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Question: We have a wonderful daughter who is back from seminary, happily working and doing very well BH, but here is the concern...
While my daughter was in high school she started taking on more and more chumras and started becoming more and more frum and shtark. It affected her relationship with her friends, how she dressed, what she ate, (or didn't eat), her sleep, her davening, her ability and confidence in herself when making decisions, what she did in her "spare time", etc. She was also very emotional from the pressure she put on herself to do so much in such a perfect way. Some of her teachers expressed concern, while others praised her, wishing all their students would be like our daughter. At home, also I was confused, to me some things she was doing were of concern, but I kept thinking that I'd rather her be like she was, then going in the other direction, C"V.
When she went to seminary this past year, we were strongly advised that she see a therapist. Nothing major, nothing to be concerned about, probably a few visits to help her... These weekly visits lasted for the whole year, and there was even talk that it may be helpful for her to continue seeing someone back at home. In the end, it was mutually decided by the therapist and our daughter that she could manage back at home without therapy.
Our daughter had an amazing year at seminary. She made a lot of friends and speaks to them regularly. Her eating is normal, she dresses nicely, she's more relaxed and B'Simcha, and knows how to say "no" when asked to do a chessed, or babysitting job that she really can't fit in, etc. She still davens very long and is makpid to learn and to do her mitzvos with the utmost Kavana, and to not waste any time, (like we all should be doing), but it's not with the same pressure that it was before she went to seminary.
My question is that if someone made a comment, "What's wrong with... Is she OCD?" How do we know if our daughter should in fact still be seeing a therapist, or if she's just a frum, shtark girl keeping themitzvos the way HaShem wants them to be done?
Your daughter is fortunate in that she has parents who love her and believe in her. As far as to when and whether she should see a therapist, I would encourage you to sit down and ask her. She is, after all, the best expert on herself. Is she feeling pressured in her Avodas Hashem or is she comfortable with her boundaries of Halacha so that she can grow within them? Would she want to discuss her pressures with a therapist and a Rav both of whom get her background and what she wants out of life? If the answer is yes, there are some wonderful licensed professionals and knowledgeable Rabbonim who would be great sources of guidance for her and for you – and the discussion can go from there. If the answer is “no”, confirm your belief in her and remind her that as parents you trust her and if she ever wanted to revisit this or any other issue, you are open to it. Your daughter will appreciate it either way.
Having said the above, I'd like to clarify the central point that underlies these types of questions. When we see such behavior, is this within the proper boundaries of Halacha with piety (middas chassidus) or is the person suffering from a subtype of OCD called Scrupulosity. OCD is a neurobehavioral disorder, which can manifest in many ways. A person’s religious convictions are merely one aspect of his or her being that OCD uses to cultivate doubt and create anxiety. If OCD didn’t attack a person’s religious beliefs, it would surely take on a different form, whether that 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.
Whereas in other cases of OCD, those suffering are logically aware that their experienced threats are irrational and unlikely, with Scrupulosity the religious consequences of the thought frequently make its irrational nature difficult to discern genuine frumkeit from scrupulosity. Still, Psychologists have noted several key features that distinguish piety from scrupulosity:
1) When practices go further than the requirements of Halacha or recognized chumra, one might be mistaking piety for scrupulosity. For instance, if Halacha 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 and can wash twenty times or more.
2) When the person becomes overly preoccupied on a seemingly trivial part of the Halacha instead of the whole picture, s/he is likely to be expressing behavior more akin to Scrupulosity. For example, if someone is more focused in Tefila on “pronouncing it perfectly” instead of developing a sense of Kavanna and connecting to Hashem through Tefillah, the focus seems to be more like scrupulosity than scrupulous. Usually the motivation described by those with this style is a fear of not “doing it right” which will have all sorts of negative consequences and no real positive desire to do it right to bring Nachas Ruach to Hashem.
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 he cannot contain intrusive thoughts, he is expressing Scrupulosity.
4) Aside from the actual mitzvah, the general pattern of Scrupulosity resemble the general OCD pattern of checking, repeating, and asking for reassurance. Thus, they will become involved with things like repetitive praying, vigilant ritual preparation and unnecessary Kappara-seeking The pre-occupation with doing a Halachic ritual until it is “perfect”, closely resemble the typical OCD symptoms of obsessive doubt and repeating. The person with Scrupulosity often demonstrates behaviors that are persistent, unwanted and repetitive. S/he will regularly report feeling “too much pressure” and experience difficulties with choices and enslaved to doubts which cause a lot of distress.
Remember: healthy frumkeit does not cause or imply Scrupulosity. In fact two of the greatest Poskim of our times – The Steipler Zatzal and Yibadel L’Chaim Tovim, HaGaon HaRav Rav Chaim Kanievski Shlita have published letters with their awareness and guidelines as to how to approach Scrupulosity. HaGaon HaRav Asher Weiss Shlita too, has beautiful Teshuvos detailing how to approach Scrupulosity. None of these Gedolim can be accused of not having strong religious conviction.
This is the difference between a diagnosis of OCD and one of piety. I cannot tell whether it applies to a particular person without meeting him or her but knowing the details of what to look for, certainly should prove to be helpful.
I thank my colleague Rabbi Jonathan Schwartz PsyD for his input. He is Rav of Adath Israel in Elizabeth, NJ & Clinical Director, Center for Anxiety Relief – Union, NJ.
Originally appeared in Yated Neeman