Religion And Health

by James J. Walsh

The subject of scruples was very thoroughly worked out and carefully described by the older spiritual writers centuries ago. They wrote elaborate treatises on it, while it was not until our own time that physicians by their careful study of corresponding conditions entirely apart from religion came to appreciate that these conditions of the spiritual life were only expressions of a rather common set of tendencies altogether independent of religion. They are prone to develop in people with certain physical and mental characteristics who are possessed of dispositions and nervous systems particularly likely to be the subject of these hesitancies and doubts and difficulties for which there is very little basis in actuality.

The whole chapter of phobias and the other chapter on obsessions and the third on what the French call la folie du doute, the doubting mania in our modern textbooks of neurology, are really so many chapters in the [{221}] literature of scruples of the old time, now transferred to the textbooks on functional nervous diseases. Some nervous people who are religiously inclined get into a very disturbed state of mind from the fear that they may commit sin almost unknown to themselves or that they may be in sin unawaredly and cut off from their Creator, and they become extremely miserable as a consequence. This is, after all, a very familiar picture to the neurologist accustomed to see patients suffering from functional nervous diseases. I have patients who suffer quite as much from the dread of dirt as these scrupulous people do from the dread of sin. Women often suffer from this dread of dirt—misophobia is the scientific name derived from the Greek—to an exaggerated degree. A woman patient of mine makes it extremely uncomfortable for the conductors on the street cars because, for fear of contaminating her hands, she dreads to touch the handle bars by which she could mount or descend easily. This adds greatly to the risks she takes every time she boards a car. She is constantly washing her hands to get the dirt off, so that in cold weather she sets up severe skin irritations and makes herself very uncomfortable. I have a male patient who would not touch the handle of my door for the world, and whom successive maids have come to know very well because he stands outside the outer door and has to have that as well as the inner door opened for him. He has said to me over and over again, "Doctor, don't ask me to shake hands with you, because you shake hands with so many people." I have seen him standing outside of a large department store with the temperature around zero, waiting for some one to open the door so that he might slip in without touching it. Nor are such states [{222}] of mind confined to the uneducated; on the contrary, they are commonest among those who have a good education and are quite sensible in other things.

Obsessions were originally described as super-religious states of mind in which some idea assumed a terrorizing character. The victims of them dread that they might commit some awful crime and as a consequence were profoundly miserable. Instead of being confined to religion, such mental states are quite common in conditions altogether apart from religious feelings. Women read of a mother killing her child in some awful way or perhaps accidentally poisoning it or burning it badly with some escharotic external application. They become obsessed with the idea that they may do something of this kind and fear that they may not be able to resist the suggestion. Medical literature is full of such cases. A typical case is described by Tangi in his textbook on insanity:

"A young married woman suffered from nervous exhaustion after her first childbirth. She watched day by day her husband cutting up meat for his parrots with a pair of scissors, and the action filled her with disgust which later increased to positive horror. Thus a repulsive obsession was produced and this in turn engendered the morbid suggestion to cut the tongue of her dearly loved child in the same way. The fear that she would not be able to resist this suggestion made the suggestion more vivid and the idea more imperative, causing an agonizing struggle each time."

Then there are accounts, some of them most poignant, from Catholic patients of my own, who were sure that sometime while in the midst of their devotions or even at the very reception of the sacraments they would [{223}] blaspheme. They are people who fear that every pious act of theirs may just expose them to the risk of committing some awful sacrilege.

Almost needless to say such states have nothing at all to do with religion, and when similar conditions occur among the religious minded, they must be attributed to the general neurotic condition and not to the incidental religious tendencies. The doubting mania occurs among the religious minded when they keep on fearing that they have not done something that they should do. Some of these individuals get into a profoundly miserable and disturbed state of mind, but that must not be blamed on religion.

This sad state of mind in people who have no religion at all is extremely familiar to the neurologist, and it has no necessary connection with religious practice or religious belief. I have a patient who has been coming to me for many years now from a city in the Middle West; he is a broker, and every time there is a panic in the money market I am almost sure to see him. Whenever he gets very much disturbed over business matters, as is likely to happen in panic times, he develops a very striking folie du doute, or doubting mania. He will take a letter to a post box and go back three or four times, first to see if by chance he did not drop it on the way, secondly to be sure that it did not get caught in the slot; then, if the letter is important, he will go back to see if perchance there may not be some bolts or other obstructions at the top of the box that may catch it and delay its collection. I have even known him to wait for some time at the post box to see if the postman might not possibly drop it when he came to collect the mail. But then he does other things just as foolish. Occasionally he will [{224}] get home from his office and suddenly have the feeling that he forgot to lock his safe. He will go back and then get part way up town when he is overcome by the fear that he may not have locked the door after him as he came out. At times when his folie du doute is at its worst, he has been known to go back three or four times to close windows or for some other trivial reason. When he is in reasonably good condition there is very little of this state of mind manifest, but he can make himself supremely miserable when the obsession is on him.

It is often said that the declaration by the Church of the idea of possession by the devil rather encouraged the development of certain mental and nervous states and thus fostered neurotic manifestations of many kinds. This whole question of the possibility of direct diabolic influence over mankind, that is, of some evil spirit deeply influencing certain human beings, is yet a matter that is not nearly so settled as a great many physicians who have not been following scientific work in allied lines seem to think. So distinguished a scientist as Alfred Russel Wallace, the co-discoverer with Darwin of the theory of natural selection, had the feeling that spirits interfered much more in human affairs than a great many people were willing to admit, and that the evil spirits probably could, under certain circumstances, deeply affect individuals. Professor Barrett of Trinity College, Dublin, is even more outspoken in what he has to say in this regard, and now there is a very general feeling among those who have investigated spiritistic phenomena most carefully that if spirits do actually communicate directly with men, it is commonly not the spirits who claim to do the communicating who are actually present. Almost needless to say any such conclusion as this would, [{225}] if maintained, throw even scientists back to the old idea of diabolism, which the Church, on the strength of many centuries of experience, still teaches.

One thing is perfectly sure: that if overzeal on the part of certain ecclesiastics rather encouraged neurotic manifestations because of the alluringly suggestive quality of the thought of diabolic possession, they did no more than physicians did in more modern times by their suggestive methods in the study of hysteria. A great French neurologist of to-day has pointed out that major hysteria as studied by French neurologists of a generation ago has practically disappeared, or occurs very rarely in our day because it is no longer unconsciously suggested to patients by physicians that these major symptoms are being looked for. Overzeal in medicine raised up a whole series of symptoms that had no existence except in the heated imagination of their patients under the influence of strong suggestion.

Another extremely interesting phase of this subject is that in the old days many of the sensible ecclesiastics and some of the civil authorities came to recognize that people supposed to be possessed of evil spirits could be cured of their condition not infrequently by roundly whipping them. Sir Thomas More particularly called attention to how much good could be effected in this way. In writing an article on "Psychoneurosis and the War" (International Clinics, Volume II, Series 29) I called attention to this in a paragraph that may be helpful in the understanding of the discussion of diabolic influence.