The Sacrament of Reconciliation and Mental Illness

The sacrament of reconciliation can be a healing experience for a person troubled with mental illness. First and foremost, the confessor extends a compassionate and understanding welcome to the penitent. It is important that the penitent feel comfortable and secure in this setting. Once this is established, the priest can size up the situation depending on how well he knows the penitent. The penitent may be down on him/herself already, and it is important that this be a positive experience.  Once the penitent shows genuine trust in the priest, great strides can be made. That may take some time, depending on the history of the person and any trauma from the past.  

It will be helpful for the priest to give the person the opportunity to express what is most pressing on his/her heart. If this is matter for the sacrament, then, the priest can address this point with care to assure the person of his/her value and the forgiveness that God offers. If the person suffers with Obsessive Compulsive Disorder (often manifested in scrupulosity), good pastoral practice should be used with emphasis on clarity and firmness along with compassion.

Ritual is important. The penitent may insist on a certain ritual of his/her own, for example, kneeling on the floor, reading a list of items from a paper or reciting certain prayers that are important to him/her. The priest should fit this into the rite of the sacrament as far as possible and give the penitent time to complete the ritual. If certain rituals are inappropriate, once the confessor has gained trust, he can gently begin to ease the penitent away from them. If the penitent requires more time to discuss the matter, or desires some spiritual direction, it is appropriate to invite him/her to see the priest later or to refer him/her to another person. It is important to know when to refer the penitent to a mental health professional for further assistance. The priest can gage this by the behavior and anxiety level of the penitent. For example, if the person is obviously finding it difficult to stay focused on the matter at hand and can’t seem to respond appropriately to the rite of the sacrament, the priest might ask: “Have you spoken to your doctor about what you are experiencing?” or “Have you talked with a counselor or therapist about this? Would you like the name of someone who can help you work on this?” Consistency is important. It helps to establish the practice of a person confessing to one priest for the sake of consistent direction toward spiritual growth.

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