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Deriving from the Latin scrupus, whose diminutive form scrupulus means a small sharp stone, scrupulosity signifies habitual and unreasonable hesitation, doubt, coupled with anxiety of mind, in connection with the making of moral judgments.

Description of the Condition. The scrupulous person's life journey has been aptly likened to that of a traveler whose pebble-filled shoes make every step painful and hesitant. Scruples render one incapable of making with finality the daily decisions of life. This psychic impotence, providing a steady source of anxiety and indecisiveness, is especially prevalent in ethical or pseudomoral areas. It causes ordinary, everyday questions to be viewed as impenetrable and insoluble. Decisions require a disproportionate amount of time and energy, and are always accompanied by feelings of guilt and doubt. Never at peace, the mind compulsively reexamines and reevaluates every aspect of a matter about which scruples center. With increasing doubts and mounting fear the mind is so blinded and confused that volitional activity becomes difficult or impossible. The will is unable to act without immediately reacting against its previous decision. There is a more or less constant, unreasonable, and morbid fear of sin, error, and guilt. The mind demands mathematical certitude in moral matters, and when this is not forthcoming, there is a fear reaction that is both unreasonable and unholy.

Scruples occur in varying degrees of severity. They may be temporary or chronic, mild or severe, limited or almost boundless in extent. The temporary attack of scruples is not uncommon, but tends to confine itself to a particular area, and this, most frequently, is sexual in nature. In the young it is often due, partially at least, to faulty information and immature moral development. Chronic scrupulosity tends to be diffusive of itself, showing both stimulus and object generalization.

View Taken by Earlier Moralists and Spiritual Writers. The teaching of moralists and spiritual writers of the past regarding the detection, identification, and treatment of the scrupulous conscience is still valuable as it was based on much accumulated observation and experience, and it should not be discarded as naïve or outmoded simply because emphasis has shifted to a more psychologically sophisticated approach to the problem.

Characteristics. Among the features of the malady that attracted the attention of these writers was that it is often accompanied by a remarkable indifference or laxity of behavior with respect to matters about which the victim is not scrupulous. This, coupled with the fact that the scrupulous person's emotional distress and vacillation of judgment are generally based on slight grounds or none at all, suggested a displacement of anxiety. Moreover, as they observed, the anxiety about sin tends to be self-centered and to involve little real concern about the offense given to God and neighbor. Confessors were cautioned to expect numerous questions, repetitious in form and content, and to be prepared to find their advice habitually ignored, misinterpreted, or challenged. It was observed that under an appearance of docility, obstinacy, doubt, suspicion, and even open hostility can often be detected. Presentation of the victim's excessively complex problems commonly brings all circumstances into sharp focus, the relevant and irrelevant ones receiving equal emphasis. The tendency of the scrupulous to substitute an exaggerated precision in minor matters for the accomplishment in major ones of which they areor at least feel themselvesincapable, was noted, as was the intensity of their introspective activity and self-concern. Although they readily seek relief in going to confession, absolution provides them only with reason to doubt their sincerity and the validity of the Sacrament.

Causes. Moralists and spiritual writers have thought that in a negative sense God is a cause of scruples, not that He is the author of the interior suffering, the anxiety, and the bad judgments of the afflicted person, but because He withholds the enlightenment of mind that would dispel the victim's illusion and would enable him to see clearly what is right and what is wrong. God withholds this enlightenment either in punishment for sin or for the purpose of promoting the victim's spiritual development by providing an occasion for the exercise of patience and humility and trust in God. It cannot be supposed, however, that God wishes the scrupulous state to continue if it leads, as often it does, to moral evil such as despair, discouragement, distaste for God's service, and the neglect of prayer.

The positive cause of scruples could be either Satan, whose object is to impede or to destroy the victim's spiritual health, or some physical or psychological condition in the victim himself. Some early writers blamed scruples on keen and overactive imaginations, especially when accompanied by a poor capacity for judgment, or a melancholic or phlegmatic temperament inclining one to suspicion, obstinacy, timidity, or despondency. Other causes were felt to be natural nervousness or association with the scrupulous or faulty training received from scrupulous parents, teachers, or confessors.

Treatment. While admitting the generally apparent futility of proposing remedies to victims of serious scruples, moralists and spiritual directors nevertheless offered directions that seemed to hold promise of bringing relief if only the victim could be brought to follow them, and these no doubt proved helpful to some, especially to those in whom the malady appeared in milder form or was treated in its incipient stages. The scrupulous person was to be convinced that he was really scrupulous, and that his judgment in the matter with which his scruples were concerned was unreliable. He was urged to seek the direction of one good confessor, whose direction he was to follow with humble obedience, and he was not to take his troubles to other confessors. He was not to concern himself with the possibility of being led astray, because even if the confessor or director erred, he (the penitent) would not be held accountable. His examinations of conscience were to be brief; he should never seek peace of mind by giving way and acting as his scruples prompted. The hope of finding peace in that way was bound ultimately to prove illusory, and the scrupulous condition would only be aggravated by yielding to it and so lead to greater anxiety in the future. The penitent was to act without question upon the confessor's judgment that doubtful sin was not certain sin, and that he need not confess doubts but only certainties. If disturbed about the possibility of having consented to evil thoughts, he was to assume that there was no consent; if troubled about his past confessions, he must assume that they were good.

In spite of the effectiveness of this method of treatment in some cases, it often failed because it dealt with the disturbance too exclusively on the superficial level of symptoms. It was open to criticism also on the grounds that it tended to make the scrupulous person, already lacking in normal maturity and self-reliance, too dependent on his confessor. This danger was recognized, however, and some authors tried to provide against it by recommending that the penitent, after gaining some victories over his condition, should be led little by little to rely more upon his own judgment.

Contemporary Thought. More recent moralists and spiritual writers show the influence of modern psychological theory and tend to see in scruples a disorder involving the deeper levels of personality dynamics and development. The malady is viewed as a form of neurosis, an obsessive-compulsive reaction characterized by unavoidable thoughts, always unpleasant, and frequently accompanied by compulsive behavior. About 1900 Pierre Janet classified it as a psychasthenia, an obsolete term indicating a kind of psychic weakness that disturbs the delicate balance of psychic energy, tipping it in the wrong direction. He noted that the "fixed ideas" of hysterics were amenable to suggestive therapy, whereas those of the scrupulous were not. Cure could be achieved, he thought, by discovering the source of disequilibrium and restoring balance through reeducation.

The psychoanalytic movement retained the notion of psychic energy but gave emphasis to conflicts in the unconscious realm of personality. New concepts were evolved to describe the symptoms. The reality-testing ego is the battleground for the conflicting demands of the animal-like id and angel-like superego. The superego makes excessively high demands on the ego by imposing impossible standards of conduct. Simultaneously pulled into the dirt by the id and lifted up to the heavens by the superego, the conscious ego is torn apart. It is unable to form practical judgments and attempts to effect a compromise in the form of various defense mechanisms. Some view scruples as an infantile attempt to avoid responsibility and think, therefore, that a confessor who exacts unquestioning obedience merely increases this futile dependency.

Those who take the view that scrupulosity is more an emotional sickness than a moral one think that in severe cases at any rate the priest should give way to the physician. The scrupulous do not confess their sins but rather their unconsciously motivated anxiety. For them confession is primarily an obsessional purification rite and only secondarily a Sacrament. They seek alleviation not through moral perfection but in achieving infallible precision in details. Since the malady is essentially unconscious and emotional, therapy directed at the intellectual components will naturally be ineffective.

Evidence of a scientific and statistical nature is still rare because of the inherent difficulties of the matter. On the basis of tests scruples have been estimated to occur in varying degrees of severity in 20 to 30 percent of adolescents. Equally distributed as to sex, it seems more related to the age variable, with puberty the peak period. If transitory, adolescent scruples may last for varying periods up to three years. Frequently faulty knowledge retards the proper development of conscience and this appears to contribute to the incidence of scruples. The more severe and chronic cases may indicate graver pathology and possibly a psychotic condition. While knowledge of scruples has grown and the appreciation of their complexity has increased, the precise cause or causes are still a matter of theory. As a consequence, the most effective methods of therapy still await either refinement or invention.

Bibliography: alphonsus liguori, Theologia moralis, ed. l. gaudÉ, 4 v. (new ed. Rome 190512) 1.1119. a. gemelli, De scrupulis (2d ed. Florence 1921). f. v. raymond, Le Guide des nerveux et des scrupuleux (Paris 1926). j. l. duffner, Pour consoler et guérir les âmes scrupuleuses et craintives (Tournai 1938). Proceedings of the Institute for the Clergy on Problems in Pastoral Theology (New York 1958). a. snoeck, Confession and Pastoral Psychology, tr. t. zuydwijk (Westminster, Md. 1961). a. tanquerey, The Spiritual Life, tr. h. branderis (2d ed. Tournai 1930; repr. Westminster, Md. 1945). n. iung, Dictionnaire de théologie catholique, ed. a. vacant et al., 15 v. (Paris 190350; Tables générales 1951) 14.2:173545. o. fenichel, The Psychoanalytic Theory of Neurosis (New York 1945).

[c. harney]

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