McHugh, James T.

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The Linacre QuarterlyVolume 39 | Number 3 Article 12August 1972Psychiatry and Psychotherapy: A PastoralViewpointJames T. McHughFollow this and additional works at: http://epublications.marquette.edu/lnqRecommended CitationMcHugh, James T. (1972) "Psychiatry and Psychotherapy: A Pastoral Viewpoint," The Linacre Quarterly: Vol. 39 : No. 3 , Article 12.Available at: http://epublications.marquette.edu/lnq/vol39/iss3/12.. · r., ,. PSYCHIATRY AND PSYCHOTHERAPY A PASTORAL VIEWPOINT Rev. James T. McHugh " Hello, Father Smith. This is Tom Brown. You probably don't remem-ber me, but I was wondering if I could drop in to see you sometime. I have a little problem I'd li ke to talk about." Every priest has listened to these words, usually uttered by someone he knows quite well. In some cases Monsignor McHugh is a priest of the A rchdiocese of Newark , New Jersey. He is currently serving as the Director of the Family Life Bureau of the United States Cath-olic Conference in Washington, D.C. 206 it has been the initiation of an in· form al discussion in which the calle1 ta lked out some personal problem. calli ng on the priest for specific advice or counsel. In other cases. it has been the first step towaro psychoana lysis and psychotherapy, for which the person was ultimate-ly referred to a professional. In the past, the clergyman was a strong authority figure, and many problems were solved by his au -thoritative - if not authoritari an -advice. Today, the variety ot mental disorders seems to be wider, and the incidence of persona l breakdown seems to be greater. Recent reports indicate th at an in-creasing number of Americans are affl icted by serious mental de-pression . No one is sure what the reason is, although increased urban-ization and an overbearing em-phasis on technology are offered as explanations. Certainly these are pressures that affect personal identity and stability. At any rate, Dr. Gerald Klerman, professor of psychiatry at Harvard, estimates that one out of eight Americans can expect to experience depression Linac re Quarterly during their lifetime. Dr. Klerman maintains that " if the 1950's were the age of anxiety, then the 1970's are the age of melancholy." Quite o bviously, this sort of pro b-lem is well beyond the competence of the parish priest. Even though an indi vidua l may call upon the priest for help, the clergyman finds himself less effecti ve and less secure in attempti ng to meet the need. He must at this point rec-ognize that the person needs the specia list, i.e ., the psychiatrist or clinical psychologist. If he attempts to provide some counseling on his own, he will likely be ine ffect ive, and possibly even harmful. At the same time, if the person is ser iously ill, then referral to a specia list may properly be the responsibility of the family doctor. As the community agencies pro-viding health care increase, the priest must look upon himself as one of many professionals that per-sons in trouble will turn to. In some cases he may recommend that the person call upon the local menta l health agency. He may a lso supply the names of reputable psychiatrists or psychologists. And in some cases, the wisest course is to urge the per-son to see his or her family doctor. At present, there are concerns about confidentiality that dissuade the priest from calling the menta l health specialist and providing some preliminary informatio n. There are a lso some therapists who tend to distrust any background August, 1972 m ·mation; and therchre dis-c . age it. As the ca~ oad in-ere '-'S - as it seems l i~ the :~llu re- efforts will t made on both sides to fi ; profe~siona l system of C( ' that is in the counsel interest. v to in e to be ..1 truly : ration ,, best In discussing the priest ole in regard to persons with m ,al and emotiona l problems, then. are two facts that must be kept in mind. First, not every priest is tempera-mentally suited to provide personal counseling. Note well , we a re here discussing the priest's role as counselor, not as spiritual guide. Second, even for the priest who is adept and trained, there a re many problems that are beyond his com petence. Granting that most sem-inary curricula have not included courses in developmental psychol-ogy o r counseling, and granting that such courses are only questionably effective without the supervised experience of counseling, the parish priest is often caught in the dilemma of trying to help people work out problems that he doesn't adequately understand himself. Clearly, the most important thing that the priest must do when faced with someone who has a serious mental or emo-tional problem is refer them to the competent psychiatrist or psychol-ogist. However, the priest's role does not end with the referral. He .;an often he lp the family of the afflicted person understand the problem, and a lso encourage them to be patient and understanding. He can also be helpful to the counselee by en-207 I ' . ·, • . ·-~· . .. ,. •' ' • ·' couraginf him to cooperate with he doctor a .. d to follow advice care-fully. 8 , .::ause therapy can often be a long-term process, and somewhat discouraging to the counselee, some firm support from the interested pastor can be valuable and helpful. Ther.- are many instances where the prk .., t comes into contact with a perso11 who does not have a ser-ious mental or emotiona l disorder, but does have a need for some personal counseling. In such cases, most priests have some abi lity and competence. Emotional stability and objectivity are basic qualities for any priest who attempts to pro-vide pastora l care. Interest, pa-tience, sensitivity, tolerance, tact, insight, and the abil ity to inspi re trust are additiona l qualities of a good counselor. With basic intel-ligence, some minimal tram~ng, and occasional reading, most priests can improve thei r ability as a counselor. The primary earmark of success in counseling is a healthy personal identity, the ability to understand oneself and thereby lead the cou nselee to a progressive-ly c learer knowledge of his or her identity in re lation to other persons. Priests who are inclined to counsel should receive some professional training. T here are a number of universities where the priest may pursue a graduate degree in pastora l counseling o r marriage counseling. T here are also the standard pro-grams in clinical psychology and educational psychology. A fair number of dioceses have also worked out special programs tha t 208 supply academic courses and s pervised practicum that lead to certificate . Good will and dedic tion are important, but do not su i stitute for professional training. Let's turn our attention now ) marriage counseling, an acti vi ; tha t many priests are called up0 to engage in. Paradoxically, tt> major impe tus to marriage counse ing is coming from the trend t revise divo rce laws in the variou sta tes. At present, at least 14 state have laws requring counseling i domestic relations cases, and Cali fornia is an indication, we ca expect a greate r demand for ma1 riage counselors in the future. T oo many couples have marri ed and expected to " live happily eve after." Five, I 0 or 20 years later they fi nd the program hasn't worked at which point they become ar add ition to the constantly increasin~ divorce statistics, or they put UJ with it and live in not-so-peacefu coexistence. Some, and their num-ber is growing, go to a marriage counselor. And often, this marriage counselor is a competently tra ined priest. Let's take a look at a diocesan program. The Marriage Counsel -ing Department of the Archdiocese of Newark, New Jersey, recently reported that 7 1 cases were ter-minated a fter periods of from three months to one year of weekly coun-seling sessions. Of the 7 1, 3 I were said to have ended with satisfactory results for both counselor and clients, 27 ended with definite Linacre Qua rterly progress having been achieved, and 13 with no progress. In this diocesan program there are four priests with graduate de-grees in marriage counseling, who have a full-time ass ignment to counseling, and more than 30 parish priests who have had special training at Seton Hall University. The University's Psycho logy De-partment provides continued super-vision for the priest-counselors. The a larming increase in marital breakup has emphasized the need for trained counselors. Contra ry to the fairy tale, many people who get married have not "grown up," and their persona l immaturity is like a bomb waiting to be detonated . And some who have grown up have "married," but have so hedged their commitment that in fact , there was little more than an arrange-ment, certa inly not a marriage. With these major persona l inad-equacies, the normal problems and tensions that a ll couples face be-come unmanageable, and the mar-riage is at the breaking point. What can the clerical marriage counselor do? First of a ll , he can't do much to make people grow up or to force a commitment or make the problems go away. Recognizing a t the outset that each marri age is unique, he can help the couple find their own strengths and honestly admit their own weaknesses. He can help them learn to cope with their problems, and help them discover facets of their persona li ties and their rela-August. 1972 tic ip 'that are pleasur '>le and re'' ling. In the vast m .. 11)rity of casl learning how to <ommu-nicat , a basic need. Con L. un ication is a great deal more than 'i t1 ing down and talking things out. Rl !lo May maintains that one of the w ... . d,.Jesses of our society is tha t " it has ll)•,t the language by which it communicates with the meaningful crises of li fe." A couple have to Jearn to read each other, to develop a sensitivity to each oth r's feelings, and even to have a good fight once in a while. The expression of hostility in a non-destructive way is part of good communication, and psychol-ogists see a therapeutic value to an argument or " fight" provided it doesn't include violence or lead to completely depersonalizing anti-socia l behavior. And married couples can usua lly verify that mak-ing up after a disagreement helps in the maturing process and can be quite satisfyihg to both persons. The priest-<:ounselors emphasize that the goal of counseling is not just " living happily ever after," but more importantly, discovering the means to deal with problems, and finding more effective ways of meeting one another on the per-sona l level. The person who makes progress is the one who is wil li ng to look into himself or herself, not just at the other person . Courage and determination a re needed, be-cause things often seem to get worse before getting better. But a couple have to be willing to find 209 , . . ·. .. .. · ... .. . : .·. .. . ·, ,· a middl:: ground between romantic fantasy ..tnd continued hostility. It's here t hat they develop a working relationship which is real, human, and satisfying. Marriage counseling will not solve everyone's problems, and many couples should not have mar-ried in the first place. But the priests in New Jersey feel that their ef-forts at least break the destructive pattern of unhappy marriage in some cases, and are therefore of greater value for future generations. These examples - referral agent and marriage counselor- certainly do not describe all the roles that the priest can play. They are chosen to illustrate the possibilities and the limits of pastoral care in regard to persons with some specific problems. Are You Moving? All priests, however, should ha a basic confidence in and respl for the counseling disciplin· psychiatry and psychology. At t same time, the priest should t cautious about sending everyo. with some anxiety or insecurity the mental health profession: And, as indicated at the outset this article, the priest should se• out new ways of cooperating wi physicians, psychiatrists and ps chologists, and community ment health facilities. Accepting his own limitation and spurred on by a deep reveren• for personal integrity as well , dedication to his pastoral respor sibilities, the parish priest can t a valuable member of the ment. health team, and also a great he! to those persons who need a st<. bilizing influence on their way t personal maturity. If the next issue of this journal should be delivered to a differ-ent address, please advise AT ONCE. The return postage and cost of remailing this publication is becoming more and more costly. Your cooperation in keeping us up-to-date with your address will be most helpful. 2 10 Li nacre Quarterly Catholic Physicians' V ~w- St. Luke'f Guild of Bo. ·~on A Study Conducted for St. Luke's Guild of Catholic Physicians Synopsized by Mary J. Lorsung Assistant to the Editor "At a time when traditional moral values are challenged and the fun-damental question of human life is attacked, the need for intelligent direction, guidance and counsel especially within the discipline of medical ethics seems conspic-uously appropriate today. "Through this study Catholic physicians say they recognize the need and have the strong desire to receive such counsel. " In fact , these physicians both recognize and endorse the efforts and contributions of St. Luke's Guild. They say that the guild has been true to its purpose: to promote a better understanding of the moral and ethical principles that should guide the medical profession." Thus begins the summary of a survey of active and inactive mem-bers of the St. Luke's Gui ld of Boston by Becker Research Corpora-tion conducted in the fall of 1970. One hundred and five physic ians (50 inactive members; 55 active members ; For purposes of the sur-vey inac tive members are referred to as "non-members".) were the sample questioned by the independ-ent resea rch group to: determine the August, 1972 present image of the Gui ld as per-ceived by its members and the d if-ference in this image between active members and potential but inacti ve members; obtain the membership's evaluation of the Guild's present purposes and activities; determine whether the membership believes that the Guild still has an appro-priate role to play in 1970's, and if it does what they feel the organiza-tion 's objectives, activities and programs should be; explore the rea-sons why inactive members are not active, and to examine ways in which they might be motivated to undertake more active participa tion in the Guild. Those physicians, surveyed by telephone, were selected by sys-tematic sampling procedures from alphabetized lists of both active and inactive members - a tota l of 509 names. Some of the results and highlights of this survey are pre-sented in this issue of Linacre Quarterly because of continuing in-terest in the study by many people associated with local guilds, as well as the National Federation of the Catholic Physicians' Guilds, and because the information gath-211 . ·. ·. .. .. ·-' . . : •' ' . . 

Psychiatry and Psychotherapy: A Pastoral Viewpoint

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Psychiatry and Psychotherapy: A Pastoral Viewpoint

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