Lastly, we may consider two great historical figures who, even though they were bitter enemies, had much in common. Both marked turning points in 1521: Luther was condemned by the Catholic Church as a heretic; and Ignatius of Loyola experienced religious conversion. Both men started great movements: Luther, the Reformation; and Ignatius, the Jesuits. Both men, too, suffered obsessions.Martin Luther underwent severe mental turmoil with obsessions and depression. In Young Man Luther, the psychiatrist Erik Erikson notes that during his first years in the monastery, Luther’s mental state was so disrupted that “it seems entirely probable that young Luther’s life at times approached what today we might call a borderline psychotic state.” Ignatius endured similar, if not quite so severe, afflictions. W. W. Meisner, M.D., writes in his biography Ignatius of Loyola that Ignatius’s early life was “filled with inner torment” due to “intense, destructive obsessions.”Luther and Ignatius both endured tormenting obsessional doubts and, to a lesser degree, other types of obsessions as well. Religious doubts, a form of scruples, were indeed a common problem in past centuries; they qualify as obsessions when they are persistent, tormenting, and recognized as inappropriate. Luther writes in his Commentary on Galatians:
When I was a monk I thought that I was utterly cast away. If at any time I felt fleshly lust, wrath, hatred, or envy against any brother, I assayed many ways to quiet my conscience, but it would not be; for the lust did always return, so that I could not rest, but was continually vexed with these thoughts: This or that sin thou hast committed: thou art infected with envy, with impatiency, and such other sins.
Because of these excruciating scruples, Luther could not feel certain that he had confessed all his sins. He would confess for hours and hours, splitting his transgressions smaller and smaller. He would go back to childhood and endlessly enumerate possibly sinful acts. After finishing he would ask for special appointments to correct previous statements. His preceptors, confused by his possessiveness, threatened to punish him for obstruction of confession. As quoted in The Way of Interior Peace, one of them told Luther: “You have no real sins with which to reproach yourself. . . give up your nonsensical and ludicrous notions.”Ignatius suffered similar battles with confessional scruples. He writes in his autobiography St. Ignatius’ Own Story:
Even though I had confessed . . . my scruples returned, each time becoming mote minute, so that I became quite upset, and although I knew that these scruples were doing me much harm, and that it would be good to be rid of them, I could not shake them off. … I continued with my seven hours of prayer on my knees, rising faithfully every midnight, and performing all the other exercises. But nothing provided me with a cute for my scruples.
Luther and Ignatius also suffered violent and blasphemous obsessions. Luther once declared at the dinner table that the sight of a knife conjured up “painful pictures” before him. He writes: “For more than a week I have been thrown back and forth in death andHell; my whole body feels beaten, my limbs are still trembling. I almost lost Christ completely, driven about on the waves and storms of despair and blasphemy against God.” Ignatius notes: “While these thoughts were tormenting me, I was frequently seized with the temptation to throw myself into an excavation close to my room. But, knowing that it was a sin, I cried again: ‘Lord, I will do nothing to offend you,’ and I frequently repeated these words.”Who knows how many other great historical figures suffered obsessions? Charles Darwin, arguably the single most influential scientist who ever lived, suffered frequent attacks of heart palpitations, shortness of breath, fainting, a buzzing noise in his head, stomach pains, and eczema. Most of his recent biographers agree that he had panic disorder. Darwin’s letters and diaries suggest he may have also been plagued by obsessions. Darwin mentions having “much involuntary fear” and sudden “insane feelings of anger.” He reports: “I awake in the night and feel so much afraid, though my reason laughs and tells me there is nothing to fear. … By habit the mind fixes on the same object.” In the 1977 medical biography of Darwin, To Be an Invalid, Ralph Cope, Jr., M.D., concludes that Darwin was “tortured by obsessional thoughts.”*19/338/2*
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WHO GETS OCD: MARTIN LUTHER AND IGNATIUS OF LOYOLA
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there are several pencil-and-paper tests that can provide a fairly good idea of whether a person suffers from OCD. Taking these tests requires only sitting down and answering a number of multiple choice questions to determine whether common obsessions and compulsions are present. Although these tests do not take the place of diagnosis by a competent psychiatrist or psychologist, they can be effective screening devices.
Below is the questionnaire that I find the most useful, the Padua
Inventory, which was developed in Italy in 1987 and has been standardized on thousands of people here and abroad. I suggest you take this test. Apart from diagnostic considerations, reflecting on the questions contained in the Padua Inventory will increase your understanding of OCD, as these represent a fairly comprehensive list of the most common obsessions and compulsions. In them you will recognize the problems of Raymond, Sherry, Jeff, and Melissa. The test requires only about ten minutes of your time.
To score the Padua Inventory, add up your ratings (o to 4) for the sixty questions.
The average result for unscreened groups of people (usually hospital employees and university students) is about 40. The average result for people in treatment for OCD is about 80. I took this test remembering back to when I suffered OCD in medical training and got a 72. Taking it now, I get about a 50.
There are several other questionnaires worth mentioning. The Maudsley Obsessive-Compulsive Inventory, developed in 1977 in England, has been used more than any other test. Unfortunately, in light of our current knowledge of OCD, it is clear that the present version concentrates excessively on checking and washing compulsions. (A new, improved version of the Maudsley Inventory will be released soon.) The Leyton Obsessional Inventory and the Compulsive Activity Checklist are also excellent screening tests but are, perhaps, not quite as comprehensive as the Padua Inventory.
The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), developed in 1989 by Yale and Brown universities, asks ten questions that assess the strength of a person’s obsessions and compulsions. It is a very useful and widely used test, but it was designed mainly to follow people’s progress in treatment, not to diagnose OCD.
If you think that you might possibly have obsessive-compulsive disorder, please do take the Padua Inventory. OCD sufferers tend to walk through life in a sort of numb confusion, approaching their obsessions and compulsions like bad weather—to be lived through and then forgotten as soon as possible. They never come to grips with the fact that they have a real psychiatric disorder. This is a major mistake.
Anyone who scores well above average on the Padua Inventory should consider that they may have obsessive-compulsive disorder. If you have it, you should treat it. There is no shame to having OCD.
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