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Stress and Vulnerability to Illness: Case Study

LukeNotes, Spring 2020

Father Philip is a thirty-five-year old diocesan priest who, on a particularly bad day, engaged in a heated argument with the chairman of the parish council. The chairman subsequently made an official complaint to the bishop. Since this was the first significant complaint about Father Philip, ordained for nine years, the bishop asked to meet with him to discuss the matter.

Father Philip was contrite about his behavior, acknowledging his mistake and saying he had spoken privately to the chairman. However, the bishop noticed Father’s significant weight increase and harried appearance. He remembered that Father Philip had lost his mother to cancer a year previously and asked him to consider speaking to an outpatient clinician at Saint Luke Institute.

In the initial outpatient evaluation, Father Philip described a normal early history. He had good relationships with his parents and siblings, did well academically, had good peer relationships, and reported no history of mental illness. His only problems in school had been a few fights as a young boy. He was sensitive about being overweight and did not like teasing. While in college, a sister in the campus ministry program noticed his occasional frustration and heated remarks and suggested he visit the college counselor.

Counseling opened up a new world for him. Recognizing distorted thoughts, e.g., “He’s never going to understand me!” or “It doesn’t matter what I do!,” gave him the opportunity to consider other ways of responding to frustration. He began to share more about his feelings and became less afraid of the intensity of certain emotions, especially anger. He learned to empathize with others and to relax, even in times of stress.

After a successful seminary experience and assignment as a parochial vicar, Father Philip’s first few years as a new pastor were positive, though challenging. However, about the same time his mother died, the parish began to experience financial difficulties, forcing him to lay off two employees and assume some of their responsibilities. He found less time to exercise and fell back into old eating habits, gaining thirty pounds in a year. He was unable to complete certain tasks on time and became frustrated with people asking him to be more accountable.

Father Philip expressed remorse about his outburst and wanted to explore the “anger issue” immediately, but the recommendation from the initial evaluation was to work first at reducing stress in order to engage fully in the healing process. He and his counselor spent the first few sessions talking about his experiences of stress, current coping mechanisms, and potential stress reduction strategies.

Father Philip said that he especially enjoyed learning the structured relaxation techniques, because they reminded him of guided meditation from his time in the seminary. Focusing on a healthy diet and exercise gave him a greater sense of self-discipline. After several weeks he commented on feeling more relaxed and engaged with life.

Therapy sessions then shifted to an exploration of the specific problem of anger, and Father Philip could quickly identify his distorted thoughts and alternate ways of thinking. He recognized that he had not worked through the grieving process after his mother’s death, having put it off with thoughts that “grieving was for weak people” and “he shouldn’t ask for help.”

When Father Philip called on the bishop three months later, the change was obvious. Still remorseful, he spoke with maturity about his work to rebuild his relationships with those whom he had hurt or parishioners who felt neglected. Father Philip described his new regimen for reducing stress and being more faithful to prayer. He requested permission to continue in individual therapy for another three months to consolidate his gains.

The bishop, whom Father Philip had authorized to speak with his counselor, called to discuss the rapid change. In his experience of priests with anger issues, long-term therapy and even residential treatment were necessary. The therapist explained the contributing role of social stress in this case. While Father Philip has a vulnerability to angry outbursts, his threshold for stress is high. Treating the anger issue was much simpler once the stress was reduced.

The same clinician offered the bishop a caveat: there are others with a vulnerability to angry outbursts who have a much lower threshold for stress. As in all cases, an integral approach to healing considers not only the presenting illness, but a person’s whole life.

For confidentiality, names, identifying data, and other details of treatment have been altered.