Religion: Improvisation on Guilt

A lot of people think that the confessional and the analyst’s couch are in competition for man’s soul. Thus when the newly formed McAuley Psychiatric Clinic in San Francisco’s Roman Catholic St. Mary’s Hospital sent out invitations to a forum combining priests and psychiatrists, the response was overwhelming. Close to 400 priests and doctors packed St. Mary’s auditorium to see what would happen. What happened was that the two groups got along as though they were made for each other.

The line-up for the psychiatrists: Dr. Joseph B. Wheelwright, British-educated Jungian; Dr. William A. Bellamy, Freudian; and Dr. Sam Nelken, an “eclectic” analyst who teaches at the University of California Medical School. For the priests: the Rev. Victor White, a Dominican, professor of theology at Oxford and lecturer at Carl Jung’s psychiatric institute in Zurich; the Rev. Mark Hurley, principal of Oakland’s Bishop O’Dowd High School; and the Rev. Willis J. Egan, a Jesuit, professor of theology at the University of San Francisco. The moderator: Dr. Carl Jonas, both a Roman Catholic and a Freudian psychiatrist. The subject: guilt.

“We will start with some definitions, just as Dave Brubeck and his boys start with a theme,” began Dr. Jonas, who knows his combos as well as his complexes. “Then we’ll improvise and take it from there.”

Is Absolution Enough? Father Hurley hammered out the opening theme. “Almighty God has created us and given us a certain nature,” he said. “He has told us by revelation what He wants . . . Guilt is the result of an offense against the law of Almighty God.” There is both objective and subjective guilt, he added: “Feelings of guilt are not the same as objective guilt.” To a psychiatrist, said Dr. Nelken, the feelings, rather than the guilt itself, are the important thing. The panel began to edge toward the idea that priests are primarily interested in a man’s sin, and psychiatrists are interested in his attitude toward himself.

But psychiatrists must have some basic system of values, too, objected Psychiatrist Wheelwright, though they try to avoid injecting their own values into therapy. When a patient has an inadequate value system of his own, “one of the [psychiatrist’s] jobs is helping him choose one.” This bothered Father Hurley. “Is there no goal or standard?” he asked.

“That’s what priests worry about.” For a moment it looked as though a clear cleavage had been reached. Psychiatrist Nelken explained that no responsible psychiatrist, whatever his faith, would try to change a patient’s standards of value, but merely show him how he is in conflict with them himself.

Father Hurley made a bold concession to the mind doctors: “Very often the priest sees people who are guilty; he can absolve them in confession, and so on.

But he, too, must realize the limits of his own competence. I have seen—and I know other priests . . . have seen—that their efforts are not enough.” The patient goes on feeling guilty even after absolution has been given and the guilt has been objectively washed away. Then, said Hurley, “we recognize that it is essential that we send them to the expert [i.e., the psychiatrist].” Nonguilt Is Not Enough. Father White broached the Big Guilt—Original Sin.

“Freud himself found it necessary to postulate a kind of original sin,” he said, referring to the father-slaying, mother-marrying impulses of the Oedipus complex. “Man does, in fact, belong to a guilty race, and that by inheritance.”

“No psychiatrist would disagree,” said Dr. Nelken. Dr. Bellamy added that guilt feelings can be useful and, in fact, necessary: “The goal of psychiatric treatment is not to make people nonguilty. If it did, you would make the patient sicker than he was.”

When the evening’s debate was over, everyone felt so happy about it that other similar forums were planned, the next probably in May. It seemed to be excellent public relations for the new clinic—the first outpatient psychiatric clinic established in a U.S. Roman Catholic hospital. Last week the clinic announced that as a result of the discussion, three psychiatrists offered to contribute their services free.