"There's a Fine Line Between Religious Devotion and Compulsiveness": On Obsession in Religious Disguise

This happens to many people: over time, they become increasingly meticulous about certain mitzvot with excessive zeal, leading them to spend a lot of time repeating the same mitzvah, like a specific blessing, handwashing, donning tefillin, and more — claiming they probably "didn't have enough intention" or didn't do things perfectly.

At first glance, they might seem more righteous than usual or possess extraordinary fear of Heaven, leading them to great meticulousness in mitzvot, but upon a second look, you feel something goes out of proportion. It's unhealthy, relentless, and repeats over and over (and over), getting worse in most cases.

The uncomfortable part is that sometimes it takes people a while to agree there's a problem and to seek treatment. On the other hand, social awareness has increased immensely, as have treatment methods, which have become much more effective and quicker on the road to recovery.

"I Met Girls Who Wouldn't Stop Praying, and I Realized They Had a Problem"

"I first encountered this problem while working at a religious school for girls," recounts therapist Yehudit Beitler. "Sometimes I would meet girls who washed their hands excessively. Some prayed repeatedly long after the entire class finished — only because they feared they hadn't directed their thoughts well enough in prayer."

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Later, she was exposed to the wonders of cognitive-behavioral therapy, also known as C.B.T, an acronym for Cognitive Behavior Therapy. She studied the field and is now a certified therapist of the method. It's a unique therapy that treats various mental disorders, mainly anxiety stemming from compulsions.

What is "Religious Compulsiveness"? What are the Symptoms?

"Compulsiveness essentially divides into two: one type is intrusive thoughts, which repetitively enter the person's mind and bother them. Usually, at some stage, it is accompanied by the second part, a compulsive action stemming from an uncontrollable urge to perform it to alleviate the anxiety generated by the thought.

"It's important to emphasize that everyone has thoughts that pass through their mind, even many automatic thoughts that can recur but the difference is they don't 'get stuck' with them. In contrast, intrusive thoughts keep recurring, get stuck in the brain, and won't let go. Often, they're not even logical, but they cause a lot of anxiety. To relieve this anxiety, the person performs a practical action.

"For example, a person might think: 'I didn't pray with enough intention, not enough precision' — in compulsiveness, they will be so anxious that they didn't direct their prayer, they will feel a persistent need to speak the words over and over, each time convinced again it wasn't enough until they might not be able to finish the prayer. The thought enters and bothers that they aren't right — then to calm the anxiety, they'll try to direct their intention repeatedly.

"Some people wake up in the morning feeling unclean and need to wash their hands — then they wash them again and again, convinced they didn't follow all the rules. In severe cases, people can get stuck for hours(!) on this, because they feel they didn't do it correctly. Thus, intrusive thoughts arise from anxiety, and to calm the anxiety, they resort to external actions like prolonged handwashing or praying."

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Beitler explains that obsessive-compulsive tendencies can manifest in countless ways, not strictly on religious grounds. "In religious people, obsessions often manifest more in religious values — immersing, kashrut, mikveh — endless checks, or prolonging immersion significantly. So, the topics are more religious; the basis is religious, but the solution isn't necessarily in that context.

"Cleanliness or hoarding, for example, also relates to obsessions. Some avoid touching certain things, fearing germs, and carry tissues; some collect or hoard things endlessly and illogically; or people for whom the order must not change in any way. There are also thoughts without external actions, but there is compulsion towards them as they constantly lead a person to a further thought about their intrusive thought.

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"For a person with a cleanliness-based obsession, it might manifest as an excessive desire to clean the kitchen, even incessantly, whereas for a religious person, it could appear more in terms of kashrut, like koshering a kitchen, separating meat and dairy, etc. But in terms of the symptom itself — it is the same symptom, just expressed differently. The treatment, however, would be nearly identical for any obsession, regardless of the context."

What to Avoid Right Now

In the past, treatment for such problems was primarily psychodynamic, involving only lengthy discussions. But in the 1980s, cognitive-behavioral therapy started developing by psychiatrist Aaron Beck and psychologist Albert Ellis (both Jewish, you guessed it — A.C.). It soon proved groundbreaking as an innovative, short-term treatment method yielding quick results.

Over time, it proved effective not just in the field of compulsiveness and obsessions— but also in anxiety issues, certain traumas, depression, and even disorganization based on emotions. "On the test of results, this therapy has proven over the years to best aid compulsiveness, as it is thoughtful and behavioral rather than emotional," explains Beitler. "Initially, people don't understand how it helps, how it's possible that they have suffered for so many years and within a few sessions, it will help, they're very skeptical — but the change speaks for itself. It occurs already during the sessions when one chooses to alter their thought patterns — resulting in automatic changes in behavior patterns as well."

How Does It Work Practically?

"It mainly involves work with tables, and it's a process. When I treat, I don't deal with the topics themselves. Usually, we don't delve deeply into the 'why it's happening'. I need to know the thoughts — but the cause is not very significant for me as a therapist to help them. We generally don't deal, for example, with reasons for anxiety and what they had when they were young — only with symptoms, thinking, and behavior. What matters more is what the thought causes him. To stop it — I'll give a practical thought-based solution intended to stop the action. The treatment essentially creates a process and provides awareness and therapeutic support to accompany the patient all the way and what to avoid at the moment.

"The aim is to reduce times or quantities, but if adhered to — it is very successful, and people have emerged from it and saw significant improvement, as their anxiety level decreased accordingly. Suppose someone must wash hands for 10 minutes — gradually help them cut down to 5 minutes, not all at once. Or if a prayer takes three-quarters of an hour — then work on it during therapy so it takes half an hour.

"The initial and most crucial step is first identifying and recognizing that it is problematic and abnormal. In the second stage, the solution for obsessions is via response prevention — that is, when a person has a powerful impulse to do something they want, like wash hands repeatedly — they are asked to stop, refrain, and not do what they desperately want. Gradually, they also learn through therapy that they are acting out of anxiety their thought creates for them, and when they pause — they learn to cope with the anxiety, they stop the 'wheel', the conditioning that occurs: they understand that what prompts them to do the action is the anxiety, and now, instead of doing the action, the thought will return, followed by anxiety, again forcing them to do the action supposedly to release them, endlessly — they just need to confront the real difficulty, which is the anxiety.

"In general, many see obsession as much more problematic and challenging to solve than other issues. I don't see it that way. For those dealing with it, it might seem impossible to refrain from the action that reduces anxiety, but it's not true, because when you stop yourself from repeating the action, although it's tough — you face the problem directly, and the anxiety automatically decreases. If we pay attention to something — anxiety levels rise, and if we stop paying attention to it — gradually, anxiety diminishes because you realize nothing happens. In severe situations, it requires a very strong desire to get out of it, as it's tough; anxiety is overwhelming and hard to confront.

"I had a patient, for example, who had several areas simultaneously that made her life very challenging, related to water: she constantly washed dishes, was anxious about mikveh issues, and more. During treatment, we took a bit from everything and decided she would wash dishes only 4 times not 10 — and gradually reduced the amount. I accompanied her all the way, taught her to notice how long it took and how she felt, and guided her on how to manage the anxiety. *Baruch Hashem*, in the end, she emerged from it."

Where the Line Is Drawn

Where is the line between a righteous person and someone compulsive?How can one differentiate between an obsessive-compulsive disorder with religious symptoms and religious strengthening?

"Generally, you could say that when it starts affecting a person's daily functionality — that's when it becomes problematic. In a religious context, when it becomes a heavy burden that doesn't bring joy, as Judaism is meant to, and when someone isn't calm, and it constantly recurs, causing anxiety, like someone who can't leave the house for fear of impurity or can't stop praying or washing hands, for instance — when it loses balance and becomes extreme. Anything that starts being excessive and certainly goes beyond righteousness is called an obsession".

How do rabbis relate to this? Could a rabbi rule for someone to stop observing a certain mitzvah?

"Yes, in certain cases, definitely. Some rabbis even refer people to therapy themselves. Often, therapists refer to rabbis to give patients a religious ruling as a religious authority. In certain instances, a rabbi may tell a person, for example, to avoid a particular mitzvah-stringency temporarily. Sometimes it allows these people a bit more release, although it doesn't help everyone.

(Photo Illustration: Shutterstock)

"I encountered a case where someone was praying and couldn't stop, constantly repeating blessings, never sure if they'd directed their thoughts well. It drove her mad. It reached a point where it prevented her from functioning daily, even from working. During the treatment, she had thoughts again that she wasn't okay, and she realized she needed to pray — just not to an endless extent. Importantly, only a rabbi can rule such a thing, and not a therapist on their own."

Regarding religious compulsiveness, why would people want to get out of it if it makes them feel more righteous?

"Good question, because sometimes the person doesn't feel it's hard for them. On the contrary, they also reinforce themselves as more righteous and socially valued. Therefore, often, those who refer these people to therapy are family, who see something wrong severely affecting that person's functionality. Often the difficulty is felt by the person themselves, and they don't know how to get out of it.

"When someone is relatively on the border, they don't always perceive if it's good or bad — but as they sink deeper into the 'swamp' of compulsiveness — they feel they have no life. The thoughts constantly take over, they can't leave the house, they feel imprisoned. It affects them socially, and they feel they derive no satisfaction from the 'mitzvah' they perform. It really becomes a nightmare life. Like a prisoner in jail. And just as 'a prisoner cannot free themselves from jail,' such a person needs therapy. When they emerge from it, they definitely feel the difference."

By the way, do you see this issue differently or otherwise in returnees to religion?

"Compulsiveness is common among returnees to religion because often in their repentance process, they wish to be the best in the world. The issue is they don't always know where the proper and good line in observing mitzvot is, and it's important for them to find it. Some have genuine obsession, thinking this is what the world of repentance looks like, a world of difficulty and anxiety — and that's, of course, incorrect, and it's important not to surrender to obsession. On the other hand, it's important they know that even if they exaggerate and are very meticulous about something — it doesn't necessarily indicate obsession, but rather some internal need of theirs, from which they simply need to retreat healthily and consciously."

Yehudit Beitler's Email - yuditbaitler@gmail.com

Contact the 'Nafshi B'she'eleti' Department: 073-3333331 anat@htv.co.il