The Catholic Couch

When Horrible Thoughts Pop Into Your Head At Church: A Catholic Guide to Scrupulosity OCD

• Catholic Counseling Institute

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🎓 Take the next step with the course: https://catholiccounselinginstitute.thrivecart.com/freedom-for-catholics/

Have you ever had a blasphemous thought pop into your head during Mass or prayer—and felt instant panic? You’re not alone. In this compassionate and truth-filled episode, Catholic therapist Amber Pilkington unpacks the science and theology behind intrusive thoughts and scrupulosity. You’ll learn how to recognize intrusive thoughts for what they are—not sins—and discover spiritual and psychological tools to reclaim peace.

Intrusive thoughts are ego-dystonic, meaning they directly oppose your values. This is especially common in religious OCD, where the brain’s error detection system (anterior cingulate cortex) is overactive and misfires around spiritual matters. Exposure and Response Prevention (ERP) helps retrain the brain to stop treating thoughts like emergencies.


Catholic Sources:
Catechism of the Catholic Church, §§1857–1859: Requirements for mortal sin
St. Francis de Sales, Introduction to the Devout Life – “It is not always in our power to banish troublesome thoughts…”
St. Ignatius of Loyola, Discernment of Spirits, Rule 1: Differentiates between desolation and consolation
Psalm 34:18 – “The Lord is near to the brokenhearted and saves the crushed in spirit.”
Pope Francis, Evangelii Gaudium, §47: “The Eucharist… is not a prize for the perfect but a powerful medicine and nourishment for the weak.”
Psychological Sources:
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR).
Abramowitz, J. S., Whiteside, S., & Deacon, B. (2004). The effectiveness of treatment for pediatric OCD: A meta-analysis. Behavior Therapy, 35(1), 55–70.
Gillan, C. M., et al. (2016). Functional neuroimaging of OCD: Error monitoring and the anterior cingulate cortex. American Journal of Psychiatry, 173(3), 286–296.
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793–802.


🎓 Take the next step with the course: https://catholiccounselinginstitute.thrivecart.com/freedom-for-catholics/
👉 Freedom from Scrupulosity and Intrusive Thoughts: A Catholic Educational Approach

This in-depth online course includes:

10+ video modules on theology, neurobiology, and therapy tools
Downloadable workbook for reflection and healing
Real-world Catholic guidance on confession, Eucharistic anxiety, and intrusive thoughts
Explanations of ERP (Exposure and Response Prevention) and Catholic discernment

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Disclaimer:
This podcast is for informational and educational purposes only and is not a substitute for professional counseling, spiritual direction, or medical advice. While I’m a licensed Catholic therapist, I am not your therapist—and listening to this podcast does not create a therapeutic relationship.If you’re experiencing significant distress, please reach out to a licensed mental health provider in your area, your parish priest, or a trusted support resource. If you're in crisis, contact 988 or your local emergency services.The Catholic Counseling Institute exists to support women with resources that integrate faith and psychological insight. We’re here to walk with you, but we are not a crisis line or emergency care provider.