[This article is the third in a four-part series on mental health. The previous articles addressed the science of psychology and the unique role that the Church can play in the lives of those suffering from mental health issues. The final article will address the idea of shalom as the ideal for mental health and well-being.]
In all of the drama surrounding Mike Lewis’s recent coverage of Fr. Chad Ripperger, one issue stood out to me above the rest: Fr. Ripperger’s pronouncements that most people with bipolar disorder would no longer need treatment if they follow his instructions. My concern grew when I listened to one of his virtual talks and heard him declare that anti-depressants should rarely be used and, if they are, they should only be used for a few weeks while a patient is stabilized. This is patently false. In fact, most antidepressants do not even begin to have their desired effects for several weeks and it can take months more to carefully titrate to a properly therapeutic dose. To be frank, Fr. Ripperger’s statements are spine-chilling for three reasons:
- It undermines years of working to combat stigma against mental illness by associating it with demonic possession.
- It promotes a way of thinking that could keep people from seeking and continuing treatment they need.
- It minimizes the real advances that psychology has made in past decades while publicizing an unproven, irresponsible idea.
In fact, it was Father Ripperger’s statements that prompted me to finally write this series that has long been sitting on the back burner of my mind, waiting to be written.
Throughout my career and studies, the relationship between evil and mental health has been problematic for me. This began to be the case when a Christian elementary school left a message saying that someone I love would not be allowed to attend their school. The details of the message are debated within my family, but my memory of the situation is that the school leadership believed that the loved one’s classic symptoms of Tourette Syndrome were actually the result of demonic activity. My family unanimously agrees that the school’s lack of knowledge about Tourette Syndrome resulted in judgements about this individual that were incorrect. Sadly, my loved one (a child at the time) was the person who received the message and it compounded the struggle with grief and stigma that they were already facing as they came to terms with their diagnosis and navigated brutal bullying and responses from the public school district; it doubtless also impacted their relationship with Christianity in complex and difficult ways. As a result, the unnecessary damage that this school’s assumption caused was significant at a time when the institution had the opportunity to be a bearer of Christ’s love and healing.
Since that time, the number of people I love who have Tourette Syndrome has grown – it is a heritable neurological condition – as has my frustration with people who, knowingly or not, allow the idea of demons to be weaponized against those with physical or mental illnesses.
As I progressed through my training, I encountered patients and even personal acquaintances who were reluctant to seek treatment or to continue with treatment that they were already receiving. This stemmed from a variety of issues, concerns about stigma and prejudice being prominent among them. In addition, therapy is time intensive and requires hard work and honesty about painful things that patients are often trying desperately to avoid. Similarly, psychiatric medications may cause unpleasant side-effects and a kind of psychological numbing that patients have difficulty tolerating. For psychotic patients, medication compliance can be particularly challenging due to paranoia related to their medications. Many of these patients believe that their treatment will poison or harm them in some way.
For some of the patients who were reluctant to accept treatment, their therapy and medication helped to make their lives more livable. For others, these interventions were literally keeping them alive by preventing suicide or dangerous hallucinations and delusions. For all of the patients, the factors that contribute to patients’ resistance towards treatment make them vulnerable. Consequently, the idea that a prominent Catholic public figure like Fr. Ripperger would suggest an additional (and unfounded) reason for patients to inappropriately halt medication is unconscionable.
That being said, I do believe that there are cases of demonic possession and oppression as the Church teaches. Consequently, I acknowledge that there are times when exorcism is not only appropriate but merciful. In fact, the USCCB considers the sacramental of exorcism to be “just one more way the Church tends to the pastoral care of souls – even souls that are not her flock.” As a Catholic with a doctorate in psychology, I have been challenged at times to explore the intersection of mental illness and demonic activity more thoroughly. As I have delved into research on this topic, certain aspects of this relationship became clear to me.
First, and perhaps most important, the Church has a long history of requiring discernment in the assessment of demonic activity. For example, the USCCB states that all dioceses need to develop protocols to address possible cases of possession. These protocols should “include an assessment which involves medical, psychological, and psychiatric testing” that should be conducted prior to making any potential referrals to exorcists. These assessments should then be used to guide the Church in its determination, since only the Church can confirm possession. The USCCB is also clear that an exorcist’s determination requires “moral certitude” and a “balance within his own mind between not believing too easily that the devil is responsible for what is manifesting and attributing all possible manifestations solely to a natural, organic source.”
The USCCB is not alone in its prescription for caution in dealing with potential cases of demonic possession. In fact, earlier this month, the International Association of Exorcists (IAE), which includes over nine hundred exorcists and was approved by the Holy See as a private association of the faithful, put out a statement about the importance of responding to questions about exorcisms with great care. Specifically, they note the importance of ensuring that only qualified individuals participate in exorcisms and that exorcists can rely on medical and psychological professionals when making determinations. In fact, they state that to assume a supernatural origin for suffering that could be attributed to a natural cause is “not only wrong, but exposes people to unnecessary risks.” The association goes on to say that “The desire to identify at all costs an extraordinary demonic action as the cause of a situation of suffering, the origin of which is unknown, having omitted a previous serious discernment, besides being useless, can cause damage.”
From the viewpoint of the Church, prudential judgement in such matters is essential because the Church does not want to deny care to those in need, but it also resists the tendency to give undue credit to the devil or to foster an unhealthy focus on his works. According to the U.S. Bishops, prudential judgement in these cases is necessary to avoid the development of “sensationalist mentalities” or “sideshows” that detract from the Church’s true mission of serving Christ and sharing Him with the world.
This is all very reassuring from the viewpoint of psychology, because it promotes the idea that experts within different fields should participate in the evaluation of a potentially possessed person. This recognition of authority derived from education and experience helps to ensure that potential victims are treated appropriately by someone who specializes in the particular issues they are facing. In other words, I do not pretend to have any expertise in demonology and exorcism. I do, however, have knowledge of mental health conditions that was gained through years of work and study – twelve years to be precise. Specifically, I specialized in work with children with emotional and behavioral issues. Some of my pediatric patients have presented in ways that a non-psychologist might think of as a manifestation of possession. Out of respect for my patients, I will not elaborate on the particulars of their symptoms here. What is important is that, because I have developed a deep understanding of child development and how children react and respond to their worlds, I was able to recognize that these patients had problems with anxiety, confusion, anger, impulse control, etc. This meant that I could treat them appropriately which, thankfully, yielded good results. I do not say this out of arrogance, but simply as a recognition that there is too much knowledge for one person to be an expert in everything. It is, therefore, essential that people practice only within their field of expertise. Exorcism is not mine. Psychology is.
With that in mind, I believe it is essential that the teachings of the Church are followed and appropriate physical and mental health assessments are conducted prior to involving an exorcist. I also feel that it is important that the Church and its pastors are quick to refer parishioners to mental health professionals when they realize that they are being asked to offer care that goes beyond their area of expertise.
At the same time, Catholic mental health professionals should wrestle with the role that evil plays in their own lives and in the lives of their patients. This brings me to my second observation. We are all living in a fallen world. All of us are born with the stain of original sin and face endless temptations to err in our daily lives. At a minimum, this reality about our existence influences the ways we think and behave, hopefully making us more compassionate towards our fellow sinners.
Psychologists who truly accept this into their understanding will be cognizant of the ways that our fallen nature contributes to mental illness, as well as the ways that mental health can predispose us to certain types of sins. For example, a person who is experiencing depression is more likely to battle despair than someone who is generally happy and content with their life. On the other hand, participation in intrinsic evils like adultery can easily lead us to places of anxiety or depression. This delicate interplay between our mental and spiritual selves is one that psychologists should be willing to work with, acknowledging that both aspects are key to human flourishing.
My third conclusion is that there are times when both spiritual care, even possibly exorcism, and mental health treatments ought to be provided in tandem. Just as it is dangerous to say that psychological therapies are unnecessary if exorcisms are provided, it would be problematic for a believing mental health professional to deny the possibility of demonic activity impacting any of their patients. In most cases, there is likely no harm, in terms of the practice of psychology, in simultaneously pursuing both the spiritual aid of exorcism and the scientific help of psychology (I say in most cases and not all because in some patients there could be harm done by conducting an exorcism– I am thinking here principally of patients with psychosis, but also those with borderline and narcissistic personality disorders or scrupulosity). In fact, a combined approach would likely be particularly helpful to patients who straddle the line between spiritual and mental torment or who present with signs of both. Nevertheless, it remains essential that both exorcists and mental health providers practice only within their fields of expertise and that neither discourages the interventions of the other. Additionally, when patient consent is obtained, collaboration between both experts would be beneficial and, according to psychiatrist Richard Gallagher, who regularly consults with exorcists, such collaboration is often the norm.
There remains the question of what to do with those patients who push the boundary of what might be considered “ordinary, run of the mill sins” and delve into the darkness of pure evil. I am thinking here about patients who are abusers, murderers, and other types of sadistic individuals. We are faced with the question of how to classify these patients. Are they mentally ill, or are they submitting to evil or possessed by it? This is a question that I cannot answer. It is well outside of my area of expertise, having never worked with or studied such individuals. Of course, I have my own ideas about what drives people to do clearly evil things, but at the end of the day, they are simply my own untested thoughts that I have developed to try to make sense of something that is otherwise nonsensical to me. What can be safely said about such cases is that they do not exist in a vacuum. We all commit evil against each other to varying degrees and the devil does “prowl about the world seeking the ruin of souls.” For most of us, who will never encounter such patients in our daily lives or lines of work, the most important thing is to fix our gaze not on what is evil but on what is good and to work to restore God’s kingdom within the small sphere of influence that we each have been given. God is a God of peace, justice and mercy who gives us rest and protection, and he can use both mental health treatment and exorcisms to bring healing into our lives. It is our job to use both prudentially.
Note
Though this article is not meant to be a commentary on the works of Fr. Ripperger, I do want to acknowledge that some have defended his expertise in psychology by referencing his 800-page tome, Introduction to the Science of Mental Health. Having heard him speak on issues of mental health, I have decided that it is not worth the time and expense it would require to read the teachings of someone whose statements have repeatedly flown in the face of the field of mental health.
This work likely contains some accurate teachings about psychology, and his ideas on emotions and the connection between Thomistic thought and psychology are often compelling. However, we must remember that it is possible for anyone to write a book about any subject they choose, regardless of expertise. His biography indicates that his education and professional background do not indicate that he has the qualifications to write or speak authoritatively on mental health, which likely explains why his statements often contradict accepted psychological theories and research.
Fr Ripperger’s statements suggesting that recognized psychological disorders are the result of demonic activity or those that serve to undermine standard and appropriate treatments and theories within the field of psychology have the potential to cause great harm. Fr Ripperger’s education and expertise lie in the areas of philosophy and theology. His comments about psychology should not be considered equivalent to the teachings of experts in the field.
Image: Adobe Stock. By JEGAS RA.
Ariane Sroubek is a writer, school psychologist and mother to two children here on earth. Prior to converting to Catholicism, she completed undergraduate studies in Bible and Theology at Gordon College in Wenham, MA. She then went on to obtain her doctorate in School and Child Clinical Psychology. Ariane’s writing is inspired by her faith, daily life experiences and education. More of her work can be found at medium.com/@sroubek.ariane and at https://mysustaininggrace.com.
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