Pastoring the Scrupulous Conscience

Abstract: Michael Lawrence helps pastors think carefully about how to minister to those with a scrupulous conscience. Both physical and spiritual factors may be affecting those who experience unusual levels of guilt, fear, and anxiety regarding their spiritual state, and pastors are encouraged to deal gently with them, pointing them to the truths of Scripture; praying with and for them; and bringing along other church members who can speak the truth to them in love.

The young man sitting in my office was clearly in distress and had come to me for help. He was convinced that he’d committed the “unforgivable sin of blaspheming the Holy Spirit,” which Jesus refers to in Matthew 12:30–32. When I asked why he thought he had done such a thing, he told me the thought had entered his mind, and he simply could not escape it. I gently suggested that those who had actually blasphemed the Spirit were unlikely to be concerned about it. He acknowledged this but could find no relief for himself. It was at this point that he told me a mental health professional had given him a diagnosis of “scrupulosity.” I had never heard of the term. But as I learned more about it, I realized I had encountered it often, and so had others.

In his book Precious Remedies Against Satan’s Devices, Puritan pastor Thomas Brooks addresses a panoply of pastoral counseling cases, including one he called a “sad, doubting, questioning, and uncomfortable condition.” What he had in mind were people whose consciences were wracked with guilt over sin, real or imagined, that left them in despair. While many causes could give rise to this, one was clearly what we would call an over-scrupulous conscience. Brooks described his counselees as those who “mind their sins more than their Savior,” those who “make false definitions of their graces,” and those who are convinced that “their graces are not true but counterfeit.” That is to say, their conscience either sees sin where there is no sin or fails to see the grace for sin that is theirs through faith in Jesus Christ.

Examples abound. The teenager who’s never sure their repentance was sincere enough and so confesses the same sin repeatedly in their nightly prayers. The child who’s never sure their profession of faith was genuine and so prays the sinner’s prayer for the umpteenth time. The missionary who’s paralyzed in his ministry lest he say something wrong that obscures the gospel he came to preach. The mom who’s convinced that her own failings are irredeemably damaging her children and only finds temporary relief from her guilt in their good behavior. These are just a few of the overly scrupulous consciences I’ve encountered. But they stand in good company. A young Martin Luther wearied his pastor so much with prolonged, detailed, and repeated confessions that his pastor finally told him to become a Bible professor, as if to say, “Physician, heal thyself!”

As pastors, how do we help those who suffer from an overly scrupulous conscience? Puritan pastors like Thomas Brooks, Richard Baxter, and Richard Sibbes, among others, wrote hundreds of pages on cases of a conscience like this. So what follows is not meant to be exhaustive and definitive, but suggestive and directional. I want to suggest two categories to explore, three resources to employ, and one posture to adopt.

Two Categories to Explore 

Fundamental to any biblical anthropology is a conviction that human beings are embodied souls. We are not Gnostics, who think the body does not matter. Nor are we materialists, who deny the reality of our spiritual nature. Some creatures that God has made are essentially one or the other. Angels are spiritual beings. My dog Hektor is alive but lacks an intelligent soul. But human beings uniquely possess both. And while body and soul are distinct, in this life, they are never separate. What happens to the body affects the soul, and what happens to the soul affects the body. Psalm 88 powerfully illustrates this. The author is clearly depressed, and it affects his body. He is like one without strength, abandoned among the dead, like the slain lying in the grave (vv. 4–5). But it also affects him spiritually and emotionally. A sense of God’s wrath weighs on him (v. 7). He feels alone, rejected, and abandoned, not only by his friends, but by God himself (vv. 8, 14). Thomas Brooks’s “sad, doubting, questioning, and uncomfortable condition” is simultaneously a spiritual and bodily experience, and we should address both categories of that experience.

This means that as pastors, we should never hesitate or fear to ask if they’ve talked with a medical doctor about what they’re experiencing. Some people suffering from overly scrupulous consciences are experiencing intrusive or perseverating thoughts and may resort to repetitive, ritualistic prayers or activities in a search for relief from their distress. These physical acts can even become compulsive, disrupting sleep and normal daily life. While no medicine can “cure” an overly scrupulous conscience, in some cases, there are medications that can help a person reassert control over what feels like thoughts and rituals that are controlling them. A doctor may also be able to help with issues that could be exacerbating their distress, like poor sleep or nutrition. It’s well known that when people came to him for counsel, Martyn Lloyd-Jones, a former medical doctor, almost always started by making sure they were getting sleep, nutrition, and exercise. If the body is not well, the soul will feel it. So don’t forget to ask about it.

But we’re not just bodies, we’re also souls, and dealing with the troubled conscience, especially an overly sensitive one, requires us to pay close attention to spiritual categories like sin and doubt, repentance and faith. These are things that pastors are deeply familiar with, but in this case, an extra level of care is warranted. While the overly scrupulous often present the same—lack of assurance, a weight of unrelievable guilt, intrusive thoughts, and a restless, compulsive search for relief—not every instance of “scrupulosity” is the same. Brooks lists no less than eight “devices” or causes that the enemy employs to bring Christians into this “sad condition.” Several of them do not involve sin at all, but rather misunderstandings about the nature of providence, the nature of sanctification, or the role of emotions in the Christian life. For Brooks, each separate cause suggests one or more specifically tailored “remedies,” or pastoral responses. Just as hay fever requires an antihistamine rather than an antipyretic, different causes of scrupulosity require different spiritual remedies. While it may be tempting to tell the overly scrupulous to repent and leave it in God’s hands, such counsel might make their suffering worse by leaving the root cause entirely unaddressed. As pastors, our calling is the spiritual care of souls. We don’t want to commit spiritual malpractice. Bringing relief to the overly scrupulous requires us to do more than the pastoral equivalent of “take two aspirin and call me in the morning.” We need to take time to carefully diagnose the causes for the specific person under our care.

Three Resources to Employ 

What resources can we bring to bear to help the overly sensitive conscience? I want to highlight three means of grace that the scrupulous conscience needs.

Scripture 

Paul reminds Timothy that all Scripture is “profitable for teaching, for rebuking, for correcting, for training in righteousness,” and at least three of those uses, if not all four, are appropriate for the overly scrupulous. As he treated various cases of conscience, Thomas Brooks repeatedly turned to the Scriptures, not least because he understood that underneath and behind the wrong thinking about their relationship to God, the overly scrupulous were believing lies about God and themselves. Both distorted theology and anthropology needed to be corrected if comfort was to be received.

For example, to those who thought more of their sin than their Savior, he reminds them that though “Christ in this life will not free any believer from the presence of any one sin, he doth free every believer from the damning power of every sin.” Then he grounds that remedy in Romans 8:1, “There is no condemnation to them that are in Christ Jesus, who walk not after the flesh, but after the Spirit.”

We need to be quick to turn to the Scriptures with the overly scrupulous, not simply to comfort them but to correct their distorted views and remind them of the truths Scripture reveals about God, themselves, and the gospel. That way, when the lies of Satan and their own conscience assert themselves, they can counter those lies with truth.

At the same time, we need to be wise in the use of Scripture. The overly scrupulous can easily take the instruction offered and twist it into further proof of their doubts or turn it into another mechanistic means of relief that ultimately fails. It’s helpful at this point to remember that, ultimately, the Scriptures reveal not a system of truths, but the person of Jesus Christ, crucified and risen for sinners. Sometimes, the best use of Scripture will not be to correct false thinking, but to direct them to the rest that’s found in the arms of Jesus.

In our preaching ministry, we need to remember that for every hardened conscience sitting in the pew, there’s at least one sensitive conscience, if not several, sitting next to them. So often our sermon applications lean toward correction and exhortation, perhaps because we’re preaching to ourselves. But the overly scrupulous conscience hears our exhortation as condemnation and further proof that they are not right with God. Jesus said, “My yoke is easy and my burden is light” (Matt. 11:30). We want to make sure that the overly sensitive conscience walks away from our sermons convinced that’s true.

Prayer 

To whatever extent “scrupulosity” is a malfunction of the brain, medical remedies can help. But to whatever extent it is a spiritual affliction, whether of unbelief or Satanic attack, we must avail ourselves of the Spirit’s aid. One of the sad byproducts of the overly sensitive conscience is that the sufferer feels either that they cannot approach God in prayer, or they turn prayer into a mechanistic, ritualistic, and repetitive exercise. Either way, faith is lacking, and James reminds us that prayers offered without faith are not answered (Jas. 1:6–7). So it is especially important that we not only pray for but also with those who suffer in this way. And when we pray, we want to pray not only for comfort and relief, but for faith, for light, and for protection. Pray for faith to trust the gospel; pray for the light of truth to dispel distorted thinking and lies; pray that the enemy would not find a foothold.

The Church 

The path to spiritual health for the overly scrupulous is long. The combination of deeply rooted lies and deeply ingrained compulsions is not quickly overcome. There will be many relapses along the way, and unexpected situations will trigger, or at least threaten to resurrect, old patterns of thinking and behaving. For this reason, the burden of “pastoring” the scrupulous cannot fall on just one counselor, pastor, or friend. The whole church is needed. So pull together a team of mature believers who can regularly but gently remind the sufferer of the truths of the gospel. Pull in friends or church members with expertise in mental health care as well as spiritual soul care. Include people whose main role is to help the suffering saint carry on with normal life. Simply having someone to take a daily walk or engage in a hobby with can be very helpful for the person paralyzed by guilt over what they may or may not have sinfully done. Trapped in their heads, they need friends who can help them escape the endless loop by simply reconnecting with their body. No one person can do all of this. It takes the whole church to do the work of the church, as “speaking the truth in love,” we “grow in every way into him who is the head—Christ” (Eph. 4:15).

One Posture to Adopt 

As I sat and listened to the young man in distress before me that day, and as I began to reason with him out of the Scriptures, I confess that what I felt rising within me was frustration and impatience. No matter what I said, no matter what Scripture I brought to bear, his scrupulosity had an objection. It was as if he were invincible to the comfort of the gospel. And so I began to pray for compassion, patience, and a willingness to listen. All those things were important. But as I continued to work with him over the ensuing months, what I realized I needed most was to adopt a posture of gentle but joyfully confident faith. Faith for him that he was safe and forgiven, even though he didn’t feel like he was. Faith that the gospel was true for him, even though he thought it was only true for others. Faith that Jesus loved him, even delighted in him, even though he was convinced otherwise. Faith that grace was evident in his life, even though all he could see was his sin.

The sad irony of the overly scrupulous Christian is that they see in themselves what should drive them to Christ, and that’s their sin. And yet it drives them away. As pastors, we labor week in and week out to get people to take their sin more seriously, to see what they don’t want to see. The scrupulous see it all too well, and then some. But that’s all they see. And yet, as Richard Sibbes so famously put it, “There is more grace in Christ than sin in thee.” As a pastor, you will need to instruct and correct and exhort. But most of all, adopt a posture that lets them see Jesus in you, so that slowly but surely they will come to see Jesus, “full of grace and truth,” for them (John 1:16–17).