Colts’ Braden Smith Speaks About Scrupulosity OCD: What it is, and how to treat it

In a powerful new interview with the Indianapolis Star, Colts offensive tackle Braden Smith opened up about a long-hidden struggle—not with football or physical injury, but with scrupulosity OCD, a lesser-known and deeply distressing form of obsessive-compulsive disorder.

Smith’s story mirrors what we often see in our clinical work at Anxiety and Behavioral Health Psychotherapy, where we specialize in treating OCD in its many forms—including the complex moral and religious obsessions that define scrupulosity.

While fans saw Smith battling back from a knee injury in 2023, few knew he was also facing daily intrusive thoughts about sin, morality, and punishment—hallmarks of religious OCD that had haunted him since childhood.

“I just thought I had to live with this,” Smith said. “I thought it was just me being crazy.”

His experience sheds much-needed light on a misunderstood condition—and points to the power of effective, evidence-based treatment.

Braden Smith has Scrupulosity OCD. What is it?

Scrupulosity is a subtype of OCD that centers on obsessive fears about being immoral,

unethical, or spiritually “unclean.” For religious individuals, this can involve overwhelming anxiety about sinning, going to hell, or disappointing God. But even those without religious backgrounds can struggle with moral scrupulosity—fearing they’ve hurt someone, told a lie, or violated a personal code of ethics.

At our practice, we've worked with clients who were paralyzed by doubt over whether they were “good enough,” obsessively reviewed conversations to make sure they didn’t lie, or avoided helping others out of fear that their motives weren't pure. Just like Smith, many feel isolated and afraid to speak up.

Why Scrupulosity Is So Difficult to Treat

What makes scrupulosity especially hard to treat is how closely it’s tied to a person’s core values. Whether rooted in religious faith or a desire to be a good person, these fears often feel morally justified—even when they are driven by OCD.

For example, a person might feel compelled to repeat a prayer over and over, terrified that saying it incorrectly could anger God. Another might avoid helping a friend in need because they fear their intentions are selfish—then obsess for days about whether that was the “right” choice.

These internal battles create tremendous distress, and yet many people delay seeking help.

We frequently see clients who’ve gone years misdiagnosed or misunderstood—even by well-meaning therapists unfamiliar with OCD subtypes.

The Role of ERP: Exposure and Response Prevention

The gold-standard treatment for scrupulosity is Exposure and Response Prevention (ERP), a form of cognitive-behavioral therapy that teaches people to face their fears without performing compulsions. In ERP, a person gradually exposes themselves to the feared thought (e.g., not confessing a perceived sin) while resisting the urge to seek reassurance, repeat a ritual, or mentally analyze their guilt.

As clinicians trained specifically in ERP, we help clients sit with uncertainty and discomfort—not because their fears are valid, but because learning to tolerate doubt is how OCD loses its grip. For scrupulosity, this can be particularly tricky, and it requires both clinical skill and deep sensitivity to the client’s belief system. That’s where expertise matters.

Scrupulosity Isn’t Always Religious

Although Smith’s story focuses on religious OCD, scrupulosity also shows up in non-religious forms, such as:

Fears of being dishonest or unethical
Obsessions about being a bad partner, friend, or citizen
Compulsions to confess “bad” thoughts or intentions
Constant checking of past behavior for moral wrongdoing

Many of the clients we work with are surprised to discover that their exhausting mental patterns are actually a form of OCD. They often say things like, “I thought I was just overthinking everything,” or “I didn’t know this was treatable.”

You’re Not Alone—And You Don’t Have to Stay Stuck

If Braden Smith’s story resonates with you, you’re not alone—and more importantly, you don’t have to stay stuck.

At Anxiety and Behavioral Health Psychotherapy, we’ve helped hundreds of individuals navigate the complexities of scrupulosity and OCD. Our clinicians are highly trained in ERP and other evidence-based interventions, and we understand how nuanced and emotionally charged these themes can be.

We provide telehealth therapy in multiple states, making it easier than ever to access expert OCD care—no matter where you are.

Could You Be Experiencing Scrupulosity?

You might benefit from working with an OCD specialist if:

You obsess about sinning, being punished by God, or going to hell
You constantly replay past behavior to make sure you were “good”
You fear having wrong intentions or “bad” thoughts
You feel compelled to confess, seek reassurance, or perform rituals to feel okay
You feel like your brain never lets you rest—even when you’ve done nothing wrong

Get Help from Clinicians Who Understand OCD and Scrupulosity

Our mission is simple: help people stop living in fear and start reconnecting with their values in a healthy, meaningful way. Whether you're dealing with religious OCD, moral OCD, or any other form of obsessive thinking, our team is here to support you with compassion, expertise, and the tools that work.

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