After returning from vacation I made it my business to get serious about my mental health coursework and take my continuing education courses to renew my license, which is up next March. It has been almost two years since I closed my practice, and while I come out of the bullpen from time to time for personal or institutional requests or workshops, more of my attention has been focused on theology—teaching for my diocese, blogging, and the like. But I do miss the regular interactions of psychotherapy and the science behind it, so it’s back to internet school, and I guess you are coming along with me whether you want to or not.
Somewhere in my recent reading on moral theology I came across a quote to this effect, “It is not enough to worry about your sins; you should worry about your attitude toward your sins.” True enough, but whenever one moves in the direction of this kind of introspective, mental health development—or the lack thereof—comes into play. The directions of our thoughts and behaviors—the heart of our spiritual life—is integrated into our brain function in ways we do not fully understand but must acknowledge. While Catholicism has never literally embraced the twentieth century theories of Sigmund Freud, its monastic mentors were counseling novices to avoid excessively rigorous penitential practices fifteen centuries ago and in 2016 the Church screens candidates for the priesthood for sound mental states of mind. (How seriously individual bishops weigh input from competent psychologists is hard to say, though.)
There are a significant numbers of good reasons for church ministers to be well versed in foundational principles of mental health and disorders, the first being that habitual self-care of one’s own state of mind is a sine qua non of professional satisfaction—lucky the parish, for example, to be led by a priest who is at peace with himself and enriched by his healthy encounters with his flock. A second reason is the assessment of volunteers and professional hires for suitability for specific ministerial placements. Introverts are not always comfortable undertaking major fundraising—a lesson I learned myself the hard way.
A third reason—and perhaps the most critically demanding—is damage control. I was reminded of this on Monday afternoon while reading Borderline Personality Disorder: The Latest Assessment and Treatment Strategies by Melanie Dean, Ph.D. (2006), for an online course of the same name. I reflected back to my practice days and I had to admit that my therapeutic encounters with such individuals were tense. BPD individuals are prone to statistically high suicide and self-harming episodes; they can be seductive in every sense of the word, unpredictable, and notoriously resistant to discipline or organized office treatment schemas. They can become immediately hostile if they sense any clue of rejection (such as a therapist’s taking notes instead of looking them in the eye.) I found it interesting that some of the Amazon reviewers gave poor ratings to the book because the author reported the sad fact that BPD individuals do not generally respond to our current available psychotropic or mental health medications. (I have a Wikipedia link here, slightly outdated, which is a fair description of personality disorders in general.)
Given that personality disorders in general are not controllable with medication—unlike “mood disorders” such as depression, anxiety, bipolar, etc.—it is also true that many of the arrows in our pastoral quivers are equally ineffective. Spiritual advice, confession, and kind listening, for example, can actually make the situation worse for an unwary minister and the troubled soul. Personality disorders such as the borderline type are, at the end of the day, diseases of thought, unlike depression which probably has organic roots. PD’s are consistent and enduring, unlike mood disorders which are “transient” and clinically proven to respond to a combination of medication and psychotherapy in most cases.
Here is a not-uncommon parish scenario. Many people approach the church for counsel, advice, or spiritual direction, most often seeking the priest. Given that about one in 50 Americans suffer some form of BPD, and the majority of cases are women, an individual seeking comfort because of an unhappy marriage or general loneliness may quickly attach to the priest, long before he catches on to the level of intensity of the counselee’s attachment. While there may be a sexual element here, the root cause of BPD is fear of abandonment and isolation, probably originating in the formative years when parents were emotionally unavailable or the counselee was abused by a parent in youth. (Dean, 19)
Thus, when a priest or minister attempts to set boundaries, such as less frequent appointments, refusal of gifts, or particularly referral, the counselee—whose whole conscious life has been a tale of rejection and separation—will usually react strongly, and it is the unpredictability of the reaction that makes BPD so dangerous for all involved. The risk of suicide is particularly high in this population. Certainly in my years as a priest I rarely thought to undertake a simple suicide assessment during my first pastoral counseling meetings, but the fact is that a previous attempt is a very good predictor of another, and we are wise to do some very basic screenings in church counseling—for substance use, for example, or history of child abuse. Such data is a flag that at least some of the counselee’s healing will need to involve a medical component (i.e. professional mental health personnel.)
A suicide of a patient or counselee is particularly difficult for church personnel, for our instincts, and some of our less informed training, leads us to take on more responsibility for individuals than is professionally wise. I suspect there may be legal risks here, too, particularly if the church counseling relationship has been prolonged for several years. A lawyer can make a good case that a church minister was essentially practicing medicine without a license and failed to take note of the counselee’s risk of self-harm. Suicide is not the only, nor even the most common, negative outcome in BPD individuals who perceive rejection, rightly or wrongly. Binge eating or drinking, binge shopping, promiscuity and self-mutilation are also common. Stalking is not unheard of. I hope to research the legal responsibilities further for future posts.
It is entirely possible—though statistically unlikely—that you will progress through your catechetical or ministerial life without a difficult encounter with personality-disordered individuals. I have focused on one type today, but in fact you are more likely to encounter histrionics or narcissists, the two types I have seen over the years on parish staffs or positions of church responsibility, and how unschooled parish workers have labored mightily and fruitlessly to accommodate them. After I take my on-line exam this week, I will look more closely at your more likely crosses to bear.
After one month and over 5,000 auto miles up and down the East Coast all the way to southern Nova Scotia, you would think that I would have a storehouse of impressions about the life of the local Catholic Church in many different locations. The sad truth is that my itinerary, for the most part, took me to famous churches, cathedrals and shrines, actually, and it is hard to sort out the locals from the tourists and the services available to visitors. We attended three Masses in the United States—the Orchard Park, New York and Portsmouth, New Hampshire Masses were nuptial Masses. The third was a Sunday evening Mass at St. Teresa’s in Brewer, Maine, just across the Penobscot River from Bangor.
I have linked here the June 26 Sunday bulletin given us at St. Teresa’s, because its information is quite enlightening. St. Teresa’s is one of six churches (!) networked together around Bangor, each church having its own patronal saint but corporately and collectively known at the Parish of St. Paul the Apostle, as indicated on the front page of the bulletin. Thus the folks in Brewer, though worshipping at St. Teresa’s or St. Mary’s up river, are canonically members of St. Paul’s, and all six churches use the same bulletin. I would have liked to see some of the others, but we opted instead for supper down the road from the church at a hole-in-the-wall fish house hanging perilously high over the river, but worth the risk for the fried haddock special.
On this particular weekend all of the local churches were bidding farewell to their pastor of the St. Paul consortium, Father Timothy Nadeau, who was being transferred to Lewiston, Maine. I am not certain if this is exactly a promotion or not, having never seen Lewiston. However, Lewiston, Maine, has a place in the annals of sports history. When the new boxing champion Cassius Clay and his vanquished contender Sonny Liston scheduled a rematch on May 25, 1965, no state would issue a license for the fight except Maine (Liston had a number of legal problems, as I recall.) In a 4,000 seat school gym that was only half sold-out for the fight, Clay knocked out Liston with a much disputed phantom punch and of course the rest, as they say, is history. We can only hope that Father Nadeau has a kinder reception in Lewiston than Sonny Liston’s.
Many parishes over the past generation or more have moved into consortium or networking arrangements, originally for staffing and financial purposes, but I suspect that more recently bishops are more sensitive about maintaining local faith communities and the enthusiasm they engender. St. Teresa’s seemed like a spirited little parish, with many confessions before Mass and an excellent sermon. The parishioners were quite friendly toward us and we left with hope that the parish might continue its presence on the local parochial landscape.
Money has been called “the mother’s milk of politics” (but probably not by Bernie Sanders); it is an undeniable reality that fiscal realities impact the numbers, availably, and quality of Catholic life and worship. There is some mild, tempered optimism about Maine’s economic future, and I have linked a 2015 statewide analysis here. The state took an extraordinarily long time to recover, albeit partly, from the great recession. The lumber industry has been decimated. Maine, as a state, has lost population or held even between 2010 and 2015. This is never good, as it is often symptomatic of young people leaving the area or state for better opportunities elsewhere. There is also a tendency in Maine of relocation to urban centers such as Bangor, Portland, and Augusta.
Such factors certainly impact the Catholic life of Bangor. In reviewing the June 26 bulletin, the total collection of the six parish units amounted to just short of $23,000. This strikes me as a “maintenance budget” in that the insurance gets paid and the facilities cared for. I do note in the bulletin that the Catholic Charities Campaign for the Diocese of Portland, which includes Bangor, is currently in its sixth week; the six churches of St. Paul Parish stand at 67% of their total goal of about $225,000. I found a more detailed description of campaign results at the Diocese of Portland’s website, an informative breakdown if you’ve never seen one. I commend the Portland Diocese on its transparency; my own diocese does not make such information so easily accessible, if at all.
Since we visited a month ago, a new pastor has been appointed, and the two parochial vicars or assistant pastors remain unchanged. There is also a full time priest who serves as chaplain to the local hospitals. In numbers, this means that four priests serve the third largest city in the state, though the population of the entire City of Bangor is only 33,000. The priests rotate through a rather detailed weekend Mass schedule. Not all parishes offer all customary services; four of the six churches have announced confession times, for example.
I have neglected to mention that Bangor does have a Catholic school. Not surprisingly, the enterprise is spread over three church campuses throughout Bangor. The principal of the school, in a farewell bulletin note to the departing Father Nadeau, observes that “the level of support that All Saints Catholic School [the corporate school name] receives from our parish is unmatched in the diocese. Father Nadeau has supported our school spiritually as well as financially. A great example of this was his support for the purchase of new laptops for our middle school.” Schools are generally a rallying point of parishes, and hopefully the pastor’s successor will continue to maintain support for the All Saints. The bulletin notes four persons with the title of “faith formation coordinator” and two with special designations for junior and senior high Catholic youth. The practical management of religious education must be a logistical nightmare; I was sorry I did not have a chance to talk to a staff member about that.
I know that I have just scratched the surface in terms of understanding the life of the Bangor Catholic Community, but I find myself fascinated by even the general scope of the operations of Catholic ministry in any locale. No two Catholic communities are precisely alike—and if you look closely enough, you can always take away at least a glimmer of hope for your own ministry.