Obsessive. Compulsive. And Orthodox.

Alone in my living room, I took three steps backward, then three steps forward in preparation for the Shmoneh Esrei, part of the afternoon prayer service. As I began to recite the first blessing, an image came to mind, unbidden: a Renaissance-era depiction of Jesus.

What was this picture doing in my head? I’m an Orthodox Jew. I don’t believe in Jesus—I never have. Why did this picture, of all things, come to mind while I was trying to address G-d?

It wasn’t the first time an image came to my mind during the prayer service. The previous week, I suffered through images of a golden Buddha and Michelangelo’s anthropomorphized G-d touching his forefinger to Adam’s on the ceiling of the Sistine Chapel. Feelings of shame replaced the calm with which I had begun my prayers.

I wish I’d known then what I know now: Those images didn’t represent a spiritual crisis or a personal failing. They were a manifestation of my OCD, a psychological condition that may have a distinctive presentation in Orthodox Jews and one that I’d been struggling with for years, even before I became observant.

***

Four years earlier, I’d been having trouble sleeping, and during my waking hours I vacillated between the verge of hysteria and a strange apathy. While I did not want to kill myself, I woke up each day with disappointment, and thought: Wouldn’t it be easier to not wake up? At the moment the darkness threatened to completely overtake me, I had gone to my university’s campus health office and requested a psychological exam.

When the therapist told me I was experiencing “moderate depression,” I welcomed the news as the first step to treatment. But I almost missed his follow-up comment. “You also seem to have a touch of OCD.”

He explained that some of my habits—checking and rechecking whether I’d taken prescribed medicine on schedule, rearranging items in a room or on a table until positioned precisely parallel to their edges—were indicative of Obsessive Compulsive Disorder. But he also assured me that my OCD was “subclinical,” meaning that my symptoms didn’t appear to intrude on my ability to function. I needed to treat my depression, he said, but not the OCD.

The therapist sent me for a psychiatric consult, where I received a prescription. Within weeks, my moods started to even out, but this touch of OCD remained untreated.

When I mentioned the OCD diagnosis to my twin sister over the phone, she snorted. “You didn’t know that already?”

I didn’t.

“Remember how many times a day you’d wash your hands when we were kids?” she said. “And all that tooth-brushing … normal people don’t brush their teeth more than twice a day, you know.”

I’d never thought of the tooth-brushing as weird, but then my sister added, “And I caught you checking knobs—you know, doorknobs and the knobs on the stovetop. That was always strange, too.”

I hung up feeling rather silly. Apparently, I’d been acting “off” for many years but never noticed it. Had the psychologist not pointed it out, I would never have questioned these behaviors. I felt comforted, though, by his assertion that the level of my OCD was “subclinical,” and as months passed and so did my depression, I learned to cope with the compulsions my sister had mentioned, too.

Whenever I sat up in bed, convinced I’d forgotten to switch off the oven, or whenever I reached the car and wanted to double back to check that I’d locked the front door, I told myself: “Checking once is normal, checking more than once is OCD.”

Reminding myself that “normal people” brush their teeth in the morning and at bedtime, I stopped brushing my teeth in between those times. If I felt the impulse to wash my hands, I only gave in if I could identify a rational reason to do so—I had just used the restroom, blown my nose, touched a sticky jar of peanut butter—and not if my hands just “felt dirty.”

Over the years, most of my compulsions faded, and I patted myself on the back. But OCD is made up of obsessions as well as compulsions. Some of my thoughts were just weird, and others were downright scary. While speaking to a loved one, a strange, dispassionate corner of my mind would wonder what would happen if they died tomorrow. If I stood on a street corner, waiting for the walk signal, that same remote corner of my mind would wonder what would happen if I stepped off the curb during the red light. I worried constantly about relationships, bills, all sorts of things. In order to soothe myself, I would count bathroom tiles, ceiling tiles in my classroom, or the planks of wood on our hardwood floor. I checked rugs for symmetry, copied my notes until they looked “perfect.” Something told me that these behaviors were really no different than all the tooth-brushing and knob-checking, but they made me feel more in control—and they were much less noticeable.

***

In the months after the Renaissance-era Jesus appeared to me in my living room, pictures of saints, goddesses, and temples interrupted my quiet prayers at home more and more frequently. However, I still didn’t think of them as a mental health problem. No one had ever mentioned to me that my OCD could affect my practice of Judaism, nor that when I became observant, I should watch out for exacerbated symptoms.

The strange pictures in my head remained my secret. I was afraid what my new husband, my friends, or fellow congregants would think of me. And, at first, they only appeared while I was at home.

Then, one day, I stood in synagogue, ready to begin my Shmoneh Esrei. Three steps back, three steps forward.

Again, uninvited images crept into my mind while praying. Tears sprang to my eyes. I knew that nobody could see the pictures in my head, but I felt humiliated just the same.

All around me, the other women were rocking, swaying, or tapping to the rhythms of their silent prayers. Even before I became observant, I was a “davener,” a person who liked to both pray in synagogue and quietly share my troubles and triumphs with G-d throughout the day. But that day, I found no enjoyment in prayer. The pictures in my head had unplugged me from my Source.

Should I sit down? Should I start over? Would the pictures just come back?

Unsure, I stood still, waiting for the cantor to begin the repetition of the prayer aloud. I wondered if people noticed I wasn’t praying. I wondered if my bad thoughts came from a bad place deep inside me. I wondered if deep down, I was a bad Jew.

Later, I mentioned to my husband that I’d been having trouble while praying.

“Everyone has problems praying, Honey. Your mind wanders, you get distracted.”

“This is different,” I insisted.

My husband looked at me attentively, expecting more detail.

Feeling relieved that he was taking me seriously, I licked my lips and went on. “I see … I see … pictures, I see them when I pray. The pictures … they’re terrible.” I trailed off. I couldn’t tell him what the pictures were. I was too ashamed.

He told me it was OK, that I was normal. He told me he loved me and offered a little advice to help me maintain focus while I pray. But still, I worried what he would think if he knew what was going on inside my head.

I started to avoid saying Shmoneh Esrei. Instead, I said many Psalms. I prayed informally throughout the day, asking G-d to making everything OK. I slipped a steady stream of change into our tzedakah box. I wanted to be a good Jew.

***

Not long after that, I sat down on a Shabbos afternoon to read an article by Rabbi Dr. Abraham Twerski. Descended from a line of Hasidim, Twerski is a noted psychiatrist and lecturer on mental health issues. He turned to the topic of “intrusive thinking.” Sometimes, he explained, people have thoughts that come to their minds seemingly out of nowhere, uninvited. Indeed, the thoughts might be downright revolting to the sufferer. Their self-esteem might falter as they wonder, “What kind of person am I that would have such a thought?”

While even neurotypical people can have intrusive thoughts, Twerski said, in people with Obsessive Compulsive Disorder, they can cause the sufferer to start avoiding trigger situations (phobias) or to counter the thoughts with rituals they believe will fix them (compulsions). Sometimes, Twerski mentioned, they even creep into the mind during prayer.

A bell went off in my head. Had all the images of Jesus and Buddha that had appeared in my head during Shmoneh Esrei been part of my OCD, just like the previous thoughts about stepping off the curb, driving off exit ramps, and so on?

Twerski went on to assert that no one should feel guilty for these thoughts. Instead, a sufferer should just calmly note them and label them: “That’s an OCD thought. I can ignore it.”

After Shabbos, I read up on intrusive thinking. When OCD behaviors reflect a patient’s religious beliefs, but in a dysfunctional way, it’s called scrupulosity. Scrupulosity was one of the first forms of OCD to be identified, and it’s not confined to Jews. Just as someone Jewish might fixate on possible dairy contamination of meat dishes even when assured by a rabbi that no such contamination exists, someone who is Catholic might repeat the rosary over and over because they believe they haven’t yet “said it right,” or someone Muslim might fear they have not adjusted their hijab properly.

Twerski’s advice was echoed in the additional articles I read. Other ideas were provided, as well: picturing an eraser rubbing out the offending image or thought whenever it popped into my head, or planning a series of replacement thoughts to counter the negative ones with when they appeared. I was not to beat myself up for the content of these thoughts. They were no reflection upon me as a person.

I tried these interventions, and—mercifully—they worked. Whenever a picture of Vishnu or a saint would appear during prayer, I’d pause, say, “This is OK. It’s just an OCD thought. I can ignore it,” and mentally erase it. My husband had suggested that I imagine my prayers flying up to Heaven like smoke rising from the altar in the Temple in Jerusalem. That image comforted me, inspired my prayers. At home, I often prayed while standing opposite a picture of the Second Temple.

In addition to these strategies, I began to work on my Hebrew skills. I found it easier to focus on the correct words and images if I understood the language of the prayers I was reciting more accurately. Prayer once again became a source of joy and spiritual sustenance.

***

While I still have issues relating to my OCD, it no longer affects my prayers. Today, my struggles with prayer are the more quotidian sort that frustrate every Orthodox Jew: remaining focused on the words and not my to-do list, for example, or finding time to pray when I have a child home sick or a pressing appointment in the morning.

Occasionally, I’ve needed professional help in order to combat my fear and anxiety, but ironically, when scrupulosity rears its ugly head, I’ve discovered that the most effective treatment is to tap into a very Orthodox resource: halakhah, the code of Jewish law. There’s an expression in the Mishnah, “Talmidei chachamim marbei shalom b’olam,” which translates as, “Wise students [of Torah] increase peace in the universe.” Relying on someone else’s judgment—that of a rabbi or a female teacher with expertise in Jewish law—instead of my own keeps me from crossing the line from “normal concern” into full-fledged obsession.

Case in point: When Passover comes around, I occasionally hear myself and others talking about chometz—leavened products prohibited during Passover—as if microscopic amounts have contaminated everything in our homes. Cleaning for the holiday can easily pass from an uplifting spiritual experience into a nightmare of intrusive thinking, obsession, and compulsion. In order to keep myself sane, I review the rules of Passover preparation every year and ask my rabbi any remaining questions. I let go of any thoughts that tell me to clean more than he says is necessary.

Similar situations can occur when dealing with other areas of Orthodox observance—kashrus, mikvah, modest dress. When I hear friends drifting into the irrational, I tell them to turn to their teachers for guidance. If I tried to tell them that they might have a mental health problem, they’d probably ignore me—and likely be offended.

Whatever “strange” thoughts people with OCD have, we don’t have to let them control our lives. They don’t make us bad people or crazy. And they certainly don’t make us bad Jews.

***

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Rebecca Klempner is a wife, mother, and writer in Los Angeles.