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Abuse: Some Pastoral And Clinical Considerations

Abuse: Some Pastoral And Clinical Considerations
V.Rev.Fr. George Morelli, Ph.D.
Factoring a Patristic anthropology into the healing of abuse
It might come as a surprise to clinicians and legal authorities that in abuse cases both the abuser and abused are victims. This is an assertion difficult to understand apart from an anthropology of the person developed by the Eastern Church Fathers based on the teachings of Jesus Christ. This Patristic anthropology posits more categories in our understanding of the human person than is recognized by modern psychological theory.
The scriptures teach that the heart is the center of the person. The heart is that which is true of the person. The scripture says that the heart is the seat of emotions and even thoughts. Matthew records Jesus saying, "But the things which proceed out of the mouth, come forth from the heart, and those things defile a man. For from the heart come forth evil thoughts, murders, adulteries, fornications, thefts, false testimonies, blasphemies (Matthew 15: 18-19). This concept of the heart is not part of most diagnostic thinking.
At the center of the heart is the nous, which functions as the most attentive and focused part of the heart. Bishop Hierotheos Vlachos, a contemporary teacher on Patristic anthropology (1994), writes:
...(the) nous has many meanings in the works of the Fathers of the Church...identified with the soul...eye of the soul...essence of the soul...We will regard it as the eye of the soul. We shall take the term chiefly to mean the power of the soul as well as the purest part of the soul.
Can an understanding of the heart be beneficial in the healing of abuse? Yes.
An initial understanding based on general principles is that the perpetrator and the victim would have quite different hearts. With no reading of an individual person's heart someone who is an active abuser is, on the face of it, different from the passive recipient. God however, reads hearts and sees and knows all (although He has granted this as a partial gift to some spiritually enlightened people according the  Church Fathers). In dealing with specific cases, the heart or nous of the individual abuser and victim has to be considered.
How abuse affects the person
The different types of abuse are also factors that need to be considered. Abuse falls into four categories:
  • Physical, (hitting, battering, etc.);
  • Sexual, (forcible intercourse, inappropriate touching, glancing, language etc.);
  • Psychological (calling someone by demeaning terms "You idiot, loser" (actually mild, often far worse);
  • Neglect (legally denying food, shelter, education, and necessary care).
Each of these categories is different in terms of sin, of how they are "miss the mark" or as an indication of the "illness of the soul" -- the two major ways sin is defined by the Eastern Church Fathers (remembering that the Holy Fathers teach us that every sin is at its foundation a departure from God and thus disdainful). Nevertheless, in terms of severity and type of abuse, including how the abuse is inflicted, they reveal something about the abuser's heart. "For out of the abundance of the heart the mouth speaks" (Luke 6:45).
The recipient's response to abuse is part of a complex interaction. Abstractly, a victim is passive and blameless. In real life, the reaction of the recipient may be much different. Once again it is the state of the heart of the victim that is critical. Many possible states of heart can exist: hate, resentment, forgiveness, or even love and prayer for the abuser. The recipient of abuse can be a participant in the sin in their own way.
However the instruction to grieve over the brokenness of mankind and to ask forgiveness for all sins, voluntary and involuntary, in knowledge or in ignorance in thought, word or deed has come out of the God inspired wisdom given to our Church Fathers. The terms "voluntary and involuntary," and "knowledge and ignorance" are general and abstract terms that require each person to supply the specific thought, word and deed that would complete the prayer. If we are fortunate, we may have a spiritual father or mother to help us pinpoint the thought, word, or deed with precision.
Abuse can also make sin infectious. This can happen in the abuser by escalation and generalization of abuse by modeling, scandal, hypocrisy, or continuation of omission (neglect). It can also happen to victims and observers of abuse by hate, vengeance, loss of faith and hope and love, lack of forgiveness, striking back, and more.
Healing abuse
I have dealt with victims of all types of abuse pastorally and clinically. The expression "hate the sin but love the sinner" is a general theme guiding my interactions. The victim's suffering has to be validated and his pain understood. Any abuse has to be labeled as such and acknowledged as wrong by all. In helping to heal the mind of the victim, psychological intervention is necessary. This is especially true for extreme cases of physical and/or sexual abuse.
Often in such cases an additional psychological disorder develops: Post-Trauma Stress Disorder. Intervention will include cognitive restructuring to counter self-blame and emotional disturbances such as depression, anxiety and anger (Morelli, 2004). Anger is a spiritual (and psychological) cancer particularly hard to address. Healing cannot take place until in the depth of the victim's heart he can truly say "Father, forgive them for they know not what they do" (Luke 23:34).
Is this easy? No! But hate kills (spiritually and psychologically) everything around us. No one has ever embarked on spiritual and psychological healing until they reach the point of working on forgiveness, while still recognizing the horror of whatever abuse they received.
Based on my pastoral and clinical experience I want to emphasize this cannot be done without Christ. In dealing with victims, I attempt to have the victim use the entire life of Christ -- all that happened to Him as taught by the Church Fathers who, by God's grace, have deep insight and experience in the healing process.
Skeptics could argue that this approach is not realistic and not of this world. But is not forgiveness exactly Our Lord admonished us to do? The scripture reads, "Be in the world but not of it." Christ said, "I have given them thy word, and the world hath hated them: because they are not of the world, as I also am not of the world. I pray not that thou shouldst take them out of the world, but that thou shouldst keep them from evil. They are not of the world, as I also am not of the world. As thou hast sent me into the world, I also have sent them into the world" (John 17: 14-18).
This healing process cannot be understood in the terms of the secular world, but once forgiveness becomes part of the heart it becomes understandable (even in our limited capacity) so that a certain beauty can emerge that words cannot express. Such victims may be granted a different understanding of and experience of God's love that remains hidden to persons who have never suffered abuse.
Healing of the abuser requires psychological and spiritual acceptance of responsibility for the abuse and recognition of the consequences of the abuse. In most cases of severe abuse, healing will not mean reintegration into the usual pattern of life the abuser previously lived. Thus, part of the acceptance of the consequences will require a radical change in lifestyle. In most cases, individuals who have physically or sexually abused others will have to be removed permanently from their social milieu.
Psychological treatment focusing on cognitive-behavioral change would have to be agreed on, not as a ticket back into society, but as an aid in the healing the total person. Spiritual healing has to focus on the heart as well. "If the light that is in you is darkness, how great is that darkness" (Matthew 6:23)!
 In a sense a “re-baptism is needed. The Church Fathers have called true repentance, especially accompanied by “the gift of tears” to be a second baptism. St. Evagrios the Solitary tells us: “First pray for the gift of tears, so that through sorrowing you may tame what is savage in your soul. And having confessed transgressions to the Lord, you will obtain forgiveness from Him.” St Peter of Damaskos wrote: “..give thanks to Him [God], especially those who have received from Him the power to renew their holy baptism through repentance, because without repentance no one can be saved.” As the heart gets cleansed, God will be seen more clearly.
As the heart gets purified of anger and resentment, God will be seen more clearly. Jesus said: "Blessed are the clean of heart: they shall see God" (Matthew 5:8). The life of the abuser must and will be changed but they can also respond to a new calling from God. They can use their experience of abuse to witness repentance and even be God's instrument in the path of holiness of others that they may not even be aware they are capable of. As mentioned above for cases of serious abuse this will not occur in same setting or living arrangement in which the abuse was previously displayed. This will demand a trust and complete abandonment to God on the part of the abuser.
The role of clergy, clinicians, and non-professionals in reporting abuse
What is the role of clinicians, clergy, and laity when discovering abuse? Licensed health practitioners (nurses, marriage and family counselors, physicians, psychologists, etc.) are mandated reporters by law. This usually means they must not only inform appropriate authorities such as the police, but inform and intervene with the victim (or potential victim) as necessary.
A priest may be a mandatory reporter in some jurisdictions. Sacramental confession is excluded.  Counseling or communication with a priest in a pastoral situations puts the priest (or other clergy) in a very ambiguous and serious position. The priest must act out of love and the purity and clarity of his heart, for both the victim or potential victim and the abuser. If the abuser comes to the priest, the priest must attempt to convince the abuser to accept the fact that they have as serious problem and must seek the help that is needed. This may involve emergency hospitalization or perhaps incarceration. In this case the hospital staff would be mandatory reporters. If a priest is a mandatory reporter, this information must be told to all involved and the laws of the jurisdiction must be followed.
Clergy also have to intervene to protect potential victims if necessary. This may include referral to appropriate emergency psychological care. In the most serious cases such as a credible death threat, an immediate call to police and/or emergency services would be warranted.
If a priest is not a licensed mental health practitioner or mandated reporter and situations of abuse (physical, sexual, psychological, or neglect) were disclosed, I would suggest telling the abuser that you will follow up on this like the "hound of heaven." Morally the priest cannot allow abuse to continue. It may take the priest or someone else to be physical present to guard the abused victim. Whatever it takes to protect and safeguard the victim (or potential victim) must be done.
If the person came for pastoral counsel to a non-licensed priest and disclosed active abuse, I would recommend telling the abuser, as a last resort, he must report his abuse to protect the victim. Once again this message has to be made out of love and charity. The priest should do everything possible to get the abuser to "sign onto" and "have ownership" in this process. People are more likely to agree to positions they are part of rather than imposed on them by external authority or other factors.
This can be done using the abuser's psychological and spiritual strengths. Appeal to the care or love the abuser may have held at one time or another, or is capable of having, and ask them to make a personal decision based on these values. Informing them that priest and God will stand by them during this process is also helpful. Clergy should have a list of community resources that handle such situations so that appropriate referrals can be made.
It is important to treat the abuser with charity, gentleness, and love but also with a firm hand. The purer the heart of the priest, the more clearly he will perceive what actions have to be taken out of love of Christ.
An interesting side issue for Eastern Orthodox (and Western Roman) priests is the Seal of Confession. Suppose an abuser or victim approaches the priest for the Holy Mystery of Confession. Sometimes it can be anticipated what the person is about to say. Other times word has gotten back to the priest hinting at some serious family trouble. Often a priest can intuit the problem through the spiritual gift of discernment.
In such a case inform the alleged abuser you cannot hear the confession at this time. The upcoming discussion will not be a confession and thus not under the seal.. A priest-mental health practitioner (like myself) can do the same as delineated above except the mandatory reporting law would have to be followed.
If someone slipped by my "intuitive anticipation" and disclosed abuse in Holy Confession, I would withhold absolution and tell the person they are "without absolution" (or "'excommunicated" so to speak) until they report the abuse to the authorities. As a followup, since the Seal of Confession still holds, I would try and contact the abused and, without violating the confession, do all I can do to protect and guide him to safety.
If abuse is anticipated, it is actually easier for a priest-licensed mental health practitioner to treat because the disclosure rules can be cited up front before "session" or a communication begins. I want to be perfectly clear however, that once Holy Confession has begun, no law in the nation can contravene the Seal -- even to the imprisonment or death of the priest.
Non-clergy, when encountering abuse should be enlivened with the love of Christ for both the abuser and abused, as well as all involved in the abuse. There are countless stories in the media about relatives, friends or bystanders who had some knowledge of abuse incidents and did nothing. Sometimes this lack of action has resulted in dire consequences for the victims.
With laity and other non-professionals there are issues of uncertainty, clash of interests, and family or friend censure or disapproval. Often these issues produce conflict and stress in the person with the knowledge or suspicion of abuse. In such cases, talking to a knowledgeable priest, mental health professional, or community agency specializing in abuse are helpful in making right decision for the good and welfare of all involved. Remember that we sin not only by commission, but omission as well.
The Church, which Bishop Hierotheos calls a "hospital," has to be brought to bear on curing the soul and enlightening the nous in the hearts of all, hierarchy, presbyters, deacons as well as the royal priesthood of the faithful. Scripture, Tradition, the teachings of our Church Fathers, the Holy Mysteries, the holy icons, the very architecture of the church building reflecting the Kingdom of God, prayer and fasting: the whole life and mind of the church will be the path of the "light of Christ illumining all."
"Acquire the spirit of peace [in the heart] and a thousand souls will be saved around you," wrote St. Seraphim of Sarov. If we can bring peace to the abuser and abused, both can be healed.
Morelli, G. (2004). Christian asceticism and psychology. In S. Muse (Ed) Raising Lazarus: Integral healing in Orthodox Christianity. Brookline, MA: Holy Cross Press.
Palmer, G.E.H., Sherrard, P., & Ware, K. (Eds.). (1986). The philokalia: The complete text compiled by St. Nikodimos of the Holy Mountain and St. Makarios of Corinth: Vol.2. Winchester, MA: Faber and Faber.
Vlachos, H. (1994). Orthodox psychotherapy: The science of the fathers. Lavadia, Greece: Birth of the Theotokos Monastery.
V. Rev. Fr. George Morelli Ph.D. is a licensed Clinical Psychologist and Marriage and Family Therapist, Coordinator of the Chaplaincy and Pastoral Counseling Ministry of the Antiochian Orthodox Christian Archdiocese, ( and Religion Coordinator (and Antiochian Archdiocesan Liaison) of the Orthodox Christian Association of Medicine, Psychology and Religion. Fr. George is Assistant Pastor of St. George's Antiochian Orthodox Church, San Diego, California.
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