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s soul, that fidelity is precarious and liable to decay. And for the religious them-selv, es, fidelity to disciplinary rules, besides being the fulfill-ment of God’s express desire, is actually a practice of religious courtesy toward all members of the community. It demand~ that they inconvenience themselves in order not to inconveni-ence others. Seen in this ’light, it should not be difficult to say what is for every religious habitual fidelity to these disci-plinary rules. Following Spiritual Directives Less simple and definite is the idea of fidelity or infidelity to the rules that propose spiritual directives. This is not a matter of a mere yes or no. When religious rules prescribe humility or charity or right intention or a spirit of prayer, they do not just demand one or more definite acts, whether external or even purely internal. "They rather propose an ideal to be striven after

they demand an interior spirit that should animate our manner of living and our whole activity. Fidelity to these rules varies in perfection. All religious who are ever so little concerned to be what they are supposed to be may be said to keep these rules to some degree. But there are many degrees of fidelity, from" a minimum degree in the mediocre 17 P. DELETTER Review for Religion,s and tepid religious to an ever growing fidelity in the fervent who are keen on their spiritual progress. What these rules demand of religious may be reduced to two points..First of all, they require that religious wish to know and to grasp the ideal of spiritual and apostolic perfection propdr to their institute and the means it expects them to use for its realization. There are within Catholic spirituality different types of ascetical and apostolic ways. Some great schools of spirituality bear the name of a religious order, such as the Franciscan or Dominican or Benedictine schools. Actually it i’s normal that a religious institute develop its own form of spirituality and of apostolate and wish to see in its members, unifying possibly wide individual varieties, some common family traits. These are generally summed up in what we call the spirit of the institute--a phrase whose meaning is more easily sensed and graspe~l from actual experience of the religious life than expressed in definite concepts and words. It always designates the proper manner in which a religious institute strives after perfection and practices the apostolate. And we find it laid down in the set of rules which give the spiritual directives we are considering. A first duty of religious then is evidently to know, less perhaps in theory than in actual practice, the spirit of their institute and its particular type of spirituality and spiritual perfection. A second duty these rules impose on religious is that they should make the effort necessary to acquire the virtues that belong to their proper spirituality. This is an objective never fully achieved

there always remains room for further progress. Consequently, these rules demand of religious that they endeavor to progress in the virtues proper to their institute and at all times keep up this effort. There never is a moment when they can say they have done what they had to do. Keeping these rules is an ever-unfinished task. Nor is fidelity to these rules impaired when religious see their efforts apparently rewarded with scant or no success. It is not success ~hat the rules demand, 18 January, 1959 KEEPING THE RULES but the effort. All this goes to show that there can be many degrees in fidelity to these rules of spirituality. The more genuine one’s desire of perfection and apostolic usefulness, the more effective also grows this fidelity. On the other hand, infidelity in keeping these rules is no mere matter of saying no or of not doing. It is rather a question of a habitual disposition. Religiouswho do not care to know and to make their own the spirituality of their institute and who more or less deliberately warp their own outlook on the spiritual life and on the apostolate by adopting a spirit and ways tha~ are not in keeping with their vocation would evidently be unfaithful to these rules. It may be difficult to say definitely by what particular acts they break them, yet there is no doubt that these religious do not live up to the demands of their rules. Similarly, religious who would set aside the effort to put into practice, in the measure of the grace God deigns to give them, .the spiritual and apostolic ideal of their rules’ and institute would fail to keep these rules. Even without such wholesale defeatism or practical scepticism and indifference toward their ideal of spirituality, religious incline to abandon the directives of these rules when they relax their effort for progress and allow it gradually to dwindle to less and less. Low spiritual fervor means in practice a declining fidelity to these rules. Exceptions to the Rules From the above it should be clear what keeping the rules means in actual practice. One more point remains to be made which is not unimportant. There are, proverbially, exceptions to all rules, also to religious rules." There are cases in which it is right and lawful to act in .a manner which on the face of it looks like breaking the rules. (We have in mind here mainly the disciplinary rules.) The question is this. At times we hear it said that religious rules do not bind under sin in theory but that in practice breaking the rules will more often than not, if not always, be sinful because of the wrong motive that prompts the violation or because of the scandal that folldws from it~ 19 P1. DELETTER Review fo~" Religious This seems to be an overstatement. If it were correct as a general statement, then the intention of religious founders who expressly said that the rules of themselves do not bind under sin would be more nominal than real and would never materialize in concrete facts. Actually, practical experience of the religious life shows that there are cases, and they are not altogether excel~tional, in which there is no such sinful motive for an apparent breaking of rules nor any attending scandal. This happens whenever a sincere desire of greater good, especially spiritual, promp.~s a manner of acting which is not in material conformity with the letter of the ~ules. Charity for a fellow religious may require that we speak in time of silence. A too rigid application of the rule of not interfering in another’s office may preclude a useful and necessary help. In these and similar cases it is better to follow the spirit of the rule rather than its letter, for that is exactly what the exception comes to. Evidently, these cases are not of everyday or every-hour occurrence. The very approval of the religious rules by ecclesiastical authority is a guarantee that they are sufficently adapted to the common run of the religious life. Yet such situations are not so exceptional as hardly ever to arise. The reason for saying so is not mysterious. Religious legisl~ltors, as any other human lawgivers, are not in a position to foresee in detail ttie concrete and chang-ing circumstances in which their laws will have to be applied. They can foresee only the common and normal situations ,and legislate according to the general laws of human psychology and of Christian asceticism. Individual cases may arise--and in actual fact, all real cases are individual and not general--in which elements enter that no one could forecast and which may, as it were, reverse the whole situation in such manner that a material application of certain prescriptions would have the very opposite effect of what the legislator intended. In such cases it is clearly the spirit of the rule that one should follow. Then such exceptions merely confirm the rule. 20 January, 1959 KEEPING THE RULES In actual practice one should say that ordinarily the right thing for religious to do will be. to follow both the spirit and the letter of the rule, for generally these two do not clash. When, however, there is an opposition between them on account of special circumstances, then it is right to keep the spirit rather than the letter of the rules. But this manner of conduct supposes on the part of religious a thorough sincerity and purity of intention in desiring the greater good. Otherwise self-love too easily may blind them and turn this so-called sinless break-ing of a rule into a cloak for egoism and other unworthy motives. Breaking of Rules Besides these legitimate exceptions to the rules, there may be cases when it is not the desire to follow thdir spirit that prompts one.to :neglect them but a disordered.motive, such as laziness or selfishness or vanity. Must we say that such a breaking of disciplinary rules, which of themselves do not bind under gin, will always be sinful because of the disordered motive or because of the scandal following from the violation? The problem is delicate and difficult. It is delicate, for which religious will claim that he never breaks a rule out of more or less disorderly motives? Will he each time sin at least venially? It is difficult, because it involves the theological problem of positive imperfections. ,We do not wish to enter here upon a detailed discussion, but only to note that there are two opinions on the question. The more rigorous, and perhaps the more common, holds that the disorderly motives will always infect the violation of the rule in such manner as to make it sinful, at least venially. The more lenient opinion, and perhaps the more realistic, says that the disordered motive does not make a transgression of a rule sinful unless the rule binds under sin

the breaking of rules which do not bind under sin, such as disciplinary rules, even from a wrong motive, consti-tutes as such a positive imperfection. The two opinions also solve differently the question of scandal, supposing there was an occa- 21 P. DELETTER Review for Religious sion of scandal in the breaking of rules

the bad example may lead others to what is considered either as sinful or as a positive imperfection. Without definitely opting for one of these two opifiions, we may perhaps say this: for all practical purposes, the breakin~ of a disciplinary rule from a disordered motive will be sinful only when it would be sinful even supposing that there were no rule. Then the sinful motive clearly would make the action -or omission an act of selfishness or vanity or laziness. If this suggestion is acceptable, then we may say that in practice negli-gent or tepid religious, who care little about even deliberate venial sins and commit these rather frequently, may often be led by venially sinful motives when they break rules. Their breaking of rules more often than not may well be sinful.. But with religious who earnestly endeavor to live up to their ideal, it need not be so. They may happen to neglect a rule now and then even from a wrong motive, but this will be more a "failing" ~han a "transgression." Ii: need not be sinful. Despite their failings in externals, they may. not mean deliberately to-neglect the spirit of their rules. The Spirit of Our Observance The preceding remarks point to the importance of the spirit in which we keep our rules. This is in a way. more important than the material fidelity to their prescriptions. It is, moveover, the only guarantee, of steadiness and thoroughness in our regular observance. What we must come to is this: to see the rules not merely as restrictions to our liberty and initia-tive- they are this/ no doubt, to some extent

and to some modern eyes they show mainly this unappealing aspect--but first and foremost as helps to our weakness and generous good-will, helps which we need badly to shield us against our own inconstancy and passions and against seductive influences from outside." This is true of both kinds of rules we considered above. The regularity and order in the community which are the .fruit of common fidelity to disciplinary rules are a great help 22 January, 1959 KEEPING THE RULES to all its members for both spiritual and apostolic effectiveness. By keeping these rules we ourselves are helped, and w’e help others as well. And the spiritual directives of our rules show the safe way in which our effort i~or spiritual progress should push on. The rule guarantees the ever-necessary help of grace, for all religious at all times, receive the graces necessary to fulfill the duties of their state. And keeping the rules is one of the main duties of their state. Accordingly, the spirit that must guide our endeavor in keeping the rules is one of gratitude and love. It should not be one of fear and anxiety, not even fear of doing wrong. It is precisely, we are told, to do away with a spirit of fear that religious founders, and Holy Church after them, do not wish the rules to bind under sin." Fe~lr, moreover, does not lead to generosity

and without generosity who could actually keep the ruleS? It is gratitude for the help the rules afford us that should inspire our fidelity in keeping them--a gratitude shown less in words than in deeds, in the very deeds of our fidelity. It is above all love for Christ, whose call to perfection and to the apostolate we answered with the help of grace when we joined, the religious life, that must motivate our fidelity to the rules. Actually, this fidelity is nothing less than our continued answer to His call. For every day and every hour He beckons us to draw nearer to Him and to bring others with us, and He does so particularly through the. i, ery directives of our rules. To do what the rules prescribe is nothing else but love for Christ in deed. This spirit of love for Christ will silently and effectively show us how to manage concretely to keep Our rules in such manner that we, as it were, feel at ease and happy in the practice of this fidelity. It will not, evidently, do away with every constraint and every sacrifice. To toe the line always means restrictions on our inclinations and whims. But, for love of Christ, we can come to love this very self-denial demanded by 23 P. DELETTER fidelity to the rules, love it as the way in which we can show Christ the genuineness of our love for Him--and for His. Love gives new eyes to see. And when we have under-stood, as the Lord cannot fail to teach us, that we cannot love Him iti truth unless we also love our neighbor and Him in our neighbor, then we shall also find other reasons for keeping our rules, particularly those that concern the good of the community. Regular external observance, animated by a genuine interior spirit, is a dut~ and help we owe to all members of our com-munity. Each one of us is responsible for the influence he has in the community. Whether we think of it or not, whether we intend it or not, our very manner of l~eeping the rules makes fidelity to them either easier or harder for our fellow religious. If we truly love Christ, we shall’ not refuse Him the help He asks of us in our brethren, the help our regularity gives them in a silent but effective manner. He on His pare will not with-hold the help of His grace we need to be faithful. Thus keep-ing .the rules in union with our brethren we can steadily push on in the uphill climb to Christian perfection. OUR CONTRIBUTORS FRANK C. BRENNAN is stationed at St. Mary’s College, St. Marys, Kansas. P. DE LETTER is a member of the faculty of St. Mary’s Theological College, Kurseong N. E. Ry., India. RICHARD P. VAUGHAN, an assistant professor of psychology at the University of San Francisco and a staff member of the McAuley Clinic, St. Mary’s Hospital, is currently engaged in psychotherapy with religious men and women. DANIEL J. M. CALLAHAN is professor of asceticM and mystical theology at Woodstock College, Woodstock, Maryland. DELAYED VOCATIONS In several previous issues of RJ~\’~I~\V ~:()R .qEI.It~U)US (November, 1957, p. 342’

March, 1958, p. 90

and July, 1958, p. 193) informa-tion has been published on religi.ous communities which will accept women who wish to dedicate their lives to God but who are older than the usual age limit for admission. Two other groups have asked to be mentioned. One group is the Daughters of St. Francis. The members of this lay apostolate live a semi-community life, become members of (Continued on page 36) 24 Severe AAeni:al Illness Among Religious Richard P. Yauc~han, S.J. LIKE ANY OTHER sickness, mental and emotional ill-ness has a wide range of variation. This variation extends anywhere from the common phobia or irrational fear of dogs or cats to the debilitating disorder which causes the’ patient in the mental hospital to think that he is God. The minor manifestations of emotional disorder are more or less common in our civilization. They are accepted as inevitable parts of everyday living. There are few who do not have an occasional day when they seem to be more tense or anxious than usual, just as there are few who do not experience an occasional cold or upset stomach. Many refer to these bad days as times when their "nerves are .on edge." On these days their mental health is not perfect

but, on the other hand, they are far removed from serious mental illness. At the other end of the scale, there are those who are severely disturbed. In psychiatric language these people are usually described as psychotic. In times past, they were called insane. In any article dealing with the subject of serious mental illness, there always exists the potential danger that the reader will apply to himself or herself many of the symptoms which are described as typical of the psychotic and, as a result, come to the conclusion that he or she is severely disturbed. Hence, a word of caution to the reader is well in order. A serious mental disorder is both chronic and disabling. The psychotic is a person who carries truly debilitating symptoms with him month after month. This is what best distinguishes him from the average person who may occasionally have similar symptoms but whose symptoms are not chronic and severely handicapping over long periods of time. The ordinary person is able to cope with the symptoms that will be described during the course of 25 RICHARD P. VAUGHAN Review for Religious this article, should they occur. In spite of them, he is able to lead a fairly productive~ life. The psychotic collapses under the impact of his symptoms. As a result, he usually has little to offer the world and his fellow man. Characteristics of a Psychosis Perhaps the most significant quality of the psychotic is his reaction to the world in which he lives. As a general rule, he either has completely separated himself from reality or has drastically changed reality. Thus, it is not uncommon to find a psychotic experiencing hallucinations through which he is convinced that he sees the devil or hears the voice of the devil speaking to him. These hallucinations are as real to him, if not more real, than his dealing with his own family. Often it is following the advice given through the medium of a hallu-cination that leads the psychotic into some kind of anti-social behavior and eventually to commitment in a mental hospital. Other psychotics, beginning from ~/ false premise, develop a system of delusions through which they are convinced that mem-bers of their own families are spending most of their days and nights concocting new ways of persecuting them. These delu-sions are soreal to the psychotic that he sees no other alternative but to fight back so as to preserve his life and integrity. When severe mental illness has completely shattered the psychotic’s personality, it produces prolonged states of stupor which may on occasion be broken by some form of incoherent speech. As can easily be gathered, most psychotic conditions are extremely debilitating and handicapping. The majority of psychotics are unable to carry on everyday activities, especially those activities which involve relationships with others. Few can assume and maintain the responsibilities involved in holding~ down a position. The greater majority are confined to hospitals, at least during the active phases of their illness. One of the most distressing qualities of the psychotic is the lack of insight into the nature of his condition. He seldom realizes or appreciates the seriousness of his disorder. 26 January, 1959 SEVERE MENTAL ILLNESS When he has hallucinations or delusions, he is firmly convinced that these phenomena are as true to reality as the fact that he is sitting in a chair before you. As a consequence of this convic-" tion, he builds many of his activities around these imagined events. This confusion of the imagined with the real not in-frequently makes him a menace to himself and others. The Psychotic Religious Since religious vocations are, for the most part, drawn from the same familial and environmental background that pro-duces psychotics among the laity, it should not be surprising that a certain small percentage of religious are afflicted with serious mental illness. Unfortunately, both the laity and i’eligious frequently are bewildered by the priest or sister who becomes psy-chotic~ This bewilderment can be attributed to two factors. The first is connected with "the humiliating symptoms of a psychosis. For this disorder strikesman’s highest faculty, namely his intel-lectual ability. It generally deprives him of his power to think and reason clearly. In many ways it reduces the sufferer to a state which appears to be less than human. To see a priest or a sister (a chosen soul of God) so afflicted and acting accord-ingly is a traumatic experience for the religious and lay person alike. The second reason for bewilderment rests upon a false conception of the_cause of mental illness. I.n spite of research data to the contrary, there still persists a vague suspicion that mental illness is in some way connected with a sinful life or at least that it cannot occur if a person is leading a truly holy life. A psychosis is a type of sickness, just as are ulcers of the stomach or cirrhosis of the liver. Whether the cause of the psychotic condition is psychological or organic or a combination of both (which is more likely) has not yet been established. "It can, however, safely be stated that a psychosis (with the exception, perhaps, of a condition brought on by alcoholism or drug addiction) is not the result of a sinful life. The idea that it is the effect of sin is simply, a remnant of past attitudes which still prevail from an era when little was known about 27 RICHARD P VAUGHAN Rewew for Rehgwus psychiatry and psydhology. The fact, therefore, that a religious person becomes psychotic does not in any way imply past moral indiscretions. Religious, even though they follow a more perfect way of life, are no more immune from severe mental illness than the average lay person. Prepsychotics and Religious Li~e Unfortunately, there are certain aspects of the religious life which attract individuals who have a tendency toward a very prevalent type of psychotic disorder. This disorder is called schizophrenia and accounts for a large portion of the psychotics in our nation. The schizoid personality and the incipient schizophrenic are characterized by withdrawal from social contacts and a love of solitude. Generally speaking, they also find considerable comfort in a highly routinized form of life. These are the seeming characteristics of the religious life which attract t~e incipient schizophrenic and lead him to believe that he has a vocation. Father T. V. Moore conducted a study: on the prevalence of mental illness among religious. After polling 93 percent of the state and private mental hospitals, he was able to determine the number of religious confined to these institutions. Through the use of the Catholic Directory, he was then able to establish the ra~io of mental illness among religious and compare this ratio with that of the general population. One of the most significant conclusions of this study was the high rate of schizo-phrenia among religious women, particularly among those who follow the contemplative life. From these findings Father Moore concluded that preschizophrenic women tend to gravi-tate toward the religious life as an escape from the hard reality of the world outside the cloister. Psychological Screening One of the major functions of a psychological screening program is to point out just such individuals. To allow an incipient schizophrenic to enter the religious life does a positive The American Ecclesiastical Re~ie~v, 95 (1936), 485-96. 28 January, 1959 SEVERE MENTAL ILLNESS disservice both to the order or congregation and to the individual involved. Many a community has spent thousands of dollars for the hospitalization of a single psychoti~ member, and this at considerable sacrifice to the other members of the community. And then after all this expense, it not infrequently happens that the religious is finally d~agnosed as incurable. In such cases one might well ask whether such a diagnosis would have been r.eached if the psychotic religious had never been ~subj~cted to the strain and disillusionment of the religious life. Although personality evaluation through the medium of psychological testing and interview has proved useful, still it is a relativdly new pr6cess. Because this process is as yet in a developmental st~lge, it should be expected that for some time psychological screening will not be completely effective in fer-reting out those candidates who are incipient schizophrenics or who may become schizophrenic at some later date. Even with a greater understanding of the causes of mental illness and the development of more perfect screening devices, in all probability we will never reach that point where psychotic. disorders will be eliminated from the religious life. Charity, therefore, demands that we make an effort to understand the sufferings of our fellow religious who are afflicted with severe mental disorders, so that we can be more effective in bringing help and comfort to them. Schizophrenia As previously indicated, schizophrenia is the most preva-lent mental disease among both the laity and religious. It is the major mental health problem which faces our nation today. This particular type of psychosis, even in its incipient stages, is marked by a number of symptoms which seriously handicap community living. As a rule, the schizophrenic has consider-able difficulty adjusting to any situation which calls for social relationships. He is a person who has withdrawn from social contacts and lives within himself. He finds it almost impossibl~ to form any emotional response normally demanded by a close 29 RICHARD P. VAUGHAN Review ]or Religions friendship. Because he is convinced that others feel the same way about him as he feels about others, he spends most of his time by himself. He finds it difficult to talk to others. He has little to say. He absents himself from community recreations and will go to great lengths to avoid contact with other mem-bers of the community. Aside from this withdrawal symptom, he will sometimes make use of odd behavior which marks him out as different from the rest of the community. It is this behavior which is usually a prelude to the final breakdown. He may become re-bellious and rude toward superiors or develop unusual habits of dress and eating. It is usually such behavior, coupled with the increasing, withdrawal from community life, that calls a superior’s attention to the fact that all is not right with a particular subject. When schizophrenia takes control of the various human powers, a marked deterioration becomes quite noticeable. The schizophrenic religious will often manifest an abnormal interest ¯ in abstract and philosophical thought, but the conclusions from his thinking will not follow the rules of logic. He may even lapse into heretical positions as a result of his faulty thinking processes. The part of his personality which probably is the most acutely affected is his emotions. Either he passes through long periods when he is completely apathetic and blasS, or he has violent emotional reactions which are totally out of propor- -tion to the stimuli producing them. Thus, for example, he may become extremely angry over some minor incident which the average religious would pass over almost unnoticed. In gen-eral, he manifests a loss of interest in the things ~which interest most religious. The religious life becomes empty and mean-ingless. In the active phase, hallucinations are not infrequent among religious who suffer from schizophrenia. These hallu-cinations may take the form of visions or the hearing of heavenly voices. Since the schizophrenic is convinced that these voices 30 January, 1959 SEVERE MENTAL ILLNESS are commands from God, he feels compelled to follow what-ever they suggest. The fact that much that they command may be entirely illogical and unbecoming the wisdom of God makes little or no difference to him. The discerning of hallu-cinations from true gifts of God has produced many a trying session for spiritual directors. For the ~chizophrenic, the most distressing feature of his disorder is a feeling of complete isolation. He is like a man totally cut off from the outside world. He is surrounded by towering walls. He can sit in a crowded recreation room and" still feel that he is alone. A sense of belonging is foreign to him. He is keenly aware that he is very different from his brethren. He is convinced that they look upon him as some-one very different from themselves. As much as he would like to get outside of himself, he is still unable to reach out to others. The wall must first be breached f~om the outside before he will ever be able to allow himself to reach out to others. In brief, fraternal charity in its fullest sense must inevitably play a part in the cure of the schizophrenic religious. Paranoia Of all the psychotic disorders, paranoia is the most dis-ruptive to community life. The priest, brother, or sister who becomes paranoid almost inevitably turns.against his or her community or certain members of the community. He sees his brethren as dangerous threats to his persorial integrity and sometimes even to his life. Starting from a few false premises which usually stem from his own deep feelings of inferiority and in-adequacy, he becomes convinced that the other members of the community are persecuting him in a variety of wgys. Thus, for example, a fellow priest may open a window to allow a little more air into a stuffy recreation room. He is immediately accused of deliberately trying to make the paranoid religious catch a cold. An unpleasant scene results with the paranoid slamming the window closed and storming out of the room. As the delusional system develops, the sick religious may no 31 RICHARD P. VAUGHAN Review for Religious longer trust the food that is offered at the regular meals. He may become convinced that the other members of the com-munity are trying to poison him. In an attempt to escape such a fate, he will make use of many forms of unusual behavior. The most distressing aspect of paranoia is the seeming normalcy of the individual in all other areas--those that are not connected with the delusion system. He can ,carry on a very intelligent conversation, and those who do not know him well can see nothing different about, him. Unfortunately, in the initial stages most religious fail to recognize the odd behavior of the paranoid as an indication of sickness. They interpret the threatening words and violent acts as simple manifestations 6f vice. Sometimes they lash back at him, only to make the psychotic episode worse. Had they calmly stood their ground and pointed out to the ailing religious that they had no intention of perseciating him by their action, they could have been of positive assistance. The apparent normalcy of the paranoid priest, brother, or sister causes him or h~r to become a great problem to the community. *Frequently, he or she is not sick enough to be hospitalized and thus must remain in the community. As a consequence

many a superior is at a loss as to just how such a subject should be treated. Should he be allowed to continue his provoking and sometimes destructive behavior, or should he be threatened with drastic action if he persists? Once a superior takes the latter stand, he immediately becomes deeply allied with the enemy.as far as the pa.ranoid is concerned. He then ceases to have any influence over the afflicted religious. If, on the other hand, he allows the outbursts of anger or even the physical assaults to continue, he is doing an injustice to the community. Expedience usually wins out, with the paranoid religious being mov