A small stone, a big problem
At the recent Eighth Annual EUARE (European Academy of Religion) conference, one of the most thought-provoking contributions came in the form of a lecture on Scrupulosity. The speaker, Dr Tasia Scrutton from the University of Leeds, located her analysis at the crossroads of clinical psychology, theology, and pastoral practice – a zone increasingly recognised as crucial as religiously inflected obsessive-compulsive patterns draw wider attention. Far from an eccentric marginal issue, Scrupulosity has emerged as a significant pastoral and clinical challenge, demanding both conceptual clarity and therapeutic imagination.
The lecture’s importance lay not only in its subject matter but in its method. Refusing either to pathologise Scrupulosity as something to be eradicated or to idealise it as heightened piety, the speaker illuminated its complexity. For academic and pastoral audiences alike, this became a timely invitation: to reconsider how faith, psychology, and embodied practice meet in both healing and harm.
Mapping the speaker’s journey: Three aims, one question
The lecture revolved around three aims. First, to clarify Scrupulosity phenomenologically, presenting it as a disabling pattern rather than a quirk of religious life. Second, to analyse its multifactorial causes, spanning biological, psychological, and theological dimensions. Third, to describe the possibility of “spiritual innocence” – the rare but real emergence of spiritual fruit through suffering.
What gave this framework its strength was its integrative method. The speaker wove psychiatric models, philosophical reflection, and theological tradition into a textured account that resisted dividing clinical from spiritual realities. Such intellectual boundary-crossing is demanding, yet essential for phenomena belonging equally to psyche and soul.
Key takeaways
The first finding was phenomenological clarity. Scrupulosity, the speaker argued, is a serious and disabling condition. Her metaphor – the small stone in the shoe – captured its essence: invisible, underestimated, yet relentlessly impairing religious practice. What appears minor to others can mean isolation, exhaustion, or collapse of faith for the sufferer.
Second, the analysis of causes showed a complex interplay. Biological dispositions and cognitive tendencies create vulnerability, but cultural and theological frameworks supply content and amplification. Doctrinal emphases, moral framings, or images of God may intensify the compulsive cycle, while others can ease it. The lecture’s refusal to reduce causality to a single factor was one of its major strengths.
Finally, the concept of spiritual innocence added nuance. While acknowledging the suffering at its core, the speaker suggested that Scrupulosity can, in rare cases, yield resources: a sharpened grasp of grace, radical honesty before God, or deepened empathy for others. This was not to romanticise the condition but to recognise that even in distortion, traces of transformation can appear. Holding Scrupulosity as both burden and occasional catalyst was one of the lecture’s distinctive contributions.
Therapy, theology, and pastoral care
A key contribution of the lecture was its engagement with therapeutic practice. Classical exposure and response prevention (ERP), the standard treatment for obsessive-compulsive disorder, falters with religious concerns. How, after all, can one empirically disprove offending God or confessing inadequately? The lecture highlighted this impasse and cautioned against importing secular methods without adaptation.
Instead, the speaker called for integrative approaches. Psychotherapy proves most effective, she argued, when undertaken with spiritual directors or pastoral caregivers who can hold the theological and existential dimensions of the struggle. Just as important is recognising that Scrupulosity may not be devoid of meaning. Dismissing this dimension too quickly risks reinforcing resistance, while engaging a sufferer’s spiritual investment can open new pathways for healing.
The lecture underscored the urgent need for ecclesial sensitivity. Scrupulosity cannot be dismissed as weak faith or demonised as spiritual failure, for such judgments only deepen isolation and self-reproach. Pastoral practice must instead acknowledge it as a real spiritual disability – distorting, but not destroying, the possibility of faith.
From this recognition follows a set of imperatives. Communities should create spaces of relief, reminding individuals that divine acceptance does not depend on flawless prayer or perfect morality. Congregations must become safe havens where fears can be voiced without shame. Pastoral care must also notice the rare but genuine resources that can arise: humility, or renewed empathy for others. Crucially, such resources must be acknowledged without minimising the suffering that produced them.
Here, the lecture’s insights resonate with a broader vision of pastoral theology attentive to embodied experience, psychological processes, and the transformative power of language. Faith in this light is not confined to confessional boundaries but concerns the human act of trust: deciding who and what one deems reliable, true, and worthy of ultimate commitment. Approaches that unite pastoral sensitivity with psychological discernment make room for precisely this work – recognising wounds, naming them truthfully, and guiding them toward new meaning.
Research Horizons
The lecture closed by identifying promising avenues for research. Too few qualitative studies have explored the lived experience of Scrupulosity. Interreligious comparisons remain rare, though similar dynamics are likely across Jewish, Islamic, and Buddhist contexts. And systematic-theological reflection has lagged behind clinical inquiry, leaving much terrain unexplored.
These gaps point to fertile ground: integrating psychology, systematic theology, and empirical religious studies could yield practical strategies and conceptual advances. This frontier offers not only academic promise but also pastoral relevance, where theoretical insight and lived practice inform one another. Such integration is precisely where my own research trajectory situates itself, bringing theological depth into dialogue with psychological expertise to expand how Scrupulosity – and faith itself – are understood.
Critical Appraisal
The lecture’s strengths were clear. Its phenomenological precision brought much-needed clarity. Its bold interdisciplinarity held clinical, philosophical, and theological strands together. And its use of imagery – the “stone in the shoe,” the “spiritual innocence” – gave the analysis both conceptual sharpness and existential resonance.
Yet questions remain. The notion of “spiritual innocence,” while suggestive, risks being misread as glorifying suffering rather than distinguishing it from its unintended fruits. The empirical base is thin, especially regarding long-term outcomes. And though the clinical and pastoral applications were promising, they still await fuller development in practice.
Taking wounds seriously, tracing resources faithfully: Why suffering and spiritual depth both matter for future research
Perhaps the lecture’s most enduring contribution lies in its capacity to hold together two truths: Scrupulosity is profoundly disabling, disrupting faith, community, and daily life. Yet in rare moments, it can catalyse spiritual depth, sharpening theological insight or nurturing radical honesty before God.
The challenge for clinic and church alike is to sustain this double vision: to take suffering seriously while remaining attentive to the occasional emergence of spiritual resources within it. The same challenge emerges in the study of religious trauma, where wounds demand recognition and healing, yet may also become unexpected thresholds of transformation (cf. also the work of Hannah James1). This very tension – between wound and transformation – defines the frontier where my own work is situated. As a pastoral theologian with psychological expertise, I explore how words and embodied practices can open pathways from fear into trust, from fragmentation into direction, from compulsion into renewed meaning. Such an orientation reaches beyond confessional boundaries, attending to the deeper human act of believing: discerning who and what one finds trustworthy, and why. For those seeking to integrate theological depth with psychological sensitivity, this is not only an academic question but a lived horizon of care.
More of this work can be found at: www.meintraumwirdwahr.at.
Photocredits: (C) Veronika Hübner
RaT-Blog Nr. 15/2025