I really had to re-post this article from PsychCentral. In working in mental health so often I have heard clients explain away serious symptoms associated with mental illnesses using faith and religion doctrine as the basis of their reasoning. My personal opinion is that humans should have the right to decide how to manage their lives. Treatment decisions whether its mental health or physical disease based should be left to the patient(s) and their families. My issue is how to support clients when they attribute their symptoms as being religious based rather than psychological or biological based. I understand that spirituality underscores all of our experiences but at the same time the guilt that many clients harbor about the meaning of their symptoms is troubling. Sometimes the guilt along with other emotional turmoil is the biggest detractor from treatment and quality of life. Here’s the article. I would like to hear what you think.
Scrupulosity: What It Is and Why It’s Dangerous
By THERESE J. BORCHARD
If you sprinkle a hefty dose of Catholic (or Jewish) guilt unto a fragile biochemistry headed toward a severe mood disorder, you usually arrive at some kind of a religious nut. Not that there’s anything wrong with that! For I am one.
I have said many places that growing up Catholic, for me, was both a blessing and a curse.
A blessing in that my faith became a refuge for me, a retreat (no pun intended) where my disordered thinking could latch unto practices and traditions that made me feel normal. Catholicism, with all of its rituals and faith objects, provided me a safe place to go for comfort and consolation, to hear I wasn’t alone, and that I would be taken care of. It was, and has been throughout my life, a source of hope. And any speck of hope is what keeps me alive when I am suicidal.
But my fervent faith was also a curse in that, with all of its stuff (medals, rosaries, icons, statues), it dressed and disguised my illness as piety. So instead of taking me to the school psychologist or to a mental health professional, the adults in my life considered me a very holy child, a religious prodigy with a curiously intense faith.
For anyone prone to OCD (obsessive-compulsive disorder), religion can serve as a trap within a sanctuary. For me, my scrupulosity in primary school was like a game of Pin the Tail on the Donkey: I was spun around blindfolded without a clue as to which side was the head and which the butt–which rituals made me crazy and which led to the beatific vision.
Almost every anxiety and insecurity I felt as I kid fed into one fear: I was going to hell.
Therefore I did everything in my power to prevent that. My bedtime prayers lasted longer than those recited by Benedictine monks; by the second grade, I had read the Bible start to finish (a few times by the fourth grade); I attended daily Mass, walking there on my own each day; and every Good Friday I would go down to my dad’s den in the basement and stay there for five hours as I prayed the all of the mysteries of the rosary.
I guess I just thought I was really holy until I landed in therapy my freshman year at college. There my counselor strongly encouraged me to read the book The Boy Who Couldn’t Stop Washing His Hands: The Experience and Treatment of Obsessive-Compulsive Disorder by Judith L. Rapoport, M.D. After I read through its pages I breathed out a huge sigh of relief that I might not be headed towards the burning flames of hell. Its wisdom has stuck with me even today when I get trapped in that OCD-scrupulous kind of thinking.
Like the other weekend.
My daughter received her First Reconciliation. As part of the sacrament, the parents are encouraged to go to confession. I hadn’t been in ten years, so I thought I should go to be a good role model. My religion teachers used to tell us in grade school that you go into confession as a caterpillar and emerge as a butterfly. That wasn’t an accurate description of how I felt. My poor caterpillar was limping, as I felt horribly guilty, disgusted with myself, embarrassed, and every emotion they say you get rid of when the priest absolves you and you feel God’s forgiveness.
I think confession and all the rites of the major religions can be a beautiful thing, and lead to a deeper faith and a sense of love and hope. However, for someone prone to OCD, who constantly beats herself up for every less-than-perfect thing she does, or thought she has, these rituals can become weapons used to further hack away at self-esteem.
Two anecdotes from Rapoport’s book accurately articulate the kind of mental anguish attached to scrupulosity:
Sally, a bright, blonde sixth-grader, had looked forward to her Confirmation. Getting a new dress and having her aunt so proud of her outweighed all the hard work. But a few weeks before the big day she started having crying spells, couldn’t sleep, and lost ten pounds. It all began suddenly, when Sally was doing a class punishment assignment. She thought that she wasn’t doing it properly, that she was “sinning.” I’m always doing something wrong, she felt. The feeling stayed with her. Each day her symptoms became more intense. “If I touch the table, I’m really offending God,” she whispered. She folded her arms and withdrew into deep thought. Sally was terror-struck that she might have offended God by touching her hands. Did that mean that she was striking God? She wondered, retreating further into herself.
Daniel described how hundreds of times each day he would “get a feeling” that he had “done something wrong” and that it displeased God. To avoid possible punishment for these “wrongdoings” at God’s hands, he would punish himself in some way, thus reducing his concern about some more awful punishment occurring at some later time. He would also avoid any actions or thoughts that had accompanied these feelings. This led to the development of complex rules which, in Daniel’s mind, placed prohibitions on his behavior and thinking in virtually every situation of his life.
I have to exercise precaution about going to confession — and participating in rites like it — when I’m feeling really lousy about who I am and can’t get away from the self-deprecating thoughts, just as I refused to fast during Lent when I was trying to tackle my eating disorder in college by eating three regular meals a day. Going without food for 12 hours would have caused a major hiccup in my recovery.
Thankfully there are wonderful resources available today on scrupulosity, and because of the awareness, I think that kids today are better educated on what healthy faith looks like as opposed to a form of OCD. That’s my hope, at any rate.