I came back to the Catholic Church during my sophomore year of college. After encountering God during a retreat, I wanted to take my faith more seriously. I wanted to pray. I wanted to be a “good Catholic” – whatever that was. I plugged into my Catholic young adult (YA) community to try and understand what this whole Catholic thing was about, thinking that maybe I could figure out how to be a “good Catholic” there.

The Dangers of Preaching One Way of Being a "Good Catholic"

My YA group definitely had a “vibe.” Going to daily Mass was like a badge of honor. People talked about praying the Liturgy of the Hours or which Doctor of the Church they were reading. Lots of the women wore veils to Mass, and more than one man had a giant rosary wrapped around his belt. There was an underlying tone of, “This is what the good Catholics do.”

And so, over time, I did those things, too. I became a daily Mass-going, rosary-praying, veil-wearing, Bible study-attending Catholic, developing my own list of spiritual practices to live my faith and be the Catholic I thought I was supposed to be. I thought there was only one way to be a “good Catholic.”

The problem was, being this kind of Catholic didn’t give me any peace. As I tried to keep up with these rules, I became quickly overwhelmed and anxious. I started getting scared of missing daily Mass or not praying the rosary, worrying that God would be mad at me for letting Him down. The rosary gave me constant anxiety because I worried I hadn’t prayed it well enough. Trying to pray at all became increasingly uncomfortable and I didn’t know how to find rest in anything in my faith life.

I didn’t know it at the time, but in pursuing the one way to be a “good Catholic,” I had developed a mental health disorder around living my faith.

The relationship between faith and mental health is a long and storied one. Notable people throughout history have dealt with “religious scruples,” anxiety, and OCD, including the well-known Saint Thérèse of Lisieux. After going to therapy and starting to work through these experiences, I discovered that I too had developed scrupulosity, a sort of pathological anxiety and guilt about being a good Catholic and living out my faith. And my story is not the only one.

The Development of Faith-Related Mental Health Disorders

Dr. Ally Sequeira, a psychologist who earned her PhD in counseling psychology at Texas A&M, works with Catholics of all ages to overcome these mental health disorders, specializing in OCD and religious scrupulosity.

“I see a lot of individuals who have scrupulosity,” says Dr. Sequeira, “who will pray multiple times, over and over again until it's just right. It kind of stems from this belief that God is going to be upset with me if it's not perfect. Or, I've had some patients who really struggle with Confession, and so won't go to Confession because they're afraid that they won't say everything perfectly, or that they'll miss a sin and then would have to do it all over again. So, it's just an intense pressure to be the perfect Catholic, which kind of goes against our faith. We're not called to be perfect.”

Where do these disorders come from and how do they develop? To some degree, mental health conditions are genetic. Dr. Sequeira explained that for OCD, “ee don't know exactly what causes it. But we do know that there is a neurobiological component to it, so it's highly hereditary. So if somebody in your family has OCD, there's a huge chance that you might have it as well.” Other mental illnesses, such as anxiety, also have a hereditary component.

However, genetics and family history isn’t the whole story. Going from a genetic predisposition to developing an actual mental health disorder depends heavily on the influence of our culture. Dr. Sequeira says that “we’re heavily influenced by the people around us, and heavily influenced by social media. When we have a belief, we tend to get any evidence that supports these beliefs that we have about ourselves. So, if we believe that we're not a good Catholic, then we're going to look for accounts and stuff like that to be like, ‘See, I need to be working harder,’ and that can really reinforce a lot of fears and anxieties.”

These toxic influences can come from many places, ranging from Instagram or other social media platforms to one’s local community. Dr. Sequeira’s sister Victoria Mastrangelo, who works as a high school theology teacher and campus minister, remarked,

“As an educator and someone who works in ministry, I’ve seen how scrupulosity can be a real obstacle to faith… I do think that there are schools of catechesis or theological formation that have led to a more everyday scrupulosity that keeps people from being able to live their faith freely and authentically, and that is so heartbreaking to me. For example, I was talking with a mom at my kid’s school about how it was ingrained in her that not praying the rosary everyday could send her to hell, which is in no way actual Church teaching.”

Women Who Have Seen and Experienced the Struggle with Mental Health Disorders and Faith

For Maria Brown*, who has been healing from OCD and panic disorder since January 2022, it started within her own family.

“A big part of my family's identity involves it being important to be Catholic, and I'm super sensitive to other people's emotions. So I was always very aware of how non-Catholics were talked about in my family… It was like an ‘othering’ of other people. And I was so terrified of not being included, that I just, like, made sure I was included.”

This desire to be included in her family eventually developed into OCD.

“I prayed the same structure of prayer from the time I was probably like seven or eight until January [of 2022]. I never deviated from it. It was the same words, and if I didn't finish it when I was falling asleep, I would wake up in the middle of the night and finish it… And I'd keep going until I made sure I made the Sign of the Cross… I was like, ‘It has to be this way.’”

Whether it be obsessive behaviors, as in Maria’s case, or extreme anxiety and fear, as in my case, the end result of these unhealthy relationships to spiritual practices is the same: a feeling of distance from God and a lack of authentic relationship with Him and the Church.

Dr. Sequeira witnessed this struggle with the patients coming to her office: 

“I think that when you're in the midst of really struggling with scrupulosity, it's really hard to have that authenticity, because you're focusing so much on, ‘How am I praying?’ versus, ‘What am I saying?’”

Victoria Mastrangelo has seen similar struggles:

“When the rules or guidelines are taught from a place of rigidity and absoluteness, then it places boundaries on people that trap them in a place of fear. And our relationship with God should never be rooted in fear – it’s in no way why He made us or what He wants. He loves us into existence and it’s His greatest hope that we are free to love Him in return, and that should be what frames our prayer lives. It also contradicts the teaching of our uniqueness in being made in God’s image to say that we all have to pray only one way to be able to reach Heaven.”

Healing from Faith-Related Mental Health Disorders

So, what’s the remedy for women like me and Maria who are struggling with their mental health and in their relationship with the Church? Naturally, the answer in part includes professional therapy. The particular therapeutic path taken depends on the individual person, but generally includes directly challenging related negative beliefs, thought patterns, and behaviors, to uncover the truth underneath them.

Dr. Sequeira explains, “[For OCD] we take a step back to say, ‘Well, what are we called to do as Catholics? What are our beliefs? What are the things that we're taught to do?’ Like, if you were to explain how someone's a good Catholic to an eight year old… Breaking it down, people are able to start realizing, ‘Oh, what I'm doing isn't what I'm supposed to be doing.’ Then, we would systematically go through different exposures that would help them realize – [we] put OCD to the test. Through that people can recognize that nothing bad happens. My discomfort goes away on its own and I actually feel closer to God when I break these rules.

“With anxiety, [because] we do get intrusive thoughts, but they feel like facts… The treatment for that is to help us identify more appropriate, more rational thoughts versus that irrational thought.”

For Maria, healing from OCD has included challenging her rigid prayer structure and focusing on her needs:

“Every morning, I'll be like, ‘What do I need right now? What do I want to do?’ I do think that understanding my relationship with God as a relationship, one in which I'm having a conversation, in which sometimes things are kind of dull, [and] sometimes I talk for a long time… It really feels way more fulfilling as prayer… The sort of antidote to my scrupulosity has been [saying], ‘Okay, let yourself kind of do what you want for a little bit and see what is or isn't working. And if something isn't working, you have a relationship with God and you will use that relationship to help manage it.’”

For women like us, this process of undoing irrational thoughts, fears, and practices can be both long and mentally, spiritually, and emotionally challenging. Mine has involved three years of therapy, intense prayer, and learning to lean into a healthy, supportive community. Maria’s journey is well underway. For others, the conflict between a genuine desire to live the faith and the feelings of pressure to do it perfectly is still ongoing. As we see from these stories, a toxic Catholic culture can teach us (wrongly) that there is only one way to be good.

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Author’s Note: Some names and identifying information have been changed at the request of the interviewee.