Obsessive compulsive disorder (OCD) is an anxiety disorder that affects many people throughout
the world. Many people observe individuals with OCD and laugh at them for their overly scrupulous
behavior, however; OCD is no laughing matter. Those who suffer from this disorder are in severe
psychological emotional pain. This pain that can torment other aspects of their lives for many years if
gone untreated.
For Yeshiva Bachurim, OCD can manifest itself in many forms. Some OCD sufferers will wash their
hands for Netilas Yadayim longer than they need to, others will repeat words of davening, while others
will obsess about whether their Tefillin are placed precisely in the center of their heads. These Bachurim
will, at times acknowledge that they are suffering and that their OCD impacts their ability to daven, learn
and function at the level of their peers. The awareness that they have OCD, is one step closer towards
getting the help that they need to move on.
When counseling Yeshiva Bachurim, I have noticed a pattern amongst the OCD sufferers. They tend to
have psychosomatic complaints such has frequent headaches, stomachaches and general lethargy. They
also complain of racing thoughts that interfere with their ability to remain focused. These racing thoughts
will often inhibit their ability to fall asleep which explains why they are feeling tired. There is usually a
family history of either OCD or some other form of anxiety disorder. When assessing these Bachurim, it
is often discovered that some other form of anxiety preceded the full blown OCD. At some point during
early adolescence, these Bachurim will admit with a deep sense of shame and guilt that they have been
thinking inappropriate thoughts. Adolescence is an awkward time for any boy, so you can imagine how
much more so for religiously observant Yeshiva Bachurim. The messages that they often misperceive due
to their concrete though processes catapult them into a downward spiral of obsession to compulsion to
dysfunction.
There have been some articles written about overscrupulosity amongst the religiously observant.
Prevalence and incidence are usually underreported. In the course of my practice, psychotherapy that
involves the Rebbe of the Bachur as a co-therapist has been helpful in reducing the OCD symptoms to the
point that the Bachur can regain functionality in the Yeshiva world.
Oftentimes when I see Bachurim, they will initially relate an incident where they had âimpureâ thoughts.
They hesitate to label and/or expound on the nature of those impure thoughts but it is usually self-evident.
However, sometimes the thoughts are relatively benign to the average person but monstrous for the OCD
sufferer. For example, A Bachur who felt he might have accidentally looked on to another studentâs test
paper and feels guilty about possibly cheating. He begins to engage in compensatory and compulsive
behaviors such as obsessive davening and learning to the extent that he neglects basic bodily needs.
Another example would be a Bachur who touched his head or feet during davening and will wash his
hands obsessively to try to rid himself of the âimpurityâ that is on his hands.
Halacha dictates much of what we do and how we strive to lead a Torah based life. But to the OCD
sufferer, Halacha is black and white. (Black and white or concrete thinking is common among OCD
sufferers). They will often misinterpret Halacha or read too much into the minutia causing them to miss
the big picture. They also misunderstand what their Rebeeim are trying to teach them with regards
to Halacha and use their Rebeeimâs words that were meant in general as if they were talking to their
situation specifically.
Fortunately, the treatment options for OCD sufferers have improved especially for those suffering from
a religious form of OCD. Individuals with religious forms of OCD are easy to recognize and therefore
they are more prone to getting the help they need while the OCD is in the early phase. In fact, Rebeeim
are usually the first ones to detect OCD in their students. Of course, finding the right therapist is crucial
to any successful interventions and some OCD sufferers become frustrated when their symptoms do
not improve immediately. Remember, the OCD sufferer thinks in concrete ways and they want to know
precisely how and when their condition will end.
Cognitive behavioral therapy which helps the individual with OCD understand their faulty thought
processes and correct the thoughts in order to reduce the compulsions, has been found to be very
successful. As mentioned earlier, consulting with a Rav is especially helpful as many religious
OCD sufferers are dubious about the therapistsâ ability to understand their situation from a Halachic
perspective.
Medications are usually reserved as a last resort for the treatment of OCD. However research has found
that medication along with therapy speeds up the healing process. Finding a psychiatrist who is familiar
with religious Jewish practices is very important. It also helps in avoiding the frustration of having to
explain or define what the patient deems an âimpureâ thought.
What I have found as a useful tool in treating Bachurim with religious OCD is the technique of
welcoming the intrusive though and giving the thought a time limit as to how long it can remain in your
mind. The theory behind this technique is simple. If I were to tell a child that you can go in any room in
this school but you absolutely cannot go into THAT room, the child would be obsessing about what could
possibly be in that room that he is telling me is off limits? The same is true with intrusive thoughts. When
a person tells himself that I cannot go there (meaning it is forbidden to have these thoughts) the obsessive
mind will wander towards that thought until it renders him dysfunctional. Trying to force thoughts out of
your mind usually backfires.
Welcoming the thought eliminates the psychological pressure on the OCD sufferer. They can have the
thought without fear of retribution, but they also have the power to control how long the thought is
allowed to remain. This technique might not work for everyone but for many, it is a powerful tool.
OCD is anxiety based and anxiety is usually related to the fear of losing control. Empowering Bachurim
to feel that they are in control of their thoughts by giving them the ability to allow the thoughts to enter
their minds is often helpful in controlling religious OCD. OCD can sometimes be a lifelong disorder but
with proper help, Bachurim can lead successful and functional lives.
Jonathan M. Lasson Psy.D. is a psychotherapist with a private practice in Baltimore, Md. He has written
and spoken extensively about psychological issues that affect the frum community. He may be reached at
[email protected]