Psychiatry and sin

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Basic question: how does modern scientific psychiatry interact with Catholic understanding of personal sin?

For example, can someone with obsessive-compulsive disorder (OCD) with compulsions about the morality of their daily activities be considered to be scrupulous in the formal sense?

Can someone with clinical depression be considered to be in a state of despair, in the theological sense?

When is an autistic person culpable for sins that would be considered mortal among non-autistic people?

I guess my question is more about conditions short of outright psychosis. I’m presuming that a paranoid-schizophrenic can’t be considered to have complete volition over their moral decision-making.
 
I don’t think anyone could answer your question other than in a specific context or in the case of a specific event. A schizophrenic person might steal simply because they wanted something and didn’t have the money, and be in a quite lucid frame of mind when they did so. On the other hand they might steal because some voice in their head told them to. The two contexts are different, despite the fact the person has a psychiatric illness. In the first case the “sin” would be greater.

My old Protestant pastor had six sons. The eldest developed manic depression. I didn’t get to know him very well, as he committed suicide a few months after I’d joined the church. Yet the other five were all fairly high achievers in their own right in different fields, although one of them has had a stroke since, which has effectively brought his nornal life to an end.

Was he culpable for his suicide, in the sense of destroying his own life? I don’t know. I certainly think there would have been mitigating circumstances. The judgment is God’s, not ours.

I don’t know that there’s much benefit in speculating about this, because I think each and every event is a different context, even when someone has a psychiatric illness.
 
**I have a form of Paranoid Schizophrenia called Schizotypal Personality Disorder.
I have finally, after 20 years, been properly diagnosed and am doing well.
I am functioning quite normal besides some paranoia and anxiety.
I am not psychotic but do have my limitations. I am sometimes to
anxious to go to Mass but I have a dispensation from the parish priest.
I have a very active prayer life with the Liturgy of the Hours and the Rosary.
I do house and yard work and get by.
But to answer you question, I would say it would be a case by case judgment.
I do well some do not.

Be at Peace
Dan **
 
Most with Mental Health issues are on many medications. When they are properly diagnosed and medicated, they fit well into society. When they have a problem with independant living and medicating themselves? Thats a situation where they are not themselves. And many things can happen depending on their specific illness. So the question is, “do they know what they are doing”? And in many case’s reality can be illusive. In that type of situation, how could they be responsible for their behavior? The answer is they can’t. But there is much room for interpretation when you say psychiatry. That word alone indicates medication is involved, From their its a matter of exactly what the issue is? How effective is the treatment? And many other factors. Many chose not to take medication prescribed because of they way they feel medicate on it. They chose to medicate with illicit drugs in some case’s. It really is a case by case situation.
 
Many chose not to take medication prescribed because of they way they feel medicate on it. They chose to medicate with illicit drugs in some case’s.
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I know you probably meant no offense but just to be clear- Some people with mental health issues just as some people without choose to use illegal drugs.

As a separate issue, mental health medications in and of themselves are no cure and are often damaging and experimental. We should be charitable to all and especially remember that those with mental illness frequently suffer a hell on the inside that we never know.
 
fnr said:
Basic question: how does modern scientific psychiatry interact with Catholic understanding of personal sin?
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fnr, this is an excellent question, but not one likely to generate much discussion here in this particular era. The practice of psychiatry is generously given much credibility and leeway in the CA forums, possibly more than it deserves, mostly because the stakes and liabilities are high (eg. self-injury and suicide). It is my observation that the great majority of psychiatrists are secular and behave as practical atheists. However, criticism of the field in this light must be tempered by the fact that they are the ones with primary responsibility for the patient.

Psychiatric diagnoses are based on observation, description, and fulfillment of criteria. In other words, the description is the diagnosis, and no one even pretends to know the mechanism, other than an imbalance in [waving hands for effect] “brain chemistry”. The real question is, what causes chemicals to become imbalanced? Could poor personal choices in defiance of natural law (ie. some types of sin) be the initiating event(s) in some patients?

I think our innate sense of the spiritual, combined with evil that is directly experienced, is responsible for most of the diagnoses of depression in the US and for most of the Prozac being prescribed. But we will probably not know the full impact of sin on mental health until the realities[SIGN][/SIGN] of spirituality, Christianity and Catholicism become truly accepted and respected within psychiatry, instead of being sources of “delusions” and psychopathology.
 
The real question is, what causes chemicals to become imbalanced? Could poor personal choices in defiance of natural law (ie. some types of sin) be the initiating event(s) in some patients?
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Let’s be careful not to blame the victim here. I find this questions troubling to say the least. I’m sure which sin you are referring to but to say that a mental health disorder is a person’s own fault because they comitted a sin is completely incorrect. Mental Health disorders are not as nebulous as you may think. There is a whole filed of neurobiology, neuropsychiatry etc. People who have diseases such as OCD, Schizophrenia, scizoaffective disorder ,manic depressive/bipoal disorder, major depressive , PTSD etc have brains that do process infomation and emotion differently.As observed through repeated studies.The same is true for vicitims of violent crime or child abuse who incidently often end up with some of the above named illnesses.

A sin no more causes these illnesses than it does being born without a leg or having cancer or becoming the victim of a crime. Yes we are need to take steps to keep our physical and spritual lives straight by following God’s laws.

Lets not add insult to injury by judging what we do not understand. Mental illness entails profound suffering and misunderstanding by the outside world.
Until the advent of medications like prozac and that class of drugs people had to be kept in mental hospitals for the illness I listed for their entire lives No kidding. That is why prozac became so popular so fast.

In addition there are millions of pastoral counselors within the Catholic Church and Catholic psychiatrists as well as other Christian counselors and Christian psychiatrists.
It has been a long time since Freud in the actual practice of the discipline.
 
MariaTheresa said:
Let’s be careful not to blame the victim here. I find this questions troubling to say the least. I’m sure which sin you are referring to but to say that a mental health disorder is a person’s own fault because they comitted a sin is completely incorrect. Mental Health disorders are not as nebulous as you may think. There is a whole filed of neurobiology, neuropsychiatry etc. People who have diseases such as OCD, Schizophrenia, scizoaffective disorder ,manic depressive/bipoal disorder, major depressive , PTSD etc have brains that do process infomation and emotion differently.As observed through repeated studies.The same is true for vicitims of violent crime or child abuse who incidently often end up with some of the above named illnesses.

A sin no more causes these illnesses than it does being born without a leg or having cancer or becoming the victim of a crime. Yes we are need to take steps to keep our physical and spritual lives straight by following God’s laws.

Lets not add insult to injury by judging what we do not understand. Mental illness entails profound suffering and misunderstanding by the outside world.
Until the advent of medications like prozac and that class of drugs people had to be kept in mental hospitals for the illness I listed for their entire lives No kidding. That is why prozac became so popular so fast.

In addition there are millions of pastoral counselors within the Catholic Church and Catholic psychiatrists as well as other Christian counselors and Christian psychiatrists.
It has been a long time since Freud in the actual practice of the discipline.
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I understand what you are saying, esp. in regard to people with psychiatric diagnoses being victims. Victims of what? Victims of evil. Committed by whom? Often a family member or acquaintance. The victims have to try to get their heads around the pain they have suffered and continue to suffer, dealt by someone they have a relationship with. Even a nominally Christian victim additionally understands justice, and may believe that their relation may go to hell for the suffering they have caused, which also does not help the victim any. A victim may pursue a life of sin to lessen the pain, compounding the problem. And at some point they end up at the psychiatrist’s door, who is most likely going to engage in a little “talk” therapy, and give them a drug and send them out the door.

I know about these disorders, I learned about them from in my training at a certain famous medical center, from a group of highly respected and published psychiatrists and neuropharmacologists. I also saw the view from the other side years later during an episode of major depression, and these same highly respected psychiatrists wanted to ship me off to a certain big psychiatric center in Kansas for months to years of very expensive psychotherapy for chronic depression and emotional maladjustment. None of them had a clue to the nature of my problem - that I was a victim of evil, surrounded by a world of practical atheists, many of whom were Catholics-in-name, many of whom were doctors, and no one ever spoke the real truth about anything. I know about suffering. And for patients like myself, when the doctor is part of the problem, good luck getting help.

I was an atheist back then, as a response to - I’ll put it simply - pain. While I considered myself an empathetic guy, I had one instance where a very upset and agitated (name removed by moderator)atient with “religious delusions” tell me “You are NOT from God, you are from the DEVIL!!”. While I nervously laughed it off at the time, I would realize years later that this exclamation was profoundly true. It could have been a fluke, but I believe this patient was wiser and more perceptive than the doctors, and probably more in touch with reality than anyone on the other side of the unbreakable glass window. And that’s how I view patients with depression and other “neuroses”; many are victims of evil and are profoundly sensitive to the insanity of a practical atheist world. Yes, their brains may process information and emotion differently, but this characteristic, this sensitivity, is hardly a disease in my book.

I hope this clarifies my earlier post. I know it is not a mainstream view. And it certainly does not apply to all diagnoses (eg. psychoses).
 
I’m Bipolar, but I’m considered a “high-functioning” Bipolar, which means, when I take my pills, I’m essentially normal. I still have some obsessive issues, but it’s minor stuff. Some trace anxiety, again minor.

I do so well, in fact, that when I’ve told people I’m Bipolar, they don’t believe it. One person told me said to me, “That can’t possibly be. You’re the most emotionally-stable person I’ve ever met!” I consider this a huge compliment because I’ve worked SO HARD to achieve this. I mean, I had to work HARD just to get to being normal. (I did a lot of cognitive behavioral therapy and counseling).

But when I’m off the pills, when the real person surfaces, I’m a nutcase. Paranoid. I hallucinate. See things. Hear voices. I have black-outs. OCD symptoms. ADD symptoms. I look like a Meth addict. And boy, can I be a b**ch! I mean, I can be the meanest person you’ve ever met. Or when Manic, I can be quite a fun party animal. Just depends on my mood. 😉

Over the years, I’ve asked myself unanswerable questions like:
Who is the real me? (Being Bipolar is like being two separate people at the same time).
If I sin mortally during a black-out, am I culpable if I don’t remember it? Or is the part of me that’s mentally ill culpable?
During Judgment, will I be judged as one single person or two?
Am I as culpable for sexual sins as others given that the DSM-IV Manual defines “hyper-sexuality” as one of the criterion for diagnosis? Etc…
What about scrupulosity vs OCD? etc …
How do I differentiate despair from depression?
How do I know the difference between voices from the Bipolar disorder versus the Evil One?
etc…

One priest told me that I can’t sin. I think that’s bull. I assure you, I can. If I’m on the pills and I’m in good control and I do something bad when I’m in the “green zone” then I can sin mortally just like everyone else.

If I am off my pills, in the “red zone” who knows. I really am not sure if I can sin mortally in such a state because I’m such a crazy whack-job. I no longer flagellate myself over the stuff I’ve done in such a state. There’s no point in it.

When I’m in the “yellow zone” the area where I’m taking the pills but they’re not working as well for some reason, or if my physician is experimenting with my brain chemistry by giving me a new drug, I’d also say I probably can’t sin mortally. Probably. Not definite though.

One bit of confessional advice that stick out more than others is this: I MAY NOT BE CULPABLE FOR CERTAIN SINS OTHERS WOULD BE CULPABLE FOR, BUT I WILL BE HELD CULPABLE FOR NOT TAKING MY PILLS!!! It is a mortal sin to not take my pills.

The reason is that I KNOW that by not taking my pills, I’m am possibly placing myself and others at harm. And there’s no excuse for not taking them. There’s really very few side-effects from Lithium because I take such a low dose. I occasionally take Alprazolam, but only a couple times a month for acute anxiety.
 
One new problem with the pills surfaced recently and that is emotional flatness.

Bipolar disorder is essentially an excess of emotions. Lithium dampens this.

Lithium isn’t supposed to do this, but I’ve read other Bipolar people having this rare side-effect on lithium … problems feeling sorrow. It would take a huge disaster to make me cry. Not even a death of a close family member makes me feel sadness.

I also have developed a strange sense of fearlessness.

Emotions are like a “sense” and if you take them away, you rely upon intellect alone to differentiate right from wrong. So, I take my time in making decisions, really think it out, because I’ve lost my “right and wrong” compass.

I can still feel happiness, joy and anger. (Much less on the anger stuff, too).

Hey, I can live with this! 👍 I just need to be aware of the danger of fearlessness, and when I attend funerals, I need to keep some onions in the glove box so that I can come up with some watery eyes.
 
I think that a lot of psychiatric disorder`s could stem from a preoccupation with self,a narcissistic attitude.

As you could know psychiatry means a healer of the spirit and the mind,which i`m not very sure they treat(the spirit,that is)with anything other than arbitrary stereotypical experience.

The old methods were in extreme cases to drill two holes in the head,and not to patronize but that obviously failed.

Now days they give them drugs which also dont,in the long run,work.

That part of the body is our lords domain entirely!!
 
mark_avery said:
I think that a lot of psychiatric disorder`s could stem from a preoccupation with self,a narcissistic attitude.

As you could know psychiatry means a healer of the spirit and the mind,which i`m not very sure they treat(the spirit,that is)with anything other than arbitrary stereotypical experience.

The old methods were in extreme cases to drill two holes in the head,and not to patronize but that obviously failed.

Now days they give them drugs which also dont,in the long run,work.

That part of the body is our lords domain entirely!!
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You really don’t have a clue.:takethat:
 
OK.

July 11, 2001…

My first meeting with Father Pecht, “the” spiritual director for our diocese and confessor to most of the priests around Wichita.

June 8, 2001, after a clerk thought she heard something important about me but was mistaken – and I was acting a tiny bit manic --she turned me into the “authorities” who locked me up for 10 days without my consent, which was either the most damaging or the most beautiful experience of my life, depending on how I wish to look at it at any given time. You are not talked to like a person, you’re “observed” like an animal. They don’t care what you say as long as you give them enough to go down their checklist, and if you try to say “none of the above” to a yes/no question like “do you believe you are here on a mission from God?” then they put down that you refused to answer, are uncooperative, and they give you more antipsychotics and tranquilizers to help you “conform.” Funny the guy who asked me that was from an eastern religion. I asked him what he meant by “mission from God” and told him that I was a Catholic and that we believe we are here to serve God’s purpose. I don’t know whether that’s what you’re asking, though, because I’m guessing you aren’t Catholic so God knows what you mean when you ask that queston?" He said, “I seeee,” and wrote REFUSED TO ANSWER on his little form justifying what drugs he gave me.

Anyway, I digress.

The first question I asked my spiritual director was, "Father, why is everybody so crazy? The psychiatrists are supposed to be experts at thinking, and they can’t hear a word I say that is so obvious I shouldn’t have even had to tell them?

His answer, paraphrased by my bad memory:

The doctors are too specialized. Every doctor has a certain experience through which they see and understand whatever is going on with you. There are six components to a human being. They are the
*Physical
*Mental
*Emotional
*Spiritual
*Social
*Sexual (closely related with identity, “he made them man and woman”)

He said that worldly experts that have depth in their field, only are experts at maybe 2 or 3 components, max. Therefore, if your problem is social and emotional, go to a medical doctor and he might give you muscle relaxant and pain killer. If a psychiatrist, maybe antipsychotics because to him it looks like a mental problem.

There was an interesting experiment but it was in 1973. I don’t know if there is more recent work, I just found it using stumbleupon. It sent phony patients into psychiatric hospitals, and told other hospitals there were phony patients, when there weren’t. The results are pretty grim.

Psychiatrists basically play **** shoot. They can’t heal the way the Lord can, nor are they usually able to give you spiritual direction to seek the Lord. That’s what the SD is for. Shrinks see you behaving X, for which the book recommends drug Y. If that doesn’t work, give drug Z and see what happens. The better ones will listen intently rather than just to go down a checklist, and actually hear whether your problem really is mental, or if you just need some therapy or relaxation – or often, laughs.

So we cannot use the same yardstick to measure sin and psychiatric conditions; they interreact but they are very different things, and few people are experts both at psychology, psychiatry, and spirituality.

Here’s where I got lucky… Father Pecht was an expert at spirituality, with much study and training and personal contacts in psychology and psychiatry. So he blended the three in his approach to spiritual direction.

Alan
 
fnr: very well if the psychiatris happens to be a good Catholic.Be careful with the others.2) Yes.although I’m not quite sure what you mean"formal sense"/Depression aand despair are two different things.Depression is generallly a state of sadness which lessens one’s ability to enjoy the normal pleasures of life.Despair has an element of hopelessness attached to it.Something has occured which is very crucial to one’s state of natural happiness and it seems impossible to cure.3)Autistics fantisize to escape reality.Don’t know much about it.Paranoid -schixpphrenics typically suffer some traumatic events in their early development stage.They put up defence mechanisms to help them cope.As they mature they are unable to adjust to the ordinary stresses of everyday life.They may appear childish and introverted or just the opposite but they can’t deal with reality.They can and do commit offences which they no are wrong and fully aware of but I’m unable to judge their culpability.
 
fnr said:
Basic question: how does modern scientific psychiatry interact with Catholic understanding of personal sin?

For example, can someone with obsessive-compulsive disorder (OCD) with compulsions about the morality of their daily activities be considered to be scrupulous in the formal sense?

Can someone with clinical depression be considered to be in a state of despair, in the theological sense?

When is an autistic person culpable for sins that would be considered mortal among non-autistic people?

I guess my question is more about conditions short of outright psychosis. I’m presuming that a paranoid-schizophrenic can’t be considered to have complete volition over their moral decision-making.
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C.S. Lewis said humans judge each other based on their actions, but God judges us for what we do with our psychological raw material. He says in Mere Christianity that someone who has been taught nothing but cruelty since infancy, if he refrains from some greater cruelty, may be nobler to God than if a normal man gave up his life for someone. Just a thought!
 
JaredR said:
C.S. Lewis said humans judge each other based on their actions, but God judges us for what we do with our psychological raw material. He says in Mere Christianity that someone who has been taught nothing but cruelty since infancy, if he refrains from some greater cruelty, may be nobler to God than if a normal man gave up his life for someone. Just a thought!
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That is interesting and I believe it to be true We are taught that in the parable of the talents.
 
Quote: Originally Posted by mark avery View Post
I think that a lot of psychiatric disorder`s could stem from a preoccupation with self,a narcissistic attitude.
Click to expand...
As you could know psychiatry means a healer of the spirit and the mind,which i`m not very sure they treat(the spirit,that is)with anything other than arbitrary stereotypical experience.
Click to expand...
The old methods were in extreme cases to drill two holes in the head,and not to patronize but that obviously failed.
Click to expand...
Now days they give them drugs which also dont,in the long run,work.
Click to expand...
That part of the body is our lords domain entirely!!
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You really don’t have a clue.
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Ditto. Attitudes such as this are why Christians with Mental Illness are afraid to speak out.

I didn’t WILL to have visual hallucinations, hear voices or have memory blackouts. And why does this go away 100% with pills? Because it’s a MEDICAL PROBLEM!!! The brain is an organ. It’s made of organic material and stuff can go wrong with organic material. That’s a simpler explanation for mental illness than explaining it away as an act of the devil.

I bathed myself with holy water and it did nothing. I surrounded myself with Hedge prayers and it there was no effect. I sprinkled blessed salt around my apartment to keep the demons out and it didn’t work. But, if I take a cheap, little pink pill twice a day, all the nightmares go away.
Now days they give them drugs which also dont,in the long run,work.
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I’ve been taking Lithium for over a decade and it seems to work BETTER over time. There’s been a LOT of research done on Lithium. It repairs areas of brain tissue that have shrunken or become lost in Bipolar disorder. It’s also being used to slow the effects of Alzheimers for the same brain repairable property. That is, it causes brain tissue to grow. My physician told me that it also increases IQ. I agree. I’m smarter now than I was ten years ago. Look on the website Science Daily for this information. They have archives.

This is all documented in the scientific literature.

One of my best friends, who is also a new Catholic, is Bipolar and also takes Lithium. For her, it was also a “miracle.” She also has few side-effects and she’s been taking it for about 7 years. She’s really doing fabulous.

Some of the newer drugs I take some issue with. Really, the drug of choice for Bipolar is Lithium and in my opinion if this drug isn’t tried at least once, it’s doing the patient a great disservice.

I can’t speak for the other mental illnesses and the drugs used to treat them because I haven’t done research on those conditions or treatments. It is best to do your homework before you speak.
 
So we cannot use the same yardstick to measure sin and psychiatric conditions; they interrelate but they are very different things, and few people are experts both at psychology, psychiatry, and spirituality.
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I couldn’t agree more. It’s a tricky area and I think that’s why there are no Catholic books on the subject of spiritual direction for the mentally ill. There should be. There is a need. There’s no one brave enough amongst theologians or priests to speak out.

The only book I could find was written in the 1950’s called Neuroses and the Sacraments. The only advice for the Bipolar and the Schizophrenic was to pray for them. This was really before Lithium and some of the anti-psychotics came on the scene.

There is a need for such books because now we have drugs to treat these conditions. Most people who are mentally ill are high functioning. We’re no longer homeless people lying in alleys unable to function in society. We’re professional people, laborers, mothers and fathers. We’re members of the Body of Christ who are unsure where we stand with God.

**We would like to know where the Church stands officially on the subject of spirituality and Mental Illness.
**
 
I have often wondered about this myself. I suffer from Borderline Personality Disorder which sometimes causes me to do stupid stuff like change my religion. I often do this even on a whim. I am usually back to the Catholic Church within a day or so though. But yeah, this just happened this morning. For some reason I got the idea in my head to suddenly be a liberal and I temporarily decided I was one. Thankfully, I have come back to my senses and am now agreeing with the Church again. I honestly feel that what I did was a mortal sin but then again maybe its not since my personality disorder was likely at play there.
 
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