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Web posted Thursday, September 9, 1999
12:53 p.m. CT

Friends can help devout keep faith when faith turns extreme

c. 1999 Religion News Service

Rachel was 13 when she began having persistent thoughts of blasphemy.

As an Orthodox Jew living in a Hasidic neighborhood in Brooklyn, the urges ran so contrary to her beliefs they nearly drove her insane. Any visit to temple triggered a panic attack. Eventually, Rachel stopped attending worship services. Only after two decades of silent suffering and several months of professional help did she return to her faith.

Therapists who specialize in treating obsessive-compulsive disorders say they often find religion to be the focus of their patients' behavior, a lesser-known symptom of the disorder than repetitive hand washing, for example. The condition is so common professionals have a name for it - scrupulosity.

"Scrupulosity is an extreme version of what is normally moral and devout," said Allen Weg, a North Brunswick, N.J., psychologist who is vice president of the New Jersey affiliate of the Obsessive-Compulsive Foundation. "These people are always concerned they are doing the wrong thing or are evil in God's eyes."

Many who act compulsively repeat prayers over and over, for example, concerned they have failed to say them correctly and fearful they'll be punished.

"I would have to say my prayers in a perfect way and a certain number of times over and over," said Jane, a 40-year-old Roman Catholic from New Jersey who suffered for decades before entering psychotherapy. "At confession, I always had a hard time determining whether I had committed a sin or just imagined it. You feel like you're nuts."

Those who have obsessive-compulsive disorder - a condition experts say afflicts more than 6 million Americans - often involve their pastors or rabbis in their actions. Experts said clergy of all faiths are plagued by congregants who return for assurance on seemingly innocuous moral questions.

"The rabbi may think of this person as a pain in the neck or a religious extremist, but it's not that," said Steven J. Brodsky, a psychotherapist at the Center for Cognitive-Behavioral Psychotherapy in New York. "It's really mental illness."

As the High Holy Days approach - Rosh Hashana begins at sundown Sept. 10 - Jewish sufferers may find their guilt and insecurity at a peak, but members of all faiths are equally susceptible, Brodsky said. An Orthodox Jew, Brodsky is helping patients like Jane sort through the difference between normal devotion and her obsession. (Both Rachel and Jane asked that their surnames not be published.)

When she was still a little girl, Jane said, she began to have haunting thoughts about sin. If she spilled a glass of water, she'd assume it was an intentional plot to make a family member fall and die. She was quick to confess these imagined sins to her priest.

"Through therapy I have become much better able to discern what is coming from God and what is not," she said. "Most of my faith is a great comfort and joy, but when it gets weird or burdensome, that's a good sign that it's OCD."

Most therapists agree the best treatment for the disorder is behavioral therapy - literally forcing sufferers to face their fears. Those with religious obsessions might keep a diary to focus on what trips the obsession. Therapists then purposely expose the patients to it while the patients try to maintain control.

What separates anxiety disorders from more serious mental illnesses, such as schizophrenia, is that sufferers recognize the extreme nature of their behavior. They feel shame and tend to hide it.

The condition often goes unrecognized in churches, mosques and synagogues because repetitive ritual is such an important part of faith. Experts said those living in the most devout religious communities may be the most susceptible to such manifestations.

It is not a modern phenomenon. Martin Luther, the father of Protestantism and, according to some therapists, a probable OCD sufferer, returned repeatedly to the confession booth during his lengthy crisis of faith.

"If you are brought up in a devout family, you put a lot more weight on those thoughts," said Ian Osborn, a Pennsylvania psychiatrist and author of the 1998 book "Tormenting Thoughts and Secret Rituals."

"The obsessive-compulsive personality is guilt-prone and looking for answers, so if they find an answer in religion, they get into it more deeply," he said.

The difference between OCD and normal devout expression is a state of mind. Sufferers of the disorder never experience the sense of well-being normal worshippers feel. Instead, they are spurred by irrational fears of punishment.

Untreated, the disorder can lead to alcoholism, drug addiction, depression,insanity or even suicide.

To the credit of her clergy, no priest ever took Jane's supposed sins seriously. They tried to softly convince her that the thoughts were imagined. Experts said such compassionate expressions are less likely to reinforce the thoughts.

Condemning such thoughts merely increases the sufferer's guilt and makes it more difficult to banish those thoughts, the therapists said. The harder a sufferer of OCD tries to fight the impulse, the more difficult it becomes.

If clergy members find congregants returning repeatedly for advice on seemingly innocuous moral questions, experts said, they should refer them to mental health professionals. And seminary officials said they are becoming more sophisticated about teaching students to recognize the disorder.

"This is definitely on our radar screen," said Herbert Nieburg, a professor of pastoral psychiatry at Jewish Theological Seminary in New York. "What I tell rabbis to do is support the person by saying, 'I understand,' but also to know when a case requires referral to mental health professionals."

Monsignor Francis J. Maniscalco, a spokesman for the U.S. Catholic Conference, agreed that referral is often the best solution.

"Over the years, most priests run into people like this," he said. "You need to be available to these people, but, in the end, this is a psychological problem. We tell them, 'Trust in God, but go to your therapist."'


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