Sainthood and (In)sanity

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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.

Life

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.

Conversion

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.

Hospitaller

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!

Resources

Scrupulosity: A Stone in the Conscience

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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.

Scruples

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.

Treatment

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.

Resources

Depression in the Desert

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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.”

Continue reading “Depression in the Desert”

From Madness to Ministry

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The Gerasene Demoniac

They travelled by boat that day, over the sea, and into the country of the Gerasenes, a pagan people. In this strange place, stranger things occur, and as they leave their boat, a madman greets them. He came from the tombs, for he lived with the dead. A strong man, no one could restrain him, he tore away the iron shackles and heavy chains they used to bind him. No one had the strength to tame him. Over and over, night and day, his screams echoed among the graves and upon the hillside while he cut himself with sharp stones.

From far off, he saw Jesus approach, and rushed towards him, flinging himself to the ground. “Why? What have you to do with me, Son of the Most High God? I adjure you by God, stop torturing me!” for Jesus was ordering the unclean spirit from him.

“What’s your name?” Jesus asked.

“My name is Legion, for we are many,” said the spirits in the man, and they begged Jesus not to throw them out of the country. On the hillside, a herd of pigs were grazing, and the spirits pleaded, “send us into the pigs!”

So Jesus gave them permission to do just that. The spirits left the man, and entered the pigs, and all at once the pigs charged, down the hillside, and straight into the sea. Around two thousand pigs drowned.

The pig-herders ran to tell of what had happened. They told it in the town, and they told it in the countryside, and people came to see what had happened. There they saw the man, the one called “Legion”, and he was sitting, dressed and in his right mind! They were frightened, and when this man’s story was explained to them, they begged Jesus to leave.

And so Jesus prepared to leave the country. As he was getting back into his boat, the once-possessed man asked to go with him – but Jesus wouldn’t let him.

“Go home,” he said, “back to your own people. Tell them what the Lord has done for you, and how he had pity on you.”

And so the man went off, and proclaimed throughout the Decapolis what Jesus had done. And the people were amazed. Continue reading “From Madness to Ministry”