I have seen too much abuse of this rite to think it is any thing helpful. Groups of people who believe epilepsy is a demon (our daughter had a teacher who offered exorcism), a way of putting bad actions off on some "other" rather than looking at our own participation, etc. It is a cheap way of not taking responsibility for the outcome of people doing bad things. There is evil around but it in to out there in demons and Satan - the potential is inside all of us and especially in groups of us.

Like Ann, I have seen abuse of this and similar deliverance-style rites. I don't dismiss ever the need, but quite frankly most evil does not come so obvious as possession, but as "angels of light" to quote Paul, in terms of purifying the nation morally or ethnically, or in subtle forms like bureaucratic decision for which no one need take responsibility even as many are harmed. The latter is the dominant way evil operates in our time and place.

This has great potential for misuse by people untrained in mental health. For example, this sort of thing would be most dangerous for someone suffering from obsessive compulsive disorders.

Would clergy with a three year master of divinity degree be able to accurately diagnose OCD? Masters level therapists often can't. Psychiatrists often have serious problems with OCD (not surprising, considering that most psychiatrists have only one year of mental health training on top of four years of general medicine.) Many mental health professionals often hear the sufferer of OCD describe their obsessional urges in terms of being told to do something. Masters level counselors hear this as "voices" and refer the client to a psychiatrist or even to the emergency room. The psychiatrists, trained by the pharma reps to look for medically treatable schizophrenia, call it just that and prescribe dangerous anti-psychotics. Or they (rather oddly but sadly much too frequently) call it bipolar disorder with psychotic features and start the client on the latest and most expensive mood stabilizer. I've seen this happen many times.

A well trained mental health provider, though, would follow up on the revelation of obsessional urges with a number of very specific questions about the commands and urges. They would know that OCD sufferers feel a lot of shame and guilt about their symptoms. They would also look for repetitions of behaviors (driving around the block three or four times to reassure themselves that they hadn't, after all, run over that pedestrian that they had passed, for example) and excessive worries about having violated codes or rules, and the ever-present OCD worries about having harmed others. With some work at understanding the presenting symptoms, the well trained mental health provider would realize that the person in front of them needed cognitive behavioral therapy for their anxiety symptoms, psychoeducation on OCD, and a support group of others fighting this disorder of the limbic system.

Would a member of the clergy know this? As well trained as they may be on theology and pastoral care, the answer is most probably no. Would the priest know to find an experienced and well trained mental health provider (ideally a psychologist with training in OCD) rather than just looking for a member of their congregation with a license to provide counseling or push pills? Somehow, I doubt this.

And yet I would suggest that sufferers of OCD are likely to be among the people who would be most likely to present for an "exorcism." Feeling an incredible sense of self-condemnation for urges and obsessions and compulsions that they do not understand, they would be willing to go along with a rite that says that they have a "devil" inside of them. It is likely that they would feel a placebo effect that worked for a week or two. And then? And then, having failed to be delivered from what they understand to be infiltration of their personality by these "demons" they would be very likely to take matters in their own hands in an act of self harm.

The best thing that we could do is to abolish this medieval rite born in an age when religion was "possessed" by blind superstition. The church needs to be a good place for referrals to appropriate mental health care as a complement to its specialty in pastoral and spiritual care. It does not need to be dabbling in the treatment of mental illness with these primitive rites.

Dennis Roberts
Chicago, IL

I actually think that this is a very good thing, precisely because it minimizes the chances of abuse. The Catholic Church is very strict about when an exorcism may be performed, and one of the prerequisites is evaluation by a competent mental health professional, to ensure that the problem is not psychological. It almost seems as though the idea is to bore any potential demons to death with so much bureaucracy and so many checks and balances that they give up and leave on their own! The more that Catholic bishops and clergy are aware of just how cautious their church is about exorcisms, the less potential there is for abuse by individuals.

In that respect, I have to say that I think the Catholic Church is actually doing better than the Episcopal Church in this matter. I know of people who have been pressured into exorcisms and similarly spiritually abusive kinds of "deliverance ministries" by Episcopal priests, and our church does not really offer any sort of protection or recourse for them, precisely because there is almost nothing in terms of protocol, and we are often convinced that this sort of thing is not really "our" problem. Indeed, when I have raised examples of such abuse with Episcopal priests, the most common response has been laughter, which is rather less than pastorally helpful, but probably shows how out of touch many of us are with the fact that these things really happening, and not just in other people's churches...