Treating Spiritual Sickness

In treating mental health conditions, are psychotherapy and medications enough to do the job? In our discussion on this subject last week, some suggested that there may even be another dimension of care needed: a spiritual dimension. Perhaps it is possible to be psychologically healthy, yet spiritually sickened, even dead? Obsessive compulsive disorder and one of its manifestations—scrupulosity—is a vexing condition for therapists and psychiatrists to treat. I have written a book on this subject, and was extremely surprised one day to hear that John Cardinal O'Connor had used it as the basis for a sermon at St. Patrick's. Cardinal O'Connor went beyond the talking, behavioral, and psychopharmacological therapies I had evaluated in the book:

Dr. Van Ornum did a survey of an organization that you might not know ever existed called “Scrupulous Anonymous.” It is much like Alcoholics Anonymous or Over-Eaters Anonymous. He received replies from a thousand people and discovered and verified everything that he had learned in his work. They depicted immense suffering and anguish caused by scrupulosity. This is not limited to those of us who are ordinary people. A number of the saints had problems with scrupulosity: the great St. Catherine, St. Alphonsus of Liguori, even St. Ignatius who founded the Jesuits.

This gives us one of the fundamental causes for scrupulosity. It itself is a horrifying condition, the belief that we are intrinsically no good. We may be considered the most brilliant people in the world, the most handsome people, the most beautiful people, the most talented people, but beneath the surface we feel we are no good. Therefore everything we do is evil and sinful. It does not matter how much praise we get. We are convinced that we are absolutely useless. Not only that nobody loves us, but that we are incapable of being loved for ourselves as persons. It is the thought, “If anybody knew what I am really like inside then that person would hate me, even God.”

What could this [book] possibly have to do with today’s extraordinary Gospel [Jn. 4:5-42] about the Samaritan woman, the woman who had been “married five times but had never really been married”? To her our Lord says, “The man you are living with now is not your husband.” What would that have to do with scrupulosity?

In this Gospel, we find that this woman does things that scrupulous people do with Almighty God–she plays games with the Lord. She tries to fence with him. “You are a Jew and I am a Samaritan. How come you are even talking to me? Jews are not to talk to Samaritans.” Ah, if you knew who it is who is talking to you! “Give me some water,” Jesus says. She says, “You want me to use my bucket to get water? Jews are not supposed to drink water out of a bucket that belongs to a Samaritan.” And so on. She was avoiding the issues, avoiding the fact that she has lived with five or six men, avoiding the fact that our Divine Lord is confronting her with the truth. But what is the truth with which he is confronting her? With his love, with his mercy, with his compassion. Initially, she thinks she is beyond that.

Then suddenly, because of our Lord’s great grace and mercy, it hits her. She runs to tell all the other people, “I have found the Messiah!” Because of things that our Lord said to her, because of his word, she believed she had found the Messiah. This is of the very nature of our Divine Lord and this is what Lent is all about.

This Gospel is the perfect summary of Lent–an encounter with Christ in which ultimately we are moved toward pleading for his forgiveness because we know that he has come to suffer and to die for us and that the God who gave his Son to be so horribly tortured and put to death for us is the same God who does not want to see us lost. Christ came to pick up the pieces of broken lives, your life and my life–not to condemn us. But he wants us to ask his forgiveness, in the confessional if this is necessary, outside the confessional if that is adequate. We are not going to ask forgiveness unless we believe we need forgiveness and unless we believe he will grant forgiveness.

This story is the great reminder that God is love, that love drives out fear. If there be any here who are afraid, whether victims of the spiritual disease of scrupulosity or not, if there are any here who are afraid, it is our Divine Lord himself who says to us as, in essence, he would say to the Samaritan woman, Be not afraid. God is love. God drives out fear. Come to me for my mercy. Come to me to be bathed in my love.'

Cardinal O'Connor was later kind enough to write a Foreword to my book. There he notes how difficult it can be to weave together the respective contributions of psychology and spirituality when working in the mental health field:

Psychiatrist Robert Coles of Harvard University expresses understandable perplexity that so many officials of so many churches refer their clergy for therapy instead of turning to the spiritual or sacramental resources within religion itself. I can testify to the phenomenon but am not surprised by it. As one with a certain background in clinical psychology and psychiatry combined with more than fifty years of active priesthood, I am most grateful for what these sciences do offer, quite aware that neither faith nor theology is an adequate substitute when psychology or psychiatry is essential. The reverse of that truism, of course, is equally important.

Part of what I hope to do with my essays for "In All Things" is to start a conversation between the fields of psychology and spirituality. Thanks to all our readers and respondents for helping to keep this conversation going.

William Van Ornum

 

Shannon Mckenna
5 years 10 months ago
After reading this blog, I can see how getting in touch with one’s spiritual side can help with a psychological disorder.  Naturally when one thinks about curing a psychological disorder they rely on talking to a therapist or being prescribed medication.  However, in the busy society we live in today, spirituality is often overlooked.  When we need a cure for something we find the quickest and easiest way to obtain it, and don’t realize that there may be other, less expensive ways to help.  Although talk therapy and the use of medications are effective, getting in touch with God and therefore feeling unconditional love is priceless. 
In response to the belief that people are scrupulous, meaning they feel guilty about moral and religious issues, the initial idea that it is a psychological disorder which requires psychological care is not always best.  Getting in touch with one’s spiritual side may be the answer.  People need to feel unconditional love and believe that others genuinely care for them and what they are going through.  Asking God for the answer and simply attending church are much better alternatives to the “right here, right now” society we live.  If people would just relax and take the time to go to church, they may feel less stressed out and therefore heal their mind, body and soul. God is love and love drives out fear. 
Katrina Ferrer
5 years 10 months ago
This is an absolutely essential article. The balance and combined use of spiritual and psychological solutions should be a staple int the life of the priest and psychologist. As no problem of the human condition is one sided, there is never an appropriate time to attack a problem only from a single vantage point.
It is just as the article states at the beginning, one can be spiritually sound but psychologically lost, or the contrary, psychologically intact but spiritually vacant. The battle for out minds and our very souls cannot be fought with one objective in mind, just as any other battle we face cannot be fought with only one tactic.
we vnornm
5 years 11 months ago
Ed and Peg #13:

Thank you for your ministry. I am sure there is a special place in heaven for you. amdg, bill
we vnornm
5 years 11 months ago
David,

Perhaps click the link for Cardinal O'Connor's sermon where definition and many examples of scrupulosoity are given. "Scientific" behavior therapy and/or medication have a varied (not 100%) therapeutic response in between 50-80% of cases and I don't think we have seen huge increases in this efficacy since the early 1990s. So these therapies need to become more effective (or, will they?) and perhps some "spirituality" is needed.  John's Gospel reading as explained by Cardinal O'Connor (I'm not able to be more eloquent than he) is the operational defintion of spirituality I am pointing to here. You are right to point out that on the surface some of this may appear as "niceness" but I think it is much deeper. thanks, bill
Lynde Kayser
5 years 11 months ago
Despite three years as a psychology major, I had never given much thought to the relationship between psychology and spirituality.  This topic had never been discussed in my psychology classes and I see now that it is an important aspect of personality that warrants consideration.  An individual’s spirituality or religious affiliation plays a large role in their sense of identity and acts as another facet of life to be considered by psychologists. 
In terms of scrupulosity, there is an evident relationship between spirituality and psychology.  Like Kayna’s posting, I found the description of scrupulosity much like that of body dysmorphic disorder (BDD).  People with BDD have obsessive thoughts about a perceived deficit in their body image.  This is much like the perceived personality deficit perceived by individuals suffering from scrupulosity.
A 2005 study entitled “Scrupulosity in patients with obsessive compulsive disorder: relationship to clinical and cognitive phenomena” investigated the relationship between religious affiliation and scrupulosity.  Results found that Protestant participants had a significantly higher number of scrupulous people than those without a religious affiliation.  Results also showed that scrupulosity in Catholics was significantly higher than that of Protestant participants. 
Christine Castellana
5 years 11 months ago
I think that too often psychology is considered to be a completely separate thing from spirituality or religion. I think they are inter-connected because to be both psychologically AND spiritually healthy are comprised of the same components.  These components include faith, stability, balance, living in harmony with others, etc.   I think that even people who are not religious need to have faith in themselves at least in order to succeed and overcome obstacles.  I also think that we all truly want the same things out of life like happiness and love.  Even someone who is afraid of love and shuns it deep down really wants it.

For some people, normal therapy may be enough, but for others, a spiritual kind of therapy may need to take place.  Personally, I think I would benefit from some spiritual counseling!  It can be a very positive thing.  Unfortunately, nowadays, kids my age associate religion with evil brainwashers and they think everyone who goes to Church must be a "jesus freak."  It is now almost embarrassing to admit if you go to Church sometimes, or people are shocked if you are in your 20s and still go. 

I think if spiritual therapy were talked about more, people could see it in a more positive light and realize that anyone could benefit. I also want to make a shout out to Jaclyn (#28), because she describes exactly what I think and offers a good example. 

And for the record, I think there needs to be more of a distinction between spirituality and religion.  Many people consider themselves spiritual but are not part of any religion.  I relate to this in a way.  I was raised Catholic and a lot of the things that I learned stuck with me, so it serves as a basis for my spirituality, but when someone asks me what my religion is, I hesitate to say Catholic because I do not go to Church anymore and I feel like I must be a bad Catholic for that.  In reality, I am actually a good person; I pray, I put others before me, I help people, I appreciate everything that I have, etc.  I truly consider myself to be a good person, except I resent not really having a religion anymore because I think it would make me more mentally healthy than I already am. This is something for me to explore and I am hoping that others will as well.

Thanks!
Daniela Pereira
5 years 10 months ago
This is a new term for me and I find it very interesting; especially the idea where religious figures had scrupulosity. From a Christian perspective you would think religious figures are fully aware their actions are wholly good and their main objective is to stray away from evil. Ironically, they believe the opposite. Unfortunately, it is understandable people may have distorted perceptions, such as Body Dysmorphic disorder (BDD) as stated by Kayna (#4). She brings up a very good when she states “like the aforementioned Saints and the Samaritan, these people think they are ugly.” Like those who suffer from BBD the Saints and Samaritan’s are unaware of what is “real” in perceptions and ideas. Kayna asks if people with scrupulosity are treated similarly as those with BDD and I believe the answer is yes, according to the book The Doubting Disease the treatment is similar to other forms of therapy. People who have scrupulosity which is similar to OCD, must first overcome the fear, be exposed to it, feel a sense of anxiety, and repeat it again. The book and some of the chapters go over in detail how to overcome the disease.
http://books.google.com/books?hl=en&lr=&id=CxJ4ebpYcwkC&oi=fnd&pg=PR7&dq=Scrupulosity&ots=Zg1RNfyF72&sig=kZXfhyDndY_U76pR0-uuqA33wfo#v=onepage&q&f=false
ed gleason
5 years 11 months ago
Having presented on weekends and followup sessions on Retrouvaille [troubled marriages] for 20+ years We came to believe that at least 80% of the troubled couples had spiritual problems not psychological problems. The healing of people, just as with the Samaritan woman comes from their encountering people with concern for them. say hello to AA.. Seeing/receiving unconditional love is the best medication there is and amazingly, it is a free over-the-counter fix.   
we vnornm
5 years 11 months ago
Ed.

Amen.

tx. bill
Kayna Pfeiffer
5 years 11 months ago
On a basic level, a spiritual problem may consist of a religious person questioning his or her faith in God. Maybe other aspects of his or her life are not going well, including having a physical or psychological problem. Due to this, this person starts to question their faith.

However, some people do not belong to a religion. Is it fair to say that they have a spiritual problem because of this? Do they even have a spiritual problem if they do not practice a religion?

Switching gears-In response to the blog, I was shocked to see that some of the saints have had issues with scrupulosity. These people have sacrificed their lives for that of others through faith. If they are not a spitting image of good then I don't know what is. After reading about the symptoms of scrupulosity, it reminded me of the symptoms of Body Dysmorphic disorder (BDD). Those who suffer from this disorder have a ''preoccupation with an ''imagined'' defect in one's appearance.'' Like the aforementioned Saints and the Samaritan, these people think they are ugly. They see themselves as ugly on the outside whereas the Saints and the Samaritan see themselves as ugly on the inside. Effective treatment for BDD consists of taking serotonin re-uptake inhibitors and undergoing cognitive behavior therapy. I wonder what some spiritual remedies could be for those who suffer from this disorder or scrupulosity. Would these remedies be similar?

Veale, D. (2004). Body dysmorphic disorder. Postgrad med journal, 80:67-71. 
 doi: 10.1136/pmj.2003.015289 
 
we vnornm
5 years 11 months ago
David,

A difficult task. When we start to define things clearly we end up with something like the DSM IV which is rightly criticized for lacking the holistic approach. But when we're holistic we risk blurring boundaries.

In the example of scrupulosity, I think Cardinal O'Connor was suggesting that people with ocd/scrupulosity could learn from the example and attitude of the Samaritan woman-i.e., her spirituality. I don't know of any medication or psychological therapy which could give this same guidance.

best, bill
we vnornm
5 years 11 months ago
Kayna,

I wouldn't equate spirituality with religious membership.

Good question on BDD. It makes me think of the book Holy Anorexia which noted how many early saints, mostly in Italy, suffered from a combination of depression/ocd/anorexia. The classic by St. ignatius ("Spiritual Exercises") has some suggestions for dealing with scrupulosity/ocd that are very much like modern cognitve behavioral therapy. ignatius was bedeviled by scrupulosity.

I think Mr. Ed Gleason above offered something of helpf for those with BDD: "Seeing/receiving uncondiitonal love is the best medicine there is." And Cardinal O'Connor would remind us of the receptive attitude of the woman at the well.

Hope this helps. bvo
we vnornm
5 years 11 months ago
David,

In the interests of a fuller discussion, I'm going to ask you instead to offer your own understanding of the differences between physical-psychological-spiritual dimensions. I suspect you've thought this through a bit during your lifetime and might offer a system of classification that you've developed along the way. So rather than providing an "answer," I'll ask instead, "What do you mean by each of these terms? How do you think others might define them?" best, bill
Crystal Watson
5 years 11 months ago
I too find it hard to figure out the difference between psychological problems and spiritual problems.  The roles of psychologists and spiritual directors must get mixed up sometimes.  I guess I'd consider a problem psychological first and try to fix it that way before assuming it was spiritual.  One difference - is it only me that sees the possibility of a kind of stigma attached to "spiritual" problems?  I mean if a person has BDD as mentioned above, they'd be considered Ill, but if we decide they have a spiritual problem, will they be considered "bad"?
we vnornm
5 years 11 months ago
Crystal,

In some ways I think it must be harder to be a spiritual director than a therapist. I would suspect that many times a spiritual director must need to make referrals to a psychologist (i.e. spiritual direction is not meant to cure bipolar disorder, OCD, major depression although some might enter it with that hope) but I suspect fewer therapists make referrals to spiritual directors.

Perhaps "spiritual concerns" might be a better word than "spiritual problems"? Each of us, even the holiest of saints, has these concerns.

Your points, as well as David's questions above, indicate that this might be a difficult area to navigate. It's easier, I think, to come up with all the varieties of psychological problems in a book like the DSM (over 280, I think) than to specify "spiritual problems" or "spiritual concerns."

Perhaps some spiritual directors might wish to comment? bill
we vnornm
5 years 11 months ago
Initially, I found it interesting to learn about scrupulosity.  Since I had never heard of this before, I looked up the definition of scrupulosity and found it is a psychological disorder characterized by pathological guilt about moral or religious issues.  It was described as a spiritual form of obsessive compulsive disorder. It is understandable why this would be a frustrating condition for therapists and psychiatrists to treat, as how does one go about dealing with a person who is spiritually dead?  This is a concept that is new to me.


I appreciated the connection between the woman who had been “married five times but had never really been married” and scrupulosity.  This woman feels as though she is no good and useless.   She believes that everything she does is evil.  She thinks that she is incapable of being loved.  This leads me to the question: How is it humanly possible for all of these characteristics to lead to a successful marriage?  And the answer: It probably is not possible.  Clearly this spiritual disorder is affecting other aspects of the woman’s life.  Here I begin to see the connection between the fields of psychology and spiritually.


A spiritual disorder has the ability to impact not only one’s spiritual life; as the opposite is also true.  For this reason, I agree that at times, churches should refer their clergy for psychological therapy instead of turning to the spiritual or sacramental resources.  In the same sense, it is equally important to experience spiritual therapy in different instances.  Both fields bring diverse points of view and outlooks to the table; both are beneficial in certain circumstances.


After researching what exactly spiritual therapy is, it seems as though the two fields obviously overlap.  Spiritual therapy helps one gain more understanding and consciousness.  According to author Dorothy Becvar, issues of spirituality can be brought into the therapy room; the two fields can work together.
ed gleason
5 years 11 months ago
Of the hundreds of couples we met on Retrouvaille, their presenting problems mainly are .   our euphemism='third party involvement. others are drugs, alcohol, pornography , spending too much, physical abuse, no communication= single lifestyle,
a newer one is gambling; also in-laws, religious differences, work issues..... .etc 
 Almost all are behavior/spiritual problems.. those who are on medication drugs before the weekend process are asked to consult with their doctor before coming to the program, maybe that's why we see so few 'psychological' problems.
Ed & Peg gleason   
PJ Johnston
5 years 11 months ago
Thanks for this - I didn't know you'd written a book on scrupulosity!  I'll have to check it out.  Do you know if anything has been specifically researched about liberal Catholics with scrupulosity?  I don't think this is the usual background of scrupulous persons so it makes some of the standard advice less applicable than it might be, but the phenomenon definitely exists.
Vanessa Adamo
5 years 11 months ago
When considering the topic of psychology there have only been two dimensions that I was made aware of and understood: talk therapy and the use of medication. The third dimension of spirituality has never been brought to my attention and although it may be abstract and foreign to many, including myself, I do understand how this can  be a strong dimension of the psychological world. However, it is a scary thought to think that patients feel spiritually sickened to the point where they feel they are dead. As I am very interested in psychology, I put myself in the situation where I would have a patient such as this, what would I do, how would I respond and create a better situation for my patient? To be honest, I do not know the answer to these questions, I do not know how I would handle this situation. I have been exposed to a variety of psychology courses; however, have never been exposed to the scrupulosity dimension of psychology. Is this something new; are current psychologists educated and aware of this dimension in order to treat possible patients who feel spiritually disconnected? I hope they are because it appears to be a very serious issue.
As I continue to read this article, I became very surprised to find that this is not a new finding, that scrupulosity is a condition that is very much relatable to obsessive compulsive disorder and had been found hundreds of years ago in many of the saints.  In the British Journal of Medical Psychology David Greenberg, Eliezer Witztum, and Jean Pisante demonstrate that to best understand this condition it is imperative to look at both aspects of the condition, religious and psychological; both being equally important to the patients recovery and satisfaction with self. As I became extremely interested in this topic, I decided to do further research. In my further research I came across an article by Jonathan S. Abramowitz who demonstrates through a study that devout Jews evidenced fewer fears of sin and punishment from God compared to devout Protestants or Catholics. I found this finding extremely interesting because it brings up the question: is the church to blame for this fear of sin and punishment, are they preaching fear into their followers? As this may very possibly be a factor of scrupulosity, the church may consider sending their clergy member to speak to a therapist before preaching to his followers. It is important that the church leaders are careful with what they say in order to avoid messages of fear.
                It is worrying to hear that one may believe as intelligent and advanced a people we are that we are we are internally no good, evil, and sinful. If I can feel this fear in the mere fact that people are faced with these issues, I could not imagine how those suffering from the condition may feel, it must be an absolutely horrifying experience and one that obviously needs close attention. Through the reading it has become clear that this is an issue that is not simply spiritual but an issue that easily turns psychological. The individual experiencing scrupulosity will find himself facing not only fear of sin, but a feeling of loneliness, a world in which they fell they go unloved. It seems to me that this condition can cause other issues such as depression; therefore it is evident that this is a condition that needs to be continuously and vigorously treated.
 
5 years 11 months ago
If one holds to a holistic view of human health, it seems to me that psychological and spirtual factors are inter-related in the human person and are hard to separate in treating human problems.  A common denominator in spiritual and psychological-emotional problems is suffering.  If you have seen a loved one in a psychotic state; friends who are chronically depressed; having panic attacks, hoarding, scrupulous...you are seeing suffering.  I have the greatest admiration for those who suffer so greatly and who live with courage and perserverence every day of their lives.

All the great religions have theologies and philosophies of suffering.  The Catholc Church has a bounty of resources.....the lives of the Saints as previously mentioned, our faith in the providence, mercy and unconditional love of God; the supreme example of Christ Himself.  And more.

I think that at the least, a therapist, should have a good understanding and an appreciation for the patient's faith.  Do therapists ever work in collaboration with clergy?  That would seem to be ideal, but hard to find.  I've read that many psychologists are agnostics and atheists.  If true, it doesn't bode well for patients looking for a therapist who can relate to their beliefs.

I have 3 personal examples of spiritual and psychological help working together.  About 30 yrs ago I had a session with a priest-psychologist to determine whether I was culpable in a personal matter and needed to confess it.  The matter was such that only a person trained in psychology could understand it.  I was greatly relieved that he found no culpability on my part.  About that same time, a depressed mother and her depressed children found their way into the hands of a capable, loving psychologist.  She is a devout Lutheran; her husband is now a retired pastor; both have ties to the Catholic diocese.  (also she was trained under Anna Freud).  She and we were most comfortable in finding resources in our religion.

The other example involves my adult son who is dx with autism and schizophrenia.  His father, after our divorce, became "born again" and influenced our son to also become Evangelical and "born again".  He refused to attend church with me.  After his first psychotic break, I looked for a counselor for him.  He refused to see our Lutheran psychologist or any Catholic.  I arranged for him (always with me) to see a licensed clinical social worker I had know at CPS to be a good decent man and moderate in his Evangelical beliefs.  His agency is called Heartland Biblical Counseling and he uses Scripture as part of his counseling.  At the time, about 17 yrs ago, my son's delusions centered on religious matters;  mainly salvation, hell, and the end times and he was very scared.  The evangelical belief that "once saved, always saved" is very comforting for Frank.  He has not had these concerns for many years.  Another benefit of this long relationship is that the counselor has gained new knowledge and appreciation of Catholicisms.  He loves it when I give him books and the copies of materials from the classes I take at the Dioc. Institute.  He even has the Catechism and he is currently listening to Thomas Merton on him MP3.

Bill, I gave a copy of your book on OCD-Scrupulousity to my priest friend who has found it very helpful in his ministry.  He works at the Dioc in seminarian  and priestly formation; he hears the confessions and counsels priests and bishops from throughout the state.  He finds scrupulosity fairly common among parishioners and clergy.

Sorry this has gotten so long.
Janice
Michelle Russell
5 years 11 months ago
Spriitual or psychological sickness?  There is probably a lot of overlap, and the focus with which one may "improve" may depend much upon the make-up of the person involved and their life experiences and life journey.  I can only address this from my own personal experiences.

I do think in many ways, Mr. Gleason  has hit the nail on the head with his observation that "seeing/receiving unconditional love is the best medication there is...."  In my experience I have also found this to be true.  Coming from an abusive home I doubted that whole love thing from the outset, and when you don't feel loved, don't feel worthy of love, don't feel you can either give or receive love, life becomes a bit treacherous and frightening.  Without love we are missing one of the pieces of our selves that makes us fully human.  Is this a psychological or a spiritual problem?  Does it really matter?  But I don't believe we are just a human machine ... well, in many ways we are, but that is not all that we are.  Can you define love?  Yes, there are biochemical changes, but can the depth of love or how the mind reacts to those biochemical changes be measured? And what about the soul?  If we believe there is a soul - an animating force beyond our biology and chemistry, then can we not presume that that part of us can be sick as well? 

I don't know what it would be like for someone not coming from a spiritual/religious background, but finding and accepting the unconditional love that comes from God was what I needed to more fully live in the love that we all need to feel more completely human.  Are we human without love?  Maybe not as human as we could be...and what is the best way to tap into this aspect of our beings? 
we vnornm
5 years 11 months ago
Alyssa #11,

Prior to the 1990 scrupulosity was rarely written about. Along with three Marist students (who presented at Conventions of the American Psychological Association in Boston, Washington, Toronto) I developed a research project which led to a book. Since then psychology as a profession has become more oopen to studying religious issues and there are many articles and even a few books on scrupulosoity. I was hoping the American Psychiatric Association would list scrupulosity as a variant of OCD in the new DSM V, but it appears this will not occur.

I'm not aware of the work of Dorothy Bevcar: you have given me an assignment which I will work on.

thanks! bvo
we vnornm
5 years 11 months ago
David,

I hope there is more to us than a machine-like nature, although someone has forecast an
"Age of Spiritual Machines" in reference to atificial intelligence in the future. In some ways scrupulosity may be the opposite of pride: feeling unable to do the right thing; incapable, even worthless. Those who experience it wouldn't wish it on anyone. tx. bill
5 years 11 months ago
I wonder how many Saints, today, would even be considered for enttrance into religious communities. Convents are no longer "hospital for sinners" but shrines to "psychological health"!
we vnornm
5 years 11 months ago
Dear PJ Johnston:

What an intriguing subset-scrupulosity as exprienced by "liberal Catholic." Yes, I think scrupulosity manifiests itself more within a "conservative" mindset and it was much more prevalent in Catholicism before Vatican II.

I suspect some therpaists would "treat" scrupulosity by attempting to have the person "loosen up" moral standards which the therapist might refer to as "overvalued ideas." Many times the therapist would be correct: the scrupulous person's worries are indeed over the top even when compared with the strictest interpretations of matters.

I suspect Martin Luther's theology of Grace-it's not our works but our belief in Christ that saves us. When Luther was a young priest, he couldn't get through saying an entire Mass without feeling he had committed some sacriligeous blunder. One of the participants in the study we did at Marist noted (with some humor), "I wish i had been born Protestant."

Yet to me this seems too simple. Another psychologist-from the 1950s-Mowrer, believed that it was important for scrupulous people to hold themselves to an even higher standard.

Since a strong component of scrupulosity is doubt, I suspect one way it might manifest itself in someone with a more liberal bent would be somehow related to "doubting." Just some specualtion on my part.

best, amdg bill
we vnornm
5 years 11 months ago
Vanessa:

You found one of the classical articles and read one of the nationally renowned cognitive behavior therapists (JA). Good researching!

Yes, fear-oriented religious education or preaching has been associated with development of scrupulosity. A person never feels comfortable with their own judgment. And yes, the loneliness can magnify all the uncomfortable feelings and other problems associated with scrupulosity.

best, bvo
we vnornm
5 years 11 months ago
Janice,

Thank you for the very pertinent examples and comments. best, bill
PJ Johnston
5 years 11 months ago
I am certain varies, but individually and anecdotally speaking what you suggested (that scrupulosity might be associated with doubt in liberal Catholics) seems dead-on.  In an extreme case a person can possess a strong sense of intellectual certainty about something yet experience profound emotional uncertainty about it if he or she is somehow prone to doubting his or her own judgments in the face of disagreement or outright hostility from peers or authority figures.

(You might find Francis Clooney's thread about the woman at the well and ensuing comments about scrupulosity interesting - the Holy Spirit seems to have been pushing in the direction of interpreting the woman at the well story in light of scrupulosity this season!)
Katherine Nielsen
5 years 11 months ago
Speaking as one who suffered from scrupulosity as a young teenager, you are right, Bill, when you say ''Those who experience it wouldn't wish it on anyone.''  I remember it as being a living purgatory, if not hell. One doesn't hear it talked about much nowadays.  I think that is one good effect of Vatican II, that we moved away from the kind of thinking that caused it. Maybe some would say we moved too far away. But I can say that it is an definitely obstacle to spiritual growth and not a help to it. Those who have compared it to OCD are right, also. It is a compulsive thing. My problems with it took place in the early and middle 1960's. I definitely do feel that some of the catechesis back then contributed to the development of scrupulosity. It started developing with me when I started puberty and began to have sexual feelings. I felt that those thoughts shouldn't enter my mind and that every time they did it was a mortal sin. It went from just being about sexual thoughts to being about everything I did or thought. I couldn't articulate what was wrong to my parents; even though my mom tried to talk to me of God's love; that I wasn't a terrible sinner. I believe that I was healed by following the advice of a priest whom I confessed to. He encouraged me to receive Communion as frequently as I could, to ask Jesus in the sacrament to heal me.  I perhaps could have benefitted from psychological counseling if there had been any available. At the time I was suffering I felt utterly alone, and envied my Protestant cousins who seemed to have their spiritual lives better together than I did. 
Jaclyn Greiner
5 years 11 months ago
          In all that I have learned about psychology at Marist College I have always learned that it involves talk therapy and medication. Although we have never discussed or learned about spirituality being a dimension of psychology I do find it very interesting. To me the two areas obviously overlap. While psychology allows patients to face and talk through what they are going through and get medical help, spirituality allows people to feel connected to something and have faith in themselves and others. I do not know if this aspect of psychology has been studied by many but if something like scrupulosity is a type of obsessive compulsive disorder than it seems to me that this type of therapy should definitely start to be looked into further if it hasn’t been already.
         I decided to do some research and found an article called Spirituality in Psychology Today where the author talks about how “spirituality is essential to human happiness and mental health.”(Elkins, 1999, p.1)  His reasoning goes on to talk about how spirituality gives life greater depth and purpose and to me this definitely promotes good mental health. The author also brings up an interesting point when he discusses the fact that many people want spirituality but not in a structured religious form. People practice spirituality in all different ways. In my opinion many people are turning to things like yoga and meditation to use spirituality as a form of therapy. To me it is clear that religion or spirituality definitely plays a role in person’s well being. Overall I think that since these two aspects of life are tied closely together psychologists should not be afraid or against helping people find spirituality if it is what will fulfill their lives and give them mental peace. Although throughout history many psychologists have tried to separate their practice from religious ways, others have not. Therefore since religion and psychology exist together within people, psychologists today should be open to viewing spirituality as another dimension of therapy.
Elkins, David. (1999, September 01). Spirituality. Psychology Today, Retrieved from http://www.psychologytoday.com/articles/199909/spirituality
we vnornm
5 years 11 months ago
PJ Johnston #26

It would be interesting indeed to have a gathering of "conservatives" and "iiberals" who all suffer ocd/scrupulosoity...I suspect discussing the burden they share would lessen the potential for any differences of opinion in causing divisivenss. best, bill
we vnornm
5 years 11 months ago
Katharine Nielson #27

Those "thoughts and feelings" that involuntarily come into awareness are part of growing up and part of the human condition and moral teaching that portrays them as "mortal sins" only serves to focus more attention on them and create guilt. Then they cycle of confession, more thoughts, confession, etc....Very hard for a teen, for anyone. peace, bill
we vnornm
5 years 11 months ago
Jaclyn,

Nice article from Psychology Today. I think it has relevance for those of us wanting to be teachers-you will want to have an awareness and sensitivity of the many different spiritual traditions present in any contemporary classroom. This adds to one's understanding of students, families, and co-workers. best, bill
Lynde Kayser
5 years 11 months ago
Despite three years as a psychology major, I had never given much thought to the relationship between psychology and spirituality.  This topic had never been discussed in my psychology classes and I see now that it is an important aspect of personality that warrants consideration.  An individual’s spirituality or religious affiliation plays a large role in their sense of identity and acts as another facet of life to be considered by psychologists.


In terms of scrupulosity, there is an evident relationship between spirituality and psychology.  Like Kayna’s posting, I found the description of scrupulosity much like that of body dysmorphic disorder (BDD).  People with BDD have obsessive thoughts about a perceived deficit in their body image.  This is much like the perceived personality deficit perceived by individuals suffering from scrupulosity.


A 2005 study entitled “Scrupulosity in patients with obsessive compulsive disorder: relationship to clinical and cognitive phenomena” investigated the relationship between religious affiliation and scrupulosity.  Results found that Protestant participants had a significantly higher number of scrupulous people than those without a religious affiliation.  Results also showed that scrupulosity in Catholics was significantly higher than that of Protestant participants.


http://ocdtherapist.com/PDFs/ScrupulosityinOCD.pdf
Cheryl Benjamin
5 years 11 months ago
Though I am not the most spiritual person around, I strongly believe that ones spirituality has one of the greatest impacts on their lifesytles but especially on their pschyological state. I think that we can see this correlation with people who believe that their bodies need to be modified in some way shape or form and are unsatisfied with the body that was given to them at birth. Arent these the people who we often see suffering from depression or develop a psychological problem because of where their spirit lies? One who is in one with their spirit may realize that the lord chose them to look, act and feel in such a way and noone...absolutely noone is exactly the same as they are. I believe that each individual needs to become one with their spirituality in order to be one with their psyche. This posting made me reflect on alot of things...thank you
Michelle Russell
5 years 11 months ago
David wrote:  " I don't see how we can discuss treating it if we don't know what it is...."

I don't know that your questions can be adequately answered.  Humans are such complex beings, with our physical, emotional, spiritual selves so entertwined I feel that in many cases it is fairly impossible to tease out what is causing what.  Especially when you begin looking closely.  There are physical expressions of psychological illness, and medical doctors are taught to rule out the physical before deciding on the psychological.  But then trying to discern between psychological and spiritual sickness adds a whole new layer of complexity.  If you believe man is just an exceptionally complex machine, and all our actions/reactions/illnesses/neuroses, etc... can be explained by physical realities (biochemical, nutritional, etc...), then I think trying to add in and figure out where spiritual illness lies just isn't going to fit into that model.  Maybe it is all chemistry (etc..), but I feel strongly that the soul, or spiritual part of us whatever we want to call it, is not bound by these physical rules. 

Perhaps one can't tell just by looking if something is spiritual or psychological. Or perhaps they are in many ways the same, but the optimal treatment for a particular patient may lie with one or the other focus.  Perhaps a spiritual sickness can be defined after-the-fact, when spiritual therapy yields results?  Pehaps most things are spiritual in nature and we just fail to acknowledge this dimension?  Perhaps you are correct, and everything really is just a product of our physical nature, and we just haven't discoverd the cause yet.  Lot of perhapses.  It is my belief, and I can't back this up with a definition or any data, that much of what is wrong with our world today is from a long-standing spiritual deficit.  Just an opinion, a belief ... is that enough?

Have you read Viktor E Frankl's Man's Search for Meaning ?  Excellent book, which on some level may help to clarify the line we are looking to draw:  a line which by its nature is not entirely solid. 
5 years 11 months ago
I agree that spirituality plays in important role in mental and psychological health. Based on personal experiences, I think that spirituality can play an important role in the treatment of certain problems like addiction. For example, an important part of AA is acknowledging a higher power and surrendering to that power. Another essential part of the program and is the kindness and support you receive from the other members. Similar to the story of the woman and the Samaritan there are no judgments. The people in the group are there to help each other no matter how many times they may need that help.
  I do feel that sometimes we equate organized religion with scrupulosity. We sometimes feel inadequate and that we don't measure up to what is expected of us. We feel that God is judging us. This article implies that scrupulosity is the belief that people are intrinsically no good. It is certainly a healthier attitude to take the view that God is loving and all forgiving. This belief would be an important component along with psychotherapy and medication in the treatment of mental health conditions.
5 years 11 months ago
A Franciscan priest from the San Luis Mission is giving a series of lenten talks at my parish.  He is age 71, has had lots of experience and currently is counseling persons who were molested by clergy..  His subject today was  "forgiveness" and it was very enlightening and healing for me.  He gave the holistic view:  the act of forgiveness is both psychologically and spiritually healing.  Persons who were abused by those older and/or in positions of authority suffer an excrutiatingly painful betrayal of trust.  From my own experience of many years ago, I thought I had forgiven the therapist.  I had made an act of will of forgiveness.  That apparantly was not sufficient for my healing.  Like a wound covered by a scab the anger from the abuse festered at some sub or unconscious level for many years and recently emerged.  The expression of that anger was dumped on a totally innocent friend and ruined our friendship which was vey important to me.  At today's talk and the priest's readings from Scripture I was overwhelmed with feelings of sorrow and forgiveness.  A great blessing from God through one of his priests.  Again, ABBA does provide.


"Therefore, since we are justified by faith, we have peace with God through our Lord Jesus Christ, through whom we have obtained access to this grace in which we stand; and we boast in ouir hope of sharing the glory of God.  And not only that, but we boast in our sufferings, knowing that suffering produces endurance, and endurance produces character and character produces hope, and hope does not disappoint us, because God's love has been poured into our hearts through the Holy Spirit that has been given to us."  Romans 5:1-5
ed gleason
5 years 11 months ago
Spiritual direction should also be mentioned. It has the talk therapy of psychology and it can help the seeking person to sooner reach a spiritual goal.
You can find spiritual directors by calling retreat centers, asking religious sisters doing pastoral work in parishes and also contact Episcopal parishes as they seem to be taking a lead in certifying spiritual directors.
we vnornm
5 years 11 months ago
#36 Christine & #37 CBenjamin

I am impressed by your humility and openness. best bvo
we vnornm
5 years 11 months ago
#39 David and #40 Michelle

Thanks for keeping the conversation going. This has been debated since before Chrisitanity and honorable people in all ages have held different viewpoint. best, bill
we vnornm
5 years 11 months ago
Kristin #40

More than once the thought has also crossed my mind that organized religion has much to do with scrupulosity! :-) / :-(

Thank you for affirming the efficacy of higher powers, kindness, and support. bvo
Alyssa Moirano
5 years 11 months ago
After reading Vanessa’s post referencing a study that showed that devout Jews evidenced fewer fears of sin and punishment from God compared to devout Protestants or Catholics, it made me think: Is the church responsible for scrupulosity?  Does the church teach that God is always judging us? This is never a feeling I received in my years of religion classes and my experience as an altar server.  However, if this is true for some, it would make therapy for clergy members all the more important, rather than seeking spiritual therapy. 
Stephanie Waring
5 years 11 months ago
Before having read this article, I had never learned of scrupulosity before. As a psychology major, I have yet to think about any cure to a psychological disorder, other than the two most common and obvious; talk therapy and medication. The spiritual aspect of psychology is easy to link to the psychological aspect of it.  In order to believe in yourself and the people around you, you have to make connections on a deeper level with other people in order to feel 'normal' by relating to other people's emotions,feelings, and problems.  Through talk therapy, patients are able to release their emotions as a therapist interprets their feelings that may be hard to uncover unless the therapist is digging deep into the mind of the patient.  Medication within the field of psychology seems to definitely impact patients and their disorders, but much of the time leads to a possible drug addiction or misuse of the drug that was once "helping" them.  
'Scrupulosity is a psychological disorder characterized by pathological guilt about moral or religious issues. It is personally distressing, objectively dysfunctional, and often accompanied by significant impairment in social functioning'.  With a psychological disorder like scrupulosity, talk therapy or medication don't seem to be the cure that the patient needs.  A patient with this disorder needs something more direct and in-depth in order to help them overcome or even just weaken their symptoms of the disorder.  Spiritual efforts must be made in order to help these patients become more open to the religious world and believe in God on a deeper level than just "saying" they believe in God.  Attending church even helps to make me feel less stressed and more relaxed because I look to God whenever I am in a situation that I feel I can't deal with alone.  Spiritual therapy definitely seems as if it would be an impressive and growing 'medication' for any patients with this disorder, or any psychological order for that matter.  
Casey McGowan
5 years 11 months ago
The disorder of scrupulosity raises an interesting issue about the connection between spirituality and psychology. In many ways religious leaders are like psychologists in that they are there to help counsel individuals and get them through difficult times in their lives. Despite this similarity, faith and science are seen as two completely different realms with little to no overlap.
While organized religion may not be for everyone, I think there is something to be said for the role of spirituality in mental health. Having faith in something, regardless of what that belief may be, seems extremely beneficial. Changing a behavior alone is not enough to fix a problem, so for many disorders, successful treatment could come from a combination of traditional psychological methods and spiritual measures.
Alyssa Moirano
5 years 11 months ago
Walter (47) I would 100% agree with your take on it; maybe sometimes some are too hard on themselves, and forget the forgiving and loving nature of God.
Samantha Young
5 years 11 months ago
When I think about the field of psychology I consider all different kinds of disorders and treatments. The key word here is treatments, because it is nice to think that everyone has equal opportunity to find a cure to their disease and find happiness in life. Until now, I had never even heard of scrupulosity. It makes sense to me that it would exsist because your religious beliefs (or lack there of) help an individual to define their own identity. Different people take on different understandings of religious scriptures and this shapes the person they will become. Having said this, it is much harder to cure a disease that is rooted in spirituality because their is no concrete rational behind it. Therefore, a spiritual healer or psychologist could potentially be talking in circles with a patient for years and still never be able to cure a person suffering from this cynical disorder.
I found it absolutely devastating to learn that some people truely feel they are incapable of being loved and that they are intrinsically evil. This goes beyond being an upsetting way of life, to a point of self-destruction. A human being can simply not survive if they are incapable of loving themselves and creating meaningful relationships with others. Life is full of tumultuous rollercoasters, and the people we surround ourselves with are what helps us get through the pitfalls. When everything goes wrong and loved ones are not there for us, it is nice to thin that there is some kind of higher being or transcendent form of love that is there for us. Unfortunately, people who are suffering from this disease do not feel this way and instead take part in destructive and sinful behaviors. These people can not ask for forgiveness from God because they do not feel that God (or anyone else for that matter) will ever love them. There are missing out on the mere essence and greatest joy in life, which is happiness, by always thinking so negatively through such tainted shades. Cardinal O'Connor's quote, ''We are not going to ask forgiveness unless we believe we need forgiveness and unless be believe he will grant forgiveness'' captures this idea perfectly. If these poor people do not stray away from their diseases through immense help, then these individuals have a futile future.
Christine Castellana
5 years 11 months ago
I think Alyssa raises a good question (#46).  Currently, I can't think of an answer, but this is something that I am going to think about for a while! 

In an objective, unbiased sense, does the Church have anything to GAIN when the people are taught to believe that they are constantly being judged and that all people are inherently evil? Why, as Catholics, are we more prone to becoming scrupulous? Do we have to follow more strict and harsh rules that scare us?

 Maybe we are lead to be afraid in order to prevent us from sinning, though I think that would be doing us a huge disservice, because even righteous people that do incredible things have some level of fear. 

Also, was it established whether these scrupulous people donate or volunteer their time? I am curious about whether they are active in their community, especially if they think that people are inherently evil; why help them? Or does this give them reason to help others?

Han Fossanova
5 years 11 months ago
Several comments mention God's love and forgiveness, and that’s always nice to see. However, because in the Catholic story a forgiving God loves the damned as they roast in Hell for all eternity, making the point that God loves and forgives us does not affect the setting scrupulosity responds to. I would like to say something about that setting, something that gives non-scrupulous folks a way into understanding scrupulosity as the sober response of an honest heart to the gospel of eternal damnation, and not as sickness.

All it takes for scrupulosity to be rational is RCC teaching that eternal damnation awaits those who fail to repent of each and every mortal sin. Self-monitoring decreases the odds of failing to repent. And because the payoff is eternal damnation, no finite amount of self-monitoring could ever be too much. So go for it! There's no comparison between the pain of eternal damnation and the pain of a lifetime of sick-making self-hatred, agony, and terror.

When the brain aneurysm or the texting driver or the lightning bolt comes and ends it all for you, if you have not repented of each and every act of freely taking pleasure in the thought of placing your hands where a woman's waist meets her hips, you're toast for all eternity. ''Watch ye therefore,'' said Jesus, maybe.

Want to help the scrupulous? Go to the root. Invite the scrupulous to consider whether we any longer have access to facts that would decide the matter of whether Jesus or anybody else acted with divine authority to set up a teaching authority that would be the sole authentic interpreter of divine revelation. Invite them to consider whether we any longer have access to facts that would decide the matter of whether any revelation has ever been made at all. Set them free.
Han Fossanova
5 years 11 months ago
Defense of That a forgiving God loves the damned as they roast in Hell for all eternity
Because the damned have being (Catholics are not annihilationists), and being is good, and God loves what's good, God loves the damned. Damned or not, the meaning of getting to be a be-er is "God loves you." And the God that loves the damned can be a forgiving God, because whether or not God is forgiving does not depend upon whether humans receive that forgiveness by their repentance. And what is takes to be in Hell is not receiving that forgiveness by acts of repentence. So having people in Hell does not conflict with a forgiving, loving God.
Another approach: For the sake of argument, let's say Jesus is God and is forgiving and the Bible records some of what he said. The Bible has him saying, "Depart from me ye cursed into everlasting fire prepared for the devil and his angels." So we've got damned and we've got a forgiving and loving God, together.
David, am I helping you become de-fascinated :), or is this not really working?

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