Introduction
Obsessive-Compulsive Disorder (OCD) often disguises itself as ordinary guilt, worry, or conscientiousness. Yet careful observation reveals telltale markers of obsessive-compulsive dynamics. Four common ones are Doubt, Distress, Repetition, and Urgency (DDRU). Recognizing these signs can helps patients, therapists, and pastors alike distinguish between healthy spiritual concerns and pathological scrupulosity. For Catholics, this distinction is crucial, since failing to identify OCD can lead to unnecessary suffering and confusion of conscience.
Doubt
Doubt is the first marker. While ordinary conscience can provide clarity, OCD generates endless uncertainty. For example:
“Did I really mean my confession?”
“Did I say that prayer correctly?”
“Was my intention pure enough?”
These doubts are excessive, repetitive, and disproportionate. They differ from healthy moral reflection by their persistence and inability to be satisfied. The Catechism warns against scrupulosity that distorts conscience: “Conscience must be informed and moral judgment enlightened” (CCC, 1783). OCD obscures conscience by producing doubt where certainty should exist.
Distress
Distress is the second marker. Intrusive doubts generate intense emotional suffering—anxiety, guilt, or even despair. While ordinary guilt may prompt repentance and peace, OCD-related guilt leads to paralysis. God does not will His children to live in despair. As St. John Paul II reminded the Church, “Do not abandon yourselves to despair. We are the Easter people and hallelujah is our song” (Homily at Easter Vigil, 1986).
Repetition
Repetition is the third marker. Compulsions often involve repeating prayers, confessions, or rituals until they feel “just right.” Unlike traditional Catholic devotions, which can be repetitive by intentional design, OCD repetition is compulsive and driven by anxiety rather than love. Jesus Himself warned against empty repetition: “In praying, do not babble like the pagans, who think that they will be heard because of their many words” (Matthew 6:7, NAB). Authentic prayer flows from the heart, not from compulsion.
Urgency
Urgency is the fourth marker. OCD can convince individuals that they must resolve a fear immediately, leaving no room for discernment. For example, the sudden compulsion to confess minor imperfections right away, even in inappropriate contexts may present itself. Authentic moral discernment often requires patience. The virtue of prudence, described by the Catechism as the “charioteer of the virtues” (CCC, 1806), involves calm reflection rather than frantic urgency.
Conclusion
When patients recognize develop their ability to recognize these DDRU markers and dynamics, they can gain insight that their distress is not a moral failure but an OCD symptom. If a given fear or concern includes repeated doubts, disproportionate distress, relentless repetition, and/or an unusual urgency, OCD is likely at work. Thus, doubt, distress, repetition, and urgency can serve as warning signs of obsessive-compulsive dynamics. Recognizing these signs can help individuals to distinguish between true conscience and OCD. It can also help individuals with OCD attain greater freedom and peace as well as a deepening trust in God’s mercy.
…and if there is doubt about the doubt, then there is no doubt that OCD is very likely at play.
References/Further Reading
Catechism of the Catholic Church. (1997). Libreria Editrice Vaticana.
John Paul II. (1986). Homily at Easter Vigil. Vatican.
New American Bible. (2011). United States Conference of Catholic Bishops.