There is an episode of “30 Rock” in which Tracy Morgan’s character says he is converting to Catholicism. He thinks he has found a loophole for continuing his wild lifestyle: confession. It is that old chestnut that a Catholic can keep sinning and confessing and sinning again, totally carefree. But Alec Baldwin’s character, Jack Donaghy, throws cold water on the idea:

That’s not how it works, Tracy. Even though there is the whole confession thing, that’s no free pass because there is a crushing guilt that comes with being a Catholic. Whether things are good or bad or you’re simply eating tacos in the park, there is always the crushing guilt.

I am not sure where the idea of the neurotically guilty Catholic comes from. To outsiders, it might seem like we have a morbid fixation on sin or that Catholicism has not fully shed its medieval reputation—with its history of hair shirts and self-flagellation. In “30 Rock,” the Irish-Catholic Jack mimes flogging himself as he warns Tracy off the faith.

But for some believers, Catholic guilt is not a joke. Taken to the extreme, it can become an obsessive-compulsive disorder, also known as scrupulosity. A number of famous Catholics have written about or struggled with scrupulosity, including St. Ignatius Loyola, St. Alphonsus Liguori and the soon-to-be-sainted Archbishop Óscar Romero. Today, helping people who struggle with scrupulosity has become a mission of the Redemptorist Order, which maintains a website and monthly newsletter called Scrupulous Anonymous.

Taken to the extreme, ‘Catholic guilt’ can become an obsessive-compulsive disorder, also known as scrupulosity.

A person with scrupulosity might fixate on having done something to offend God. She might think that the prayer she just said was not heartfelt enough or was said incorrectly. She might have unwanted blasphemous thoughts and worry that those thoughts are a mortal sin or indicate spiritual depravity. Even if she is pretty sure that she did not do anything wrong, the needling doubt wears away at her. St. Ignatius called it “making it make out sin where there is not sin” in his Spiritual Exercises.

To alleviate their anxiety, people prone to scrupulosity might try to repeat prayers or perform acts of penance. But their efforts often become chores without any of the spiritual meaning and in the end, only increase their distress. Eventually, their anxiety can even estrange them from their church.

Scrupulous Anonymous features letters sent by men and women worried about the state of their souls. Missing Mass while traveling is a recurring concern. One person writes: “Summer travel makes me anxious. What if we’re far from a church on Sunday or travel reservations conflict with the Mass schedule? Every summer I find myself worrying about mortal sin instead of enjoying the time with my family.”

Another common question is what to do when someone receives Communion, and you think they might not be eligible for it. “We have a family wedding coming up,” one person writes. “Many extended members of my family no longer go to church. If they try to receive Communion at the nuptial Mass, what is my responsibility? To avoid unpleasantness at the wedding, should I make a general announcement, perhaps at the rehearsal dinner, reminding everyone about the rules?”

To alleviate their anxiety, people prone to scrupulosity might try to repeat prayers or perform acts of penance.

Another asks if it is a mortal sin to accidentally hit an animal while driving. “I read that serious cruelty to animals is a mortal sin. When I see things on the road that could be small rodents, snakes, or turtles, I try to avoid them, but sometimes it’s impossible. Is that cruel, and therefore a mortal sin?”

One particularly poignant letter comes from an older person, who says “I’m seventy years old. Lately I’m plagued by memories of serious sins, even some from my childhood. I can’t remember whether I confessed them or whether I tried to minimize their seriousness in my description to the priest. I’m trying to trust in God and leave the past behind. What should I do?”

The Patron Saint of Confessors

A common symptom of O.C.D. is confessing your bad thoughts to others for reassurance. Psychologists who treat people with O.C.D. help patients learn to stop confessing their worries because they only lead to more anxiety. But for scrupulous Catholics, for whom confessing is a sacrament as well as an impulse, avoiding confession altogether can seem like a nonstarter—especially if you are already anxious about sinning.

For people with scrupulosity, going to confession can create a perfect storm.

For people with scrupulosity, going to confession can create a perfect storm. For example, a man might confess a blasphemous thought to his priest but be dissatisfied with the reassurance he gets in response. So he might ask his priest about the same issue again and again, or he might try asking another priest for a second opinion. The spiritual meaning of the sacrament is lost, and the person is being driven by his anxiety, not his faith.

St. Alphonsus Liguori, the patron saint of confessors and founder of the Redemptorist Order, who struggled with scrupulosity himself, gave this advice:

For the consolation of timid and scrupulous souls, I will here state that, according to the common opinion of theologians, when a soul that fears God and hates sin is in doubt whether she gave consent to a bad thought, she is not bound, as long as she is not certain of having given consent, to confess it: for it is then morally certain that she has not consented to it. Had she really fallen into grievous sin she would have no doubt about it.

St. Liguori also emphasized the importance of trusting one’s confessor. Even if the confessor is wrong, trusting what he says is following the direction of God.

His intimate understanding of scrupulosity is perhaps why he is so identified with compassionate confessors and why the order he founded continues ministering to those with this affliction to this day. Father Thomas Santa, a Redemptorist priest and the director of Scrupulous Anonymous, also leads workshops on scrupulosity for pastoral ministers and professional therapists.

In a recent blog post, Father Santa wrote: “At any given moment, we are attacked by the idea that we are not what we are supposed to be, nor what we hoped to be, not to mention what we professed or believed ourselves to be.” He was writing about scrupulosity, but you do not need to have O.C.D. to have these thoughts. In fact, they sound a lot like Catholic guilt—but it is bigger than that, too. These qualms are part of the human condition.

If the guilt has not reached a clinical level—if it is simply the sign of an active conscience—it might not be such a bad thing. Maybe it will make us take more care in our interactions with others or have more sympathy when we see people struggling. But if we find ourselves worrying too much—if misplaced guilt sucks the joy out of life’s simple pleasures, even eating tacos in the park—that is a different matter. But that, too, is very human, and there is help.

This article appears in September 3 2018.