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