For the Priest / Confessor

Pope Francis speaks almost effortlessly, on many different occasions, about the priest as a “minister of mercy.”  More often than not he makes this reference when he is speaking about the sacrament of reconciliation and the role of the priest.  On other occasions he also references this powerful description of the ministerial priesthood as the primary concern and focus of those who are called to serve in this vocation.  The just completed “Year of Mercy” enabled the reference more often than not but even with the special year of jubilee completed I would not be surprised if we continue to hear the Holy Father speak to us in this manner.

My experience informs me that my brother priests appreciate this perspective of the Holy Father.  I believe that we strive, in the confessional and also outside the confessional, to pastorally apply the experience of mercy, understanding, and reconciliation whenever possible.  At the same time I know that the People of God appreciate this particular emphasis and effort because they experience this reminder of God’s love and concern for His people as both life-giving and grace filled.  Priest and people both desire to powerfully connect and to experience the profound mercy of God as often as possible in their daily lives.  They desire to be both strengthened and encouraged by the outpouring of God’s abundant grace.

Despite our ministerial efforts and despite the pronounced desire for the People of God to experience the mercy of God there is one group of men and women for whom the experience of knowing and feeling the mercy of God seems so very distant.  These are the men and women who suffer from scrupulosity, who are unable to truly believe that they are loved and accepted by God.  No word ever seems to calm their aching spirits.  The assurances we offer as ministers of God’s grace seem to have no effect.  The inability to accept and to believe in the saving mercy of God is not the result of stubbornness or hardness of heart.  It is rather the particular manifestation of a disorder that floods the mind and the heart with “a thousand frightening fantasies” as one author so powerfully identified the disorder and the experience.

It is within the confessional during the celebration of the Sacrament of Reconciliation where we routinely encounter the scrupulous person.  More often than not the manifestation of scrupulosity is experienced by both priest and penitent through a disconnected and pain-filled voice that fills the darkness of the confessional.  A recitation of perceived sin punctuated often with an expression of both doubt and endless questioning.  I deliberately choose to describe the experience as disconnected because the priest struggles to connect with the penitent and with the pain filled experience that is being shared in the darkness.  At the same time the scrupulous penitent is disconnected and disengaged in a very real sense because they are performing a complex ritual, the last expression of a sustained struggle that is marked with anxiety, guilt, and a profound sense of loneliness.  The often expressionless confession of a litany of sins, most of which are either perceived sins or supposed sins rooted in the fear of sin, is the final step in the ritual.  Unfortunately, as soon as the confession is concluded and the ritual completed, a new ritual will be engaged that needs to be played out.  There is no finality in the confession, no assurance of mercy, no experience of inner calm and peace let alone any conviction of reconciliation or God’s mercy.

The scrupulous person who is performing the ritual of confession and questioning is trapped and suffering.  They have entered the confessional with what they understand is the unrealized expectation that perhaps they will experience, through the recitation of perceived sin and doubt, some form of relief from the torment of the disorder.  It is all the more painful because they also understand that this almost mechanical recitation of sin and perceived sin is a useless attempt to calm the anxiety that rages within.  The disconnect that is palatable is expressive of their heart-felt desire not to be in this situation and caught-up in the ritual that is being performed.  In a very real sense both priest and penitent are witnesses to the expressive power of an experience that both would prefer not to engage.

The experienced pastor and priest will recognize this encounter since it is played out often in the ministry of the sacrament of reconciliation.  At the same time the experienced priest will recognize that this is descriptive of one type of scrupulous penitent only.  His pastoral sense and experience is correct.  What I am describing in this scenario is a person who is suffering from a powerful disorder, understood as scrupulosity, but perhaps better understood as a manifestation of Obsessive Compulsive Disorder.  This is not the traditional understanding of scrupulosity that was routinely handled in the seminary class that is devoted to preparing a priest for the ministry of reconciliation.

The classical understanding of scrupulosity that is outlined in the moral texts is perhaps better understood as a “tender conscience.”  This form of scrupulosity is best pastorally remedied through patience, the insistence of maintaining the discipline of a single confessor who can aid the penitent through the navigation of their understanding of sin.  This pastoral care is rooted in an awareness and understanding that this manifestation of scrupulosity, although painful, is not permanent.  Good catechetical training will eventually win-out and the anxiety and the doubt will be significantly reduced, enabling the penitent to enjoy a practiced and helpful discipline of the sacrament of Reconciliation.  This is most assuredly not the experience of scrupulosity that is a manifestation of OCD.

It is essential and very helpful for the application of good pastoral care for the priest to both recognize and understand that there is a difference between a tender conscience and a person who is suffering with scrupulosity as a particular manifestation of OCD.  It is essential that the priest understand that OCD is a behavioral disorder, an emotional disorder that has many specific manifestations, one of which is the manifestation of religious scrupulosity.  The pastoral response of the priest is dependent on his personal recognition of what the penitent is expressing and what he is actually hearing in the disconnect voice behind the screen and in the darkness.

If what the priest is hearing is not the expression of a tender conscience but rather a penitent who is suffering from OCD a focused response that is helpful is possible.  The priest does not need to be a professional therapist or for that matter even well-schooled in personality disorders.  He just needs to be aware of what he is experiencing and willing to take the next steps and offer to the penitent pastoral care that is effective and useful.

It is helpful to understand that there is essentially no difference in the psychological and emotional roots of the OCD disorder from one person to the next, the only measurable difference is found in the particular manifestation of the particular doubts and questioning that are experienced.  For a person with scrupulosity it is sin, most often a particular form of sin that is the focus of their questioning and doubt.  For still another person with OCD it may be germs which leads to endless hand washing, it may be a fear of not maintaining basic responsibility in routine household tasks such as locking the door of the house or turning off the oven, the list is endless.  It should also be noted that the men and women who suffer with OCD often experience a variety of manifestations of the disorder although one concern does tend to dominate as is often the case of a person whose central manifestation of OCD is with scrupulosity.

When the priest encounters a person who is struggling with OCD his patience will be tried as will the patience of the penitent.  Both priest and penitent will become even more exasperated if the incorrect pastoral remedy is replied.  It is in the application of the most helpful pastoral response where many priests need some improvement in order to focus their pastoral skills.

Central to the understanding of the appropriate pastoral remedy is empathy and not catechetics.  It is not possible to explain away OCD even with the most brilliant dissertation.  If OCD could be managed with a catechetical application or with accumulated information the penitent would long ago have reached a point of healing.  Their persistent questioning, which is part of the experience of OCD, would have arrived at the sought after answer that would soothe the anxiety and take away the experience of doubt.  However, that is not possible with the disorder.  More information produces more questioning and it fuels the manifestation of the disorder.

I understand that the best pastoral practice that can be engaged by the priest is to inform the penitent that you feel and understand their pain and suffering.  It is often difficult for the penitent to hear the confessor share this insight but eventually, perhaps after months and months of confessions, the penitent may respond to the offer of spiritual guidance and support and ask for help and direction.  When the penitent asks for help the priest can then respond with a focused and well-practiced pastoral care that is effective.

The application of good pastoral care in this situation will require additional time and commitment from both the priest and the penitent.  However, the time required will be time well spent because it will produce a helpful pastoral result.

In conversation and within the context of a focused period of spiritual direction, preferably outside of the confessional and within an agreed upon appointment expressly for the purpose of the needed counseling, the priest should share with the penitent who is suffering with scrupulosity that he is one  resource for helping the person learn to manage their scrupulosity.  At the same time it is helpful for the priest to also suggest to the penitent that good psychological care and therapy is very useful in learning how to manage the disorder.  This is essential because many people with scrupulosity mistrust psychologists and in particular the application of behavioral modification applications and occasionally even prescription therapy that is ultimately very effective.  The core message of this conversation is for the penitent to understand that the priest will work with them in seeking good psychological health and well-being.  Expect at this point sustained push-back and resistance from the penitent.

There will normally be some sort of resistance to the suggestion of a psychological intervention even if the person understands that this is the best chance for learning the skills that are necessary for managing the disorder.  More often than not the penitent will express their reluctance by claiming that if they engage in psychological care they will somehow “lose their religion.”  In this expression there is often a deeply held perception that in some manner their scrupulosity is understood as their personal “cross” and by learning to manage the disorder they are somehow displeasing the Lord.  The priest can be very helpful in guiding the discernment of the penitent to choose a healthier way of living and to understand and accept that this choice for health is also a choice to accept God’s will in their life.

Entering into a relationship with a scrupulous person to be a resource for them in learning how to accept and to manage their disorder is the only reason for a priest to agree to this commitment of time and energy.  If the scrupulous penitent is unwilling to engage the professional help that is required and intends only to use the time for spiritual direction as an opportunity to not manage their disorder but rather to engage the disorder through even more questioning my pastoral advice to the priest is not to agree to enter into the conversation.  It is counter-productive and not at all helpful for either priest or penitent.  This is a painful decision to make but it is the most loving decision that can be experienced by both the priest and the person who suffers with the OCD disorder.

If the priest and the scrupulous person have managed to arrive at a point where they are in sync with each other and are working together towards the effective management of the disorder a sacramental option can then be applied.  The most effective sacrament for the celebration of the Lord’s healing and reconciliation for a person with OCD manifested scrupulosity is not the Sacrament of Reconciliation but is rather that Sacrament of the Anointing of the Sick.  The good and sustained pastoral care of a person who suffers with scrupulosity is the regular reception of the Sacrament of the Anointing of the Sick.  This sacrament enables a strong spiritual connection between Jesus who is encountered in the sacrament and the person who is suffering from an illness, a disorder that is in need of healing.  It also removes the occasion of the confession of perceived sin and guilt and the doubt and anxiety that is experienced by the person who suffers from the disorder.  In a very real sense this spiritual practice, under the direction of a skilled spiritual director in the person of the priest, further enables the experience of healing and wholeness, in a sense reconnecting the person with the healthier part of themselves and their experience of the Church in the practice of the sacramental life of the Church.  The Sacrament of Reconciliation may still be celebrated but only when both priest and penitent agree that there is actual sin that needs to be confessed and not the fear of sin or the perceived guilt of sin that is the result of the ravages of the disorder.

If for a variety of reasons this type of pastoral care cannot be applied there are still some practical helps that the priest can engage.

The first pastoral skill that can be implemented is for the priest confessor to understand that the confession of a scrupulous person is often highly structured and ritualistic.   It may sound to the inexperienced ear to be an invitation for counseling or spiritual direction but it is not.  Frankly when a scrupulous person is performing the ritual of confession what they desire is only the completion of the ritual and nothing more.  The most loving response of the confessor is to hear the ritualized litany, and without comment to offer the needed absolution.  Secondly the priest confessor should understand that the appropriate penance should be easily understood and simple to perform effectively eliminating any possibility for doubt or confusion.  I would suggest something like “pray one Our Father, even if it is distracted and imperfect, all that is required is that you try and pray this prayer, nothing more.”  Avoid any penance that cannot be measured easily such as “tell someone that you love them or spend a few minutes in silent prayer.”  Believe me the scrupulous penitent will be most grateful for your brevity and your clarity.

On one occasion in his apostolic exhortation Pope Francis reminded his readers that the confessional is not intended to be a “torture chamber.”  If a priest is aware of the ravages of OCD and is willing to apply good pastoral advice and direction, the pain and suffering of the scrupulous penitent will be substantially reduced.  Instead of a chamber of torture the confessional will be rather an experience of the outpouring of the God’s grace and mercy.

Continuing Education For Clergy

Workshops for Continuing Education can be arranged for any groupings of priest confessors in an (arch)diocese.  Education opportunities are helpful on a deanery or vicariate level, during priest convocations and other gatherings, or as a special event within the (arch)diocese.  The time frame is fluid depending on the identified needs of the participants. Zoom meetings are an opportunity that has recently been added to the listing.

To arrange a presentation please contact Rev. Thomas M. Santa, C.Ss.R. directly at managescrupulosity@gmail.com.

A note of consideration:  The effective pastoral application of the necessary skills for ministering to the scrupulous requires a certain “openness” to the application of a pastoral response to a given ministerial need.  Clergy who routinely resist the application of pastoral skills outside of the traditional remedies that they may have learned in seminary sometimes have difficulty with the presentation on this subject.  Although the presentations are firmly anchored in the Roman Catholic Moral Tradition, and do not stray from orthodoxy, they do rely on the understanding of scrupulosity that is relatively new and more complex than the traditional understanding of a “tender conscience.”

This note is unfortunately necessary in order to plan for a continuing learning opportunity that is relatively free of debate and confrontation.  Participants are trying to learn a new pastoral skill that will be helpful; not accumulate debate points.