The Mormon Therapist
My husband has been diagnosed with Major Depression, GAD and OCD with Religious themes. Through all my research, I have found some information on the internet about OCD with Religion as it’s theme and it is referred to as Scrupulosity. This description of Scrupulosity fits my husband to a tee. I don’t know if you are familiar with it because I don’t know how common it is.
My husband’s OCD manifests itself in severe guilt. When he was in High School he was constantly confessing to the bishop anything he could think of to try to rid himself of guilt. Sometimes he would even confess things he hadn’t done but had obsessed over so much that he eventually believed he possibly did. Once he had confessed something, he would obsess over whether he had worded it right or whether the bishop really understood the severity of what he had told him (even though he hadn’t ever done anything remotely bad). It was a vicious cycle. This obsession with guilt has never left him. No form of therapy or medication has touched this. It has affected every aspect of his life. He was sent home from his mission for being suicidal. He had to drop out of college 3 separate times when he entered serious episodes of depression and couldn’t function. Last fall, he was accepted to a PhD program. After going for two weeks, he sunk into such a severe depression that he had to drop out and watch his dream of getting his PhD go down the drain. It has been very devastating for him, for me and our little family. He is not currently seeing his therapist because after about 3-4 years of treatment the success had just leveled off and he wasn’t getting anything from the sessions. I have since tried to get him to go to someone else to get a new perspective. In the past few years he has started masturbating. It all started in a moment when he was so severely depressed that he didn’t even care that he shouldn’t. That was followed by some of the most extreme guilt so far. It now comes and goes and masturbating cycles with his depressive episode. He mostly does it when he is extremely depressed. You can imagine what this has done to his guilt. He often talks about confessing to a bishop, but I worried that would start a bad habit of confessions, so I encouraged him not to. I also have known that it would start an unhealthy cycle of confessing and never getting relief from guilt. He is further in a pit of despair than he has ever been before. It is really quite unexplainable. He doesn’t know what to do. He told me that he has been researching suicide on the internet and that he has a few plans of how to do it and ensure that it works. He honestly feels like that would be the easier route right now and I believe he would do it. I am panicked and don’t know how to help him anymore. He feels like his parents (who are extremely conservative LDS), his siblings and the bishop don’t understand. Another, very sad issue is that the guilt has driven him to want to leave the church. I can’t say I blame him. He doesn’t feel like he has a testimony of it, mainly because he doesn’t understand how the power of the Holy Ghost and the Spirit can’t overpower this guilt. While I would support (and even encourage) him if he decided to leave the church, it devastates me in a way I can’t express. We have two young children (ages 5 and 3) who I feel will be confused that their dad doesn’t go to church anymore. It also brings a lot of sadness to think that when my little girl (who has a very close bond with my husband) turns eight and wants to get baptized that he wouldn’t be able to do that. While I know he supports me in continuing to raise our kids in the gospel and attend church myself, I feel like there will be issues down the road as he starts doing things (specific things he has mentioned as things he wouldn’t follow) that aren’t in harmony with church values. I guess I just have a lot of feelings of fear and panic about now and the future. Should he stay or should he go (from the church)? How are the kids going to handle it if he leaves? I feel like if he stays he may kill himself.
- I hope with the complexity of diagnoses involved and suicidal ideation that you and your husband have sought out treatment not only from a primary care physician and a therapist, but specifically from a psychiatrist.
- Again, because of the complexity of the diagnoses, I suspect that attending therapy should be a long-term endeavor. It may be something your husband needs his entire life. However, I highly encourage anyone in the position of needing therapy for longer than a year (and especially two) to evaluate whether or not the current therapist is still helping. If so, then continue. If not, then by all means switch therapists. This doesn’t mean that the therapist you were seeing didn’t serve their purpose, but you learn different things from different people and from different approaches. I also hope that you have been included as the spouse in the therapeutic process.
- You need to know that you have the right to call authorities if you feel like your husband is suicidal and get him admitted to the hospital. You can do this by calling 911, by calling his therapist and/or his physicians. You can also call the suicide prevention hotline and always ask their advice 1-800-273-TALK.
- It is important to understand that these mental health diagnoses are diseases, and serious ones – much like diabetes, congenital heart failure, etc. Therefore, even with much faith and righteous gospel living, it may not be that symptoms will magically disappear or that the disease will be cured. However, most diseases (even chronic depression and OCD) are manageable and can benefit through preventative and health-conscious efforts. You may both need to work around how you change your expectations on how to live in conjunction with these diseases, rather than trying to completely rid yourselves of them.
- Managing healthcare issues can also be benefitted by gospel teachings and church support. However, HOW you currently choose to use the gospel teachings should be reevaluated at this point. You can both have a discussion of how to use the gospel principles and church resources that will currently offer you most relief. For instance, all family home evenings, gospel discussions, and lessons in your home can be focused solely on Jesus Christ, His love for us, and how the atonement makes up for our imperfections- keeping it to the basic foundations. It would behoove you as a couple to speak candidly with your bishop and even stake president TOGETHER about the diagnoses your husband has and things they can do to specifically be helpful in this situation. For instance, confession (whether officially necessary or not), probably offers your husband a sense of immediate relief. Compulsive behavior in OCD is usually what offers relief to anxiety and guilt and why people resort to this type of repetitive behavior. So, maybe for a time as part of managing feelings that won’t go away, you have a weekly scheduled confession (where the bishop understands his role is that of loving supporter not guilt inducer). This confession should be kept short and non-dramatic. I would recommend for you to be present to add spousal accountability, and I would also recommend for the therapist to be communicating with the bishop through a “release of confidential information.” The therapist can act as educator to the bishop/stake-president regarding the mental health piece of this equation and therefore, since religion is how OCD is manifested, there can be more fluidity in the treatment with ecclesiastical leaders and therapist working together. Even home teachers could be guided as to the type of messages they bring into the home.
- Since religion has been the main way your husband has manifested his OCD I’m not sure how withdrawing from church all together would be beneficial- it will more than likely cause further problems in the long run. However, you may discuss taking a break from church attendance (say a month) and see if not going to church offers any type of relief. I would do so together as a family, and choose other worthwhile things to do specifically on those Sundays such as service at a food pantry, visiting a nursing home, going on a family picnic and enjoying nature, etc., etc. Hopefully over time, you can explore how participating in church can serve as a positive force in both of your lives and your children’s lives rather than a negative one. Maybe your husband can see his role as one of teaching your children the hope and love the gospel is founded upon, rather than the messages he incorrectly personalized. When you prioritize your decisions, your husband’s ability to live should come first and foremost.
- I encourage you to be very verbal regarding what you see as your husband’s strengths and the confidence you have in him to manage these struggles he faces. Be very verbal of your need for him to live and the needs of his children for him to live. Be verbal in your declaration that together, you can survive whatever it is he faces. That you signed up to be with him in sickness and in health – and that you expect the same from him. Be willing to listen and empathize, while at the same time gently challenging towards wellness and life.
- As far as the masturbation piece, I would want to know how often this is occurring. I would want to know if pornography is involved? I would also want to know what the history of the sexual relationship is between the two of you as husband and wife.
- How has all of this affected your marital relationship? You sound like a supportive and loving spouse. What strengths and positives remain in your marriage?
- How has this affected your husband’s role as father? What strengths does he show as a parent?
- How are you able to take care of yourself at this time of your life? How are you surviving all of this? I assume you must on your own account be experiencing much anxiety and undue responsibility.
- What kind of resources do you currently have?
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