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A HISTORICAL PERSPECTIVE ON OCD TREATMENT: SOUND ADVICE FROM SAINTS WHO SUFFERED OCD

Saint ignatius of Loyola, Saint Therese of Lisieux, and John Bunyan are all celebrated for their unique spirituality. As discussed in Chapter 3, these three luminaries also suffered OCD early in their lives. Of special interest is the fact that Ignatius, Therese, and Bunyan incorporated into their writings what amounts to behaviorally sound advice for OCD: exposure to obsessions and prevention of compulsions.
The approach of Saint Ignatius (1491-1556), founder of the Jesuits, is strongly introspective and analytical. Ignatius emphasizes the cardinal importance of identifying the nature of the thought that one is experiencing. Some types of thoughts come from Satan, the traditional purveyor of all bad thoughts. One specific type is that which we now call obsessions. Once it is recognized that Satan is at work, and that obsessions are the problem, Ignatius recommends preserving peace in the mind by ignoring these particular thoughts. In a letter to a friend suffering apparent obsessions, Ignatius writes:
It is necessary therefore to ascertain the nature of the condition we experience. … If the enemy discovers a conscience that is overly tender, he endeavors to torment, suggesting sin where there is none, anything to be able to disturb and afflict us. . . . If it is this kind of temptation that besets us, we must bear up against it without any vexation, and await the consolation of the Lord with patience. . . . Pay no attention whatsoever to the bad, impute, and sensual
thoughts.
This excellent advice is consistent with modern behavioral therapy: once it is recognized that an obsession is the problem, try to bear it with patience and avoid fighting it.
John Bunyan, whose Puritan spirituality influenced Protestantism, including modern-day Evangelicalism, to a degree that cannot be overestimated, wrote two pamphlets, The Doctrine of the Laic and Grace Unfolded and Some Gospel Truths Opened, only a short time after recovering from his lengthy OCD crisis. In them he says:
Know it for a truth that the greater you see your sins to be, the more cause you have to believe. . . . You must come to Christ with the fire of hell in your conscience; come with your heart hard, dead, cold, full of wickedness and madness; come as a blood-red sinner. Throw yourself down at the foot of Christ and say, “Lord Jesus hear a sinner, a sinner that deserves to be damned.” Resolve never to give over crying until you find that he has washed your conscience with his blood.
The important point here is that Bunyan encourages maximum exposure to obsessions. In fact, putting a remarkable spin on tormenting thoughts, Bunyan suggests that having sinful obsessions is actually good for you, because “the greater you see your sins to be, the more cause you have to believe.” Bunyan’s advice is to keep coming to God with the full weight of your obsessions until you feel peaceful, or, in behavioral terms, to keep exposing yourself maximally to obsessions until habituation takes place.
Bunyan also emphasizes response prevention. Having learned from painful personal experience that efforts to reform, performances of certain rituals, and reassurances gained from reading scripture were of no help for his OCD, he cautions against the use of compulsions.
Have care of putting off your trouble of spirit in the wrong way: by promising to reform yourself and lead a new life, by your performances or duties, [by being] content with any knowledge that you can attain to by yourself. They that are saved are saved by Grace through faith; not for anything they can do themselves.
Therese of Lisieux, called by a recent pope the greatest of modern-day saints, developed a spirituality centered on abandonment and trust. Like Bunyan, she discovered through personal experience that obsessions do not respond to acts of will. What worked was surrender to God. In Story of a Soul Therese writes: “Even though I have on my conscience all the sins that can be committed, I go, my heart broken with sorrow, and throw myself into Jesus’ arms. . . . What pleases God is the blind hope that I have in His mercy.”
Therese’s cousin, Marie Guerin, suffered sexual obsessions. In a letter to Therese, Marie admits her shameful thoughts and requests counsel. Therese responds affectionately with advice that is behaviorally sound.
I understand everything, everything, everything, everything! You haven’t committed the shadow of any evil; I know these kinds of temptations so well that I can assure you of this without any fear. . . . We must despise all these temptations and pay no attention whatsoever to them. . . . Don’t listen to the devil. Mock him.
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A HISTORICAL PERSPECTIVE ON OCD TREATMENT: SOUND ADVICE FROM SAINTS WHO SUFFERED OCDSaint ignatius of Loyola, Saint Therese of Lisieux, and John Bunyan are all celebrated for their unique spirituality. As discussed in Chapter 3, these three luminaries also suffered OCD early in their lives. Of special interest is the fact that Ignatius, Therese, and Bunyan incorporated into their writings what amounts to behaviorally sound advice for OCD: exposure to obsessions and prevention of compulsions.The approach of Saint Ignatius (1491-1556), founder of the Jesuits, is strongly introspective and analytical. Ignatius emphasizes the cardinal importance of identifying the nature of the thought that one is experiencing. Some types of thoughts come from Satan, the traditional purveyor of all bad thoughts. One specific type is that which we now call obsessions. Once it is recognized that Satan is at work, and that obsessions are the problem, Ignatius recommends preserving peace in the mind by ignoring these particular thoughts. In a letter to a friend suffering apparent obsessions, Ignatius writes:It is necessary therefore to ascertain the nature of the condition we experience. … If the enemy discovers a conscience that is overly tender, he endeavors to torment, suggesting sin where there is none, anything to be able to disturb and afflict us. . . . If it is this kind of temptation that besets us, we must bear up against it without any vexation, and await the consolation of the Lord with patience. . . . Pay no attention whatsoever to the bad, impute, and sensualthoughts.
This excellent advice is consistent with modern behavioral therapy: once it is recognized that an obsession is the problem, try to bear it with patience and avoid fighting it.John Bunyan, whose Puritan spirituality influenced Protestantism, including modern-day Evangelicalism, to a degree that cannot be overestimated, wrote two pamphlets, The Doctrine of the Laic and Grace Unfolded and Some Gospel Truths Opened, only a short time after recovering from his lengthy OCD crisis. In them he says:
Know it for a truth that the greater you see your sins to be, the more cause you have to believe. . . . You must come to Christ with the fire of hell in your conscience; come with your heart hard, dead, cold, full of wickedness and madness; come as a blood-red sinner. Throw yourself down at the foot of Christ and say, “Lord Jesus hear a sinner, a sinner that deserves to be damned.” Resolve never to give over crying until you find that he has washed your conscience with his blood.
The important point here is that Bunyan encourages maximum exposure to obsessions. In fact, putting a remarkable spin on tormenting thoughts, Bunyan suggests that having sinful obsessions is actually good for you, because “the greater you see your sins to be, the more cause you have to believe.” Bunyan’s advice is to keep coming to God with the full weight of your obsessions until you feel peaceful, or, in behavioral terms, to keep exposing yourself maximally to obsessions until habituation takes place.Bunyan also emphasizes response prevention. Having learned from painful personal experience that efforts to reform, performances of certain rituals, and reassurances gained from reading scripture were of no help for his OCD, he cautions against the use of compulsions.Have care of putting off your trouble of spirit in the wrong way: by promising to reform yourself and lead a new life, by your performances or duties, [by being] content with any knowledge that you can attain to by yourself. They that are saved are saved by Grace through faith; not for anything they can do themselves.Therese of Lisieux, called by a recent pope the greatest of modern-day saints, developed a spirituality centered on abandonment and trust. Like Bunyan, she discovered through personal experience that obsessions do not respond to acts of will. What worked was surrender to God. In Story of a Soul Therese writes: “Even though I have on my conscience all the sins that can be committed, I go, my heart broken with sorrow, and throw myself into Jesus’ arms. . . . What pleases God is the blind hope that I have in His mercy.”Therese’s cousin, Marie Guerin, suffered sexual obsessions. In a letter to Therese, Marie admits her shameful thoughts and requests counsel. Therese responds affectionately with advice that is behaviorally sound.I understand everything, everything, everything, everything! You haven’t committed the shadow of any evil; I know these kinds of temptations so well that I can assure you of this without any fear. . . . We must despise all these temptations and pay no attention whatsoever to them. . . . Don’t listen to the devil. Mock him.*68\223\2*