have become so OCD over what the lateast social and cultural chumra is that they forget how important it is just to be happy instead of creating a tense atmosphere that often times is a damper to the holiday atmosphere.

      Cut the chumra garbage and there will be less things for everyone compulsivly obsess over and maybe then there will be happy families celebrating yom tov the way hashem intended.

      • While I agree with you that contemporary chumros have gone over the top, I think you are missing an important aspect of OCD. It is a psychiatric disorder–that’s when the chemicals in the brain are off balance–which is not caused by excessive emphasis on chumras. In the article, Dr. Schwartz confirms that without the religious element, the person would still experience OCD, only in a different area of his life. This is just a “convenient” way for the OCD to express itself.

      • Boruch Hashem that you have never suffered from OCD, so you can make such statements that “holier then thou” is the cause of this illness. This illness is not at all a product of religion, but when it hits a frum person, it usually hits with the religious version of OCD called “scrupulosity” which can be very painful for the mind and emotions and can even cause a person to hurt himself physically (knowingly and without much choice). I never considered myself “holier then thou” and nevertheless suffered badly from this. After going for counseling by a frum therapist I got rid of most of it. It does resurface from time to time and I try, and am B”H usually successful of crushing it before it takes me over.

      • The bug issue is very different as one bug eaten as we all know is cause for numerous aveiros. In numerous instances in halacha the most minute details are very important for example when it comes to the writing of sifrei torah mezuzos or tefillin where a line the size of a hair can cause enormous problems. So don’t slight all chumrous and enormous attention to detail anywhere, just where they are unwarranted..

      • Huh? What does one have to do with the other? OCD is a mental disorder. Being very religious is not. Psychological data does not support what you say. It may be dangerous to use an article about OCD to justify your lack of religious observance.

        • I am convinced that a large segment of the yeshivish population are at least moderately OCD. Our culture, as opposed to our religion, is conducive to OCD behavior by focusing on the superficial rather than the essence of yiddishkeit. See commenter #14 who worries about bugs and hairline errors in seforim. The preoccupation with perfection in the service of God is not healthy. Yet this is how our religion is taught in our Yeshivas and Bais Yakov’s. It is easier to teach the picayune superficialities than the deeper concepts that might entail questions that our teachers might find difficult to answer.

    2. The part about the tefillin is *very* common. A few weeks ago I saw a yungerman walk to the back of the shul again and again to spend a minute or longer checking his shel rosh, drawing invisible lines from his eyes up and down his forehead. He must have gone back there at least 10 times.

    3. To give an example of OCD/Scrupulosity, when I was in yeshiva, one bochur would miss minyan every morning because he was focused on having a movement before tefillos. Also, he was so obsessive about netillas yadaim that by the time he arrived at the beis medrash, his hands would be red and cracked. Rebbeim would be well advised to be aware of this condition as it is often mistaken for frumkeit, preventing treatment of what can actually be a debilitating illness.

    4. a few points
      1. DR SCHWARTZ is an excellent cbt therapists , i personally know of 3 people that were helped
      2. if the ocd is “yidishkeit related ” , the client may be better off with a dayan that knows ocd well ( rav shmiel neiman in mnsy. who sees clients for sessions, rav aush in willy, rav landau (tosh) in bp & others (not beacause i have anything against pro’s but simply beacuse these kind of clients may respect the pro but don’t really trust him .
      3. the exposure therapy[y will not work well with pure “O” as far as gehinom… because a person cant live with a script of him getting ro
      4. MEDICINE- really really works in the right dosages- one can compare the ssri meds to using “easy off ” on a stove top- when the “shmaltz” has been sitting all year the easy off wont get rid of it – but it will soften it so that when you scrub it comes off similarly the meds wont oblitirate the ocd but it will make it less frequent & with less intensity -so the sessions are more successful
      5. in my opinion the sharpest OCD diagnostician is a shomer shabbos DR. steven (shia ) Friedman in downtown Brooklyn 718-624-0488
      6.the hypnosis willy & on the radio is A HOAX – i personally discussed it with dr michael Jenike- chief of the OCF in boston – &hypnosis is not a form of treatment for ocd (& we may throw in one brain- in fact the 2 one brain practitioners in bp are not even registered with the one brain institute in california

      • Forgive my Scrupulosity for having to point this out, but please note that SHMIEL GLASSMAN’S mention of “Easy Off” oven cleaner in his comment is a comparison to another point.

        “Easy Off” is highly toxic, and is in no way a cure for OCD or any other psychiatric disorder.

      • No, instead of being insensitive by joking about the real suffering of Jews who have this mental illness, you should compulsively try to develop some derech eretz.

      • babishka, i know a rebbetzin who actually said, “save your ocd for pesach.” so don’t take meds or get therapy. just clean like you have ocd. 🙂

        • I beg your pardon? Tell your rebitzen she doesn’t know what she’s talking about. If you’ve ever tried cleaning a refrigerator for Pesach with OCD, you’d know what Gehenom really feels like. I’ve been treated for OCD, and the weeks before pesach were a living nightmare, because whatever I did was never enough. I could stay in one spot, cleaning the same thing for hours, and it never got clean. (It sounds crazy, but the Chometz felt so real, and it was nearly impossible to get rid of it. Don’t judge anyone till you spend some time in their shoes.)
          Now with meds and therapy the difference is unbelievable. Pesach cleaning is easy. Just spray it, wipe it and it’s clean!! Maybe my house is not as spotless and sterile as it once was, but now I can experience Simchas Yom Tov.

          • You’ve said it all. What you describe is a typical endless loop, going in circles until it is physically stopped by someone or something. That something can also be, to say to yourself: self! why are you doing this? There is no Halacha that it must be perfect; there isn’t even an halacha that it has to be half perfect.

            Off on a tangent those men who want their wives to clean the house spotless, pleae remember that your wife isn’t a KORBON PEASACH!

      • Clean for Pessach and get therapy anyway It is important to do so. I don’t know how much you feel it is in your way. I also don’t know if you are being real or sarcastic.

      • You must be really obsessing about cleaning for Pesach that you would compare it to having OCD. But you should try to take it more easy.
        Pesach cleaning should not be such a pressure!!! First, try to learn what actually needs to be cleaned and what not. Many women are spring cleaning, not Pesach cleaning and doing way more than is required.
        The way Women are taking the pressure of Pesach cleaning in today’s day in age surely makes it seem like they are all bombarded with a sudden surge of OCD.

    5. I too have a spouse that has OCD. The meds help a little but it’s nothing to write home about. The problem with OCD and frumkiet is that the OCD has a place to fester. If this person was not observant, they might suffer from some of the maladies that plague an OCD person. However, the frumi stuff brings the issues out to the surface. you MUST do XXX or else Hashem will strike you. Or, you must do XXX in order to do the mitzvah correctly. Unlike the shrinks of today that believe that one is born with this, I am of the belief that this is a learned behavior.

      I will have to say this, As the world gets more frummy, this become a bigger issue to deal with. The You musts, you have to and everything is osser will push some of these folks including my spouse to (further) snap.

      It has been a long and painful ordeal.

      • I feel sorry for you. My wife also had to swallow my meshugasim when I still actively had it. Talk to your spouse nicely and with understanding and try to convince him/her to get help; it is for their own toiveh.

    6. I am married to an OCD person , never judje a person until you are in their shoes.OCD has nothing to do with frumkeit, it will attack the brain cells in every way. OCD is a phisical ailment just like any other sickness and life is not easy for the whole family

    7. OCD has been one of the more difficult psychiatric conditions to help. The older classes of medications had minimal effect. The current array of psychiatric medications has proven far more successful in lowering the impact of the OCD symptoms.

      There is a collection of letters from the Steipler Gaon ZT”L addressing the religiosity overlap with OCD. He takes the position that treatment is needed, and that the additional “chumros” that the OCD sufferer seems to be practicing have no religious merit.

      OCD is the brunt of many jokes, many of which can be really be funny. However, the individual that has OCD is truly suffering, and much of the family also suffers as a result. Such articles that help the average person understand a little bit more about these conditions are invited and useful.

    8. as a graduate student of forensic psychology during a class on ocd, etc., I wrote a note, are Jewish rituals part of ocd, or are any religious rituals ocd? if a person does a ritual everyday perhaps it satisfies the ocd need? instead of constant hand washing or checking to see if the door is locked, perhaps a person checking his yarmulke, or someone needing to make sure his teffilin is on exactly in the center between his two eyes, or someone needing to fulfill some mitzvahs without knowing why – could be that they have OCD.

      • As a fellow student of psychology (also interested in forensics, maybe we should talk about that), I think you have to look at behaviors in a context. the question to ask is “Are these behaviors an accurate or reasonable response to the situation. Another way to put it would be “Are these behaviors ego-syntonic or ego-dystonic?”

        In context, an individual reared in a religious environment who responds to religious stimuli, i.e. tefilin, for example, by adjusting them once or twice, is acting reasonably toward that stimuli, or in an egosyntonic way. It causes know report of self distress.

        So I would say adherence to religious prescriptions certainly is not OCD, and a statement to that end is really actually not culturally sensitive.

        What this article is talking about is OCD behavior, behavior that causes distress, is egodystonic, and is not a reasonable response to external stimuli, rather an anxiety provoked, obsessive provoked, compulsive response to internal stimuli.

        For anyone else besides #16 or mental health professional, I am agreeing with this article, It is an accurate description of the inner torture that some people feel.

    9. Institute for Behavior Therapy – (212) 692-9288 – helps people through Behavior Therapy. Know someone who had severe OCD that was helped. Other frum Yidden, including Chassidish have gone to this place. They don’t just help with OCD

    10. An experienced, unbiased mental health professional or physician can readily distinguish between true obsessive-compulsive disorder and religious behavior.
      OCD is a brain chemical dysfunction, often runs in families, and is distressing. (We will not discuss obsessive compulsive personality disorder, which is not really distressing to the person, but rather to those around the person).

      I would not say that our schools specialize in turning out children with OCD-like features, but certain there are many neurotic and disturbed people who find refuge in appearing holier than thou and finding all sorts of ritualistic behaviors to occupy their minds and the minds of their students, to the detriment of the students.

    11. Dr. Jonathan Grayson PH.d is a physchologist in bala cynwed PA near Philladelphia he is a a world known specialist in this field and has helped many many people. His way of treating OCD is through exposure.

    12. Dr. Jonathan Grayson PH.d is a physchologist in bala cynwed PA near Philladelphia he is a a world known specialist in this field and has helped many many people. His way of treating OCD is through exposure.

      • PANDAS, is an abbreviation for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep. infections such as “Strep throat” and Scarlet Fever.

        The children usually have dramatic, “overnight” onset of symptoms, including motor or vocal tics, obsessions, and/or compulsions. In addition to these symptoms, children may also become moody, irritable or show concerns about separating from parents or loved ones. This abrupt onset is generally preceeded by a Strep. throat infection.

    13. What about wearing 50 pair of Taalis Katan? Or winding a gartel many times over until it sits just right and hangs evenly? Or getting a triple zero haircut every week to avoid Chatziztah for Tefillim? Or not eating healthy fruits and veggies for fear of microscopic bugs? Or the bugs in the water which I can never find with my plain eyes? Chai Hashem- this is not the Torah given on SInai. Moses himself wouldnt recognize todays Jew if he walked through Willy or BP on Shabbos. Funny hats, funny socks, funny food.

    14. OCD, autism, ADD, and many other unexplained ailments including chemical sensitivity, muscle ache, and unexplained fatigue are often linked to mercury poisoning from mercury amalgam fillings(do a Google search for amalgam illness for more information). The way to solve this is to have the mercury fillings replaced with composites, inlays or onlays, or porcelain crowns, and to wait a few months then start on a regimen of chelation using oral alpha lipoic acid(available at vitamin stores. Solgar makes kosher vegicaps which you can open and dissolve in water to divide the dosage) every 3 hours for 3 days on then 3 days off, continuing this cycle for months. A dosage of 1/8 of a mg for each pound of body weight every 3 hours is a good starting dosage.Do a Google search for frequent dose ALA chelation to get more information.

      • Spoken alike a true chelation proslytizer. By all means, google it. People have died from it being used as an alternative to medically proven treatments. HKBH should save us from such charlatans.

    15. “Spoken alike a true chelation proslytizer. By all means, google it. People have died from it being used as an alternative to medically proven treatments. HKBH should save us from such charlatans.”

      Not as an alternative, but when doctors keep telling you they have no idea what is wrong with you. Your blood tests might be a bit abnormal, but not pointing to any specific cause. There have been many cases where people have seen over a dozen doctors and were not helped by them, but who cured themselves by having their mercury fillings replaced, and doing chelation. Many have what is labeled as fibromyalgia, multiple chemical sensitivity, or chronic fatigue syndrome. My belief is that many who have several mercury fillings, received one of these diagnoses and have not had any relief from treatments by physicians are suffering from chronic mercury poisoning. Blood tests for this will not show elevated mercury levels, as the body accumulates mercury in the organs(including the brain) and tissues and not in the blood. Some have a challenge test done where mercury excretion is measured, then measured again after a huge dose of a chelating agent. This test can be dangerous and many have gotten very sick from it. The increased levels of excretion after the chelating agent still doesn’t tell you how much is in your body.

      Dr. Andrew Cutler has a PHD in chemistry and suffered from amalgam illness.
      He developed a protocol for detoxification from mercury that is quite safe.
      He used it to heal himself.Also do a Google search on Freya Koss and read her story.

      While replacing mercury fillings is annoying and can be expensive, it makes sense to do for those who received no help from traditional medical treatment. Make sure the dentist uses high speed suction while drilling out the mercury fillings, and that you are careful not to swallow the debree.

      Low frequent dose ALA is inexpensive and very safe. Instead of attacking amalgam replacement by saying that people will do this rather than getting standard medical treatment, say that this is something that those who have received no help from traditional medical treatment can try. Many do the chelation on their own since they can’t find a doctor knowledgeable in mercury chelation.. Finding a physician who will prescribe oral DMSA and use it with ALA on a 3 hour dosage schedule (3 days on 3 off) makes sense. The combination of DMSA plus ALA will chelate out not just mercury, but also other toxic heavy metals.

    16. Institute of Behavior Therapy, Manhattan (212) 692-9288. Do a great job in helping people with OCD – without medication. They take Medicare.

    17. Thank you for presenting this article. OCD is a mental health issue that is quite common in our community. OCD can manifest as religious scrupulosity or as other varied obsessions and compulsions. It can cause varying degrees of anxiety and depending on the severity can be very difficult to live with (both for the sufferer and for the sufferer’s family).

      The very good news is that OCD is definitely very treatable either by Exposure and Response Prevention (ERP) or through use of psychotropic drugs (usually an SSRI) or a combination of both treatments. There are professional frum Cognitive Behavioral Therapists as well as excellent frum psychiatrists who have successfully treated members of our community. No one has to suffer needlessly. If you suffer from OCD or have a family member who does, please get help by seeing a mental health professional. Relief Resources does a fantastic job of medical referrals for mental health issues. Please contact them at 718-431-9501 (their web address is

      You can be helped. Act now!

    18. I saw this bahaivor frequently as a bachor in a certian Yeshiva, even one bachor who spent 45 min, each morning making sure he would davin with “goof naki. we all thought he was just “goofy”. Now I can see that he had this condition. IT HAS NOTHING TO DO WITH CHUMROS! IT IS A “KRANK IN KUP”! As such, it can be treated, not be laughted at or even worse, emulated

    19. It seems to me that some of you responding to this article have scrupulosity by your obsession regarding treatment with a “frum” therapist. There is this obsession with the fact that you or your relative suffering from scrupulosity or other mental illness need to be treated by a person with the same hashkafah as yours. A cognitive/behavioral therapist with the training and knowledge to treat mental illnesses will use the same methods regardless of their own hashkafah.


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