Review: Cutting Edge


2652175‘Cutting Edge: Witnessing Rites of Passage in a Therapeutic Community’ Elizabeth Baxter
in Controversies in Body Theology ed. by Marcella Althaus-Reid and Lisa Isherwood (London: SCM Press, 2008) pp48-69

While there a number of Christian books offering advice and help for self-injurers and their families, it is rare to discover theological thinking about self-injury. Within this book, which focusses on theology and the wounded bodies of women, Rev’d Elizabeth Baxter, Executive Director of Holy Rood House, Thirsk, has contributed an essay drawing on her personal experience as pastor and chaplain to a Christian therapeutic community.

Within her essay, she describes self-injury in theological and psychological terms, and sees self-injurers as Christ/Christa figures whose wounds tell a story, and calls upon the Christian community to walk alongside them as witnesses and agents of structural change.

Continue reading “Review: Cutting Edge”

“Welcome Me As I Am”


Just a short post today! I’d like to introduce my readers to a website I’ve just found, called “Welcome Me as I Am“.

It provides information and training resources for churches and chaplaincies on the subjects of mental illnesses and dementia. There is a free toolkit with resources for discussing mental illness and the church, information about mental health first aid, a guide for dealing with mental distress and some interesting prayers in the mould of Michel Quoist.

It looks excellent, and it’s great to see churches and denominations (Roman Catholic, in this case) engaging with mental ill-health, and offering a genuine welcome to their churches for those who are ill.

They also offer seminars as well as workshops in parishes – I assume they charge for these.

An interesting and useful resource for all churches, not just Roman Catholic ones! Please do visit:

Stress: Mental Health Awareness Week


From the 14th to the 20th May is Mental Health Awareness Week, hosted by the Mental Health Foundation and with the theme this year of “Stress: Are we coping?” Started in 2001, Mental Health Awareness Week in the UK aims to raise awareness of mental health and ill-health, and to promote the message of good mental health.

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Unreliable Witnesses?


“You are my witnesses,” says the Lord,
“and my servant whom I have chosen,
that you may know and believe me
and understand that I am He.” (Isaiah 43:10a)

“You shall be my witnesses in Jerusalem and in all Judea and Samar′ia and to the end of the earth.” (Acts 1:8b)

It will soon be Pentecost, the great Christian festival celebrating the coming of the Holy Spirit on Jesus’ disciples, the power behind the great mission of Christ’s Church, to proclaim the Good News to all creation.

Christ’s followers are his witnesses – people who have seen and experienced his love in their lives, and whose duty and desire is to share that love with others, “for we cannot but speak of what we have seen and heard.” (Acts 4:20) They witness by testifying of what they know and have experienced of God, his grace, forgiveness, and love. Both in their words and in their deeds, Christians are to witness to the truth of Christ’s divinity, his sacrifice upon the Cross, and his resurrection – to the love of God made known in Jesus. This isn’t a choice, or a specialist role, but part of what it is to be a Christian (Matt 10:18, 28:19; Mark 13:9; Luke 21:13; Acts 1:8 and more), and the testimony of Christians helps others to believe (John 4:39; 2 Thess 1:10). So, evangelism, bearing witness to Christ, is the duty of all Christians – but what does it mean to testify to the truth of Christ as a mentally ill person?

Continue reading “Unreliable Witnesses?”

Jesus of the Scars


If we have never sought, we seek Thee now;
Thine eyes burn through the dark, our only stars;
We must have sight of thorn-pricks on Thy brow,
We must have Thee, O Jesus of the Scars. 

The heavens frighten us; they are too calm;
In all the universe we have no place.
Our wounds are hurting us; where is the balm?
Lord Jesus, by Thy Scars, we claim Thy grace.

If, when the doors are shut, Thou drawest near,
Only reveal those hands, that side of Thine;
We know to-day what wounds are, have no fear,
Show us Thy Scars, we know the countersign.

The other gods were strong; but Thou wast weak;
They rode, but Thou didst stumble to a throne;
But to our wounds only God’s wounds can speak,
And not a god has wounds, but Thou alone.

I used to self-harm, and, as a result, have quite a large collection of scars on my arm. All of us, whether we self-harm(ed) or not, have scars on our bodies, and on our minds. They tell the story of our lives – the time we fell in the playground, the time someone hurt us, the time we hurt ourselves, making up a physical picture of who we are, and where we have been. For many self-harmers, the injuries we inflict are signs – in the words of C Blount:

How will you know I’m hurting
If you cannot see my pain?
To wear it on my body
Tells what words cannot explain.

Edward Shillito, the author of “Jesus of the Scars“, was a Free Church minister during the horrors of World War I. From that war, young men returned broken, if they returned at all, with horrific wounds and scars, the treating of which led to the development of plastic surgery. Here, Shillito gives a message to all who are wounded – soldiers, and ordinary people alike: only Christ can bring us comfort.

In the book of Isaiah, the coming Messiah is described as

“a man of sorrows, and acquainted with grief…he was wounded for our transgressions, he was bruised for our iniquities; upon him was the chastisement that made us whole, and with his stripes we are healed.” (Isaiah 53:3a, 5)

In the New Testament, the torture and death of Jesus is presented as a victory, rather than a defeat, and a glorification rather than the humiliation it was intended to be. Through Christ’s death, the believer is crucified with him (Rom 6:6; Col 3:3) and, like him, is resurrected (Rom 6:5-8; 2 Tim 2:11) so that Christ now lives in the believer (Gal 2:20). The wounds that Shillito writes about (thorn-pricks, hands, side) are the marks of Jesus’ Passion, the marks of his crucifixion and death. Those wounds are the signs of our salvation, signs shown to the Apostles when he first appeared to them after his resurrection (Luke 24:36-44John 20:19-29).

So, when we are in pain, when we are wounded, when all seems dark, we are to remember that Jesus has been there too. He knows grief, sorrow, and agony – all the awfulness that being human can entail – and he, too, is scarred, just as we are. Christian faith is in an eternal wonder that God himself chose to become human, to become just like us, except without our sin, and that he chose to die for us, with all the betrayal and pain that implies. He is the wounded God, for a wounded humanity, a scarred Saviour for a scarred people. His wounds are the balm for ours, and our very woundedness is a sign of our need for him.

Let us, then, hold firmly to the faith we profess. For we have a great High Priest who has gone into the very presence of God—Jesus, the Son of God. Our High Priest is not one who cannot feel sympathy for our weaknesses. On the contrary, we have a High Priest who was tempted in every way that we are, but did not sin. Let us have confidence, then, and approach God’s throne, where there is grace. There we will receive mercy and find grace to help us just when we need it. (Heb 4:14-16 GNT)


Beside the Waters of Rest


Have you ever been on a retreat? In my previous post on Elijah’s depression in the desert, I talked about the value I find in retreats – formal and informal – as ways of refreshing mind, body, and spirit, before returning to the world once more. Your retreat might be a formal retreat in a place designed for the purpose; or it might be a few days with a friend. It might follow a programme of reflection and worship; or it might be some time doing nothing at all. One thing all retreats have in common is that they are a time out, a time away from our normal lives, a time to recover, and perhaps to discover more about ourselves, and our faith.

Continue reading “Beside the Waters of Rest”

6 Ways to be a Welcoming Church for People with Mental Illnesses


This week, 1 in 6 people experienced mental ill-health. During this year, 1 in 4 people will be mentally unwell. [1] There are people with mental health problems all around us, among people we know, and those we don’t, in our workplaces, and in our places of worship. Mental health issues often come with a burden of stigma alongside the illness, and the employment rates for people with mental illnesses are low – only 45.5% of people with long-term depression or anxiety are in work, and only 26.2% of people with mental illness or phobias are currently working. [2] People with mental illnesses disproportionately suffer from social isolation, poor housing, unemployment and poverty [3] as a result of the stigma attached to mental illness.

As Christians, we follow a God who found his followers not among the rich, but among the poor; among outcasts, not the ‘respectable’; and who affirmed the equality of all believers as his friends, and his children. The Bible affirms that all have sinned (Rom 3:23) and all are offered salvation (Rom 10:12-13). Just as we all are equal before salvation, we are all equal afterwards – regardless of mental illness or wellness, disability or ability, or anything else about us, for:

There is neither Jew nor Greek, there is neither slave nor free, there is neither male nor female; for you are all one in Christ Jesus. (Gal 3:28)

As Christians, we seek to bring God’s lost children home to faith in him, and to encourage and build one another up (1 Thess 5:11) as we seek to follow Christ, day by day. Many Christians (and seekers) from marginalised groups have felt turned away, rather than welcomed by the Church, including people with mental health problems. These are my five suggestions as to how we, as a Church, can be more welcoming to people with mental illnesses, both those who are new to us, and those who are within us. I’ve put them together under the acronym PSALTR – Pray, Share, Ask, Learn, Talk and Relax.



When we pray, how often do we include people with mental health problems in our prayers?

In my church, each service includes a time of intercessions, under the rough headings of “church”, “world”, “nation”, “region”, “those who are ill” and “those who have died”. In the last two sections, we will often pray generally for people who are ill, or who have recently died (and/or their loved ones) as well as for people whose names are on our church prayer list.

Mental illness is often hidden, and people may not wish to be in a named prayer list if they are suffering. One way to increase the visibility of mental ill-health, and to signal that the Church sees this as an illness like any other, is to pray regularly for people with mental illnesses and those who care for them. Like all people who are unwell, mentally ill people stand in need of prayer, and naming mental ill-health in among our prayers for those with the ‘flu, with heart problems or other illnesses is one way to lessen stigma. Be careful, however, with language – do not give the impression that mentally ill people are being punished, are afflicted with demons, or are different to other ill people, which would have quite the opposite effect!

The formal prayers of the Church are one way in which we can support those around us who are ill, but not all of us lead intercessions. We do all pray, however, and offering (not demanding) to pray for those who we know to be mentally unwell is good, as is asking for prayer when we ourselves are not mentally well.


Church should be a place where we can share our troubles in life and receive the support of others. I recall being startled once, when I mentioned I was having a bout of sciatica, when lots of my church friends rushed up to pray for me all at once! That was lovely – and it would be great to get to a point where we could reveal we are struggling with depression or anxiety as easily as that, and receive prayer as readily as that.

One way to do that is to be open ourselves. While there’s no need to go telling everyone the instant I meet them that I have a mental illness, many people in my church know that I have bipolar disorder. One way of combating stigma is that openness – I have no idea what stereotypes people may have had about bipolar people, but I do know that stereotypes get broken down by getting to know the people behind the stereotype. As a result of my being open, I have had a number of people inside and outside my church who are mentally ill come to talk to me, feeling that they too can be open about their health.

Specifically when it comes to church leaders and preachers, it is more helpful than you know if you share any struggles you’ve had with your mental health, or even just mention it sometimes. Statistics from the US (which are borne out in my own experience in the UK) show that mental illness is a taboo topic in the pulpit, with 66% of pastors speaking about it once a year, rarely, or never.


I’m not suggesting that mental illness should be mentioned in every sermon, or shoehorned into sermons where it isn’t appropriate, but a powerful way of acknowledging that mental illness is an illness like any other, quite common, and not shameful, is to mention it regularly. A particularly powerful weapon against stigma is if a church leader can talk about their own experiences of mental ill-health, if they’ve had them. Clergy are disproportionately likely to suffer from mental ill-health [3] and, dare I say it, I’ve found that being open about not being well is a good way to maintain good mental health. That said, not all clergy may want to be open, and there may be fewer clergy able to talk about their own experiences of mental ill-health because, certainly in my own church, people with mental illnesses are less likely to be ordained. (I’d like to see that reconsidered, but that’s for another post).

Nevertheless, openness from us as individuals is one way to normalise mental illness, to express it for what it is – a family of common illnesses, and nothing to be ashamed of. The support of church leaders in talking about mental ill-health is an important one, but so is that of the rest of us.


As with all disabilities, we go wrong when we make assumptions. We may think that Mrs Smith won’t want anyone else to know she has depression, or that Mrs Jones’ schizophrenia means she would find it too hard to be a Sunday School volunteer, but we won’t know unless we ask them. All of us have some stereotypes in our heads, which we may not even be aware of, but everyone is different, ill or well, and we need to ask rather than make assumptions about what people need, or can do. One constant sadness for many people who are mentally ill is that theirs is a “no casserole” illness. Where people will organise food, or shopping for someone who has broken a leg, they don’t think to ask if someone with depression would like the same. Likewise, people often forget to ask if someone who is mentally ill would like to be added to the church prayer list, or reach out to ask if they’d like to be included on a church trip. These are all ways to help support one another – if that is what the person wants. So ask!

In a wider sense, asking how people are and listening to what they say are important. Asking, for example, how someone who is a carer is doing, if they are looking after themselves, or gently asking a widow how she is doing, not just after her husband has died but for a long time afterwards might be a lifeline to someone. We should aim for a cultural change, so that we can be open with one another about ways in which we are suffering, able to talk about our problems and both offer and accept help.


If someone tells you they have schizophrenia, or bipolar disorder, or any of the mental illnesses, what do you think? As I mentioned above, we all have stereotypes in our heads which can affect what we think someone who is mentally ill feels, thinks, or can do. So, if someone tells you they have a mental illness, learn about it. Bear in mind that all illness is a spectrum, so take diagnostic criteria as a general guide, not something set in stone. Someone currently in a manic episode of Bipolar I, for example, would present very differently from me, who has been “recovered” from Bipolar II for a decade. With that in mind, though, there are many good websites around, like MIND, the NHS website, or the Royal College of Psychiatrists which give good, general information about mental illnesses. The priority, though, is to listen to the person who told you about their illness, to learn how their illness affects them, rather than assuming what it must be like or consist of. Knowledge is power – and certainly knowledge from the person and/or professional bodies beats whatever detritus from TV and films may have got into our heads!


Time to Talk, the UK’s national stigma-busting day, has a good title. It is when we talk about mental ill-health that we can dismantle stereotypes and reduce stigma. Consider the change in how we talk about cancer – at one time, that was heavily stigmatised, and people would avoid naming it or talking about it. Now, people with cancer feel free to talk about their illnesses and receive support from others. We can hope for the same for mental ill-health – but to do that, we all must talk about it, making our churches places where people are comfortable talking about their illnesses, and where everyone else is happy to support them back to health.

The ways in which we can do that are really covered above: openness, mentions in services and sermons, asking people how they are, learning about mental illness, and sharing our struggles with one another. Being a loving and open community, in other words.


Finally, relax. Remember that even people with the most stigmatised disorders are still people, still children of the same heavenly Father. One of the most damaging stereotypes of mentally ill people is that we are violent – when actually, those with mental illnesses are far more likely to be the victims of violence. Sometimes, churches can be frightened of people who are very obviously unwell, and I’ve heard of people being asked to leave, and told not to return because of it. If someone is seriously unwell, the police have the power to detain people under section until they can be assessed by a medical professional. If someone is hurting themselves, trying to hurt others, or otherwise terrifying you, call them.

If, however, someone’s behaviour is odd, but not harmful, then that is the time to relax. Sometimes, mental illness makes people behave in odd ways, dress strangely, or just be a little strange in services. Understand that this isn’t deliberate, but a part of illness, and adapt to it – just as we adapt to children, people with dementia, and people with all sorts of disabilities.

We are all different, but we are all one body through Christ. That’s something I always try to keep in mind.

So, to recap, my 6 ways to be welcoming are: Pray for each other and for all mentally ill people; Share our own struggles, especially if we can do so in church leadership; Ask if people would like help and how they are doing; Learn about mental illnesses and how they affect the individuals we know; Talk about mental illness to reduce stigma and, finally, Relax in the presence of people who are different.

May we see more and more mental health-friendly churches!


[1] Mental Health Foundation Statistics
[2] TUC, Mental Health and Employment, 2017 (


Sainthood and (In)sanity


All those who die in the faith of Christ are considered saints, but among the many faithful believers are some who are seen as being particularly close to God, who lived particularly holy lives. These men and women are seen as good examples for us to follow, as especially worthy of honour and, in some traditions, faithful people ask for their prayers, particularly in areas of which that Saint is the patron. There are more than 10,000 Saints within Catholicism, from all the ages of the Church, and from all walks of life.

If they lived today, some of those Saints might well be called ‘mentally ill’, rather than ‘holy’, but in this post, I’d like to take a look at a Saint who was judged by his peers to be mentally unwell, confined in a mental hospital – and yet still made it out the other end to be proclaimed a Saint by the Church. His name is St John of God.


ST.-JOHN-OF-GOD-1On 8th March 1495 a boy named João Duarte Cidade was born in Portugal. At the age of 8 he disappeared from his home, for slightly unclear reasons. One story is that he was so impressed by a visiting priest’s talk of adventure that he ran away with him, never to see his parents again. He ended up homeless in Oropesa, Spain, where he was taken in by a local farmer, Francisco Mayoral. He worked as a shepherd, and his benefactor saw John as a potential husband for his daughter – which John was less than keen on. At the age of 22, John joined a troop of passing foot-soldiers, setting off to fight in France. He was forced to leave his troop after a failed episode of guard duty. While he was supposedly guarding a large amount of loot, things were stolen, and naturally John was suspected of the theft. He was sentenced to death, but reprieved by an officer, and left the army to return to the farm at Oropesa.

John evidently liked a more exciting life than tending sheep, for just four years later he joined another troop, this time going to fight the Turks in Hungary. He was to stay with this troop for eighteen years. At the end of that time he found himself near his birthplace in Portugal, and decided to find his family. He couldn’t remember his parents’ names, but was able to find an uncle, through whom he found out that his parents had died. He had no reason to stay in Portugal, and so returned to Spain.

John was a soldier like any other, keen on drinking and gambling, but not particularly on religion. By the time he left the army, however, his interest in his faith had rekindled, and he had been on pilgrimage, and had resumed his prayer life. Working as a shepherd once more, this time near Seville, John developed a burning desire to go to Africa and free enslaved Christians there, and perhaps die a martyr’s death in the attempt. At once he set out for the Portuguese colony of Ceuta, on the northern shore of Morocco. On the way there, he befriended a Portuguese knight and his family, who were being exiled to the colony. When they arrived, the knight and his family first had their money stolen, and then became ill, and John nursed them, and found work in order to provide for them. A priest in the colony advised John to return to Spain, which he did, after seeing the knightly family receive pardons.


When he arrived back in Spain, John spent some time wandering, hoping to see what God wanted from him, and then settled into selling religious literature in Granada. He had a vision of the Infant Jesus around this time, who both advised the move to Granada, and gave him the name by which he would become known – John of God.

59e5e4aa2aa78de107043f661dd82cd0--open-book-patron-saintsIt was on St Sebastian’s Day, 20th March, 1537 that John experienced a powerful conversion. He was listening to a sermon by the mystic and teacher John of Ávila when he was overwhelmed by his sins. He tore out his hair, beat his body and ripped his clothes, begging for mercy and repenting of his sins. Naturally, the people around him thought he had lost his reason, and he was taken to the nearby hospital and committed to the wing for the mentally ill. There, he underwent the then-standard treatments for lunacy – being chained up, flogged, and starved.

John of Ávila came to visit him, advising him to tend to the needs of others rather than embracing personal hardships, and had him transferred to a general wing of the hospital. There, John of God helped care for the other patients before leaving the hospital to work among the poor.


John begged around the streets of Granada to get together the money to rent and furnish a house in which to nurse the poor and sick. At first, he had no help, and nursed patients during the day, begging for the money he needed at night. He was known to carry patients into the house on his shoulders if need be, and his house was open to all – beggars, criminals, vagabonds – anyone.

Sant_Joan_de_Déu_1John experienced suspicion and stigma about his work – his time in the mental hospital was known – but, with time, others came to help him in his hospital. Priests and doctors offered their services, wealthy benefactors helped to fund it, and angels paid visits. The local bishop, Sebastian Ramirez, Bishop of Tui, asked to meet John, and asked him his name. John replied that once upon a time a child he had helped in a country lane had called him John of God. “Then John of God shall be your name always,” the bishop answered. The bishop gave John a habit to wear, to show he was acting with ecclesiastical approval. That habit became that of the Order that grew up around him – the Brothers Hospitallers of St John of God.

John of God caught pneumonia trying to save a boy who had fallen in the river. He died on 8th March 1550, and was found dead, kneeling before a Crucifix, his head on the feet of Christ. He was canonised (proclaimed a Saint) in 1690, and his Order (the Hospitaller Order of the Brothers of Saint John of God) now operates across 40 countries, caring for people with mental and physical illnesses.

The Saint in the Asylum

John of God’s story is an interesting one. He seems to have been a man of impulse from childhood onwards – running away with a priest, joining passing army troops, rushing off to Africa – a man who felt a keen emotional response to things, and who then followed through with that enthusiasm. His emotional response to John of Ávila’s sermon was obviously much more acute than anyone was expecting, leading to his being, effectively, “sectioned”.

54e47c3dfcb86ab06d9d2aa728efb856--catholic-saintsWas John mentally ill? It’s hard to say, though I think it’s significant that those around him and who knew him observed such a sudden change in his behaviour that they had him committed, yet we can see from other aspects of his life that he was evidently an impulsive man. What I do find interesting is that after his time in hospital, John was able to settle down, cease wandering, and spend the rest of his life in one endeavour – the healthcare of others.

One of the things I found from my illness is that it awakened me to the sufferings of others. I spent three weeks in a mental hospital, some years ago, and found that I left that place with a greater empathy for other people, and a heart for those who are mentally ill, or different to others. Perhaps something similar happened to John while he was in hospital, whether or not he deserved to be in there. His priorities were somewhat different when he came out – focussed outwards, not inwards, which is certainly something I found.

Another interesting part of his biography is that John experienced stigma as a result of his diagnosis. He had been in a mental hospital – he was a lunatic – and therefore experienced difficulties afterwards, even though he was quite sane. I’m sure lots of us have been there! Perhaps it behoves us – ill or well – to look at that feature of his biography and work harder to eradicate the stigma of being mentally ill, in the church, and outside it.

The main thing I take from the story of John of God is that here is a man who was certainly seen as “mad”, and who experienced the unpleasant treatment (medical and social) that comes from that – and yet who established something enduring. His gift to the world is an Order who seek out and look after the sick, and he himself is considered a Saint – someone worthy of veneration and emulation. Hope for all of us, perhaps!


Scrupulosity: A Stone in the Conscience


Sometimes, the line between faith and mental illness becomes blurred, and mental ill-health can be manifested in specifically religious ways. One such religious mental health condition is scrupulosity, a variant form of obsessive-compulsive disorder (OCD). It has been known and written about since the 12th century, and is an immensely distressing disorder.


The term “scrupulosity” derives from the Latin word scrupulum, or sharp stone, of the sort that gets trapped in your shoe – a constant, stabbing aggravation.

Someone experiencing scrupulosity lives in fear of sin, judging their own behaviour as sinful even when no one else would. They may be troubled with a fear of committing the unforgiveable sin, or by intrusive thoughts of a blasphemous, violent or sexual nature. They may worry about having failed to say their prayers entirely correctly, or that they have not made a total confession of their sins. They may feel compelled to continually repeat prayers, penances, or confessions to ‘get it right’, and either fear or be convinced that they will go to Hell.

Much of the treatment for scrupulosity comes either from secular therapies used to treat OCD, such as exposure and response prevention (ERP) or from specifically faith-based treatments. Much of the literature I have found about scrupulosity is Catholic in origin, and relies primarily obedience to a confessor/spiritual director in treating the disorder. Scrupulosity is not just found among Catholics, or Christians in general, but can affect members of any religion and none. The Catholic Church is more aware of the issue, it seems, because it comes to light via the practice of sacramental confession.

Types of Scrupulosity

Joseph Ciarrocchi, author of “The Doubting Disease”, identifies two types of scrupulosity: developmental, and emotional. The first is a type of scrupulosity which occurs at adolescence or religious conversion, and is brought on by a newly emerging sense of conscience or the conviction of past sin. For most people, this time of having a ‘tender conscience’ is temporary.

Emotional scrupulosity is more serious, and may be lifelong. It conforms more closely to the ‘classic’ symptoms of obsessive-compulsive disorder, including:

  • Obsessional checking (for example, to see if the front-door is locked, or doubt that prayers have actually been said, or the sign of the cross made)
  • Obsessional cleaning (fear that germs or chemicals might somehow harm another, or that particles of the Eucharist are on the floor/in dentures)
  • Obsessional slowness (precision in carrying out activities so that it takes excessive amounts of time to complete them – for example spending forty minutes making the bed to get it just right)
  • Obsessional doubting – or conscientiousness. (This is the doubt that something is done properly, either by omission or commission. For example the person may believe they have offended a neighbour by their tone of voice on greeting them, or that they have really confessed all their sins)
  • Obsessional ruminating – going over and over an idea or image. (The person may have unpleasant intrusive thoughts such as the death of people they love, sexual or blasphemous thoughts, thoughts of committing acts of violence or other sins despite being horrified by the idea)

There is also a significant risk of co-morbidity, where people with scrupulosity may also have depression, anxiety, and non-religious OCD.

Distinguishing Scrupulosity

The marks that distinguish scrupulosity from just being very devout are:

  • Going beyond the normal requirements of religious law (being ‘more Catholic than the Pope’)
  • Unreasonableness – scrupulosity stems from an unreasonable fear of having sinned, or done things incorrectly
  • A narrow focus
  • Focussing on trivial parts of religious experience
  • Important areas (e.g. love for one’s neighbour) may be neglected in favour of minutiae (saying prayers correctly).

Sacramental Scrupulosity

Among Catholics, scrupulosity seems to revolve around the Sacraments, and especially around the Sacrament of Reconciliation (confession) and the Eucharist. There are various rules about when and how to make a good confession, and rules surrounding the Eucharist and how it should be received, and people with scrupulosity may find they fixate on these rules, and whether they have broken them.

The ‘classic’ picture of a scrupulous person is someone who will confess the same sins over and over, worrying that they haven’t confessed correctly, and therefore not received forgiveness, and who will continually repeat the penances they were given out of fear that they did something wrong. It is also apparently quite common for scrupulous people to go from confessor to confessor in search of relief, confessing the same sins many times, without ever finding that relief. They may also avoid receiving the Eucharist for years for fear of not being in a state of grace.


confession_custom-cd4250f874907662d42d33c0930196ed2b74c31a-s900-c85For Catholics, the treatment most often recommended is to find one confessor, hopefully one used to people with scrupulosity. The instructions of that confessor are then to be obeyed – so if he says not to confess a particular sin again, it should not be confessed, and if he says not to go to confession very often, that too should be followed. Trust is to be placed in him on the basis that the sufferer’s reason when it comes to moral matters is temporarily impaired by the scrupulosity, and if they then follow the confessor’s direction, if mistakes are made, they will be held against the confessor, not the scrupulous person. Redemptorist priests, whose founder, St Alphonsus Liguori was himself a sufferer, often specialise in the treatment of people with scrupulosity.

For non-Catholics who do not practice sacramental confession, choosing a wise spiritual director, friend, or pastor may be helpful. It is important, though, just as with the advice above, that their directions should be followed, and only their directions – repeatedly changing spiritual director is not helpful.

Professional help, especially for the most severe type of scrupulosity, is very important too – if you can be sure of finding a therapist who is understanding of the religious content. They may use treatments such as Exposure and response prevention (ERP) or cognitive therapy. Sometimes, antidepressant medication is also used.

One of the principles of ERP is that of agere contra – doing the opposite. If, for example, you are troubled by blasphemous thoughts when reading the Bible, then you must read the Bible more, and face the fear. I should add that the book I gained this information from states quite clearly that self-help, and particularly the use of self-help books, is not ideal for those who are scrupulous. It does mention that what can be useful is keeping a record of circumstances surrounding scruples – of recording triggers, using the “who, what, when, where, why, how often, how many and how much” questions, and including the intensity of the anxiety, amount of time spent and so on. This presupposes a therapist to work with this system, and comes (along with lots of other information on this, from Ciarrocchi’s book)

Loved ones may also help, by interrupting rituals where they apply to themselves – for example if someone obsesses that they have offended their partner and must hear the words “I forgive you” over and over then to say it reinforces the problem. The advice is to learn more about scruples and say, for example, “The doctor said we were not to do that for you.”

General Points

I have compiled this post using two books (cited below). I have never suffered from scrupulosity or OCD myself, but thought this might be of interest and/or use to others.

mind-wanderingOn a general note: I can see, from my own, ordinary experience, the shoots from which scrupulosity grows. I have certainly had times in church where my attention has been distracted, and my mind has wandered. Sometimes, in the middle of the Eucharistic prayer, I realise that I have in fact been thinking about lunch, rather than God, or my attention has been caught by someone’s interesting hat when I should have been concentrating on something else. On occasion, I’ve had quite random, very inappropriate thoughts while praying or worshipping. These don’t trouble me, because I feel sure that God understands my human frailties, and that I don’t mean any disrespect, but I can imagine these ordinary experiences being fanned into a big anxiety.

It’s a sign of how deeply the scrupulous person loves God, that they are so worried about offending him. I can only liken it to the occasional, horrifying thought I have about harming my cat, who I love dearly. It is a horrifying thought to me, but I realise that it only pops into my head because I love her so much, and that I would never actually act upon it. As far as my understanding allows, people with scrupulosity dearly love God, but are impaired in their ability to recognise how much God loves them, that he understands the frailty of humanity, and the perversity of our brains, and that, as the writer Adrian Plass once wrote, “God is nice, and he likes you.”

May we, and all scrupulous persons, learn to live in the full reassurance of the love of God.


Depression in the Desert


At his prayer the fire had fallen; at his word four hundred and fifty enemies had perished. Rain fell on a parched land; victory was his. But at the gates of the city he heard the news, the rulers still fought him, and swore on their gods to take his life.

From victor to victim: fear drove him, running, to the city of the desert. There he left his servant, and continued on alone, into the arid wastes. Finally, he could flee no more, and came to rest under a tree.

“I’ve had enough. I can’t go on. Lord, take my life – I’m no better than my ancestors.”

And then he slept, under the tree. While sleeping, an angel came, touched him, and said,

“Get up, and eat.”

Beside his head was bread, still warm from the fire, and a jar of fresh water. The man ate and drank, and slept once more.

Again, an angel came, touched him, saying,

“Get up and eat some more, or the journey ahead will be too much for you.”

He ate and drank, and that food sustained him for forty days and forty nights, as he travelled to God’s mountain. There, he sheltered in a cave.

Then God said,

“What are you doing here, Elijah?”

And the man replied,

“I have been passionate for you, Lord, but your people have broken their covenant with you, broken down your altars, and killed all your prophets – I’m the only one left. Now they’re seeking my life, too.”

“Go and stand on the mountain, for I am coming.”

And a mighty wind split the mountains and shattered rocks into pieces. But God was not in the wind. Then a tremendous earthquake shook the world – but God was not in the earthquake. Then there was a fire – but God wasn’t there either. Finally, there was a sound of sheer silence…

The man wrapped his face in his cloak and stood at the entrance of the cave. A voice said again,

“What are you doing here, Elijah?”

Again, the man said,

“I have been passionate for you, Lord, but your people have broken their covenant with you, broken down your altars, and killed all your prophets – I’m the only one left. Now they’re seeking my life, too.”

Now God said to him,

“Go back the way you came, to the wilderness of Damascus. Anoint Hazael to be king of Aram and Jehu son of Nimshi as king of Israel. Then anoint Elisha son of Shaphat of Abel-meholah as prophet in your place. Anyone who escapes from Hazael will be killed by Jehu, and those who escape Jehu will be killed by Elisha. But I will leave 7,000 in Israel, all those who haven’t bowed to Baal, all those who have never kissed him.”

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