Scrupulosity is a very private experience and a very private disorder. For most people who struggle with it, few who know them have any idea there is a problem. A spouse might sense that the private sufferer has anxiety, but most often the level of detail unique to the scrupulous person is known only to the one with the disorder. His or her questions and doubts, which are masked by anxiety, all are hidden within.
People may be aware of rituals that scrupulous sufferers perform, such as a preoccupation with germs, but few understand that what looks like a preoccupation is much more. The ritual dominates everyday choices, constricts one’s ability to engage in routine behaviors, and severely limits the amount of time a person can share with others. The anxious concern is always present. Rest is impossible in the minute-by-minute battle for “purity” and temporary “safety.” In their minds, scrupulous people can never achieve a pure or fully safe state of being.
Perhaps the most isolated experience in the spiritual life of a scrupulous person occurs in the confessional. In the communication between priest and penitent in the darkness of the confessional, the disconnected voice of the penitent pleads for peace and satisfaction. The plea is not heard, even by the most empathetic confessor, not because he has no desire to listen, to be truthful, and to help, but because only the symptoms of the suffering are shared, not the depth of the struggle and the reality of what is being experienced.
The language of sin and the highly developed commissions and omissions associated with the Catholic understanding of sin are the biggest barriers to any potential healing for the scrupulous person, in my view. Sin is not the issue. The problem is the language used to describe the struggle, the feelings, and the emotion that the disorder manifests.
As a result, when a confessor and a scrupulous penitent communicate about sin within the sacrament of penance, they miss the point. The only result for the penitent can be even more suffering, even greater isolation, and fatigue for both the penitent and the confessor. The sacramental celebration thus is unsatisfying. And although grace is present, it is buried in the frustration of the experience.
The language of sin and the fear of displeasing God contribute to the frustration experienced when professional psychological help is engaged. The scrupulous person often finds therapy of limited help because the therapist is trying to get to the root of the behavior. The therapist is truly motivated to help but often is reduced to offering strategies for engaging the disorder that, ironically, seem sinful to the scrupulous person. It is not unusual to hear a scrupulous person describe both therapy and therapist as “not at all helpful,” with more isolation resulting.
Spouses who want to help are not fully informed about the troubles of their spouses. Friends and family members observe only the occasional frantic behavior. Confessors do not understand what is really needed. Therapists rarely help. All of this leads to deepening isolation, which ensures unhealthy living and even more suffering.
The growth of social media, which itself encourages isolation, brings yet another consideration that cannot be ignored. The so-called “experts” who populate the virtual reality of the internet offer all kinds of useless advice and damaging directions. Worse, people who do not understand or accept that scrupulosity is a psychological disorder populate online discussions.
I believe it is ludicrous that humanity, with the active grace of God, has not made substantial progress in devising effective ways to manage and treat this disorder.
For now, I further believe the key to confronting isolation and open the possibility to at least some kind of healing and relief requires courage. It is exceedingly difficult for people to admit they cannot heal alone and need help. But as difficult as it may be to acknowledge that help is required and to take the necessary steps to acquire what is needed, there are no shortcuts.
I have learned that a particularly good and positive first step in stepping out of isolation is to join one of the support groups or spiritual-direction groups that are emerging. It is heartening to know that some people have come to understand that isolation is unhealthy and have determined to take the necessary steps to end their personal isolation and engage with others who feel the same and will support them.
For those who are ready to take this positive step in their own growth and spiritual development, there are numerous resources. The International OCD foundation (iocdf.org) is an excellent place to look for support. Your local diocesan or archdiocesan Catholic Charities is often a place that can provide useful direction and help in securing good, consistent, and reliably Catholic counseling and support groups. A ministerial service called Managing Scrupulosity (managingscrupulosity.com) has been established recently and offers individual and group spiritual direction.
Isolation is the petri dish of the scrupulous condition. It is the necessary condition for even more suffering and a barrier to both grace and healing. Stepping out of isolation is the first move needed to fully engage and experience help and guidance. It can be a fearful step, but it must be taken to walk the path to recovery and healing.
Fr. Thomas M. Santa, CSsR