My Side of the Confessional

For months, I had been mustering the courage to go to confession. I had faced the terror of Hell to marshal my sins. I had waited in the empty church for half an hour, palms in a cold sweat, rehearsing my lines. It had been three months and two weeks since my last confession.

“Bless me, Father, for I have sinned. Before I begin, I should mention that I struggle with scrupulosity.” I begin most confessions this way. Even after my warning, the results can be disastrous; without it, I shudder to consider the consequences.

I continued with my confession. The straight-forward sins were finished in thirty seconds. Now for the confusing sins: those sins over which I had sobbed in terror and misery in the dark of the night for weeks as I prepared for confession.

“I don’t think I have committed this to the point of mortal sin, but if I have I am sorry.” A moment of silence. Would Father allow me to continue? No. He was going to question me. He concluded that it was indeed a mortal sin, but I need not fear, because God would forgive it. The scars of terror and anxiety on my heart, opened and reopened since I was a child of eleven, unable to sleep for fear of mortal sin, flared back to life. The confession lurched to an end. I grasped desperately for “the peace of God, which surpasses all understanding,” but was immediately assailed by new doubts. Even as the forces of darkness receded to the edges of my hollow freedom, I knew they would return.

Why Confessors Need to Understand Scrupulosity
I have a great deal of respect for priests, particularly for their efforts as confessors. To hear the sins of many, and to respond appropriately to each sinner, is no light burden for any man. To stand in persona Christi is a great gift, but also a great responsibility.

Yet, the sacrament of confession is often a stumbling block to the scrupulous. The confessor’s approach to a scrupulous person’s confession can greatly exacerbate the affliction of scrupulosity. I have experienced confessions, the content of which was fairly ordinary, which have, nevertheless, unhinged me for weeks. Most of the time, these priests were good and well-intentioned, and their advice would have been sound if I had not been scrupulous.

I do not wish to criticize harshly priests who have not dealt with me in the manner I believe most prudent, but rather to offer constructive insights from my own experience, which is far from unique. I hope to shed light on a problem I believe to be misunderstood and, therefore, mishandled by many good confessors. I am not a psychologist, nor am I a priest. My understanding of science and spirituality is on the level of a layman in both realms. I have undergone counseling for my scrupulosity, which has helped me to understand and cope with it better, although in my case it has not been a cure; and I have discussed the problem with a number of priests and other prudent and faithful Catholics.

I believe, along with many psychologists and priests, that scrupulosity is a form of Obsessive Compulsive Disorder. One must, therefore, understand some details about the nature of OCD in order to develop an effective approach towards handling and treating scrupulosity in general. More specifically, this foundational understanding of OCD should inform priests’ approaches when faced with the confession of a scrupulous penitent. The approach I advocate has two main parts: understand scrupulosity sufficiently to recognize it, and avoid being fooled by it; and when you recognize it, don’t engage it. The second part is counterintuitive, but highly important, because it is easy to accidentally reinforce the disorder from the exterior.

Introduction to Scrupulosity
Let me begin with what scrupulosity is not. Despite its spiritual subject and effects, it is not primarily, or fundamentally, a spiritual disorder or affliction; nor is it particularly likely to be a sign of some real, but hidden, vice or sinful addiction. It is not “nothing,” or spiritual narcissism, or hypochondria. It is not a simple lack of catechesis, or intellectual confusion, about sin and morality. And it is not holiness, nor is it inherently a direct cause or effect of holiness, though it can have some of the same effects on a person’s holiness that any suffering, borne in love, can have.

Scrupulosity is a mental health disorder. More specifically, it is a type, or a particular manifestation, of Obsessive Compulsive Disorder, which may or may not be accompanied by other OCD tendencies, outside of the spiritual realm. Until recently, OCD was classed as an anxiety disorder, along with a number of other disorders, including a more familiar one, depression. Anxiety disorders are based in the limbic system of the brain, the seat of human emotion. Although OCD has now been moved into its own category, “obsessive-compulsive and related disorders (OCRDs)”, and some new research suggests that it may be more productive to understand OCD as rooted in executive function, rather than directly, or primarily, in anxiety—the existence of a connection between anxiety and OCD is undeniable. I believe this connection to be a fruitful tool in understanding the experience of a person who suffers from OCD, although I am unqualified to comment further upon the psychological implications of this recent re-categorization.

Anxiety, itself, is natural and necessary. Like all human passions, by nature and Divine intention, anxiety is designed to be governed by reason. But again, like all human passions, it is not fully subordinate to the intellect, by reason of Original Sin. But not all cases and degrees of insubordinate passions are classified as psychological disorders. A child who is afraid of monsters under his bed is not immediately diagnosed with an anxiety disorder, although his anxiety is irrational. He is taught to integrate that fear under the governance of his intellect as he matures, and in most cases adulthood finds him none the worse for his childhood foible.

If, on the other hand, such a child is not successfully taught by his elders, or by experience, to govern such anxiety rationally, adulthood may find him irrationally phobic, subject to all manner of terrifying, uncontrolled anxiety, to such a degree that he may indeed have a formally classifiable a psychological disorder. His anxiety is so far from being subject to his intellect, that his actions are substantially governed by the anxiety itself. Though he may argue with the passion, his intellect cannot assert its rationality to any significant, practical effect.

Obsessive Compulsive Disorder
In an obsessive compulsive person, uncontrolled anxiety creates obsessions—persistent, irrational fears of false “dangers,” which overcome the person’s rational understanding that these dangers are false, and force the development of compulsions, irrational responsive behaviors which temporarily assuage these obsessive fears. The obsessions are experienced as persistent, intrusive thoughts over which the sufferer has little or no control. For example, many OCD people suffer from an intense, obsessive fear of germs, even in safe and hygienic situations, which causes them to take compulsive, irrational steps to resolve their fears. For instance, they may wash their hands so often that they crack and bleed, or avoid going out in public, or eat only cooked food, or exhibit a variety of other unnecessary behaviors designed to assuage their fundamentally irrational fears. The OCD person may intellectually know that shaking a person’s hand is highly unlikely to infect him with a fatal disease, but if his OCD is not checked, he may still be driven by the obsession relentlessly intruding on his consciousness to compulsively avoid shaking hands. His anxiety controls his actions more than his intellect does.

Uncontrolled anxiety in an OCD person can “latch onto” anything, creating an obsession which falsely portrays that thing as dangerous to the sufferer’s brow-beaten intellect. Of course, it is easiest to make something appear dangerous if there is a grain of truth: if the feared danger isn’t wholly impossible, if the outcome to be feared is truly terrible; in other words, if the stakes are high. This is certainly the case for the person whose OCD latches onto germs and disease. The intellect may be correct that shaking hands is unlikely to cause disease; but there is a miniscule chance of real infection resulting from this behavior. Isn’t that small chance worth considering seriously when the result could be death? Once this obsession has set in, the terror and misery are so great that some sort of response becomes almost irresistibly imperative.

The sufferer may realize that his obsession is irrational, at least in his more lucid moments; but the obsession is only demanding a small thing which is within his power anyway. Why not just avoid situations where he might need to shake someone’s hand? He believes he will feel calmer because his obsession will be pacified, and the small chance of infection will be avoided. One can see how the fear of infection still rules beneath the semblance of reasoning here.

Acquiescing to Compulsions
Unfortunately, when a sufferer of OCD gives into a compulsion, this strengthens the obsession, rather than pacifying it. It has been vindicated. For the moment, the anxiety has been soothed, but it knows that it has been proven right about the danger of infection (for example), because the sufferer now avoids shaking hands. Soon it will bring the fear back in a new guise, or latch onto something slightly different, with renewed vigor. The sufferer is in the grip of an ever-strengthening bondage to the compulsive demands of an escalating anxiety expressed in ever-varying obsessions. It becomes harder and harder for his intellect to assert itself in action. If this progress remains unchecked from within and without, the sufferer may go insane, despair, commit suicide, or take other desperate action.

Scrupulosity and OCD
I have deliberately focused this description on OCD in general, using the familiar, though often caricatured, example of germ-phobic OCD to illustrate the nature and scope of the disorder itself. Of course, OCD is a far broader and deeper disorder than simply the obsessive-compulsive fear of germs, as the intrusive, obsessive thoughts can arise in any area of a person’s life. Sometimes the obsessions don’t even produce compulsions, but simply trap the sufferer in the seemingly inescapable labyrinth of his or her own inner anxiety. Nevertheless, the common image of germ-related OCD provides an illustrative example of the average overall course of the disorder, in both its obsessive and compulsive parts. A brief consideration of scrupulosity will illustrate how it is simply OCD with a particular subject.

The danger of disease and death provides sufficient material for the obsessions of many OCD people. How much more “juicy” is the fear of eternal death – Hell? Furthermore, just as germs are invisible and, therefore, easy for the ungoverned passion of anxiety to imaginatively blow out of proportion, sin and the state of one’s soul are similarly invisible, difficult to assess, murky, and elusive. Finally, just as avoidance, and eradication of germs, appear to rest in the control of the individual (“if I just avoid shaking hands, or if I just wash my hands again, then my anxiety will calm down…”), so, too, do the avoidance and eradication of sin (“if I just stop watching TV, or if I just go to confession again, then my anxiety will calm down…”).

The obsessions of the scrupulous person pertain to real or perceived sins, long past or recent, mortal, even if already confessed, venial, or even entirely fabricated. The scrupulous person’s intellect may realize that it is unlikely that a particular “sin” was mortal, or even sinful at all, but what if he is wrong? The stakes are eternal. Better to confess it just to be safe.

By confessing it, he is giving in to a compulsion, which, as we have seen, will only serve to strengthen the disorder more. And confessing these perceived sins is only one possible compulsion; there are others. Perhaps this obsession demands repeated “logical” analysis to convince the sufferer that it is not a mortal sin. This analysis could itself be a compulsion. Perhaps an obsession requires discussion of the elusive “sin” with a person other than a confessor to assuage the anxiety: a spouse, a parent, even a counselor. This could be a compulsion as well. Or perhaps an individual’s scrupulosity is more obsessive than compulsive, so he must simply continue to obsess with little hope of relief. All these, and more, are true faces of scrupulosity, possibly all happening even in the same person over time.

Treating Scrupulosity
If the compulsions prescribed by the obsessions themselves do not resolve anxiety in an OCD person, what does? External circumstances do affect scrupulosity. Stress in any area of life can increase anxiety levels, and thus exacerbate OCD and scrupulosity. Excessive free time can provide a convenient empty space for obsessive rumination to root and expand. Conversely, low stress, and healthy productive business can suppress scrupulosity, sometimes to the point of it temporarily becoming invisible.

External circumstances are not a cure, however; and since they are often beyond our control, they are not even a reliable long-term solution. Healthy internal mastery of anxiety is the hope of true power for a scrupulous person. The goal, of course, is to integrate rogue anxiety back into its rightful place: under the governance of reason. The detailed method of achieving this internal order is beyond the scope of this overview, especially as I am not a psychologist; but from all we have seen, it is no surprise that the solution requires the development of new habits of denying and ignoring potential obsessions and compulsions. This is counter-intuitive to the scrupulous person, who feels that the solution to his anxiety is simply to fulfill its compulsions as faithfully as possible. But since compulsions only exacerbate obsessions, the opposite is true: he must learn to ignore compulsions, and to nip obsessions in the bud, a process which will almost certainly require specialized psychological counseling, and can sometimes be assisted by medication, although this is outside my personal experience.

People who Interact with the Scrupulous
This approach can also be counter-intuitive to the people around a scrupulous or OCD person. Confessors, parents, spouses, children, friends, and spiritual advisors have often spent untold hours arguing with the sufferer’s irrational obsessions. They do not understand why logic does not convince the person, because they think they are arguing with the sufferer’s intellect. But since a scrupulous person’s intellect is in many ways governed by the unbridled passion of anxiety, rational arguments fall short of healing the situation. In fact, a person who argues with the obsessions of a scrupulous person may be assisting the sufferer in his obsessive rumination, or even worse, may himself become a compulsion. “If I tell everything to my spiritual director, and he tells me this sin was not mortal, then I will be free and safe.” As with all compulsions, the more the scrupulous person fulfills the demands of this compulsion, the deeper the obsession bites. Soon he ceases to trust the advisor, finding a host of reasons to disbelieve his conclusions, and the compulsions become stronger and more demanding.

Such advisors also risk a kind of “hypnosis” by the arguments of raging anxiety. In a desperate effort to obtain a certain and accurate assessment of his state, the scrupulous person usually paints his sins in the blackest light possible, which is the light in which he himself sees them in the depths of his anxiety. This can be convincing to an unsuspecting outsider. Soon the spiritual director may find himself wondering if his advisee’s sin truly was mortal. If he allows the scrupulous person to see this doubt, then he is vindicating the person’s obsession from the outside, which is a stronger vindication than anything the scrupulous mind could conjure for itself. The obsession is accordingly strengthened, and the sufferer driven that much closer to despair. If even that seemingly unavoidable, murky “sin” was mortal, can he ever remain free of mortal sin?

My former counselor, who specializes in treatment of scrupulosity, has repeatedly told me that he has “never met a person with scrupulosity that did not have a very strong imagination.” He continues, “they also usually are quite sensitive and are quite bright, resulting in them thinking circles around themselves.” Advisors of the scrupulous should not underestimate the convincing creativity of those they counsel at the depths of this affliction. The same anxiety that persuades an intelligent person’s mind to acquiesce to the deranged arguments of his own scrupulosity, by manipulations of his sensitivity through his own powerful imagination, often possesses sufficient persuasive powers to draw others into its false conclusions.

Scrupulosity and Confession
Obviously, then, this disorder can have grave effects on the sufferer’s experience with the sacrament of confession. The behavior traditionally expected of a scrupulous person are excessively frequent, and painfully detailed, confessions. This is indeed a possibility, and a dangerous one, as confession has become a compulsion for such a person, and his frequent recourse to it is strengthening the hold of his anxiety over his intellect. If such a pattern becomes evident to the confessor, he might be wise to encourage such a penitent to address his scrupulosity, in and of itself, through counseling, if the penitent seems receptive. The priest might also advise this person to cease compulsively confessing his obsessions. At the very least, the priest should not encourage or participate in the excruciating dissection of dozens of wispy, anxiety-produced “sins.” I will say more about this in the next section.

In my teens, I experienced a period when frequent, detailed confession was the compulsion that was demanded by my obsessions, which such obsessions would also often attempt to compel me to refrain from receiving Holy Communion. This, however has not been my experience as an adult with confession. My own scrupulosity has ultimately made confession a torturously painful requirement, so that I avoid “spontaneous” confession entirely, and all confession for months at a time. I instead now prepare for each confession for agonized weeks, and choose my priest ahead of time.

The process of examining my conscience can easily become a voluntary opening to the obsessive ruminations I have learned to suppress at other times. What sins have I committed? “Well,” says my OCD, “how good of you to ask!” Beyond all my regular mundane sins, my anxiety insists on parading before my conscience all manner of trumped-up nonsense. That sin in the past that might have been mortal—did I ever confess it? This sin over which I agonized, ultimately concluding it was nothing—was it actually mortal? Have I, therefore, been neglecting to confess a mortal sin in my past confessions? Are all the confessions of the past ten years thus invalidated? Are all my communions sacrilegious? What about this strange sin that I have recently committed? I don’t even know how I would confess it. What is the proper name of such a sin? If I use the wrong name, will I be lying in confession? Will I be forced instead to describe it in excruciatingly embarrassing detail, without a name? If I decide not to confess it, will I be neglecting to confess a mortal sin? Yet, it seemed so barely intentional, I could hardly have avoided it if I had wanted to. Does this mean I am doomed to repeat it? Do I therefore lack a firm purpose of amendment?

All these risks of error, and further sin, associated with confession make it seem to my anxiety that it would be morally safer to avoid confession altogether, but I know that I must go, or risk Hell for unconfessed “possible mortal sins.” More importantly, as my intellect recognizes, I must go to confession to avoid cutting myself off from God’s grace and forgiveness for the real sins I have committed, and so that I may continue to advance in sanctity. I feel trapped, literally “damned if I do, damned if I don’t.” I am a little tempted to despair, and I realize this. Has giving in to this obsession been itself the beginning of the sin of despair? Do not mistake my meaning: the rational part of me knows this ruminating is irrational, but reason is not in control.

The Priest’s Reaction
When I have sufficiently wrestled my examination of conscience into submission, I must then face the priest’s reaction, which I cannot control. I usually tell any confessor that I struggle with scrupulosity, though I have needed to do this less as my own handle on the problem has strengthened. Most priests acknowledge this without much comment, as if they have heard of the disorder, which I believe they have. However, I do not think they usually understand the complete landscape of the vulnerable soul laid before them.

Most of my confessions include both mundane, real sins, and some of the murky, elusive “possible mortal sins” that are the subject of obsession. Priests react to those murky, elusive sins in different ways. Often they ask questions, trying to ascertain whether they really were mortal. This practice is probably appropriate for most confessions, and perhaps it would not be too damaging even to a scrupulous person if it were focused only on the clear, mundane, real sins in his confession; but honing in on the obsessions which have been preying on the mind of the scrupulous penitent can do serious damage. At the very least, it feeds the obsession. Even worse, the priest is probably encouraging and validating a compulsion (the confession of an obsession), which will in turn strengthen the obsession and the hold of the disorder over the penitent, as mentioned more generally before.

And what does the priest decide when he has finished questioning the penitent about his potential mortal sin? He may determine that it was not a mortal sin, and attempt to reassure the penitent of this; but the penitent is unlikely to believe such reassurance for long, as the damage of attending to the obsession has only strengthened it, and reinforced the behavior of compulsive confession. Worse, deceived by the anxiety’s persuasive veneer of rationality, the confessor may determine that it really was a mortal sin. If he confirms the worst fears of the obsession by affirming that it was correct, it will be deeply reinforced, and the penitent will be pushed closer towards despair, because the nagging fears that beset him have received a priest’s stamp of approval. How can he continue to fight them? Yet, if he ceases to fight, the progress of his disorder, it will go unchecked, and he will end in mental and emotional ruin.

What if this discussion reveals that the priest and the penitent honestly and rationally disagree about a prudential matter? Even in a normal confession, I believe priests would do well to tread softly here, as it is difficult to take full stock of the circumstances and education that have formed a person’s conscience from one, often-anonymous conversation. When the penitent is scrupulous, the potential for damage in an argument in the confessional is even greater, as the penitent may feel pressured by his over-sensitive conscience to give his intellectual assent to something he doesn’t believe, though it be the priest’s opinion, not that of the Church; and so a new avenue for guilt is opened, as he also believes such assent might be a lie on his own part. Once again, he feels, “damned if he does, damned if he doesn’t.” He is already confused about the state of his soul, and may also be terrified of lying or misrepresenting his position in confession, or of lacking contrition.

Advice to Confessors of the Scrupulous
For all of these reasons, I believe it is prudent for a priest to avoid descending into particular, detailed questions or discussion of the more confusing sins of the scrupulous penitent. If the “sin” is the product of an obsession, the priest will soon find himself arguing with irrational anxiety, rather than correcting any reasonable confusion of the penitent; and whether the priest is persuaded by the anxiety’s deceitful arguments or not, no good, and a great deal of harm, can come of dignifying it with a response. Any real sin at the base of such an obsession will be forgiven anyway, since it has now been confessed.

Similarly, in my opinion, any general advice a priest may wish to offer such a penitent should pertain either to positive steps in the advancement of holiness, to his real sins, if the advice must touch directly on sin at all (although once again, targeting specific sins is risky in these cases), or to promoting a healthy approach towards scrupulosity itself. Finally, although it is almost impossible to convince unbridled anxiety that God is merciful, it certainly confirms its obsessions to affirm anything else; so it is well to be merciful and gentle with the scrupulous penitent, and to remind him of God’s mercy.

Priests should refrain from offering any advice, however gentle, regarding the detailed particulars of obsessions. If a priest feels that it is necessary to address a penitent’s scrupulosity in some way, then general advice to avoid focusing on obsessions, and to ignore compulsions, is far more likely to be beneficial than analyzing particular obsessions. For example, a priest once advised me that if I wasn’t sure something was a mortal sin, I should continue to receive Communion. After all, when one truly commits a mortal sin, with not only grave matter, but full knowledge and deliberate consent of the will, his guilt should be obvious to him. This concrete suggestion has stood me in good stead over the years. Notably, it didn’t pertain to any particular sin over which I was obsessing. It was a tool offered for my own use against my scrupulosity.

Finally, if the priest is aware of good local resources, and believes the penitent to be receptive, perhaps an even more beneficial way of addressing his scrupulosity would be advising him to find a counselor who can help him with the scrupulosity itself. (Clearly, in order to do so, the [preferably Catholic] counselor cannot simply tell him that all his problems are the fault of his “guilt-based religion” and that he needs to stop practicing the Catholic Faith.)

Other Effects of Scrupulosity on the Spiritual Life
I hope all this places confession for the scrupulous in perspective against the backdrop of psychology, but I would also like to place it briefly in a broader spiritual context before I finish. Most of the obsessions experienced by a scrupulous person are lies—in part or in whole—as we have seen; but this does not mean that scrupulous people do not sin. In fact, they are much like anyone else striving after holiness, and the fabric of their spiritual life. Although it is not punctuated by the outlandish sins proposed by their anxiety, yet it is constituted of the same kinds of virtues and vices that anyone else cultivates, and battles over, throughout the course of his life. Scrupulosity is an easy tool for distraction from all this, in the hands of the devil. Therefore, it is important that the scrupulous work towards mastery of, and healing from, their OCD, not only for the sake of their mental health, but also for the sake of their spiritual well-being.

Scrupulosity can distract us from our real sins and vices. It can absorb energy that should be focused on spiritual growth. It can tempt us to discouragement and despair. It can turn us inward in an intense focus on ourselves, opening the door to real selfishness. And it sharpens its sword by separating us from the grace of the sacraments—particularly Confession and Holy Communion. When I say that scrupulosity is not primarily a spiritual disorder, I mean that its nature is that of a psychological disorder; but scrupulosity, like other psychological disorders, can have a profound effect on the spiritual life. All this, too, must be at the back of the confessor’s mind.

Despite its dark nature, though, scrupulosity can be subdued, and perhaps, in some cases, even cured. Counseling, and the formation of healthy mental habits, can help, and even medication may be warranted in some situations. Reason can take back its rightful position in the afflicted mind.

Amidst all these necessary efforts towards wholeness and health, both priest and penitent should remember that the suffering itself is not without value. It may be harder to offer up an affliction of the mind than of the body, because the will to offer it up has its seat in the very same mind that is laboring, in misery and confusion. But, it is not impossible. Suffering borne in love, in union with Christ’s passion, is always redemptive. Christ Himself has conquered sin and death. Thus, even scrupulosity can bear good spiritual fruit, in one who fights the good fight against its evil, while simultaneously uniting his suffering with Christ’s. But this kind of spiritual fruit should never be confused with the erroneous notion that scrupulosity is holiness, or that obsessions and compulsions regarding sin are a valid, unobjectionable path to sanctity.

Final Plea
My plea to confessors is this: please understand the nature of scrupulosity, and let that understanding direct your strategy in confessions of scrupulous penitents. Bear in mind that scrupulosity is a form of Obsessive Compulsive Disorder, rather than any vice, or intellectual ignorance. Recognize it for what it is. Neither believe the heinous accusations of which it tries to convince you, nor try to argue with it. By avoiding these mistakes, I believe you will make God’s sacramental grace available to the scrupulous, without simultaneously obstructing the path to that grace, or making it a means of unnecessary additional pain. By your wise and prudent words and silences, you can lighten, or remove this cross, that those suffering from scrupulosity have often had to bear. May God bless you for this beautiful service to his suffering children.