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What I Have Learned

In January 1996, Fr. Patrick Kaler, CSsR, died suddenly at the age of sixty-five. Still young by the standards of the time, he suffered from heart disease and died of a heart attack. At the time of his death he was a member of the staff at Liguori Publications and—most important of all—the long-serving director of Scrupulous Anonymous. His passing required that a new director be named. I stepped in “temporarily” until we were able to find a new director. Soon I will celebrate twenty-five years in this “temporary” assignment.

For the last twenty-five years, I have written a monthly newsletter, with two interruptions in the process necessitated by a change in assignment. However, never in those twenty-five years was there even a moment when I was not answering questions, conducting retreats, attending and leading workshops, and serving as a resource person for people who suffer with the disorder. It has been a privileged time for me and a wonderful opportunity to learn—and I needed to learn quite a bit.

Fr. Kaler and I shared some qualities, but we do not share an essential condition: I am not scrupulous; Fr. Kaler was. He would carefully study the many questions he received and would struggle to find an answer that seemed to him to be useful and pastoral. I do not necessarily struggle to discern a direction or to provide a pastoral response. My challenge, something I have patiently learned over these last years, is to discover the many manifestations of the scrupulous disorder. I try to discover and adequately explain to the readers of the newsletter the dynamic and the consequences of the struggle with scrupulosity.

I have learned over the years that the struggle is profoundly personal for each of our readers. No two manifestations of the disorder are alike. The only person who is an expert on their scrupulosity is the person who suffers with the disorder. This makes it difficult to be helpful in the pastoral approach that is the core reason for the newsletter. At best we can only hope and achieve a consistency in our counsel. The individual applies the counsel according to his or her own needs and understanding.

Over the years I have changed the emphasis and the focus of the counseling and pastoral direction I provide. Initially my emphasis was on the traditional approach for ministry to the scrupulous that was embedded in the pastoral theology textbooks. I understood that the person with scrupulosity suffered from a “tender conscience.” If a scrupulous person would freely place himself under the direction of a competent confessor, he would enjoy some needed relief. This was the consistent directive of St. Alphonsus Liguori and the pastoral practice that was in place for centuries. It is and was particularly good advice for those who suffer with a tender conscience. Unfortunately, it is inadequate advice if something more is going on.

Gradually, I discovered that the “something more that was going on” was that often scrupulosity was a religious manifestation of obsessive-compulsive disorder (OCD). For a person who suffered with OCD, the traditional pastoral practice and direction was inadequate and not helpful. It might provide some relief, but the relief was only temporary. The only way to effectively treat OCD is a treatment plan that is beyond the skill or the ability of a confessor. Trained professional psychological therapists are required. A sound treatment plan would include communication among a confessor, a therapist, and the person who suffered with the disorder, but unfortunately this was not the common practice. The result was often that the person with scrupulosity was not receiving the treatment that was needed or learning helpful management protocols that would be useful.

I also learned that even though the most effective treatment for scrupulosity included the necessity of some manner of psychological therapy, what was most needed was routinely rejected. Often the reason for this rejection was that the treatment itself would “rub up against” strongly held religious beliefs that would make therapy impossible. Examples would include deliberately engaging behaviors that triggered the OCD response but were also understood as sinful. In such an instance the client often believed that the therapist was not helping but rather leading them further into sin.

Still another belief was that by trying to find a way out of the scrupulous disorder, a person believed he might be guilty of not “carrying their cross” and somehow being unfaithful to Jesus. The list of possible reasons for resisting therapy has always been extensive.

Perhaps the most crippling resistance to therapy was by people who spent countless hours researching theological journals, the writings of the saints, and other resources looking for any scrap of traditional teaching that might support their resistance. Through this effort, they could justify their resistance and call into question the orthodoxy of people who were trying to help them. I admire their persistence, but I also understand the futility of their path. All they are accomplishing is the postponement of any type of real healing. In observing their misguided certitude, you can feel the rising hopelessness and the depth of anxiety and anger that often fuels the search. This combination proves to be deadly and crippling in both the long run and the short run.

Perhaps the most important lesson I have learned is one I am beginning to incorporate in my pastoral direction. It has been in front of me all these years. I hope I can discover a way to share this new insight in a manner that is helpful to our readers. I now understand that what is important is to resist the impulse of “either or”and to embrace the truth of “both and.” Scrupulosity is a disorder with many layers of meaning. It is not helpful to seek to define a person’s scrupulosity as a manifestation of a “tender conscience.” It is equally not helpful to identify scrupulosity as the religious manifestation of OCD. Both designations contain only a partial truth, not the fullness of the experience.

Scrupulosity is not one or the other; it is both and another. The layers of scrupulosity and its consequences can be discovered everywhere in a person’s life. The only way to manage it is to pay attention to all of the components, not just one. I believe that to put energy into just one aspect of the disorder is not helpful. That approach will just enable another avenue to wreak havoc. A consistent and integrative path to management and healing is required and necessary.

Fr. Thomas M. Santa, CSsR

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