The Secret Struggle of the Great Ss. Ignatius & Alphonsus: Scrupulosity

A secret menace, scrupulosity prevents Christians from truly believing in God’s mercy and grace. But there is hope!Soon we celebrate the days when we remember St. Ignatius Loyola (July 31) and St. Alphonsus Liguori (August 1). Many do not know that each of these saints suffered from severe forms of scrupulosity, a variety of obsessive-compulsive disorder. Within the past fifteen years, this malady has been increasingly recognized and studied by psychologists.

St. Ignatius suffered greatly from scrupulosity. He worried that he would be committing blasphemy if he stepped on anything resembling a cross. Whenever a salacious or aggressive thought came into his consciousness, he believed he had committed a mortal sin.

Similarly, St. Alphonsus experienced scruples that kept him in a conscious state of anguish and doubt. He used his own inner battles to become compassionate toward others. Theologically, he fought Jansenism, a philosophy denying free-will. Intriguingly, people with scrupulosity often fear being controlled by their scruples.

St. Ignatius emphasized how necessary it was to fight one's scruples – one of the main principles of the modern treatment known as cognitive behavior therapy. Cardinal John O'Connor (interviewed in my book, A Thousand Frightening Fantasies) explained this in the following manner:

St. Ignatius had a fundamental principle that you may be familiar with – “Age quod agis,” (Do what you are doing). He would say give full intensity and your total presence to the moment. In the Spanish Civil War novel of many years ago, The Cypresses Believe in God, Ignace, as I recall, is the hero throughout. I think this hero was clearly named after Ignatius. There is a passage where Ignace's confessor gives him important advice. It was basically “Age quod agis.”

What is it like for modern sufferers of scrupulosity or obsessive disorder? Here are some things about them: they hide their scruples; they worry selectively; things that may bother others pass them by; numbers may be magic (i.e., counting prayers, re-checking the number of Hail Maries in the rosary); their feelings puzzle them; some turn to alcohol; sexuality frightens them; they worry constantly; they often wash or check things excessively, or make sure that objects are placed in a certain order. Each moment they may feel the danger of mortal sin just a few seconds away.

One man noted: “My image of God is a punishing God. I feel He watches my every move and waits for me to sin. He marks it in a book in heaven. I cannot escape the punishment I know I deserve.”

Another stated: "When I go to Mass, I must be perfect. There must be no rips in my clothes. I worry if the priest or deacon does his job right. Is it a valid Mass? The dismissal prayers cause me concern. I worry that the priest forgot to say, ‘Go in peace, the Mass is ended’ or said these words in the wrong order.”

Modern therapies include cognitive behavioral therapy, a treatment in which the person faces scrupulous fears and substitutes healthy thoughts about spirituality. Medication is also used in many cases; when it is working effectively, it can literally give some persons their life back. One study indicated that spiritual direction can be especially helpful. Cardinal O'Connor stressed finding the right balance between psychological treatment and the spiritual life:

As one with a certain background in clinical psychology and psychology combined with more than fifty years of active priesthood, I am most grateful for what these sciences do offer, quite aware that neither faith nor theology is an adequate substitute when psychology or psychiatry is essential. The reverse of that truism, of course, is equally important.

There is a support group for persons with scrupulosity sponsored by the Redemptorist Priests. They send out regular bulletins upon request and make available a great deal of information on the Internet.

Economic poverty is not the only way to be poor. Perhaps sufferers of scrupulosity or obsessive-compulsive disorder are blessed because they are “poor in spirit.” The upcoming feast days of St. Ignatius and St. Alphonsus, the latter Doctors of the Church, remind us that emotional problems need not internally imprison their sufferers or stop them from helping others. Learning more about scrupulosity and obsessive disorder may one day help you assist someone – a truly unique form of evangelization.