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On what level may we (or may we not) intervene with OCD sufferers when they are not related to you in any way?

I am referring to a sizable demographic of religious OCD sufferers, who don't necessarily know what OCD is, and surely have not been diagnosed or treated for their anxiety disorder.

Within the religious context and practice it's very easy to spot OCD sufferers. At Synagogue they may spend more time than any other congregant pronouncing the words of prayer carefully or repeating the words many times. I'm in no way referring to the congregants that spend time truly meditating on the words with proper intent, or repeating words that have been pronounced correctly. I am referring to practices that catch the average person's attention. Repeating words 10 or 20 times, starting over from the beginning of a particular prayer repeatedly, or creating buzzing or clicking sounds in the misguided attempt to "pronounce the words properly". To the unfamiliar eye, this may appear to be religious fervor and zest. Unfortunately it's far from this, the sufferer is struggling with compulsions, intrusive thoughts, fear, and worry.

These behaviors can be treated. The question is how to approach the suffering individual.

Whether or not religion breeds or fosters OCD behavior is a separate argument, but a large number of religious sufferers simply believe they are acting in accordance with their religion. By repeating "Poseach Es Yadecha" in the "Ashrei" prayer 10 or 20 times for example, or repeatedly washing their hands, to get it "right" for "Netilat Yadayim" the sufferer believes he or she is merely following "Halacha" more strictly than anyone else.

On what level may we intervene to try and help the sufferer? Can we make them aware that their suffering is unnecessary and can be corrected? Surely outright confrontation wouldn't be advisable, What would be some other methods of intervention (or confrontation) that conform with "Halacha"?

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Is the primary purpose of this question to request information or to convey an opinion? –  Isaac Moses Jan 1 '13 at 15:16
@DoubleAA, this question features assertions that certain practices are the result of OCD and are not, as their practitioners believe, in accordance with Halacha, leading me to wonder whether communication of these assertion is the main point of the question. In any case, the question could be improved if support for these assertions were edited in. –  Isaac Moses Jan 1 '13 at 15:23
@IsaacMoses the point of the question was to understand if it's ones responsibility to interfere with sufferers and try to help them. The assertions were simply explaining the question. If communication of the assertions were the main point of the question, it wouldn't be a question then? –  shnozolla Jan 1 '13 at 15:37
background: scrupulosity psychology.huji.ac.il/.upload/articles/huppert3.pdf –  josh waxman Jan 1 '13 at 16:44
@shnozolla, you say both "it's very easy to spot" and "To the unfamiliar eye, this may appear to be religious fervor". These seem like opposites, unless you're a medical professional (so it's easy for you). If that's the case -- if you're asking from the perspective of someone with specialized medical knowledge -- you might want to bring that out in the question. What's appropriate for Dr. Ploni may be different from what's appropriate for ordinary Ploni. –  Monica Cellio Jan 1 '13 at 22:42
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3 Answers

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It seems that many OCD sufferers' (regardless of what they obsess over) don't realize that they OCD'ing. They will usually give many 'excuses' and 'hidden reasons' for why it's not OCD.

When someone that we care about has a problem we try to help them, but the problem gets compounded when the person doesn't even realize that anything is wrong.

In this case (OCD) it would probably be most advisable to bring it up with a relative or friend who has considerable influence on him (obviously with the sensitivity it deserves).

Many times relatives and friends don't know where to get the professional help / advice, so it might be a good idea to do some research of professionals in your area (that are Frum, and have experience in this specific area - if possible), and to pass it on to the friend / relative (if it seems appropriate at the time)

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An important point to consider is that people tend to judge behavior by community norms, and that a legitimate expression of halachic behavior can sometimes be misconstrued as aberrant. A person should exercise caution before potentially branding someone else with the stigma of a neurosis (especially if the person observing the behavior is not a Talmid Chacham or mental health professional). –  Fred Jan 1 '13 at 19:45
@Fred It's hard to construe repeating Poseiach es yadecha 20 times as Halachik behavior. And no one is 'branding' anyone. If one suspects a disorder one should speak about it privately with a qualified rabbi and psychologist to understand if there is a need to go forward. (This is true about all disorders, not just religious oriented ones.) –  Double AA Jan 1 '13 at 20:05
@DoubleAA Not everyone would draw the line in the same place. If someone is seen repeating poseach es yadecha twice, an observer might be sure that that guy has OCD. And the answerer did not suggest (as you did) to "speak about it privately with a qualified rabbi and psychologist to understand if there is a need to go forward." The answerer instead suggested to "bring it up with a relative or friend." –  Fred Jan 1 '13 at 20:39
@Fred But he did qualify that with 'if it seems appropriate'. There are no fixed rules about who to talk to. It requires some sechel and social awareness. (Again, nothing I'm saying is Jewish specific.) And the original OP was assuming the case is way out of proportion. –  Double AA Jan 1 '13 at 20:45
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Introductory Note of Clarification: Parts of the answer (below) that are critical, are not directed at the questioner, but rather to some people who jump to conclusions about whether another person has (or likely has) OCD - often based on faulty premises or a lack of context concerning the other individuals behaviors or perceived behaviors:

It is good that you note in your question examples that really stand out. There are halachos that require the individual to pronounce words a certain way and make the proper pauses so as not to change the meaning of what they are saying (see Hilchos K'riyas Shema, for example - Siman 61). An individual who had, in the past, been less familiar with the halachos concerning pronunciation, kavanah..., may be working on themselves to become accustomed to davening in accordance with halacha. For some people, this may take time and added energy. However, you would expect that the individual would get it right after a certain period of time. Another factor to consider is that in some minyanim, it is harder to have proper kavanah and pronounce the davening correctly due to other individuals in the minyan who daven loudly, in a way that really detracts from the kavanah of some congregants. If the person who "repeats" parts of the davening a-lot does not have such problems when davening alone in a quiet place, it may be better for that individual to daven in private. This is in accordance with the Sha'arei Teshuvah (Orach Chaim: 52: 1) who notes that if a person has difficulty with kavanah when davening with a minyan, they may daven alone.

Another matter to consider is that some people easily come to the conclusion that someone has OCD simply because they don't daven in the 25 minutes (or 45 minutes) that the minyan takes to complete Shacharis. If, as you note correctly, the person takes longer for reasons of kavanah or halacha, that certainly would not be a problem and assuming such a person has a problem of OCD would be incorrect.

There are some individuals who claim that a person who davens Shacharis for a substantially longer period than 25 minutes has OCD. This claim, for example, does not address tefillos that are recommended but that many people do not do (Ketores, Karbanos, Parshas HaMan...) as well as the halachos governing pronunciation and the fact that a person should daven slowly (rather than quickly) - b'nachas. In other words, the individual is not regularly repeating pesukim many times (as you noted), but is rather davening at a slower pace.

The main point is that some people recognize OCD for what it is, while others seem to jump at the "conclusion" that an individual is OCD if he does things that are viewed as OCD-like. Before speaking to people about a person "having OCD", it is important that this outside individual not have inappropriate criteria for what is and is not OCD. A person who is careful/scrupulous to follow halacha is certainly not OCD - that's absolutely absurd (even if he/she is following halacha where most other people are unaware of the halacha in the given case). First, make sure you are not incorrectly assuming an individual has OCD - as telling others about someone having OCD, when they do not could be Motzi Shem Ra (though unintended). If you want to help the person, the first step should be to not compulsively assume a person has OCD - in other words, make sure that you have truly objective criteria to determine whether OCD is involved AND that you understand the other person's situation properly - not coming to an incorrect conclusion.

If a person truly has OCD, try to help them in a way that avoids problems associated with Lashon Hara and Motzi Shem Ra - make sure you know the halachos as they apply directly to the specific situation you are trying to address.

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The OP never said Shacharit in 25 minutes is OCD. He did say that saying Poteich et Yadecha 20 times might be. Those are very different and I don't see why you need to attack a straw man here. What did the OP do wrong to deserve such (attempted but false) criticism? –  Double AA Jan 2 '13 at 6:49
@DoubleAA - As far as I can tell, the answerer did not accuse the OP of saying that; he was making a general point. (Maybe he was also alluding to the JA article to which you linked that suggested that Shacharis ought to take 25 minutes). –  Fred Jan 2 '13 at 7:07
@Fred This answer does spends time at its beginning critiquing the examples in the question (though you are right he does not claim that 25 min was there) but that sets the tone for his final comments. | The article did not suggest that more than 25 min was OCD; only 3 hrs. It didn't specify that it wasn't only referring to the Amida (I suspect it was). And it also states the reason was bad kavanot not extra parts or slow speech (as this answer posits). Even Chasidim Rishonim only spent an hour, and there are few people alive who I'd even begin to begin to have a hava amina are on that level. –  Double AA Jan 2 '13 at 7:17
@DoubleAA The article specifies "morning prayers", so I can understand how someone could think it is not referring solely to the Amida. But let's not get bogged down. The answerer agreed with the more specific and extreme examples in the OP. I read this answer as essentially cautionary rather than critical. –  Fred Jan 2 '13 at 7:37
@Fred Perhaps you are right. TorasEMES613 if Fred's read is correct, I encourage you to edit parts of the answer (mostly first and second-to-last paragraph) to further clarify, as Fred said, that you are being cautionary not critical. –  Double AA Jan 2 '13 at 8:17
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There is a distinct difference between suffering from OCD and being religiously meticulous. Someone repeating words in prayer over and over again is not fulfilling the requirement to pray, and is very likely violating the prohibition of saying G-d's name in vain. Someone who is washing over and over again is in danger of hurting his or her hands and could possibly put him or herself at risk of infection due to dried out and broken skin. While it is always a good idea to take into account a person's overall mental health and religious sensitivities, as well as general personality and how one might react to suggestions of seeking mental health services, there is no special need to be sensitive to a person's scrupulous observance of religious rules when the actions in question are not in accordance with the rules or are not improving upon the observance of the rules. If someone needs help, then the person needs help. Period.

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Exactly. I agree. The distinction is necessary. If a person repeats Hashem's Name contrary to halacha - or violates halacha otherwise due to feeling a need to do so, that may indicate a problem - particularly if a person does this regularly for an extended period of time (e.g., over the period of a few years, for example). When judging whether a person is acting contrary to halacha, it is important that the person doing the "judging" be familiar with the halacha to know whether the other individual is acting in line with any halachically acceptable psak. –  Toras EMES 613 Jan 2 '13 at 19:38
Context is also important - e.g., a person may think they see a problematic behavior engaged by another person but are incorrect due to lack of context. –  Toras EMES 613 Jan 2 '13 at 19:39
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