When people struggle with the scrupulous disorder, most of the suffering, fear, and anxiety they experience happens in isolation. Scrupulosity is mostly an interior struggle, seldom manifesting itself with easily identifiable or observable mannerisms or behaviors. You can’t tell if people are scrupulous by looking at them. While some compulsions of obsessive-compulsive disorder are identifiable, most of the suffering associated with the disorder is personal. Only the sufferer fully knows its debilitating nature.
People with the disorder often feel as if they are isolated in darkness. They describe this feeling as a “cloud” that perpetually engulfs them. They feel the disorder constantly and uncomfortably, even in the background of day-to-day living.
Scrupulosity demands constant attention and can feel like a severe and unrelenting master. At best, most people who suffer with the disorder have learned to live with it. They hope it does not get more pronounced or spill into other areas of life. Relief does not exist, so any promises of relief through activities like rituals are essentially dead ends. For those who are religious, consistent spiritual practices can help and at the same time be debilitating.
It is difficult for the scrupulous to learn and accept that some spiritual practices do not help them. This is particularly true for those in the Roman Catholic spiritual tradition, a religion with many defined spiritual practices and disciplines that people perceive as required or expected as a sign of being a good Catholic. It is difficult to help practicing Catholics with scrupulosity to identify familiar spiritual practices and disciplines as barriers to their spiritual growth and mental health.
It is common for scrupulous people to want to take part in some Catholic practices and traditions that do them more harm than good. They know some common spiritual practices are harmful, but they may think it is unfair to make such practices off limits. For instance, practices that increase personal isolation or focus too much on the examination of an individual’s life and choices are no good. Examples include sitting alone in the back of a church, absenting yourself from the holy Communion line, and becoming preoccupied with the ordinary disciplines of the Church during Advent and Lent to the point of obsession.
Two seemingly harmless spiritual practices that do not help a scrupulous person are the examination of conscience and the reception of the sacrament of reconciliation in a darkened and isolated confessional. They fail to help because they are intensely isolating, focusing too much attention on what is missing or imperfect in life. They stir up fears and anxieties about the past, and they disconnect the scrupulous person through their anonymity and vocalization in the darkness to a blank wall or a screen. It should be no surprise that most scrupulous people report that their individual practice of the sacrament of reconciliation is most often unsatisfying and a source of more anxiety rather than the peace and the calming of the spirit that the sacramental practice intends and promises.
In a partial pastoral response to this dilemma, I recommend to scrupulous people that they seek the sacrament of reconciliation only in a communal setting such as at a liturgical service, where there is a common examination of conscience and where the confession of sins is communally experienced. If that is not possible, then a regular reception of the sacrament of the anointing of the sick in a communal setting is preferred. (Scrupulosity fulfills the requirements for participation in this sacrament.)
A second pastoral response I recommend is to separate the confession of sin (sacrament) from seeking pastoral advice and direction (spiritual direction). The two spiritual practices are unique and have different focuses and purposes. I have also learned that a good confessor and a good spiritual director are often not the same person. Both practices have their own skill sets and parameters.
In addition to a spiritual practice of confession and spiritual direction, it is good to know that regular therapeutic counseling is essential and helpful. Scrupulosity cannot be managed only on one front but demands multiple interventions and directions to make progress and to experience the potential healing and relief that is desired.
More good news is that major obstacles to the successful management of the scrupulous condition can be identified. One is generated by the individual person and the second by the pastoral-care person who is essential to the caregiving and spiritual growth process.
The first obstacle, the person with the disorder, often tries to research and study his or her way out of scrupulosity. That common error is stubbornly pursued, resulting in confusion, disappointment, and frustration. The second obstacle is an uninformed or underinformed confessor who falsely believes he or she understands the disorder while remaining unaware of any developments in the true understanding of the disorder, insisting on “spiritual remedies” that fall short of being effective. Unfortunately, such a confessor’s persistence is not at all helpful and dooms both the confessor and the scrupulous person to unnecessary suffering and frustration.
If you suffer with scrupulosity and intend to learn how to manage the disorder, the pathway to healing is difficult but not impossible. As in any healing process, there is the necessary patience that is required until the men and women who can be a helpful part of your healing journey are identified and engaged.
As in any healing journey, there will be false starts, detours, and frustrating dead ends, but persistence will pay off. A team of professional and pastoral caregivers can be engaged who will help you. The personal conviction and determination to end the self-isolation and the anonymity of a patient sufferer is the first and essential step. Move out of the darkness and into the light.
Fr. Thomas M. Santa, CSsR