Friday, August 14, 2020

Too Hot to Handle: Religious Scrupulosity

In which our regular writers toss around subjects a little more volatile than usual.

Sometimes you come across something so odd you don’t know what to think about it. For example, when Immanuel Can sent me this link last week, I responded with, “Seriously? Is this real????”

Tom: Turns out it’s as real as obsessive compulsive disorder (OCD), and probably worth making Christians aware of, assuming they have not encountered it already.

The post IC linked me to is not about OCD per se, but about a particular variety of OCD referred to in the article as “religious scrupulosity”. Like other forms of OCD, religious scrupulosity is a biochemical aberration. As we discussed last week, Christians who try to give spiritual help to a person suffering from a biochemical condition which affects their spiritual lives, and who dive into counseling them without acknowledging and accounting for these underlying physical causes, are likely to frustrate both themselves and the person they are counseling.

Maybe I should let you explain it a little bit, IC.

OCD in the Pews

Immanuel Can: Well, being occasionally anxious does not mean one is obsessive. And performing a behavior, even repeatedly, does not make one compulsive. A thing is really only an obsessive-compulsive disorder when: (a) the person in question simply cannot stop those thoughts or behaviors, and (b) there are no sufficient grounds for them to be having them. “Compulsive” means “have to”, and “obsessive” means “can’t stop”. So let’s get that mistake cleared away: most people are not obsessive-compulsive, even if they have some of the described behaviors. A truly OCD behavior or pattern of thinking significantly impairs normal function.

Tom: Fair enough.

IC: Now, when we’re talking about scrupulosity in particular, we’re talking about a condition that impairs one’s spiritual functioning and the relationships associated with that. So, for example, instead of enjoying the freedom of Christ, the scrupulous person becomes abidingly anxious, maybe legalistic and overly detailed, maybe focused much more on sin than on grace, compelled to perform rituals (from manic church attendance to constant trips to the clergy, the counselor or the confessional), unable to achieve any sense of peace or rest, inclined to go over and over old issues long after they should have been settled, repetitive in cleansing and praying (all the while looking for perfection), avoidant of situations that seem to entail risk of defilement or failure, superstitious in a personal way, and continually earnest to make new ‘pacts’ with God. Some combination of such things is what’s involved.

Tom: Okay. That’s a good start.

Cycling and Cycling

IC: Religiously scrupulous behavior exceeds or disregards Christian norms — for example, overemphasizing a trivial aspect of religious life while ignoring more significant areas. That’s what the international OCD foundation says, anyway.

Tom: Good enough. So let’s just say it’s a professionally recognized pattern of behavior that Christians would be unwise to ignore, or to try to treat as if it’s simply a weird preoccupation. I can immediately think of at least one Christian I know which your summary describes to an absolute ‘T’. If in fact an underlying medical condition is part of his problem, it would explain why years of love and care and attempts to help from his fellow believers have never made him feel secure, and why he continues to be miserable and out of control today.

IC: Now you’ve got it, I think. It’s something that shouldn’t be happening … there’s every reason for it to be over … and it’s still going on, and the person keeps cycling and cycling, and no normal explanations, encouragements and attempts to help really solve it at all.

Tom: Now, of course, we have to be careful about making uninformed diagnoses ourselves on the basis of an internet article. Assuming without warrant that someone has a medical condition when they don’t is just enabling bad behavior. You are handing them a convenient excuse for disobedience.

That said, simply assuming a person’s current condition is only a consequence of sin is equally unhelpful, as we tried to point out in last week’s discussion. If one of the contributing factors is biochemical or trauma-related, you will not be able to solve the problem by reading a few verses and trying to get the person to put them into practice.

Trying to Help

Let me ask this: What role might a Christian without professional mental health experience play in helping someone suffering from religious scrupulosity or another mental condition?

IC: Here’s something I learned first-hand while teaching. You get kids in your class who can’t sit still, for example. And some traditional teachers just hate that. So they tighten the rules, ratchet up the discipline, and yell at them some more. But it doesn’t really work, and it makes both student and teacher miserable. Sometimes it precipitates the relationship into active antagonism, which is then interpreted by the teacher as intransigence or defiance, and blowups occur.

Then you find out something about Asperger’s, or Tourette syndrome, or PTSD, and you see that there IS a way to help that kid be less anxious, impulsive and out-of control, and to feel better about himself.  And more, it's a way to get that kid not only to behave, but to like you in a way that even makes them desperate to please you as their teacher. It transforms your relationship with them, as well as their experience of life.  And you realize that not everything is about more discipline. That doesn’t mean you have found a cure, but it does mean you learn how to make their lives and yours a lot better.

Tom: So then being informed about possible physiological causes of bad behavior is important, even if we are not experts. That’s good.

IC: Would it be good for Sunday School teachers or youth group leaders to know what one of these conditions looks like? Probably. They will eventually encounter one. But it’s really more about being slow to jump to conclusions and remaining open to alternatives, rather than about knowing precisely what causes a person to behave (or misbehave) in particular ways.

Recognizing the Problem

Would it help Christians if we could recognize the symptoms of chemical imbalance or abuse? Probably. Can we expect ordinary believers to become experts or do therapy? Unlikely. But that’s the sort of profitable fusion between correct, secular science of mind and Christianity. Something like that needs to be worked out in the case of elders or others who are counseling the mentally ill.

Tom: Another way to help is to offer encouragement and practical support during the inevitably drawn-out process of searching for effective help from the mental health profession. After all, a mentally ill person is not well equipped to see doctor after doctor and try program after program of possible drug “fixes”, never knowing what might work and what might make things worse. They haven’t the emotional reserves to cope with the endless series of delays, false hopes and rabbit trails that is modern medicine. I have seen repeatedly that people in that situation become completely discouraged and give up the search, at least until the next life-and-death crisis hits them. To the extent that you can be their driver, alarm clock and calendar during this process, and try to keep their spirits up, that’s something I think.

IC: And maybe that’s what we’re looking for in the churches, too … not a cure, sometimes, but just a way of managing this person who’s going to struggle with this issue all the way to Glory, and of keeping them functioning healthily in the local congregation. Sometimes, that’s the best you get.

Judge Not

Tom: Another thing I learned when dealing with a relative’s mental illness is that coming on all judgmental absolutely doesn’t help anyone. If a person believes their spiritual or emotional problem is caused by underlying medical issues, you will not get anywhere proposing spiritual solutions, even if they are a necessary part of what needs to happen in that person’s life. That has to come once they have exhausted their efforts. The woman who came to Jesus in a crowd “had suffered much under many physicians, and had spent all that she had, and was no better but rather grew worse.” Sometimes you have to “try the broken cisterns” to find that “the waters fail”.

So I would say this: DO support people in their search for help, wherever that may lead. (Within reason, of course. I would draw the line at Wicca, for example.) DON’T take the attitude, “This won’t help, so I won’t enable it. I’ll have nothing to do with secular psychology” or whatever. That just leaves your friend alone with their problem. I didn’t believe for a second that my relative’s problems would be solved by psychologists, but I drove her to all her appointments and hoped for the best. And she stayed willing to listen to what I had to say.

Two Sources of Suffering

IC: The ideal would be to find a Christian psychiatrist, a guy with a medical degree plus good theology. A real one. But we have very, very few of those. I know of only one. Next best thing: a Christian who is adept in one particular counseling speciality, and is really trained for it. Next best? A Christian who really cares, and is careful, observant, and thoughtful in dealing with the victim., or a group of elders very submitted to the Spirit. Worst option: whoever else feels like doing Christian counseling.

Tom: One other thought: in trying to help people with mental illnesses, we have to remember that these folks do, think and say sinful things just like the rest of us. A person suffering from religious scrupulosity may feel a whole lot of phantom guilt, but that doesn’t mean every guilty feeling they experience can be excused away. Some of them are genuine problems of conscience. A problem may have both spiritual and physical components, each of which need to be addressed, but which need to be addressed differently. So then, in the case of guilt, for example, a discerning Christian who knows about the scrupulosity problem can give the perpetually-guilty person biblical guidance about how to distinguish between phantom guilt and real guilt. Real guilt has a cause you can point to. It is not just an amorphous feeling of worthlessness and insignificance.

IC: That’s a very important distinction, Tom. Well said.

Phariseeism and Personality Disorders

But now, there’s another aspect of this I want to get to. It’s easy for us to assume that the biblical counselor in a situation will automatically be the mentally-balanced person, and the counseled person will be the one with the disorder. But scrupulosity raises a different possibility: namely, that a person could get into the role of a leading congregant, a teacher, or even a counselor or elder by way of having such a disorder himself. This might be possible because the expressions of the disorder are specifically religious.

Tom: Right. Scrupulosity mistaken for unusual devotion.

IC: Yes. After all, what would we be likely to say if we found one congregant who seemed much more than normally dedicated to tradition, to gestures of repentance, to precise dealing with sin, to attention to spiritual powers, and to maintaining ritual performances? We could, I suppose, diagnose him as OCD-Scrupulous, if we were qualified; but we Christians generally are not. So what might well happen is that a congregation might actually promote such a person to a position of prominence and trust, to encourage him and to give him healthy range for his religious ambitions … after all, he wants it a lot ...

Do you think that could ever happen, Tom?

Tom: I can’t say for sure that I’ve seen it, but I see something like it in scripture. Religious scrupulosity strains at gnats and swallows camels, and so did the religious legalists of the first century. If some were doing it because of spiritual blindness and others were doing it because they had personality disorders, how would anyone tell the difference?

IC: Sounds like Diotrephes — you remember him? The guy who John indicted for demanding first place, denying basic doctrines, accusing people, refusing reception to other Christians, and kicking folks out of the church if they didn’t play ball. He was one serious problem, and it looks like he had a lot of power. Of course we can’t be sure ...

Legalists with Anxiety

Tom: Now, I’ve definitely heard stories about men who dominate churches and behave in ways that sound just like this today, and I’m not about to make a lay-diagnosis of their mental states from afar. But I think it’s something we’d have to consider when we see a person in leadership displaying excessive fussiness and legalism about church life while also evincing high levels of anxiety. After this, bells will go off.

IC: Right. I think one telltale sign that we’re dealing either with a hard-headed legalist or a person with some sort of a personality disorder is going to be his or her willingness to go beyond scripture in imposing rules, rituals, traditions and demands, a preoccupation plus perhaps weakness in particular doctrines such as those that deal with guilt, repentance and reception.

Tom: Mind you, a man who has secured for himself a leadership position in the church may not be open to the possibility that he is suffering from a personality disorder. More likely he will be convinced he is being persecuted for his love of the truth. But what may be persuasive in such situations is this: Sure, leadership is stressful, but those the Lord calls to himself are guarded in heart and mind by the peace of God, which surpasses all understanding. A man who is chronically anxious to the point of obsessiveness may realize deep down that something is not right with him because he never has peace. And if he doesn’t recognize it, the rest of us certainly should see it in his daily behavior. Assuming he is a genuine believer, the Spirit of God may speak to his conscience to confirm he needs help when his brothers in Christ confront him about his problem.

IC: Right. The person who is behaving this way is not happy either. That doesn’t change when we are talking about a man with responsibility in the church. It may get worse with pressure. So we do him no favors by opening up latitude for his illness to rage. Real love seeks out the best means of delivering the person from such suffering, whether it’s personal counseling, medical and psychiatric help, or just a better role that doesn’t aggravate his dysfunction.

The big takeaway is perhaps this: religious fervor may be a sign of spiritual seriousness, but it may also signal a character flaw or even a psychological disorder. And the best way to detect whether we have a problem is to resort to scripture to see if the way the person in question is behaving is normal, biblical Christian behavior. If it’s not, then something needs to be done to address that.

3 comments :

  1. 1 of 2 I've been thinking about the biblical example you mentioned here about the religious legalists who ‘strain gnats and swallow camels.’ I took a look at the whole verse and I think its more insightful than I’ve realized previously. Here it is and then I’ll share more of my thoughts: ‘Woe to you, scribes and Pharisees, hypocrites! For you tithe mint and dill and cumin, and have neglected the weightier matters of the law: justice and mercy and faithfulness. These you ought to have done, without neglecting the others. You blind guides, straining out a gnat and swallowing a camel!’ Matthew 23:23.

    I’m particularly interested in how to deal with scrupulosity in leadership and I think the first thing to note is the hypocrisy. If this word were brought to their attention, I think they would not see its relevance to their life and not welcome the possibility. I think it would also catch them in a dilemma because they would want to dismiss the possibility that hypocrisy might apply, but that they would also not be able to dismiss it easily because of their scrupulosity.

    Secondly, Jesus reveals a tiering in the weightiness of the law. Some things are simple and straightforward, like tithing a tenth of everything. That is a simple mathematical calculation of externalities. Internalities like character are a different matter, but they show up in words and deeds and become observable to others. Likewise, the absence of proper internalities is also telling.

    Thirdly, I think Jesus is very insightful when he says they should do both the simple and the weightier things. I think the reality here is that someone caught up in scrupulosity doesn't have enough time or focus to devote to character development. They don’t get to the weightier matters because they opt for simple and straightforward behaviors that consume their time and attention and garner praise from others, but all of this is at the expense of the complex matters of the heart.

    Fourthly, Jesus calls them blind. I think that is a direct hit against the false confidence they feel by being so meticulous about legalistic spiritual things. Inner blindness is a problem for people struggling with anxiety. This may sound unlikely but long-lasting anxiety acts like a dense fog that prevents people from seeing other, more important things in their hearts and minds. If the truth were told, I think a scrupulously driver leader is someone who is desperately trying to calm their long-lasting anxiety (the root emotion of OCD) with external measurables. They probably have no idea how to sort the inner world of their hearts or how to mature their character. In this way they turn a blind eye to their own inner worlds and might even teach others to do the same. By calling them blind, Jesus accurately points out that a person can notice a smaller thing and at the same time miss bigger, more important things.

    If these things were applied to a scrupulous church leader, I think the main point to focus on would be their character development. The presence of character problems or the absence of good character are both problems that more rule following will not help.

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  2. 2 of 2 Another avenue that might help comes from 1 John 3:19-20 and could be helpful with a scrupulous person who does want to repent of their scrupulosity. I've heard these verses called the verses for people with an overactive conscience. I think the scrupulous behaviours are a misguided attempts to quiet a condemning heart that is fueled by unrelenting anxiety. It is the unrelenting anxiety that needs attention and relief and if that relief can be found the fuel for the scrupulosity dries up and the behaviours diminish or stop. It simply doesn’t help for very long to try to arrest the behaviours but leave all that emotional fuel (anxiety) unaddressed.

    In a practical way finding the emotional fuel requires a bit of heart-level digging. I walk people through a mental exercise to help them locate the true source of their anxiety. The idea is to prune away everything that is fine and good and see if anything is left over. If something is left over then that might be the source of the anxiety, though it may not seem intuitively or logically obvious how that could be so. When someone (including the helper) doesn't know how to find the source of anxiety, there is great temptation to grab onto the first thing that seems to explain it. Behaviours are the easiest things to spot and grab onto, both by the individual and by those trying to help. In truth, and people might not like to think this, but the anxiety might be functioning properly in its attempt to alert someone to a real heart-level problem in their life in the same way a check-engine light alerts a driver to a problem deep in the car’s engine. Fix the engine and the light will turn off; fix the real heart-issue and the anxiety will turn off far more often than people realize. The way to test whether the root issue has been found it to see if the anxiety lowers or stops after facing the suspected root issue. And don’t be deterred if the anxiety rises up again because there are lots of heart-level issues we each need to face, once is not enough.

    If we consider Matthew 23 in light of 1 John 3 the men in question have neglected their character growth so their condemning/anxious heart is appropriate. Their meticulous tithing misses the heart-level problem of their immature character. If they shifted focus and developed their character more and made an ongoing practise of it, then it is quite possible that their anxiety would lower (probably quickly) because they are fixing the root problem of immature character. Then they would not be blind to their own inner world, would be able to address internal and external aspects of the life of faith, could use the bible to see what is weighty in God's sight and spend more time on those things. Then they would no longer be hypocrites. They might mature into men who are able to lead others well.

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    Replies
    1. Bellator, there are some very useful thoughts here. Thank you for taking the time to express them.

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