Studying Scrupulosity

The temple is generally a place of peace, a respite from worldly cares and stress. But what if attending the temple was one of your greatest fears, triggering intense anxiety and self-doubt? For some people, attending the temple is fraught with emotional difficulty. Debra Theobald McClendon’s (B.S. ’99, Ph.D. ’09) goal is to help.

McClendon specializes in a religious form of obsessive-compulsive disorder (OCD) called scrupulosity. “In scrupulosity, toxic anxiety attacks religious content with distressing, intrusive thoughts or obsessions,” McClendon explains. “Religion doesn’t cause OCD, but if someone is religious and has OCD, it may manifest itself in the religious content of their lives because the anxiety tends to hyper-focus on things the person values.” Scrupulosity can cause fear, anxiety, and panic when a person participates in religious activities like scripture study, attending church, or listening to General Conference talks.

For some of McClendon’s clients with scrupulosity, the temple is a major source of anxiety. “They struggle to attend the temple or avoid attending at all due to a fear that they are not worthy to be there, fear of having a panic attack, or fear of having intrusive thoughts while they are there,” explains McClendon.

One of McClendon’s clients ranked attending the temple as his top fear. On a scale of 1 to 10, with 10 being the highest, he ranked doing temple baptisms as a 9 and doing an endowment as a 10. “And then, he even ranked an 11 on his 10-scale; doing initiatories in the temple was for him an 11 out of 10! It was impossible for him,” says McClendon. “We worked on his temple fears for quite some time.”

The most effective treatment for OCD is exposure therapy, in which a person confronts their fears rather than avoiding them. “When fears are confronted, anxiety initially increases,” says McClendon, “but as the person remains in the fearful circumstance without avoidance or enacting a compulsion, the anxiety starts to settle on its own without them having to do anything.”

This client began attending the temple as a therapeutic intervention. “There was little spiritual uplift for him in those earlier sessions—attending was just an exposure exercise,” says McClendon. “However, after some time, going to the temple shifted for him. Instead of it feeling like a therapeutic exposure exercise, it began to just feel like ‘going to the temple.’” In a visit with this client near the end of his treatment, he shared some of the positive experiences he had had in the temple with McClendon.

Then—causing tears of joy to come to McClendon’s eyes—he told her he had met with his bishop about becoming a temple worker. “The temple, which had been a source of agonizing, paralyzing fear for him, had now become a place of peace, a place that he desired to be even more frequently,” says McClendon. He began serving in the temple shortly thereafter.

McClendon has felt the Lord leading her along throughout her professional career. Her outreach efforts have expanded in recent years. In 2019, the Ensign (now Liahona) published two of her articles on anxiety and scrupulosity, bringing her work to people around the world. Since then, she has written more articles, been interviewed on multiple podcasts, produced an online course, and in 2023 published the book Freedom from Scrupulosity: Reclaiming Your Religious Experience from Anxiety and OCD.

“People who had never heard of scrupulosity were able to put a name to something that was a tormenting influence in their lives, giving them hope. If there was a name for what they were struggling with, then perhaps there was also a treatment,” says McClendon. Her work has helped those who may have felt hopeless begin their path to healing.

Since the COVID-19 pandemic, insurance companies have been willing to reimburse patients for telehealth psychotherapy sessions and legislation now allows the interjurisdictional practice of psychotherapy. This has allowed McClendon to treat clients in most U.S. states. “I am humbled that the Lord has chosen to expand my reach, and I hope and pray I can continue to serve Him well,” says McClendon. “I am honored to be able to serve my clients, to help them find peace and joy in the gospel as they continue their journey through mortality.”

Full Name: Debra Theobald McClendon
Grad Year: BS '99, PhD '09
College: Family, Home, and Social Sciences; Humanities
Major: Family Science, Clinical Psychology
Post date: April 1, 2025
Author: Avery Stonely and Anna Sneddon