There is a disorder, called Scrupulosity, that isn't spiritual at all; it's neuro-biological. A rare, often-misdiagnosed subtype of obsessive compulsive disorder, affecting maybe 180,000 (or 6 percent) of the approximately 3 million Americans suffering from OCD. 

 
  Meet Tom, a guy a lot like you. He works hard, makes a good wage, has a girlfriend who loves him. He's a God-fearing man as well. Sound familiar? Here's the difference: His belief in God almost killed him.
 
The condition Tom describes as "high tide" has a long, if shrouded, history. In the 15th century, San Antonio (Archbishop of Florence) wrote of a malady specific to the faithful, describing "a doubt accompanied by a groundless fear, which afflicts the spirit, and makes it apprehend sin where none exists." Saint Ignatius Loyola, founder of the Jesuit Order, was nearly suicidal with thoughts of spiritual impurity, and attended confession compulsively, fearful he'd not properly repented. Martin Luther was plagued by blasphemous thoughts. As long as there have been devout men, there have been men whose devoutness offered no peace, but only an agony of dread, and obsession, and ritual—a flesh-eating bacteria of the spirit.
 
But the disorder, called Scrupulosity, isn't spiritual at all; it's neuro-biological. A rare, often-misdiagnosed subtype of obsessive compulsive disorder, affecting maybe 180,000 (or 6 percent) of the approximately 3 million Americans suffering from OCD, according to the Westwood Institute for Anxiety Disorders. But unlike cleaners, who can't wash enough, and checkers, who can't be too careful, scrupulous people can't get good enough. The desire to be properly God-fearing, or morally upright, turns traitor, like a diseased immune system attacking its host.
 
In an obsessive compulsive's world, obsessions are intrusive thoughts that provoke intense anxieties. Compulsions are rituals performed to release or negate those anxieties. Except they don't. They only reinforce the obsessions. "If you go into a situation and you're anxious, and you do something to protect yourself—a compulsion—what you don't find out is whether in fact the situation is dangerous," says Dr. Jeff Szymanski, Ph.D., president of the International OCD Foundation. "You've told your brain, yeah, I think we might have been in danger."
 
Sufferers recognize their behavior is irrational. They are prisoners to it. And for the scrupulous, those prison walls are fashioned by their own moral impulses, their very belief systems, religious or otherwise. In fact, a growing body of scientific evidence indicates a neurological overlap between the areas of the brain that underlie OCD obsession and the seat of human morality itself. It's no surprise: Moral emotions (such as guilt and empathy) have evolved with us since our knuckle-dragging days. Absent them, we're a planet of Patrick Batemans from American Psycho. It's a balance we take for granted. But too much of them and we cripple ourselves with judgment. Too much of them and we might find ourselves undeserving of a sip of beer.
 
Tom's problems started when he first went to elementary school (childhood-onset OCD is predominantly male). Catholic school, which his Methodist parents preferred to the shabby public schools in his small southern hometown. He was diagnosed with separation anxiety in the second grade, but he couldn't tell anyone the reason for his distress: He thought that while he was at school, his parents would die. He couldn't tell anyone, because if he did, they would also die—a classic example of what OCD specialists call "magical thinking." The burden was his. He obsessed about death, couldn't see it dramatized on television.
 
 
"Man, that would just send me off," he recalls. "Now I know they were panic attacks. I would start sweating right here." He points to the peak of his hairline. His heart would race. His hearing would fade, like someone turning the volume down on the world. "My thought was, It's not going to be OK. It's not going to be OK. Somebody's going to die. I'm going to die."
 
He found relief from his anxiety in chapel confirmation classes. "It was a safe place," he says. "Also, it was made very clear what I was to do. You are to stand here. You are to put your hand on this bead, say a Hail Mary, and move it. And so, for the rest of my life..." Tom leaves the thought hanging, but I get it. For the rest of his life, he'd be looking for rituals to soothe those anxieties, to make it okay again. Tit for tat. Obsession compulsion. And when he was old enough to understand that God had some providence over death, he linked, in his little boy's mind, his fear of death to a fear of God. Or rather, a fear of God's judgment. "To some people," he tells me quietly, plucking at his beard, "God is the ultimate love. For me, God became the ultimate displeasure."
 
There's a fine line between someone who is devout, and someone suffering from Scrupulosity. Szymanski defines the difference like this: "People who enjoy their religious practice find fulfillment and purpose. Scrupulous people are driven by fear. The thinking is, I've committed a sin. I've done something blasphemous. I've done some sort of unforgivable thing toward God and he is now angry with me." Scrupulous compulsions usually involve repetitive prayers, mental pacts with God, or punitive shows of piety. Often, patients can't see the theological forest for the trees: stuck for hours perfecting the Rosary, rather than taking solace from their convictions.
 
Scrupulosity also manifests as a secular, hyper-morality: the man who is incapable of lying (think: Jim Carey in Liar Liar) on even the smallest scale, or the teenager so terrified of harming another creature that he can't wash his car, for fear of drowning a passing spider. But the more severe cases tend to be the religious ones, where repetitive rituals and institutionalized guilt play into the hands of the disorder. And where intrusive thoughts are blasphemies. "There's a ton of shame with Scrupulosity," says Szymanski. "Because they're thinking these horrible things about God, and if they're thinking them, they must mean them in some horrible way, when in fact it's just a random spitting out from a part of the brain."
 
Thought Action Fusion, psychologists call it: If I think it, it's as though I did it. This is especially devastating for people of faith, who are often taught that thoughts are equitable to actions. I spoke to one patient who became convinced that he was posessed, after curses against Jesus and pledges to Satan swarmed his mind like wasps. His life collapsed. It's the old pink elephant experiment: Tell yourself not to think about something, soon it's the only thing in your head.
 
 
Scrupulous people demand an unattainable level of perfection from themselves. There is no middle ground between righteousness and depravity. And no room for doubt—which of course, fuels tons of it. Szymanski remembers treating an atheist who fell prey to scrupulous obsessions just in case. "In any instance," Dr. Szymanski says, "it isn't about religion. It's about the brain malfunctioning."
 
The malfunction in Tom's brain, through childhood, resulted in garden variety OCD symptoms: Certain notes on the piano had to be played when he entered or left the house, sinks had to be completely free from water. Then came junior prom, when he found himself in a crowded hotel room, stoned and drunk. Around him, boys in rented tuxedos and girls with teased bangs drank Jack Daniels and smoked weed. A few were huffing paint. Fumes blanketed the air. He'd spent his whole childhood rebelling from school (his GPA wasn't a full number), but he was suddenly disgusted. He thought to himself: I can do better than this. "I attributed that to God speaking to me," he says. "It was a calling." Researchers note a spike in OCD symptoms in late adolescence or early adulthood. Tom was right on target.
 
After that, he had to read a certain number of Bible verses every morning, sitting in a particular spot, one leg propped on a shelf. The verses became a chapter, and the chapter became a book, which could take over an hour to finish. His legs would fall asleep while he read, cramped in that unnatural position. He developed a prayer he had to recite before bed, which got longer and longer, until he needed hours to complete it. If he fell asleep during the prayer, he had to finish it the next morning, before his reading. If he made a mistake, he had to start over. "I had to give the day to God," he tells me. I ask him what he thought would happen back then if he didn't complete those rituals. "God would be pissed off," he says, without hesitation. "He'd be after me. He would definitely hate me. All the blessings in my life would fall away." The frightening God from Tom's boyhood—his first scrupulous invention—was back. Penance was required.
 
Not long ago, treatment for a guy like Tom would have consisted of talk therapy, only worsening his obsessions. In fact, there remains so much ignorance about Scrupulosity—and OCD in general—that lots of people endure years of unhelpful treatment. Not to mention bad advice. (Researching for this story, I stumbled on a Web health forum, where a Christian woman wrote complaining of intrusive thoughts like I hate God. And every response encouraged her to pray, to redouble her commitment to the church, to rebuke the devil.) Right now, Scrupulosity isn't even listed in the Diagnostic and Statistical Manual of Mental Disorders. Therapists familiar with OCD might not recognize it when they see it.
 
Leslie Shapiro, a petite, bird-like woman, is a behavioral therapist specializing in Scrupulosity at the Obsessive Compulsive Disorder Institute at McLean Hospital, one of only three residential treatment centers for OCD in the country. The institute's 30 beds are filled with severe, treatment-resistant patients. They come here, to Belmont, Massachusetts, from all over the world. There is a 4-month waiting list. Leslie runs the Scrupulosity Group (composed of three patients when we spoke). And she believes there's another reason scrupulous patients slip between the cracks. "Many therapists are biased against religion," she says, sitting in her office at the institute's top floor. Behind her is a bookshelf packed with tomes on psychology, OCD, and religion. "There's a lot of judgment. It's counter-transference—that's psycho-babble for bringing your own baggage into the room." Dismissed as over-zealous nuts outside their religious communities, and primed with ritual inside them, these people often have nowhere to turn. Shapiro considers treating religious Scrupulosity an obligation. "It's a neurobiological disorder," she says. "It's nobody's fault. Nobody made it happen."
 
For all subtypes of OCD, treatment is the same: an SSRI (selective serotonin reuptake inhibitor, the same class of drugs prescribed for depression) combined with exposure and response therapy. When patients ritualize to combat anxiety, they only prove to themselves that their obsessions are real, that rituals protect them, reinforcing the OCD feedback loop. During exposure therapy, a patient endures an obsession without performing compulsions, anxiety skyrocketing, until the brain realizes that there is no real danger. "The goal is habituation," Shapiro says. "When you face your obsessive fear and let the anxiety run its course, you habituate to that situation." It's a painful process—especially so for scrupulous patients, since the treatment forces them to repeat their private blasphemies aloud, piling imaginary sin on sin. Therapists use religious counsel to reassure patients (though, I'm told, many wind up doubting their religious counsel, too).
 
 
Shapiro introduces me to Ann, a middle-aged Catholic woman, suicidal before she arrived at the Institute just four weeks before, wracked with feelings of sin and unworthiness. Her hairless forearms are red and scraped, from years of compulsive washing and praying. Ann shows me her current exposure treatment, the reverse of a compulsive prayer that has dominated her life for years. She holds up three pages of yellow notebook paper, covered front to back with the following sentence: Oh God, please don't help me. At first, just writing those words caused anxiety attacks. Slowly, she's starting to realize that her Scrupulosity is not interchangeable with her piety.
 
But while a person obsessed with germs can be taught, definitively, that a doorknob is safe, a person convinced he's damned will never know for sure. Not in this life. The awful doubt remains.
 
Tom's doubts chased him to college. And while other college kids were doing what college kids do—partying, meeting girls—Tom suppresed all sexual impulses. He remained a virgin until he was 28, and for a three-year period, the only orgasms he had were in his sleep. He did find a girlfriend, another Christian, whose own private demons kept her physically shut down. They enabled each other's anxieties. Meanwhile, Tom deteriorated. "I was losing the ability to do things in my life," he says. "The obvious stuff, like sex, alcohol, stuff like that. Any pleasure. And pretty soon, I couldn't eat. At all. I couldn't even drink."
 
By May 1999, Tom, 6-foot tall, had withered to 90 pounds. Skin shrink-wrapped to bones. He didn't deserve to eat while others starved. It was wrong. The only thing that felt right was to take up less space. To diminish.
 
"You were dying," I tell him.
 
"At that point," he says flatly, "I didn't care."
 
He was overcome with nervous tics: gulping, clicking his throat, rolling his head around on his neck. It was wrong to work, to move. And wrong to explain. These were God's prescriptions. Asking for help was tantamount to betraying God.
 
When his parents—alerted to his condition by his desperate girlfriend—brought him back to their house, he hadn't showered in weeks. He smelled like an animal. They took his filthy clothes to wash, and Tom collapsed on a pastel couch in their living room, where he lay for days, in his boxers, staring out of empty eyes. He listened to hushed voices discussing his condition. His mother's movements in the kitchen filled him with dread: mealtimes meant food. She brought him saltines, and Tom might take two hours to chew and swallow a cracker. At one point, she tried to force one through his closed lips. He kept his teeth clenched.
 
His first psychiatric evaluation, Tom was tested to assess the severity of his obsessions. "Congratulations," said the doctor. "You got a perfect score."
Moral crises like the one Tom describes have traditionally been the provenence of clergy and philosophers. That's changing. Neurologists have discovered that morals, and moral emotions, are not just abstract concepts, but coded in specific regions of the brain. Harvard psychology professor Joshua Greene, with help from a fMRI scanner, collected data from brains considering an old two-part philosophical quandary. First, would you pull a lever to reroute an unstoppable train from a track with five workers standing on it to a track with only one? Overwhelmingly, people say they would. Second, would you push a man into the tracks of the oncoming train to save the five workers? Overwhelming, people would not, even though the math—kill one guy, save five—is the same. Greene found that the two questions trigger different regions in the brain. The first activates the dorsolateral prefrontal cortex, behind the brow, partly responsible for reasoning and problem solving. The second activates areas known to regulate empathy and social cognition.
 
Researchers like Greene suggest that these two regions duke it out in any moral situation. If you've ever felt like you were wrestling with yourself over the "right" thing to do, you probably were. And a powerful emotional response drowns out logic when confronted with primal notions of right and wrong (don't push people into trains). This idea is further supported by evidence that people with damage to the medial prefrontral cortex—emotion's advocate—have no problem pushing the guy, suffocating the crying baby to save hiding villagers, sacrificing one hostage for the rest (pick your hypothetical). The numbers add up, but the acts are repulsive to most of us. We need both subsystems talking to each other for our moral compasses to find true north. To extrapolate a bit, hyperactivity in either might be as debilitating as no activity at all.

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Oil Change instructions for Women:
1) Pull up to Jiffy Lube when the mileage reaches 3000 miles since the last oil change.

2) Drink a cup of coffee.

3) 15 minutes later, write a check and leave with a properly maintained vehicle.

Money spent:

Oil Change $20.00

Coffee $1.00

Total $21.00

==========================================­================

Oil Change instructions for Men:

1) Wait until Saturday, drive to auto parts store and buy a case of oil, filter, kitty litter, hand cleaner and a scented tree, write a check for $50.00.

2) Stop by 7-11 and buy a case of beer, write a check for $20, drive home.

3) Open a beer and drink it.

4) Jack car up. Spend 30 minutes looking for jack stands.

5) Find jack stands under kid's pedal car.

6) In frustration, open another beer and drink it.

7) Place drain pan under engine.

Look for 9/16 box end wrench.

9) Give up and use crescent wrench.

10) Unscrew drain plug.

11) Drop drain plug in pan of hot oil: splash hot oil on you in process.
Cuss.

12) Crawl out from under car to wipe hot oil off of face and arms. Throw kitty litter on spilled oil.

13) Have another beer while watching oil drain.

14) Spend 30 minutes looking for oil filter wrench.

15) Give up; crawl under car and hammer a screwdriver through oil filter and twist off.

16) Crawl out from under car with dripping oil filter splashing oil everywhere from holes. Cleverly hide old oil filter among trash in trash can to avoid environmental penalties. Drink a beer.

17) Buddy shows up; finish case of beer with him. Decide to finish oil change tomorrow so you can go see his new garage door opener.

1 Sunday: Skip the holy place because "I gotta finish the oil change." Drag pan full of old oil out from underneath car. Cleverly dump oil in hole in back yard instead of taking it back recycling.

19) Throw kitty litter on oil spilled during step 18.

20) Beer? No, drank it all yesterday.

21) Walk to 7-11; buy beer.

22) Install new oil filter making sure to apply a thin coat of oil to gasket surface.

23) Dump first quart of fresh oil into engine.

24) Remember drain plug from step 11.

25) Hurry to find drain plug in drain pan.

26) Remember that the used oil is buried in a hole in the back yard, along with drain plug.

27) Drink beer.

2 Shovel out hole and sift oily mud for drain plug. Re-shovel oily dirt into hole. Steal sand from kid's sandbox to cleverly cover oily patch of ground and avoid environmental penalties. Wash drain plug in lawnmower gas.

29) Discover that first quart of fresh oil is now on the floor.Throw kitty litter on oil spill.

30) Drink beer.

31) Crawl under car getting kitty litter into eyes. Wipe eyes with oily rag used to clean drain plug. Slip with stupid crescent wrench tightening drain plug and bang knuckles on frame.

32) Bang head on floorboards in reaction to step 31.

33) Begin a cussing fit.

34) Throw stupid crescent wrench.

35) Cuss for additional 10 minutes because wrench hit and broke favorite bowling trophy.

36) Beer.

37) Clean up hands and forehead and bandage as required to stop blood flow.

3 Beer.

39) Beer.

40) Dump in five fresh quarts of oil.

41) Beer.

42) Lower car from jack stands.

43) Accidentally crush remaining case of new motor oil.

44) Move car back to apply more kitty litter to fresh oil spilled during steps 23 - 43.

45) Beer.

46) Test drive car.

47) Get pulled over: arrested for driving under the influence.

4 Car gets impounded.

49) Call loving wife, make bail.

50) 12 hours later, get car from impound yard.

Money spent:

Parts $50.00

DUI $2500.00

Impound fee $75.00

Bail $1500.00

Beer $40.00

Total - - $4,165.00

But you know the job was done right!

 
 
COLUMBUS, OH—A ravenous caterpillar escaped from captivity today, wreaking havoc as it devoured everything in its sight and carved a half-centimeter path of destruction across the city, horrified sources reported.

Confined to a glass viewing chamber since late May, the savage creature reportedly broke free from its bedside enclosure before slithering out of an open window and charging wildly toward the city's unsuspecting commercial district.





Residents Advised To Wear Socks As Precaution

"I came back home and it was gone," said 8-year-old resident Daniel Bogen, whose hubris and reckless abandon has unleashed a terror of immeasurable proportions onto the community. "I thought I twisted the lid on the jar real tight. Where did it go?"

Stretching out to a monstrous 75 millimeters, the beast's segmented body left behind a swath of devastation as it uprooted entire blades of grass, snapped whole clover stems in half with a single bite from its jaws, and marauded past residential structures helpless against its larval fury.

At press time, authorities remained no closer to locating the caterpillar.

While many Columbus residents avoided peril by staying indoors, the multi-legged creature continued to quench its insatiable hunger for the flesh of foliage. In fact, the rapacious insect was said to only momentarily pause its mindless pursuit of nutrients when it climbed atop a branch and coldly surveyed the city with its unfeeling eyelets. One terrified onlooker said he watched the creature use its razor-sharp mandibles to tear through the leaf of a 100-foot-tall oak tree as though it were paper.




The unstoppable beast devoured more than a dozen leaves.

"That thing is a menace," said resident Derek Kriesel, who noted that his 25-foot chain-link fence provided little defense against the caterpillar's feeding frenzy. "It ripped through an entire stem of my basil and consumed almost two whole buds from that one tomato plant. There's nothing left. Nothing."

With little regard for life or private property in the crowded urban area, the raging caterpillar instantly rendered dozens homeless when it knocked over an anthill, its three pairs of legs crushing everything beneath them into the dirt. Although the full extent of the damage caused by the .250-foot creature is not known, many estimate it will take more than 10,000 ant-hours to rebuild.

Though the caterpillar left a chewed-up trail of leaf remnants in its wake, numerous Columbus residents admitted they had not personally witnessed the voracious pest's reign of horror.

"Was it one of those fat-furry ones or the green ones?" Columbus native Andrea Barlow said. "Those furry ones give me the willies. They're so creepy."

How long the creature's destructive rampage will continue, or what—if anything—can stop it, remains to be seen. A unit of plastic army men and tanks, stationed on the edge of a local sandbox, proved no match for the insectoid, as it lumbered through the group with terrifying speed, knocking a half-dozen infantrymen onto the ground below.

Shortly before press time, the caterpillar began to exude a translucent and stringy discharge, which it wrapped around itself until it had completely disappeared inside the alien casing. While few know what is occurring inside the hanging structure, some speculate that the creature has entered a horrifying state of mutation, one that may transform the ungodly caterpillar into an even more deadly and revolting organism.

"Whatever is happening inside of that thing, it's far from human," said Columbus police chief Keith Morgan, who predicted that if the creature gains the power of flight, nothing will be capable of standing in its way. "Once again the folly and ignorance of man has unleashed nature's fury. May God help us all."
 
 
:hehe:

 
 

 
 
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