I now speculate on how Catholic beliefs, practices, and values might influence mental health, either in a positive way or a negative way. The next chapter will put these hypotheses to the test based on systematic research.

Positive Effects on Mental Health

 

Catholic beliefs, practices and values (BPV), when seriously held and engaged in, have the potential to enhance mental health and increase emotional resiliency. Belief in salvation, in the forgiveness of sins (through the death and resurrection of Jesus Christ), in the meaning of life, and in the existence of life after death – all should help Catholics deal with guilt and provide hope. The emphasis on God’s love, compassion, and mercy should help to relieve loneliness, isolation, or the belief that no-one cares. Catholic BPV should help Catholics cope better with loss, change, and difficult life events, and prevent or relieve depression. Belonging to a community of people with a common belief system, common religious practices, and a common emphasis on love of neighbour, might also result in greater social support and stronger, more durable relationships. Jesus, Mary, and the Saints serve as prosocial role models that can be emulated, potentially influencing individual and community well-being.

Religious activities such as praying, saying the rosary, lighting candles, wearing a cross or medal blessed by a priest, or going on religious pilgrimages, may help some Catholics cope with grief and  other forms of suffering. The Catholic sacraments provide powerful rituals that may enhance self-esteem and give Catholics activities that enable them to gain control over their lives. Baptism and confirmation mark the Catholic as a member of a spiritual group started by and dedicated to Jesus, the saviour of all humanity, whom they believe is God incarnate. Participating in the sacraments of penance and the Eucharist (taking Holy Communion) are activities that Catholics believe purify them from sin and prepare them for heaven, thus providing a sense of peace and security. This is especially true for the act of confession. Being able to unburden oneself in a completely anonymous setting, similar to what occurs during psychotherapy, can have immense benefits – especially when so readily available and free of charge.

Given the sacred nature of the sacrament of matrimony, Catholics may be less likely to separate, divorce, or commit adultery, thus increasing the likelihood that they will have an intact family over their lifetime.. This means having a committed spouse available to help cope with stress, and having spouse/children available to provide care during later life when health may decline, thus impacting physical and psychological health. Finally, when Catholics or family members are physically ill, the sacrament of the Anointing of the Sick can provide great comfort and hope for healing. These sacraments and rituals provide continuity to the lives of Catholics, connecting them to the generations that came before them and to the generations that will come after them.

Strong values concerning the need to address social problems, the importance of service, care for the poor and needy, compassion, justice, and emphasis on forgiveness and reconciliation, should give meaning, purpose, and direction to Catholics’ daily lives and reduce anger and conflict. Greater meaning and purpose should help counteract feelings of worthlessness and helplessness, and increase motivation towards positive goals. Less anger and conflict should help to reduce social problems among Catholics and prevent the dire consequences of seeking retribution that may include incarceration and deep-seeded resentments that are fertile ground for psychopathology. Other Catholic values that may impact mental health include the importance of being honest and having integrity, which are essential ingredients for success in business and social relationships more generally.

Finally, as noted above, one of the most important Catholic values is respect for human life, especially with regard to committing suicide. The belief that suicide is a mortal sin may prevent some Catholics from doing it, even when suffering is severe. Catholics believe in a Saviour who has suffered for them and someone they can emulate. This may provide suffering with meaning that transcends the pain.

Much more controversial, but also directly related to mental health, is the practice of exorcism. Little known is the fact that every Catholic diocese today is required to have a specially-trained priest who can perform exorcisms (the casting out demon/demons from those believed to be possessed). For a comprehensive discussion of this issue from a mental health perspective, see the discussion by psychiatrist Pattison and Wintrob (1981). Note that Church leaders have made clear that demonic possession is very rare and most cases after being properly investigated turn out to have mental illness (Squires, 2014). Although highly frowned on by mental health professionals (Karanci, 2014; Scrutton, 2015), reports on the mental health benefits of exorcism in some cases of dissociative identity disorder have been reported (Khan & Sahni, 2013; Irmak, 2014). One mechanism is that exorcism may produce abreaction from hypnotic suggestion. For a relatively recent review that balances risks and benefits of this practice, see Sanford (2016).

The psychological benefits discussed above would be expected among actively practicing Catholics, but not necessarily for nominal or cultural Catholics uninvolved in their faith tradition. According to the Pew Research Center (2015a) and General Social Surveys (Grant, 2014), of persons raised Catholic in the U.S., only 59-65% identify themselves as Catholics when adults (compared to 85% in the 1970s). Even among those who identify as Catholic, more than half don’t attend Mass more than once a year, indicating that only about one-third of Catholics overall are active in their faith (Grant, 2014).

Negative Effects on Mental Health

The Catholic Church has many rules and obligations that Catholics are expected to abide by. This together with the fact that many Catholics do not always comply with Church doctrine, leaves plenty of opportunity for guilt. Guilt may in turn increase vulnerability to depression, anxiety, or other emotional problems. Belief that one must suffer in Purgatory for imperfections in this life or be sent to Hell for all of eternity may lead to fear and anxiety, especially when Catholics become sick or approach death as they grow older. In addition, the Catholic values discussed above set the bar high in terms of what Catholics may expect of themselves, leading to psychological strains from failure to live up to these high standards and leading to a lowering of self-esteem.

Catholic rituals and practices may also foster religious obsessions and compulsions among those who are vulnerable to such tendencies. Prayer, saying the rosary, going to confession, or attending Mass may be done out of a compulsion to compensate for obsessive thoughts of sinfulness or impurity. Such individuals may even be viewed by other church members as particularly holy and faithful, rather than as neurotic and needing professional help.

Unrealistic expectations for physical healing from the sacraments (Anointing of the Sick, in particular) or from going on pilgrimage to a Catholic shrine (i.e., Lourdes, Medjugorje, etc.) may lead to disappointment, discouragement, and giving up, exacerbating emotional distress.

Thus, there are many aspects of the Catholic faith that could foster mental illness, not lead to its relief. Consider what Hailparn and hailparn (1994) say in the Journal of Contemporary Psychotherapy about treating Catholic patients:

“Issues such as shame, guilt, masochism, anger, sex, and magical thinking, take on a unique significance when applied to Catholic patients. These issues are a constant struggle for the Catholic because they represent “mortal sins.” Committing these sins will result, in the patient’s mind, in spending an eternity in the tortures of Hell unless they can be erased by confession and appropriate penance. The therapist must actively work to “exorcise” this punitive superego in a way that may differ from psychotherapy with other patients.” (p.271)

These authors also state (although with little evidence to back up their claim) that Catholics suffer from “powerful superego guilt” that is punitive and demanding, more so than do Protestants. Before such conclusions can be made, however, direction of causation must be considered. Since religious participation and affiliation is voluntary, people self-select themselves into various religious groups. Thus, there may be those with emotional or mental illness due to developmental or genetic reasons who also just happen to be Catholic or who become Catholic because they feel comfortable in this faith tradition (or have had positive experiences with Catholics who have tried to help them, given the strong outreach of Catholics to the mentally ill). Sorting out the chicken from the egg, then, may be a challenge in some cases.