I had the pleasure of speaking with Dr. William E. Minichiello, a psychologist at Mass General Hospital, about OCD with Catholic scrupulosity. You can listen to our conversation and read the complete transcript below. Here are the links to the resources he mentioned:
– Lee Baer, Ph.D.
Play audio here:
You said that you recently saw a woman who was raised Catholic who came to you with scrupulosity concerns about having committed a sin. Do you want to start, without identifying her, by saying what her fear was and then what you told her about what sin is and isn’t?
That was an elderly woman who was referred to me with scrupulosity. She had a lot of doubt about sins, confessions that really weren’t sins. What I explained to her was that in order for something to be seriously sinful, first of all, the matter of what she was concerned about had to be serious matter. That was one thing. The second thing was that she had to know that it was serious. Then the third thing was that she had to have full consent of her will to do that which is serious. Clarifying that for her was very important because she was confessing things that really weren’t sins – they were faults. She never had what we call sufficient reflection. In other words, she never reflected on the fact that she wanted to do that which was seriously sinful. In other words, something that would separate her from God. She never had that reflection. Most importantly, she never had full consent of her will to do that which was seriously sinful, which she knew to be seriously sinful. She was confessing a lot of sins which, as I said, weren’t sins. Certainly nothing that would separate her from the love of God. That was extremely helpful to her, once she got that clear. Her trips to confession became normal rather than what they were. She would go to confession frequently and whenever she went to the liturgy she wouldn’t take part in the most important part, the reception of the Eucharist. That was important to clarify that for her.
Would you say the majority of Catholic priests would agree with the three points that you laid out to her?
I would say the majority of priests should. If they in fact do, I don’t know. The majority of them should be familiar with the principles I laid out. Certainly those who reflected on the teachings of the second Vatican council would be aware of those. I would say they were taught them, whether they carry them out in practice I don’t know, but they should be aware of them.
If someone who’s Catholic has excessive praying or doubts about whether they committed a sin, where would you recommend that they go first for advice in their community?
What they should do to start out with is to find out what they can about an organization called Scrupulous Anonymous, which lays out those principles pretty clearly in its publications. Start there and then go to a parish that’s a progressive parish – where there’s a high probability that the priests would be progressive in their outlook and progressive in their moral teachings. I think that would probably be the best approach.
Let’s say that they’ve been going to a church with their family for years and they haven’t spoken to the priest there yet. Do you think that should be their first step?
If they have a feeling based on having gone to Mass there and based on what they’ve heard in the sermons, they can make a judgment that this is a person with a progressive approach or a black and white approach. If it’s a black and white approach I would suggest that they not and suggest that they go to a place like the Paulist Fathers Chapel in Boston. In most major cities the Paulists have a chapel where they celebrate the liturgy, hear confessions, give lectures, etc. Based on what their assessment is of their local parish from what they’ve heard when they’ve gone there and what they’ve talked to other people in the parish about, if they have a feeling that the priests there are progressive in the spirit of the Second Vatican Council, go there. If not, seek out a place like a Paulist center – if they’re near a large city.
How often have you run into or spoken to priests who you would consider black and white in their thinking and might make the persons scrupulosity worse, or not recognize it as scrupulosity?
It’s certainly less so than it used to be, before the Second Vatican Council. I don’t know if it’s the majority, but a fair number of priests are knowledgeable about scrupulosity and how to handle scrupulous patients.
What’s your impression of the current Pope? If you were to sit down and speak to him about patients you’ve seen who are Catholic who have OCD, do you think he would generally agree with the points that you mentioned? From what you know of his writings and speeches.
Based on what I’ve seen, he’s terrific. His approach is exactly what’s been needed for so long. He emphasizes the love and mercy of God rather than the aspect of sin and punishment and damnation. His approach is fabulous, and I just hope it continues. He’s emphasizing the right things – he’s emphasizing compassion, love, and forgiveness.
Do you think he would recognize when someone has a problem with doubt, he would separate it being a spiritual problem from being an OCD problem?
I think so. I think his approach is excellent. If every priest in the world adopted his approach I think that would be a major step forward in helping people with religious scrupulosity.
The major ritual or compulsion we see is obsessive praying, or not feeling like the person said the prayer with the right frame of mind. Maybe you could talk about what you’ve seen and what you advise people to do about prayers that can take hours, or they worry all day about whether they’ve prayed correctly.
The important thing there is for people to realize that God knows what’s in their heart and that it’s not necessary for them to repeat prayers. What is prayer – it’s talking to God. You wouldn’t talk to your closest friend and keep repeating the same thing – it would be meaningless. With God, it’s even less necessary to repeat anything because God knows what’s in our heart. The scrupulous person needs to keep that foremost in his or her mind when they pray. They just need to talk to God as if they would talk to their best friend and not continue to go over and over the same thing.
What have you advised patients as far as knowing when to stop or knowing when a prayer is enough?
What I would advise them to do is to start off with what I just said: focus on the fact that God knows what’s in their heart and try and go against what their OCD is telling them to do, which is to repeat what they just said. The goal would be to try and do what someone who doesn’t have OCD with scrupulosity would do, they would say their prayer once and not repeat it. Someone who’s scrupulous, that’s going to be a little difficult, so you try and get them to reduce the number of times they repeat based on how many times they are repeating. You set a goal, and get them to reduce it each day or each week until they get to the point where they’re like someone who doesn’t have OCD and they just say their prayers once.
How does a person without OCD know when is enough and what’s average length to spend in prayer?
What people who don’t have OCD do, they say their prayer once because they understand and accept that God knows what’s in their heart and it’s not necessary for them to repeat again what’s in their heart. They’ve already done it and God knows what it is. Move on, say it once and that’s it.
Let’s say they can stop repeating but they feel that they have to mention everyone in their family, or is sick, or every friend in their prayer. So even if they don’t repeat it can take hours and hours for them to mention everyone. What advice would you give them?
I’d give them similar advice. So maybe mention everybody once and then after that when they pray they can just say “all those people who I had previously mentioned to you, God. These are the people for whom I’m offering this prayer.” And not go through the list of a hundred people. If they’ve done it once, then they can just make that reference. “God I’ve already told you the people for whom I offer this prayer.”
One of the problems that mental health professionals have in treating people with scrupulosity of whatever religion is they’re not as trained or knowledgeable about the scriptures or the particular religion. Are there New Testament quotes or verses that particularly bother people?
I think there are New Testament verses that would help people not to get into those kinds of things. Some of the verses from John’s gospel about God having loved us, those are important verses to help people. The best approach is getting people to just accept that God loves them and that God knows what’s in their heart. They don’t have to repeat prayers, they don’t have to be afraid that God is waiting for them to make a mistake and that he’s going to hammer them. Try to get them to understand some of the parables that Jesus taught and pointing out how forgiving God is, how accepting God is of our frailties and our sins. The parable of the Prodigal Son, going over that and getting them to understand that in the parable, the father had a big party to celebrate the return of his son, who had gone down to the city and blown his inheritance on riotous and sinful living. When the son had lost everything and wanted to return to his father’s house, the father didn’t make him jump through any hoops. He ordered a big party and sent his other son out to kill the fattened calf and rejoice – the son who he thought was lost had returned.
That’s an example of someone who with intent did something wrong.
People who have OCD, they don’t intend to do those kinds of things. They have all this overwhelming doubt that they did. Doubt doesn’t count. Where there’s doubt there’s no sin.
The last thing I wanted to talk to you about is something that you’ve emphasized talking to me and I don’t think I’ve heard from anybody else. It’s just this idea that the view of the Catholic God as a punishing God seems to have changed a lot since after the Second Vatican Council. I think you’ve said that psychiatrists see a lot less OCD with scrupulosity than they used to. Could you just talk about that change and when it happened and why it happened?
I think that’s one of the encouraging things with Pope Francis. He’s much different than the last two popes who focused on sin and punishment rather than on love and forgiveness. Prior to the Second Vatican Council (1962-1965), that’s what the focus was on and since the Council, the focus has been on love and compassion and not on sin and punishment.
For younger people who weren’t around in the 60’s, what changed in the teaching?
It was a change in focus. The focus went from the negative aspects of religion to the positive aspects of religion. The emphasis shifted away from sin and its consequences and punishment to positive things like compassion, focus on the social gospel; feeding the sick, comforting the grieving, helping the homeless, administering to the poor and the needy. These are the works of mercy as spelled out in the 25th chapter of Mathew’s Gospel. Jesus talks about the last judgment. There’s nothing in there about sexual sins or anything like that. “I was hungry and you gave me to eat, I was naked and you clothed me, I was a stranger and you welcomed me.”, etc. The passage goes on: “When did we see you this way?” and Jesus says: “As long as you did these things for the least of my brothers, you did them for me.” That was the change and emphasis away from sin to ministering to the least of the brothers. The emphasis changed.
That was around the early-mid 60’s?
That was when the council started in 1962 and ended in 1965. Under the next Pope, Paul VI, there was implementation of that. With John Paul II, here was a retrenchment, an effort to get back to the way things were before the Second Vatican Council. I think that has ended now with Pope Francis who is much more like John XXIII who called the Second Vatican Council to reform the church.
Do you think a lot of the differences in advice that a scrupulous Catholic might get would depend on when their priest attended seminary?
I think that’s part of it. But not exactly. You have a lot of young priests who were devotees of Pope John Paul II who are part of that retrenchment. It’s really about how priests responded to the Second Vatican Council and how they’ve tried to implement it at their parish. In different Catholic parishes you’ll see a big difference depending on how the clergy in that parish have responded to the Second Vatican Council.
You mentioned that people should look at Scrupulous Anonymous…
One of the things that they can find there are the 10 commandments of the scrupulous. I think those are extremely helpful. Not to confess doubtful sins when they confess their sins in the Sacrament of Reconciliation, not to repeat sins that have previously been confessed, not to repeat their penance, not to be afraid of looking at a crucifix or a statue because a bad thought enters into their mind. A lot of excellent things are in those 10 commandments.
And their organization is run by knowledgeable, reputable priests and scholars?
It is run by the Congregation of the Redemptorists whose founder, Saint Alphonsus Liguori, also suffered from scrupulosity himself. They’re very reputable and they’ve been at the forefront of helping people with scrupulosity.
The last thing you mentioned was that people can contact the Paulists in their area?
The Paulists are highly educated. They run a lot of the Newman Clubs in the major universities in the United States. In all the major cities in the United States – Boston, New York, Chicago, San Antonio – they have what they call the Paulist Center. It’s like a parish for people who are alienated from their own parish. They have daily Mass, Sunday Mass, confessions, a series of lectures and outreach to carry out the social gospel in the city. To help the poor and so on.
What about people who live in South America or Canada or Europe? Are there Paulist Centers there?
I know there are in certain countries, in Europe and Canada, I don’t know what they have in South America. I know they’re found in some of the European countries.
Any last advice to give to a Catholic who suffers from scrupulosity?
The advice would be that they need to understand that they have a treatable condition and it’s not something that they should continue to suffer with. It’s not something that God wants them to suffer with. God wants them to achieve peace and hope. That’s what Jesus’s message was all about, to bring God’s love and God’s peace and God’s healing and God’s forgiveness to them. There is help out there if they can find the right place to go and the right people to give it to them.