Religious OCD Explained: How Excessive Stringency Becomes a Mental Health Challenge

Over time, many people become increasingly strict about certain religious commandments with excessive intensity. This leads them to spend long periods repeating the same mitzvah, such as saying a particular blessing over and over, washing their hands again and again, re-laying tefillin — because they fear that they “didn’t have enough intention” or didn’t perform the action with perfect precision.

At first glance, such people may appear unusually righteous or exceptionally pious, meticulous in their observance. But upon closer look, you sense that something is out of proportion and unhealthy. It doesn’t let go. It repeats again and again (and again). And in most cases, it only becomes more extreme.

The unpleasant part of the story is that sometimes it takes people a long time to admit they have a problem at all — and even longer to agree to get help. On the other hand, public awareness has grown tremendously, and with it, treatment methods have become far more effective and efficient on the path to healing.

“I met girls who couldn’t stop praying — and realized they had a problem”

“I first encountered this issue when I worked in a Haredi girls’ school,” describes therapist Yehudit Beitler. “Sometimes I would see girls who washed their hands dozens and dozens of times. Some would pray again and again long after the class had finished, simply because they feared they hadn’t prayed with enough intention.”

Later, she discovered the power of Cognitive Behavioral Therapy (CBT), studied the field, and today is a certified CBT practitioner. It is a unique therapeutic approach that treats various mental health conditions, especially anxiety with obsessive-compulsive features.

What exactly is “religious OCD”? What are the symptoms?

“Obsessive-compulsive behavior has two parts:

1. An intrusive thought that repeats itself uncontrollably, entering a person’s mind against their will and causing distress.

2. A compulsive action, which the person feels an overwhelming urge to perform in order to reduce the anxiety caused by the thought.

“It’s important to note: everyone has thoughts running through their mind — many automatic thoughts, even recurring ones, but the difference is that most people don’t get stuck on them. Obsessive thoughts, however, latch onto the mind and don’t let go. Their basis isn’t even logical, but they generate intense anxiety, and to calm that anxiety, the person performs a behavior.”

“For example, someone thinks: ‘I didn’t pray with enough concentration.’ In OCD, the anxiety over not having prayed properly becomes so overwhelming that the person feels compelled to repeat the words again and again — and each time believes it still wasn’t good enough. Eventually, they may be unable to finish the prayer at all.”

“There are also people who wake up and feel impure, insisting they must wash their hands — then wash them again and again, convinced they didn’t follow all the rules properly. In severe cases, people can get stuck on this for hours, because they believe they haven’t ‘done it right.’ The intrusive thought produces anxiety, and to calm the anxiety, they repeat the act.”

Beitler explains that obsessive-compulsive tendencies can manifest in countless ways — not only religious ones.

“For religious people, obsessions often appear in religious contexts such as immersion, kashrut, and mikveh — endless checking or excessively long immersions. The content is religious, yes, but the mechanism is not.

“Cleanliness and hoarding also relate to obsessions. Some people refuse to touch certain objects for fear of germs, carrying tissues everywhere. Some hoard endlessly. Some can’t tolerate any change in the arrangement of objects. Others have obsessive thoughts without any physical behavior — yet they compulsively dwell on those thoughts.”

“For someone with a cleaning-related obsession, it may show up as endlessly scrubbing the kitchen. For a religious person, it may appear as obsessive kosher concerns — separating meat and dairy, ‘kashering’ constantly. The symptom is the same; it simply appears in different clothing.”

The Value of CBT

Once, treatment for these issues was mostly long-term talk therapy. But in the 1980s, psychiatrists Aaron Beck and psychologist Albert Ellis (both Jewish) developed Cognitive Behavioral Therapy — an innovative, short-term, highly effective treatment.

Over time, CBT proved effective not only for compulsions and obsessions but also for anxiety disorders, certain traumas, depression, and even emotionally driven disorganization.

“CBT is the most effective for OCD because it works on thoughts and behaviors rather than emotions,” says Beitler. “People often don’t understand how this helps. How can years of suffering be relieved in just a few sessions? They’re skeptical — but the results speak for themselves. Changes begin during the sessions themselves when a person shifts their thinking patterns, which automatically shifts their behavior.”

(Photo: Shutterstock)

How does CBT work in practice?

“It’s mostly done through structured worksheets and guided exercises. I don’t treat the content of the issue — meaning I don’t dive into the childhood roots or why it started. I need to know the thoughts, but not the reason behind them. We don’t focus on past trauma or childhood anxieties — only on the symptoms, the thought patterns, and the behaviors.”

“The goal is to understand what the thought causes. To stop it, I give a cognitive and behavioral tool to interrupt the cycle.”

“The early stage — and the most important, is recognizing the problem. Then comes response prevention: when a person feels an overwhelming urge to repeat a behavior (like washing hands over and over), we ask them to not do it. Slowly, they learn that the urge comes from anxiety. When they resist the urge, they confront the real issue — the anxiety, and break the cycle.”

“For example, someone who washes hands for ten minutes — we gradually reduce it to five, then less. Someone who prays for 45 minutes — we slowly reduce the length of the prayer. If they stick with it, it works incredibly well, because their anxiety threshold drops.”

She shares a story: “One of my patients had multiple areas of obsession related to water — constant dishwashing, fears about mikveh, etc. In therapy we reduced each behavior gradually. I supported her through every step, tracking her progress and guiding her through the anxiety. Thank God, she eventually recovered.”

(Photo Illustration: Shutterstock)

Where is the line between righteous stringency and religious OCD?

“When it interferes with daily functioning, that’s the red flag. In the religious world, when mitzvah observance becomes a heavy burden rather than a source of joy, this is no longer normal. Someone unable to leave the house because they fear impurity, or someone who prays endlessly or washes hands compulsively — these behaviors lose balance and become extreme. Anything exaggerated ceases to be piety and becomes obsession.”

Are there cases where a rabbi instructs someone to stop performing a mitzvah?

“Yes. In certain cases, absolutely. Some rabbis even refer people to therapy. Sometimes therapists send patients to rabbis to provide halachic permission to avoid a stringency temporarily. That can help reduce pressure — but not always.”

She gives an example: “One woman repeated blessings endlessly because she was never sure she had enough intention. It became impossible for her to function — even to work. In therapy, she learned she must pray, but not endlessly. Only a rabbi can make such a ruling, not a therapist.”

(Photo Illustration: Shutterstock)

If religious OCD makes people feel “more righteous,” why would they want to stop?

“Good question. Sometimes the person themselves doesn’t think anything is wrong. They may even feel spiritually superior. Usually, it is the family who seeks help because they see how dysfunctional the behavior is.”

“At borderline levels, the person may not notice the harm. But as it deepens, life becomes unbearable. The thoughts dominate. They can’t leave the house. They feel trapped. There’s no joy in the mitzvah — only fear. It becomes a living nightmare. Like a prisoner.”

“And as the saying goes, a prisoner cannot free himself from prison. They need help. Once they break free, they feel the difference immediately.”

What About Baalei Teshuvah?

“OCD is also common among baalei teshuvah because in their spiritual enthusiasm, they want to be the best. But they don’t always know where the healthy boundary lies. Some develop genuine obsessions and believe this is what religious life looks like, but it’s not true.”

“Still, not all stringency is OCD. Sometimes it’s just a phase of spiritual growth, and they simply need guidance to step back in a healthy, conscious way.”