This article presents clinical work with an ecclesiogenic neurosis and difficulties encountered by therapists working with very religious patients . In contrast to a few studies of this topic Author draws attention to the need to take into account the difference between conscience and superego for the effectiveness of such therapy. The article focuses on the presentation of theoretical grounds for distinguishing between conscience and superego , not only from an interdisciplinary perspective of theology, philosophy and psychology , but also within contemporary psychoanalysis. Clinical cases described in this article demonstrate effective and ineffective strategies of work with an ecclesiogenic neurosis in case of conflict between sexuological and theological norms of evaluation of masturbation.. Article will present phenomenological differentiational criteria of conscience and superego in clinical context. Effective work with an ecclesiogenic neurosis have to distinguish not only inner conflict and defence against it and the structure of the God image but also conflict between conscience and superego and a more differentiated approach to guilt.