Question: I am a tenth grade Rebbe in a local mesivta. I am concerned that one of the bochurim in my shiur may have OCD. He is a very good bochur and does very well, but is shy and seems very anxious about his grades. I noticed recently that he spends a very long time putting on ( and taking off) his teffilin. At least 10 minutes. He is constantly adjusting them during davening. He also takes a very long time davening. How do I know the difference between dikduk bamitzvos and unhealthy behavior? 

This is a common and important question with many applications (e.g., Pesach cleaning, Mikvah,  saying Krias Shma).

Some anxiety before performing Mitzvos is appropriate. Klal Yisroel is referred to as “De’eegai Bemitzvos” (Shabbos 86), those who worry about performing Mitzvos correctly. It is normal for frum people to occasionally experience doubt, guilt, and anxiety. However, with some reassurance and discussion, they are able to come to terms with their challenge and move on. It is therefore appropriate for a responsible parent, Rebbi or Menahel to have a conversation with this boy and offer the requisite guidance. The Sefer Eitzos Vehadrachos Meba’al Kehillas Yaakov contains some excellent letters from the Steipler addressing these challenges.

However, if the bochur doesn’t respond to this and regularly feels nervous and worried, then he is likely crossing the line to unhealthy anxiety.  Completing a Mitzvah should be followed by a feeling of mastery and accomplishment. Regularly questioning oneself and needing to repeat things is likely not emanating from Yiras Shomayim, but from religious based OCD, or scrupulosity. Those who struggle with this feel stuck and need constant reassurance from others and themselves. They often feel as if they are going crazy and are consumed by feelings of guilt.

Sadly, it can take years of suffering for those struggling with this to access the right treatment. Because of the fine line between Yiras Shomayim and anxiety, they and the Tzibur may view their challenges as struggles in frumkeit and don’t realize that these symptoms really reflect OCD and scrupulosity. A specialized form of cognitive-behavioral therapy, Exposure and Response Prevention, is the preferred treatment for all subtypes of OCD, including scrupulosity.

This article appeared originally in the Yated Neeman.