ABSTRACT

Scrupulosity is a form of Obsessive-Compulsive Disorder (OCD) with moral or religious obsessions or compulsions and otherwise the same cluster of features as other forms of OCD. OCD in general is an anxiety disorder in which a person has persistent, intrusive, and unjustified anxiety-evoking thoughts, or obsessions, that she resists or reduces by repeatedly performing some behavior, or compulsion. The first complication is that psychiatric treatment is often much less efficacious when the patient objects, everyone need to determine the treatment's likelihood of success not in general but specifically with a recalcitrant patient. The therapist can justify treatment by citing the patient's own moral or religious standards or at least the standards that the patient would hold if view were not distorted by desire to relieve anxiety and doubt. This chapter also concludes that, contrary to initial appearances, treatment of the scrupulous even over moral objection is morally justified in most cases.