The clock read 1:35. I slipped out the car door, ambled past farm buildings and sodium lights, opened a door that weighed more than 300 pounds, and entered the Abbey of the Genesee. Words like massive or mammoth understate the feeling of the space I entered. The walls of granite were extraordinarily thick, and gigantic wood beams extended over 100 feet to the ceiling. A hand-carved crucifix, about 4 feet high, was suspended above the altar, its shadow distinct on the adjacent ceiling--a manifestation of Dismas, the Good Thief, perhaps?

I would be spending the rest of the night in the Abbey, through Vigils and Lauds, and was looking forward to my 7 a.m. appointment with former abbot John Eudes Bambergber. Trained as a physician and psychiatrist at Georgetown and a veteran of the United States Navy, Dom John was taught by Thomas Merton at Gethsemani, and worked with Merton for 18 years conducting mental health and spirituality assessments on the surge of applicants to the Trappists in the 1950s. Dom John also had the sad task of identifying Merton’s electrocuted body in Asia in 1968. Dom John and I had an appointment to dicuss Obsessive Compuslive Disorder and its religious manifestation, scrupulosity.

Despite the vigorous efforts of psychologists and psychiatrists, OCD remains difficult to treat. The standard treatments--cognitive behavior therapy and/or medication--show emerging but far from curative rates of healing. In light of these challenges, perhaps mental health professionals need to think outside the box, backwards instead of forwards, to better understand and heal this nettlesome affliction.

Dom John views treatment of OCD from a spiritual and philosophical rather than an empirical perspective. Obsessive Compulsive Disorder, notes Eudes, and its underlying panic and anxiety, work through a prism of Platonic philosophy, where abstractions and concepts rather than reality remain central. “Will the house burn down if the gas isn’t checked 100 times?” “Will there be death by germs if the hands aren’t washed 50 times?” “Was that fleeting thought a mortal sin?” Such thinking is not reality-based but mercilessly drives the thinking and behaviors of the person with OCD.

“The problem with OCD,” John Eudes said, “is that it is too abstract, too narrow. God is life-giving, not a taskmaster or harsh judge of solitary behaviors, as OCD/scrupulosity suggests. To fight OCD, one has to develop other images, thoughts based on reality, and to savor these and go beyond them in a life of prayer. Our Lord didn’t choose a Greek princess to be his mother, he chose a young Hebrew girl who knew the real world of mysteries they communicate. We celebrate this mystery when we say the Magnificat: My soul proclaims the greatness of the Lord, my spirit rejoices in God my savior, for he has looked with favor on his lowly servant.”

“It is the Hebrew, and not the Greek way of thinking, that brings us to touch the immediacy of God--a reality revealed rather than an ideal to be grasped by the intellect alone. Modern science and OCD also share common characteristics: by trying to control things--whether outward events or inward images considered to be vile and foreign, both OCD and science neglect the implicit world that is not available to the  senses. Even 21st century physicists now acknowledge ‘multiverses’--other universes that always influence our world. Their interactions are subtle, and they escape our observations or do not even register on our most carefully crafted scientific instruments.” (There is a good book on OCD/scrupulosity, one consistent with Dom John’s viewpoint and recommended by Harvard psychiatrist Robert Coles as well as John Cardinal O’Connor.)

Spiritual direction can complement psychological and psychiatric treatments currently available for OCD. As a spiritual director, Gerald Blaszczak, S.J. points advisees toward direct awareness of the loving presence of God in their lives. “God has given us the gift of freedom,” said Blaszczak, “and he offers us this gift and experience of peace. God is the one who brings this freedom into our lives.”

Dom John Eudes, who guided both Thomas Merton and Henri Nouwen in their spiritual lives, emphasizes making others aware “that Jesus is life and the Father is one of mercy and love. Those experiencing OCD don’t feel right or whole. The problem is not in the behaviors. Knowing the One-Who-Heals directly and immediately can help bring freedom from the burdens of OCD.” Perhaps a combination of spiritual direction and modern therapies is the most effective treatment available for Obsessive Compulsive Disorder?

If you decide to go to Genesee, both Amtrak and major airlines serve Rochester, New York. For more information, contact Father Jerome, O.C.S.O., guestmaster.

William Van Ornum

Comments

we vnornm | 6/10/2010 - 3:00pm
David,
 
Great thought. Yes, OCD itself and the awful anxiety that can accompany it can be incredibly distracting for the individual, making it hard to concentrate in the here-and-now as well as remembering things into both long and short term memory. I think I have even read of cases where Ritalin-like medications have been used in clinical trials of sorts for individuals who have been treatment-resistant to front-line medications like the SSRIs. (Belief now is that amphetamine-like medications help persons with certain conditions focus better. But that is an entirely different story.)
 
As a college teacher I have heard stories from students that, after their OCD was brought under control, they were able to sit for longer periods of time, remember things better for exams, and get much more out of school. (With severe OCD like this, I believe the "spiritual aspects" would come into play more after the severe symptoms were treated.)
 
On this condition I believe we are just scratching the surface. Thanks for pointing out the attention and memory problems that co-occur with OCD, they can be debilitating for those who have OCD. best, bill
we vnornm | 6/10/2010 - 2:52pm
Father Perry,
 
Thank you very much for your good thoughts from the Southern Hemisphere. amdg, bill
Anonymous | 6/9/2010 - 3:53pm
Interesting post  :)
 
I had thought OCD was a brain thing that could not really be helped by counseling or spiritual direction but only with medication, but I've also read that the structure of the brain can actually be changed by experience and thought patterns, so ....
 
I  was thinking of Ignatius too when you mentioned scruples.  I've read that Peter Faber was also a victim of this and that Ignatius was able to help him overcome his view of God as a scary taskmaster - maybe Ignatius'  own working through of the problem showed him a way to help his friend later. I also tend to worry about God being impossible for me to satisfy, so  the examples of Ignatius and Faber  (and Luther) reassure me.
Francis Perry Azah | 6/9/2010 - 10:09pm
Thanks Bill for this wonderful post. It is always true that science cannot totally answer humankinds numerous problems, it has a limit. As such man is composed of body, soul and spirit and anything that affects one aspect affects the others. Due that treatment must be holistic in the life of one with OCD/scrupulosity. Psychologist/psychiatrist would be helping their patients if a blend of medication and spirituality/spiritual direction is used in their treatment of OCD/scrupulosity. Whether we like it or not, without the hand of the ultimate Healer (God), our efforts in science and life in general will come to nothing. That’s why in my Ghanaian culture, all sicknesses are treated not only with “herbal medicine” (medication) but also with rituals calling on the gods (God) to assist the patient regain his/her health. With that I think Dom John is in the right direction in his approach to treating OCD/scrupulosity and I believe other psychiatrists/psychologists will also follow.
we vnornm | 6/9/2010 - 9:20pm
Thanks, Stan.
 
I especially liked the chanting of the Hours, the great bookstore, the walk down to the river and greenway, and of course the maple bread hot out of the ovens on bread day.
 
A person with severe scrupulosity once explained to me, "OCD is when you clean off the germs before you sit on the public toilet so you don't get sick. Scrupulosity is when you clean the seat AFTERWARDS so you don't make someone else sick." Seems like more than a few persons with scrupulosity have good senses of humor, needed, probably, to get through each day.
 
best, bill
Stanley Kopacz | 6/9/2010 - 9:02pm
Been to Genesee, Bill,
Loved it, hope to return there for a stay.
I think OCD latches on to other things in the persons mental world.  I knew a Catholic closely who had the scruples problem.  An atheist I knew had problems with germs.  There's always something for it to attach to.  Perhaps the Catholic with OCD can be convinced God isn't out ot get him or her.  I don't know what the atheist does about germs.
Stan
we vnornm | 6/9/2010 - 8:29pm
Thanks Janice. Perhaps I will focus on what you suggest and stay away from canon law for awhile, or always. :-)     bill
we vnornm | 6/9/2010 - 8:27pm
Crystal,
 
I didn't know any of this. Sometimes one who has suffered an affliction like scrupulosity can be kind to others. Thank God for people throughout history like Pierre Favre. I suspect some of the best counselors never write books and remain unknown except to those whom they have healed. best, bill
JANICE JOHNSON | 6/9/2010 - 7:01pm
Thanks Bill for the guidance.  I've passed the info on to my friends and I' know they will be most appreciative .  I hope you will write futher on Catholic faith and spirituality and mental health issues. Blessings.  Janice
Anonymous | 6/9/2010 - 5:52pm
Bill,
 
I do think spiritual direction/cognitive therapy would be a good way to try to help with OCD.
 
You probably know of him by the  French version of his  name, (Blessed) Pierre Favre ...
http://en.wikipedia.org/wiki/Peter_Faber
 
I read of him and his problem in a book by spiritual director and paychologist  William Barry SJ.  He wrote ....
 
"When Ignatius went to Paris to study, he roomed with Pierre Favre and Francis Xavier, both young students in their early twenties. Pierre Favre quickly came under the influence of Ignatius. But Ignatius did not direct him through the full Spiritual Exercises until four years had passed. Pierre was full of scruples, terrified of God's wrath. He seems to have had an image of God as a terrifying snoop seeking to catch him out. With such an image of God he could not enter the Spiritual Exercises with trust and hope and great desire for closeness to God .... But Ignatius worked kindly and patiently with him during the four years and gradually Pierre's image of God changed and his scruples disappeared. He now desired closeness to God and wanted to know what God's hopes and plans for him were. Ignatius led him through the Spiritual Exercises, and Pierre decided to join Ignatius as a companion. He was one of the ten founders of the Society of Jesus and was considered by Ignatius to be the best director of the Spiritual Exercises among all of the first Jesuits."
 
we vnornm | 6/9/2010 - 5:24pm
Thanks Norm,
 
Great to see your thoughts and hope you return with more wisdom. I especailly like how you noted that the scientific approach is "an approach" not "the one and only approach" to understanding our world.
 
Your example serves to remind us that, driven to its extreme definition, science cannot help us understand, explain, or help to heal suffering. At this point, more is needed.
 
As you note, Fr. Blaszczak is one of those great Jesuit fathers whose wisdom speaks to all humanity, not just the Church. blessings, bill 
we vnornm | 6/9/2010 - 5:17pm
Janice,
 
Here is the best of the latest professional literature on hoarding/ocd:
 
http://www.ocfoundation.org/search.aspx?searchtext=hoarding
 
The OCD Foundation has been doing good work for over 2 decades. They are a fine organization to join or to support financially:
 
http://www.ocfoundation.org/search.aspx?searchtext=hoarding
 
They are doing some great work in researching genetics, brain patterns and measurement, varieties of OCD along a spectrum, different ways that OCD is manifested in different cultures, and support of a brain bank (donated brains) for future researchers. They can be doctrinaire, but who are we Catholics to throw stones about this? :-)   Spirituality is an emerging variable.
 
For anyone with severe OCD, especially older persons, a high level of expertise in the psychopharmacologist/psychiatrist is necessary. At times the levels of antidepressants used to treat OCD are higher than for depression. Or the doctor may have to do a clinical trial of sorts with a combination of doses, again at high doses.
 
The older antidepressants-Tofranil, Anafanil, etc-all had anticholinergic side effects, effecting Vegus nerve and its peripherals such as the heart, urinary and bowel system, and others, and so they can be dangerous to use with older persons, and require intense monitoring for side effects. But newer drugs in the SSRI class like Prozac, Lexapro etc. have a lower side effect profile.
 
There is a relatively new Board specialty, Geriatric Psychiatry:
 
http://www.abpn.com/gp.htm
 
One might wish to consider one of these specialists for an older person. The potential and severity of medication and side effects in the elderly, along with the combination of possible dementias, stroke effects, etc. is much greater. Geriatric psychiatry has become a helpful and effective speciality.
 
amdg, bill
we vnornm | 6/9/2010 - 4:56pm
Crystal,
 
It is true that OCD is a brain thing. OCD, as well as bipolar, schizophrenia, and a few others have been said to be more "brain disorders" than other psychological problems like adjustment disorders or simple phobias. But everything changes our brain, even reading AMERICA.
 
There is an entire continuum of OCD from mild to extremely severe. For many kinds, one has to use behavior therapy/medication because the problem is so severe. However, I've read that these approaches don't help up to 30% of those with OCD, and of those they help, they improve the condition up to 80%. So there is no cure.
 
Psychologists can have their own doctrines and ideologies, and when I wrote A THOUSAND FRIGHTENING STUDIES: Understanding and Treatment of OCD/Scrupulosity, I reviewed hundreds of studies.
 
Many of the studies had small numbers of subjects, used short psychological tests to measure OCD, have not studied other variables than cognitive behavior therapy or medication. I think as scientists we have to say there is alot we don't know. Hence the suggestion today. I think John Eudes has good creds.
 
I didn't know about Peter Faber. Thanks. Do you talk about him somewhere on your blog? bill
JANICE JOHNSON | 6/9/2010 - 4:08pm
 
 
 
 
 
 
 
 
 
 
 
Thank you, Bill , for your essay.  I am wondering if there have been any studies on the relationship between hoarding and depression.  I have dear friends who are sisters.  The younger of the two is single and for yrs lived alone in a house which became stuffed with stuff.  She has suffered from depression for yrs and was on anti-depressants but did not have therapy and was never confronted with the hoarding.  Now, for a combination of reasons she is in crisis and is living with her sister.  Her cardiologist took her off the old anti-depressant and put her on a different one which is not doing the job.  I've encouraged them to ask for a referral to a psychiatrist to coordinate care and , at the least, make an assessment of her mental status.  The hoarding problem has reached the point where her whole family is negatively impacted.  I found so much wisdom in the words of Dom  John and Cardinal O'Connor's homily.  My friend is a devout Lutheran and I've encouraged her to attend her church's services.  Hopefully, she can find guidance there.
 
Ed and Carolyn:  I believe we are of the same generation (or close) so it is very interesting to me to learn about the differant ways we were brought up in the Catholic faith-influences of parents, schools and parishes and how our lives were impacted in different ways.  I often wonder how our different ethnic backgrounds also effected our spiritual lives.   I grew up in a small mid-western town , attended the local parochial school, grades 1 through 8 and public high school.  Our parish was predominantly Czech in an area of Scandinavians, Germans and Irish.  Our religious expression was not triumphalist as Ed has described, but rather humble.  In a large extended family, a great-aunt was singled out as ''pious'', the term used for scrupulous in this case.  My mother  tried to follow the ''rules of the faith''and was very devoted to the Blessed Mother.  There was a laxness but a sincere trying !  My father, as a younger man, would miss Sunday Mass if a chance to go fishing or hunting came up.  But, as my mother told us, he never failed to kneel down and say his prayers before going to bed, no matter how tired he was.  The teachers in grade school and college were the Sisters of St. Joseph of Carondolet,   I have always thought of them as wonderful role models of mature Catholicity.  Our 7th and 8th grade teacher told us she was not a policeman and she kept to that statement.  What a great attitude to help students develop an interior self discipline!
Of course, I blame parents, teachers, pastors for all my spiritual shortcomings!  LOL  I also find it very difficult to put myself  in one camp or another in the church, one political party or another so I just call myself, ''Catholic'' with no adjectives.   I pray too for a prophet in our time to find that ''sparkling middle''  that Carolyn describes so well. 
 
 
 
 
 
we vnornm | 6/9/2010 - 2:14pm
Dear Ms. Carolyn Disco;
 
I hope there is a nobel prize and sainthood for whomever can guide most of us to that sparkling middle. In the post below by MSW, he talks about that same tendency in politics/church to go to the extreme. I hope scrupulosity is not a sin, and perhaps the canon lawyers on board can help us here.
 
For many people, the medications and findings of neuroscience bring dramatic relief, and so does cognitive therapy. I also know those who were helped by dynamic psychology.
 
Thanks for reminding us of the harm and toxicity of a negative and rigid approach to religious observance, in out faith and others. Martin Luther, St. Alphonsus Liguori, and St. Ignatius of Loyola all suffered from ocd/scrupulosity but were able to transcend it by looking at God's grace and goodness. 
 
I even once heard a Catholic person with scrupulosity say, 'I wish I had been born Protestant."
 
thanks for writing, bill
we vnornm | 6/9/2010 - 2:01pm
Ed,
 
I suspect that in many ways OCD is just behavior toward the extreme end of a continuum. Many people find great joy in their collections, from kids who collect marbles or rocks or dolls, to big kids who collect automobiles, art, or books (!).
 
Lots of us have a special possession (s) like the security blanket in the Peanuts comic strip.
 
Recently there was a story on the New York area news about couple who had disappeared into the clutter of their own home for days, and were finally rescued. Sad. amdg. bill
Carolyn Disco | 6/9/2010 - 1:08pm
As someone brought up in Catholic boarding schools in the 40’s and 50’s, I believe we were trained to be scrupulous about religious observance, examination of conscience, reception of the sacraments, behavior, and attitude. It was drummed into us, to negative effect, from the beginning on through adolescence.
 
 
It was only many decades later that I learned scrupulosity was a sin of all things. You can’t win on either end, LOL. So, be trained in effect to become sinful, with mental illness as a corollary. How sick is that, and I suspect remnants of that deformation are alive and well.
 
 
How hopeful that some enlightenment is peeping through the cracks, and may it not be snuffed out in the restoration period now underway. I wonder how many priests and sisters who suffered through the seminary/motherhouses of those days found themselves de-formed and struggling in confusion. Not to exclude the laity, and its experiences of toxic spirituality.
 
 
Neither extreme of rigidity or total laxness, but the sparkling middle beckons. Religion should also not overlook the insights of brain neuroscience and depth psychology, other disciplines that supplement a healthier version of its own focus. We are all one, body and spirit.
 
 
I have heard from clergy who serve in hospice work how vital their decontamination of people’s attitudes is in bringing some measure of peace to the dying. All that hellfire preaching had its tragic impact.
ed gleason | 6/9/2010 - 12:12pm
Watching the new cable program 'Hoarders' we can watch the OCD people who appear bright, lucid yet horribly crippled by their need to hoard junk.Their obsessions are hard to see.  And It does seem to be a spiritual lack rather than a mental problem. The spiritual side of OCD seems to get/set the picture right. Next time I watch that program . Ill try to reflect how I [others[  take on. and hoard all the material  junk in my own life. maybe we are all 'hoarders' ???