Psychological Support for Scrupulosity
Are you feeling consumed by doubts about your faith, constantly worried you've sinned, or seeking repeated reassurance about your moral or spiritual standing?
You may be experiencing scrupulosity, a form of OCD that can cause deep anxiety around religious or ethical beliefs. Support is available. Therapy can help you understand what’s happening, reduce the distress of obsessive thoughts and compulsive behaviours, and create space for a more peaceful, grounded relationship with your values and beliefs. Freedom from relentless guilt and fear is possible—with the right support, healing can begin.
“It’s okay if you’re tired of trying to make sense of it all. You don’t have to do it alone.”
Information about Scrupulosity
What is Scrupulosity
Scrupulosity is a form of Obsessive-Compulsive Disorder (OCD) that involves persistent, distressing thoughts or fears about being morally or spiritually wrong. While it’s common for people of faith to reflect on their values and choices, scrupulosity goes beyond healthy self-reflection. It leads to intense anxiety, excessive guilt, and repeated attempts to gain certainty about one’s spiritual state or moral standing.
People experiencing scrupulosity often worry excessively about being sinful, offending God, or failing to live up to spiritual or ethical standards. These thoughts are distressing and persistent—and no amount of reassurance or religious practice seems to provide lasting relief. Scrupulosity is not a reflection of weak faith or character, but a mental health concern that deserves compassionate support.
Individuals with scrupulosity may experience:
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Intrusive thoughts about sinning, blasphemy, or displeasing God
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Constant fear of doing something wrong without realising it
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Repeated prayer or confession rituals to feel “clean” or forgiven
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Avoidance of spiritual practices due to fear of doing them incorrectly
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Difficulty feeling spiritually assured, no matter how much effort is made
Despite the spiritual content of these thoughts, scrupulosity is not a reflection of weak faith. It is a recognised mental health condition where the mind becomes caught in cycles of doubt and reassurance-seeking. Treatment is available—and effective.
How is Scrupulosity Treated?
Effective treatment for scrupulosity requires an approach that respects an individual’s spiritual beliefs while helping reduce the anxiety and compulsive patterns that fuel OCD. Below are three therapeutic approaches that can be particularly helpful:
Exposure and Response Prevention (ERP)
ERP is the most researched and widely recommended treatment for OCD, including scrupulosity. In ERP, individuals gradually face the thoughts, images, or situations that trigger their fear (exposure), while refraining from engaging in compulsive behaviors such as repeated prayer, confession, or mental checking (response prevention).
For scrupulosity, ERP might involve:
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Sitting with the uncertainty that one may have prayed “incorrectly”
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Choosing not to repeat a confession or seek reassurance
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Allowing the discomfort of not knowing with 100% certainty whether one sinned
Over time, this process helps break the cycle of anxiety and compulsion, restoring a more peaceful and trusting approach to faith and morality.
Inference-Based CBT (I-CBT)
I-CBT addresses the reasoning style behind obsessive doubt. In scrupulosity, this might involve recognising how a person arrives at a conclusion like, “Because I had a bad thought, I must have sinned,” even without any real evidence.
I-CBT helps individuals:
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Understand the difference between imagined scenarios and real spiritual risk
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Reconnect with reality-based thinking instead of trying to “solve” every doubt
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Reduce the need for mental rituals by challenging the obsession at its root
This approach can be especially helpful when someone feels they need to "figure out" whether they are right with God before they can move forward.
Schema Therapy
Schema Therapy explores deeper emotional patterns that may contribute to scrupulosity, such as fears of punishment, a deep need for perfection, or a belief that one is fundamentally flawed or unworthy.
This approach may be helpful for individuals who:
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Grew up in highly rigid or fear-based religious environments
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Struggle with deep guilt, shame, or spiritual unworthiness
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Experience coexisting difficulties in relationships, self-esteem, or identity
Schema Therapy works by identifying and healing these longstanding beliefs, fostering a healthier self-understanding and a more grace-filled relationship with faith.
What are the Symptoms of Scrupulosity?
Obsessions in Scrupulosity
Obsessions in scrupulosity often involve intrusive thoughts, images, or urges related to:
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Fear of sinning unintentionally (e.g., “What if I lied without realising it?”)
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Fear of offending or displeasing God
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Excessive concern about blasphemy, impure thoughts, or spiritual failure
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Fear of going to hell or being spiritually condemned
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Excessive worry about moral decisions or ethical ‘grey areas’
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Intrusive doubts about salvation, forgiveness, or one's standing with God
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Fears related to religious practices being done incorrectly or without sincerity
These thoughts are typically unwanted, distressing, and not aligned with the person’s true beliefs or intentions. Individuals often recognise that the thoughts are irrational but feel unable to dismiss them.
Compulsions in Scrupulosity
To try to manage or neutralise these distressing thoughts, individuals may engage in compulsive behaviours—either outwardly or mentally. These are done in an attempt to gain certainty or feel “clean,” “forgiven,” or “right” with God.
Common compulsions may include:
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Repeatedly praying for forgiveness, often in a rigid or exact way
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Confessing sins frequently or repeatedly, even for minor or imagined offences
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Seeking reassurance from religious leaders, friends, or scripture
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Avoiding certain words, images, or settings considered “impure” or spiritually risky
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Re-reading religious texts or repeating verses until they feel “just right”
Mental Compulsions
Many compulsions in scrupulosity happen internally. These mental rituals are often invisible to others but can be exhausting and time-consuming.
Examples of mental compulsions include:
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Silently repeating prayers or verses to “cancel out” a bad thought
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Mentally reviewing one’s actions to check for sin
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Trying to “prove” or reassure oneself that they are right with God
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Replaying conversations or events to ensure no wrong was done
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Engaging in debates with oneself about theology, morality, or forgiveness
These compulsions often provide only brief relief before the cycle of doubt returns.
When Faith Becomes Entangled with Fear
Scrupulosity can deeply affect a person’s sense of peace, joy, and connection with their faith. What was once a source of comfort can begin to feel like a source of fear, guilt, or confusion. It’s not uncommon for people experiencing scrupulosity to feel spiritually stuck, ashamed, or uncertain about how to move forward.
Seeking Psychological Support for Scrupulosity
You don’t have to walk through this alone. Support from a psychologist who understands both OCD and the role of faith in a person’s life can be incredibly helpful. With the right care, individuals can learn to differentiate between genuine spiritual conviction and obsessive doubt—and begin to reconnect with their faith in a way that brings peace rather than fear.
Kylie Walls is a registered psychologist with an interest in helping individuals experiencing religious or moral OCD, including scrupulosity. Kylie can help you understand what’s happening and work toward peace of mind.
Kylie works sensitively with clients navigating faith-related distress, offering evidence-based therapy in a space that respects your spiritual values and beliefs.
How is Scrupulosity Different from Genuine Faith or Morality?
Healthy faith involves trust, reflection, and growth.
Scrupulosity involves fear, certainty-seeking, and mental checking.
If 85% or more of people in your faith community would consider a practice normal, it’s likely part of genuine spiritual life.
When you find yourself adding extra rituals, repeating prayers until they feel perfect, or avoiding spiritual activities out of fear — OCD may be influencing your faith.
The goal of therapy is not to weaken your beliefs, but to help you practise your faith freely again — without anxiety dictating what is “holy enough.”
It’s Important to Me That My Therapist Understands My Faith. Will You Respect That?
Absolutely.
Many people with scrupulosity feel anxious about working with a therapist who doesn’t understand the depth or significance of their faith.
It’s very important to me that your spiritual life is treated with the same respect as any other aspect of your identity.
In therapy, I encourage you to speak openly about your beliefs, values, and experiences, and we’ll explore together how faith can be a source of strength rather than fear.
Therapy is not about changing what you believe—it’s about helping you live out your beliefs with peace, grace, and freedom from OCD-driven distress.
How Can Therapy Help?
Therapy helps by teaching your brain that uncomfortable thoughts and doubts are not dangerous, and that you can safely let them pass without doing compulsions.
You’ll learn to:
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Recognise intrusive thoughts for what they are — mental events, not moral facts.
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Face the things you fear (through structured Exposure and Response Prevention, or ERP).
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Reduce reassurance-seeking, repetitive confession, and checking behaviours.
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Re-engage with faith and community in a more peaceful, trusting way.
What Is ERP (Exposure and Response Prevention)?
ERP is the "gold-standard" evidence-based treatment for OCD.
It involves gradually facing the situations, words, or thoughts that trigger anxiety, while resisting the urge to perform compulsions.
For scrupulosity, exposures are always faith-sensitive and respectful.
You will never be asked to:
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Do or say anything that your faith forbids.
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Mock or disrespect God, Scripture, or sacred practices.
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Violate your conscience.
Instead, ERP helps you stop doing what OCD has added to your faith — the repetitive rituals and fears that go beyond what your religion actually teaches.
What Does ERP Actually Look Like for Scrupulosity?
It’s very common to feel confused about how “exposure therapy” could possibly apply to faith. ERP for scrupulosity never involves doing anything sinful, irreverent, or against your conscience.
Instead, ERP helps you face the things that OCD has caused you to avoid — such as prayer, Scripture, worship, or moral decision-making — in a way that helps you experience them as they were meant to be: peaceful, not punishing.
Example 1: Reassurance and Prayer
Typical pattern:
People with scrupulosity often feel they must pray until it “feels right,” or until they’re sure they said every word perfectly. The effect is that prayer becomes a ritual of anxiety rather than connection.
ERP approach:
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Pray once — just as most others in your faith community would — even if it feels incomplete.
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Sit with the discomfort and resist repeating the prayer.
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Notice what happens in your body (tightness, guilt, doubt) and practise allowing those sensations to pass naturally.
Impact:
You begin to rediscover prayer as a genuine act of faith, not a performance for OCD’s approval.
Example 2: Scripture-Related Anxiety
Typical pattern:
Many people with scrupulosity avoid certain passages (for example, verses about judgment or blasphemy) altogether because they trigger fear or obsessive rumination. Over time, this avoidance reinforces the belief that these passages are dangerous.
ERP approach:
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Gradually read those passages again, starting with a few lines and increasing over time.
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Read them without seeking reassurance (no Googling or re-reading to find comfort).
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Sit with the anxiety, guilt, or confusion that arises and practise noticing that you can tolerate it.
Impact:
You learn that Scripture itself is not the threat — the threat lies in OCD’s interpretation of it. Over time, reading becomes less distressing and more spiritually meaningful again.
Example 3: Moral Perfectionism
Typical pattern:
Clients may spend hours analysing whether their motives were 100% pure or whether they offended someone without realising it. This leads to exhaustion and isolation.
ERP approach:
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Make an everyday decision or interaction without overchecking your motives.
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Resist apologising or clarifying unless you clearly need to.
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Observe your discomfort (“I feel uncertain, but I can live with that”).
Impact:
You regain energy and perspective, learning that being a good person doesn’t require constant self-surveillance.
Example 4: Fear of “Bad” Thoughts in Worship
Typical pattern:
Scrupulous clients often avoid church, worship, or prayer groups out of fear that intrusive thoughts will appear (“What if I think something blasphemous?”).
ERP approach:
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Attend worship, notice when intrusive thoughts arise, and silently label them: “That’s an intrusive thought.”
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Stay in the situation, without mental neutralising or repeated confession.
Impact:
You begin to experience worship as a place of safety again, recognising that thoughts are not actions and do not separate you from God.
Example 5: Fear of Uncertainty About Salvation
Typical pattern:
The person becomes stuck in endless cycles of reassurance — confessing, re-committing, or checking for “feeling saved.”
ERP approach:
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Write or say, “Maybe I’ll never have complete certainty, and I can still live faithfully today.”
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Sit with the discomfort without seeking reassurance or repeating affirmations.
Impact:
You learn that uncertainty can coexist with genuine faith, and that peace often grows through acceptance, not certainty.
Why This Works
ERP gradually retrains your brain to stop treating normal faith experiences as threats.
You learn that fear and doubt can be present without you needing to fix them, and that genuine connection with God or your values can return when OCD no longer runs the show.
The process might feel uncomfortable at first — but the discomfort is the signal that your brain is learning a new, healthier way to relate to faith and morality.
Do You Only Use ERP When Treating Scrupulosity?
No. While Exposure and Response Prevention (ERP) is one of the most effective treatments for OCD, I also draw on Schema Therapy to address the deeper emotional and relational patterns that often underlie scrupulosity.
Schema Therapy is an integrative approach that combines elements of cognitive-behavioural therapy, attachment theory, and emotion-focused work. It explores the core beliefs and life experiences that shape how we see ourselves, others, and God.
Many people with scrupulosity grew up in environments where approval, love, or safety felt conditional on being good, pure, or perfect. Over time, this can create rigid internal rules such as:
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“If I make a mistake, I’m unworthy.”
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“I must never let anyone (or God) down.”
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“Feeling angry, doubtful, or uncertain means I’m bad.”
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Schema Therapy helps identify these deeply rooted patterns—called schemas—and the coping styles that develop around them, such as over-control, people-pleasing, avoidance, or excessive self-criticism.
By bringing compassion and understanding to these patterns, clients learn to:
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Develop a kinder, more realistic inner voice.
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Connect with their emotions safely rather than suppressing or judging them.
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Strengthen a “Healthy Adult” part of self that can balance faith, reason, and emotion.
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Experience God and relationships through trust and grace, rather than fear and shame.
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Combining ERP and Schema Therapy allows us to address both the surface cycle of OCD (the compulsions) and the deeper emotional roots that keep it alive.
Together, they create lasting change—not just symptom relief, but a more grounded, peaceful, and integrated faith experience.
What Does Schema Therapy Actually Look Like for Scrupulosity?
Schema Therapy is a deeper form of therapy that helps you understand why OCD and scrupulosity feel so powerful and personal.
While ERP focuses on changing behaviours and responses to anxiety, Schema Therapy looks beneath the surface — at the core emotional patterns, early experiences, and self-beliefs that drive those fears.
For many people with scrupulosity, the problem isn’t only anxiety about doing wrong — it’s also a lifetime of messages, experiences, or environments that taught them that being good, perfect, or pure was the only way to feel loved, safe, or accepted.
Schema Therapy helps you uncover those deeper layers, respond to yourself with compassion, and begin living from a place of grace rather than fear.
How It Works
Schema Therapy starts with identifying recurring emotional themes called schemas — deep beliefs or “templates” that shape how you see yourself, others, and even God.
Common schemas in scrupulosity might include:
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Punitiveness: “If I do something wrong, I deserve to be punished.”
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Unrelenting Standards: “I must always do everything perfectly or I’ll be a disappointment.”
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Defectiveness/Shame: “There’s something deeply wrong with me.”
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Abandonment: “If I fail, God (or others) will withdraw from me.”
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Emotional Inhibition: “Strong feelings are dangerous or sinful.”
We also look at modes — the parts of you that take over at different times:
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The Vulnerable Child (who feels scared of being rejected by God or others).
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The Punitive Critic (the harsh inner voice that calls you sinful, dirty, or unworthy).
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The Detached Protector (who shuts down, avoids worship, or overthinks to stay safe).
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The Healthy Adult (who can offer balance, compassion, and realistic perspective).
What It Looks Like in Session
Schema Therapy for scrupulosity isn’t just talking — it’s about experiencing new, healing ways of relating to yourself.
1. Exploring the Story Beneath the Symptoms
You’ll trace when you first learned you had to be perfect to be safe, loved, or accepted. We might gently explore messages from childhood, family, school, or church that shaped your sense of moral worth.
2. Naming the Inner Voices
We’ll identify and personify those inner voices — for example, your “Punitive Parent” part might sound like an angry preacher or critical authority figure, while your “Vulnerable Child” part feels terrified of making God angry.
3. Developing a Healthier Inner Voice
Through guided imagery, chair work, and dialogue, you’ll learn to strengthen the Healthy Adult mode — a compassionate, wise, and faith-consistent part of you that can care for your anxious inner child and challenge the harsh critic.
4. Healing the Emotional Experience of Guilt and Shame
Instead of endlessly analysing whether you’ve sinned, you’ll learn to connect with what’s underneath that guilt — often sadness, fear, or a longing to feel worthy. We might use emotion-focused or imagery techniques to express those feelings safely and bring comfort where it’s long been missing.
5. Integrating Faith and Grace
For clients of faith, Schema Therapy also helps realign your spiritual understanding with compassion. Together we ask: What does your faith actually say about forgiveness, grace, and being human? Often, clients rediscover a more relational and trusting view of God, replacing fear-driven beliefs with hope and connection.
Example Themes in Practice
Underlying SchemaTypical OCD ThoughtSchema Therapy Focus
Punitiveness“If I think something bad, I deserve punishment.”Challenge the punitive voice and practise grace-based self-talk.
Unrelenting Standards“If I don’t pray perfectly, I’ve failed.”Build self-compassion and flexible standards; focus on intention, not perfection.
Defectiveness/Shame“I’m not good enough for God to love me.”Explore early experiences of shame and build an internal sense of worthiness.
Emotional Inhibition“It’s wrong to feel angry, doubtful, or sad.”Learn that emotions are human, not sinful; practise expressing feelings safely.
Why It’s Helpful
Schema Therapy helps you move beyond surface-level reassurance to a deeper emotional transformation.
It gives you tools to:
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Understand why moral or faith-based anxiety feels so strong.
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Heal the parts of you that still fear rejection, punishment, or abandonment.
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Develop a kind, balanced, spiritually grounded inner voice.
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Experience faith, relationships, and self-worth through connection rather than fear.
In combination with ERP, Schema Therapy provides both short-term anxiety reduction and long-term emotional healing.
ERP teaches your brain that anxiety doesn’t equal danger; Schema Therapy teaches your heart that you are safe, loved, and allowed to be human.
As a psychologist, how much do you understand spiritual abuse?
Spiritual abuse is an area of particular interest in my practice. It can take many forms—sometimes it reflects clear patterns of coercive control, while at other times it emerges through shaming, manipulation, or rigid systems that erode autonomy and wellbeing. My own research has focused on control and coercive control, giving me a deep understanding of how these dynamics develop, why they are so damaging, and how they can be addressed in therapy.
In addition to my clinical training and research, I have also worked in both volunteer and work roles within Religious and Christian organisations. This has given me unique insight into how church and spiritual environments function—their potential for good, but also the ways power can be misused.
As a psychologist with faith, I recognise the central role spirituality can hold in people’s lives, and also the profound disorientation that occurs when trust in those environments is broken. This dual perspective allows me to walk with clients as they process harm, while honouring their faith journey and supporting them to find a safe and authentic way forward.
What If My OCD Is Severe or Mixed With Other Issues?
Some people experience OCD alongside other challenges such as anxiety, depression, or trauma. These are relatively common and can be treated effectively through therapy, often with strong outcomes via telehealth.
However, there are times when additional or more intensive support may be needed.
Some individuals experience co-occurring conditions such as elements of psychosis, active suicidality, or other complex mental-health concerns.
These presentations are generally less suited to telehealth unless there is an existing primary treating team—for example, a GP, psychiatrist, or adult mental-health service—who can support with risk monitoring and crisis planning.
If this applies to you, we can discuss whether a referral or collaborative care plan with another service would best support your safety and recovery.
As a psychologist, how much do you understand spiritual abuse?
Spiritual abuse is an area of particular interest in my practice. It can take many forms—sometimes it reflects clear patterns of coercive control, while at other times it emerges through shaming, manipulation, or rigid systems that erode autonomy and wellbeing. My own research has focused on control and coercive control, giving me a deep understanding of how these dynamics develop, why they are so damaging, and how they can be addressed in therapy.
In addition to my clinical training and research, I have also worked in both volunteer and work roles within Religious and Christian organisations. This has given me unique insight into how church and spiritual environments function—their potential for good, but also the ways power can be misused.
As a psychologist with faith, I recognise the central role spirituality can hold in people’s lives, and also the profound disorientation that occurs when trust in those environments is broken. This dual perspective allows me to walk with clients as they process harm, while honouring their faith journey and supporting them to find a safe and authentic way forward.
Will you Try to Change My Faith or Beliefs?
No, absolutely not.
Therapy is about helping you practise your faith more freely — not changing your theology.
You can bring your full self — emotional, psychological, and spiritual — into therapy.
We’ll explore what is consistent with your faith and what OCD has distorted.
You remain in control of your values at all times.
What If I’m Unsure Whether I Have Scrupulosity?
That’s common. Many people feel uncertain at first.
Therapy can help you understand the difference between:
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Healthy conviction vs. obsessive guilt.
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Genuine moral awareness vs. compulsive checking.
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Trust in grace vs. the need for perfect certainty.
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You don’t need to have it all figured out before seeking help — exploring these questions is part of the process.
What If I’m Unsure Whether I Have Scrupulosity?
That’s common. Many people feel uncertain at first.
Therapy can help you understand the difference between:
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Healthy conviction vs. obsessive guilt.
-
Genuine moral awareness vs. compulsive checking.
-
Trust in grace vs. the need for perfect certainty.
-
You don’t need to have it all figured out before seeking help — exploring these questions is part of the process.
What can Progress Look Like?
Progress can be a bit different for everyone. However, over time, clients often notice they can:
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Pray, worship, or reflect without repeating or analysing every word.
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Feel uncertain about moral or spiritual matters and still feel at peace.
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Stop seeking reassurance and start trusting grace.
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Reconnect with their community and faith in healthy ways.
The goal isn’t to eliminate all doubt — it’s to live with confidence, peace, and compassion, even when uncertainty remains.
Is Online Therapy Available?
Yes. I offer online sessions across Australia, providing accessible, confidential care for adults seeking support with OCD, scrupulosity, or other mental-health concerns.
All sessions are conducted via secure telehealth platforms.
