Confession and Psychiatry
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Peace-of-mind literature is flourishing today. Dr. Frederic Wertham, a noted New York psychiatrist, has remarked that many of these self-improvement books work in the suggestive twilight of abnormal psychology and supernatural revelation. "It is not clear whether they smuggle psychoanalysis into religion or religion into psychoanalysis." The road to Damascus, he points out, is not the road to the Vienna of Freud.
There is a danger that we priests may look upon peace-of-mind as the new apologetic of the Church, or else may go to the other extreme and view it as so much sentimental rubbish. However, there is one fact that stands out clearly against the background of technical jargon and wishful optimism: people are interested in peace-of-mind because they don't have it. The incidence of mental anguish, confusion and worry is frightfully high in these United States. They who labor and are heavily burdened are looking for a source of refreshment. We who preach, especially to non-Catholics, are tempted to go overboard with assurances that the Catholic Church has all the answers to all the problems, and that we can relieve all the ills of the human mind.
This is a special temptation at the present time when the Church in America is at the very pinnacle of her prestige; indeed a writer in the Christian Century claims that Protestants had better resign themselves to Roman supremacy in America, sucking what little consolation they may from books like that of Paul Blanshard. Now when the convert-prospects are so bright, it is so easy to grasp this peace-of-mind argument and use it to lure the disillusioned, the worried, the frustrated, the eccentric into the true fold. There is, however, a vast difference between the aims of psychiatry and of religion, and this can be cogently illustrated in a sermon by pointing out the differences between psychoanalysis and confession.
Confession Is Not a Mere Haven for Neurotics
To begin with, it is rash to compare the relative merits of the two procedures. They do have a certain surface similarity (like an adding-machine and a typewriter) but they are quite different in function. I think that Father John A. O'Brien lays himself open to controversy in his otherwise excellent pamphlet "Psychiatry and Confession" (Paulist Press) by pointing to the confessional "as offering a relief from the sense of guilt which surpasses any medicine or remedy developed by the psychiatrist or the psychoanalyst. For the removal of guilt and all the brood of fears, worries, dreads and anxieties stemming from it, confession is the unfailing remedy" (pp. 29-30). Psychiatrists themselves are sometimes a trifle too flattering and gratuitous in saying that a priest will do without charge what they can do for a price. Certainly the official teaching of the Church has never guaranteed that the Sacrament of Penance will infallibly produce psychiatric benefits.
Therefore, it is well for the Catholic preacher to be cautious in his claims on behalf of the Sacrament of Penance. To the neurotics in our congregation and to the mentally diseased non-Catholics among our hearers, we can promise no more than the Church promises — the pledge of absolution of sin and the possibility of emotional or other consolations. Dr. Norman Vincent Peale and other famous American ministers assure their parishioners that, "if you change your thoughts, you change your world," and thus eliminate hypertension, marital conflicts and other enemies of buoyant living. That is because psychiatry enters so largely into their parochial counselling, but a priest, aware of the neurotics' hunger for quick results, will generally restrict his claims to the ambit of the theological tract on penance.
Contrast between Confession and Psychoanalysis
The Rev. Victor White, O.P., former editor of Blackfriars, wrote a thoroughly competent article on the differences and similarities between confession and psychoanalysis in the Commonweal ("The Analyst and the Confessor," July 23, 1948). His attitude to psychiatry is utterly fair and genial, yet he draws a clear line of demarcation between its purposes and the goals of the sacramental process.
First, he clarifies the boundary line between the subject matter of psychoanalysis and the subject matter of confession. The Sacrament operates on sin, human activity which lacks the rightness it should have in conformity with divine law. Sin is the evil "men do," and men's actions are sinful only in so far as they are willed. But psychoanalysis pertains to the field of mental sickness, to the evil "men suffer." As a sickness, this evil is involuntary and usually quite contrary to the wish of the sufferer. Sin, therefore, is something that men do while psychoneurosis is something that happens to them. Confession presupposes the power to turn freely from sin, while psychoanalysis supposes a certain slavery to blind compulsions. In short, confession deals with willful misdeeds whereas psychoanalysis deals with involuntary misfortunes.
Confession Is Concerned with Sin, Not Emotional Vagaries
We should demonstrate to our hearers that the priest in the confessional is interested only in the question of sin, not in the past personal history of the penitent or in a detailed description of all the environmental factors that bear upon him at every moment. Aside from advice about avoiding occasions of sin, the priest as priest does not burrow into the external circumstances of the penitent's life. If such circumstances affected the freedom of the penitent's will, the penitent should have determined all that in his examination of conscience. He himself was the best judge to decide whether or not he committed a certain act — a theft or assault or lie — with sufficient reflection and full consent of the will.
By concentrating his attention on the removal of sin, the confessor avoids the pitfalls into which so many psychiatrists fall. They think that they can remove a neurosis and automatically eliminate all the worries of the patient. Dr. Wertham tells about these little drugstore psychiatric books which presume that all mental anguish arises from the mind's disorders. They ignore the fact that many of our troubles come from abnormal sociological and economic conditions. Dr. Allers also complains of the fact that certain persons expect too much of psychiatry: they think, for instance, that it ought to be able to solve the incredibly intricate problem of juvenile delinquency. Yet, that is a problem that involves more than repressive mechanisms of the mind of the delinquent: it is tangled up with the housing problem, parental supervision, decay of family life, poor education, loss of religion, and many other factors. The priest is judicious, therefore, in making very modest claims on behalf of confession.
The Sacrament of Penance is quite different from psychoanalysis, however, in its procedure. Confession must be made in both cases, but what a difference in the manner of confessing! Here again the resemblance is superficial. Perhaps we can be happy over the resemblance, at least for one reason: Protestants who used to assert that they would never tell their sins to a man are today disarmed of that objection due to the prevalence of psychiatric consultation. Confession to a priest, however, is an exercise of the conscious mind retelling sins evoked by the conscious memory: it is a careful, thoughtful process. But the psychoanalyst aims at a different type of confession. He aims to suspend regular, orderly mental activity in order to bring about the free flow of uncontrolled fantasy, dreams and other manifestations of the unconscious. As Father White says: "The uncomfortable confessional box with its hard kneeler, and the couch or armchair of the analyst's office, admirably express and promote the two very different kinds of 'confession' for which each is appointed."
Then too the penitent in the confessional is confined to the sins committed since Baptism, or usually since his last confession. Not so with the patient on the couch. He plays "roving center." He tells not only his sins but also his good actions (which are irrelevant in the confessional), and he peregrinates among all the weird and wild notions and images that ever entered his mind, the psychoanalyst hoping to strike oil that will gush up and bring mental health to the patient.
Confession Demands Contrition and Purpose of Amendment
The heart and center of sacramental confession is contrition. Yet, that is not necessary in the psychoanalyst's studio. Dr. Wertham (Sat. Rev. of Lit., Oct. 1, 1949) entitles his article "The Air-Conditioned Conscience." He tells about the vast mass of peace-of-mind literature flooding the market today, and his conclusion is this: "Is there anything new in this literature? I think there is. It is, of course, a type of escape literature. It will not help you in the long run to an escape from anxiety, from suffering or from doubts. But it does go a long way to an escape from social responsibility. One can extract from these books a new concept, never before so fully elaborated — the concept of an air-conditioned conscience."
Father White admits that psychoanalysis does not require contrition, but he seems to feel that it can produce the climate of contrition — i.e., that it can do much to free the patient from those compulsions that take away free-will, and it can and should bring about a radical change in the patient's outlook on life. He quotes Dr. C. G. Jung as saying that none of his patients were really healed unless they regained their religious outlook.
However, Father White knows that a change of outlook is not enough. There must be a firm purpose of amendment if a sinful man hopes to improve. This lack of insistence on a firm determination to avoid sin is the Achilles' heel in the whole program of psychiatry. We rightly say that psychiatry is an infant science, and that we should give it time to prove itself; yet, any priest who has had care of souls can tell the world that no man will behave himself unless he wills to behave himself.
Confession Emphasizes Our Responsibility for Past Sin
In the various peace-of-mind books that give the know-how to confident and buoyant living, very little stress is placed on will-power. Improvement comes by thinking about it, according to these authors, rather than by a firm determination to improve. Even a religious guidebook like that of Dr. Peale doesn't seem to demand much violence to self. "I suggest that you allow your body to assume a relaxed position in order that tension may go out of you. Perhaps you may wish to close your eyes to shut out the world. In this moment of silence, the one thing you must not do is to think about yourself or any of your problems, Instead, think of God for one minute and conceive of Him as recreating you. Let us retire into a vital and vibrant period of creative meditation." That sounds very consoling, but I doubt if it will produce very much permanent improvement in the habits of an inveterate adulterer, thief, gambler or liar. We priests have been meditating at least an hour every day, and we know that meditation is creative only if we make firm resolutions of the will after a period of quiet intellectual reflection.
Our Lord said that the Kingdom of Heaven suffereth violence and only the violent bear it way. That is still very true: there is no rosy way of the Cross. And St. Paul saw no way to self-improvement other than self-discipline. "Put you on the armor of God . . . For our wrestling is not against flesh and blood . . . Stand therefore having your loins girt about with truth . . . taking the shield of faith, wherewith you may be able to extinguish all the fiery darts . . . " (Eph., vi. 11-16). These are fighting words, whereas the peace-of-mind books give you the impression that soul health falls like dew upon you as you rest on the psychoanalyst's couch.
The state of those people who think they spiritually improve after merely telling their sins to a psychoanalyst is a rather dangerous one. I think they are like the souls that Fenelon talks about: they leave a dissipated life and take a few steps forward to God. Then they begin to canonize themselves, judging their present state, not by the Gospel, but in contrast to their former state. Fenelon says that this condition is worse and more fatal than a scandalous debauchery. An orgy of sin would rouse the soul to faith after disturbing the conscience, but not so with these semi-conversions. These people lull their consciences asleep.
Satisfaction is not required of a patient by the psychoanalyst. The assumption is that he is not guilty of these misfortunes that have happened to him, and therefore he should not pay any penalty. In the Catholic teaching on satisfaction, however, we can see again the importance of contrition. A penalty attaches to every sin but, if the penitent has perfect contrition, there is no need of satisfaction. The penitent need not pay any penalty because his perfect contrition wipes away all punishment for the sin. Not so if the contrition is imperfect: in that case, the penitent must make up in suffering what he lacks in sorrow.
Contrasting Roles of the Priest and Psychoanalyst
As to the actual absolution itself, there can be herein no resemblance to any phase of the psychoanalytic process. The psychoanalyst stands by, helping the patient to keep the stream of free association flowing. He takes no active part in the proceedings. The patient does the work. The priest, however, under the authority delegated to him by Jesus Christ remits the eternal punishment due to sin. He may perhaps lack all of the social graces; he may even be gruff and crude in his manner so that the penitent is quite uncomfortable while talking to him. That is unfortunate but not very important. The penitent goes to confession, not to be charmed by a magnetic personality or comforted by soft spiritual syllables, but to obtain forgiveness of sins. He may, in some conceivable cases, leave the confessional feeling worse rather than better than before entering, but at least he leaves with the intellectual realization that his sins are no longer eating away at his soul.
Father White points out several similarities between confession and psychoanalysis, genuine and true resemblances. First, confession may have a therapeutic value in certain cases just as psychoanalysis has a healing value. Original sin is the cause of much of the disharmony in the mental powers, and that perversity is added to by actual, personal sin. Absolution does not destroy totally all bad habits, for instance, but it does diminish their force just as Baptism does not destroy but diminishes concupiscence. It is becoming increasingly difficult for psychiatrists to distinguish moral from neurotic disorders, but it is certain that absolution does weaken the tendency to misbehave.
Contribution of Confession to Mental Hygiene
By way of prevention, confession certainly serves purposes of mental hygiene. The firm determination of the will demanded in confession will surely purify one's mind, to say the least. But it will do more than purify; it will strengthen, and strength of character is the world's great need. There are so many men roaming the streets because they have no will-power: they pity themselves for the misfortunes that fall to their lot. They won't fight against adversity; they prefer to psychoanalyze about it. Instead of getting down to work and reforming themselves, they want to tell their neighbors about their tyrannical mothers or the dominating schoolteacher who induced in them an inferiority complex. The Church insists upon firm purpose of amendment, and there is no more therapeutic force in human character than that. If a man has a firm determination to avoid sin, he won't fall into narcissism, into compromises with temptation, into trickery and double-dealing. Instead of sinking into unconsciousness, he will consciously imitate Christ, his master and his friend.
A cartoon in a recent newspaper shows an author of a peace-of-mind manuscript discussing it with an editor. The latter suggests as a title: "Guide to Peaceful, Confident Living, Liberty and Pursuit of Happiness Without Worry." The Sacrament of Penance is the way to peace with God through heart-scalding contrition.
© Joseph F. Wagner, Inc.
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