1. Introduction
1.1. The purpose of this document is to present the position of the Russian Orthodox Church regarding pastoral care for persons suffering from mental disorders, as well as the principles of working with this category of people. In their pastoral practice, clergy frequently encounter the mentally ill. According to the data of the World Health Organization, 14% of the world’s population suffers from some form of mental disorder; in the coming decades, depression may become the leading cause of loss of working capacity; more than 800,000 people commit suicide every year worldwide, making suicide the second most common cause of death among young people aged 15 to 29. Each year, dementia develops in 9.9 million people. According to contemporary research, the increase in borderline mental disorders and addictive diseases has been stimulated by the loss of religious and family values.
1.2. In Holy Scripture, madness is mentioned on several occasions and in different senses. Primarily, the godless man is called mad—one who transgresses divine and earthly laws and lacks the fear of God. This understanding of madness is connected with the idea that man’s fall into sin manifests as the alienation of the mind from the Creator: “The fool says in his heart: There is no God” (Ps. 14:1). Furthermore, in the biblical texts madness is also described as behavior that deviates from accepted social norms: “So he disguised himself before them and acted like a madman in their hands. He scribbled on the doors of the gate and let his spittle run down his beard” (1 Sam. 21:13). In the New Testament, madness is often mentioned to highlight the paradoxical, ineffable, and supra-rational character of Christ’s teaching: “But we preach Christ crucified, a stumbling block to Jews and folly to Gentiles” (1 Cor. 1:23); “For the wisdom of this world is folly with God” (1 Cor. 3:18–19). In this way it is shown that the understanding of God and the religious life of the Christian community are radically different from the norms prevailing in a society that does not follow Christ’s commandments.
1.3. “The Church regards mental illnesses as one of the manifestations of the general sin-induced brokenness of human nature. Distinguishing in the human person the spiritual, psychic, and bodily levels of its structure, the Holy Fathers made a difference between illnesses that arise ‘from nature’ and those caused by demonic influence or resulting from the passions that enslave man. In accordance with this distinction, it is equally unjustifiable either to reduce all mental illnesses to manifestations of demonic possession—which leads to unjustified exorcisms—or to attempt to treat every spiritual disorder exclusively through clinical methods.”
1.4. The Church, which from the very beginning has shown concern for human health, considers mental health to be a sphere of shared responsibility between clergy, psychiatrists, and other mental health specialists. Prejudices, myths, and misconceptions about psychiatry and mental disorders, which exist in society, often lead to patients not seeking medical help in time. Furthermore, patients themselves and their relatives sometimes attempt to place the priest in the position of the psychiatrist, interpreting every mental disorder as a form of demonic possession.
2. The Attitude of the Church Toward Mental Disorders
2.1. Mental illnesses represent states of the human person that manifest in the impairment of the ability to preserve the inner unity and integrity of the personality, as well as in the inability to maintain an optimal emotional state, sound judgment, appropriate behavior, and a correct perception of surrounding reality.
2.2. According to the definition of the World Health Organization, “health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” The Church also perceives human health as the wholeness of all aspects of human existence, which, by God’s goodness, wisdom, and mercy, has been present from the very beginning in the God-created nature of man. It is not possible to preserve true mental health if only man’s bodily nature and psychosocial well-being are taken into account, while ignoring his moral-ascetic state, worldview, and relationship with God. The Church bears witness that healing and salvation extend to the fullness of human nature in its entirety.
2.3. The Church continually follows scientific research dealing with the causes of mental disorders, their manifestations, questions of therapy and rehabilitation, as well as the influence of religious beliefs and practices on mental health. Medical and theological perspectives on the causes of mental illnesses and behavioral disorders complement one another. The Church affirms that it is unacceptable to reduce the entire complexity and diversity of the psychic and spiritual manifestations of human life to mere biological processes occurring in the brain.
3. Classification of Mental Illnesses from the Perspective of Contemporary Medicine
3.1. Mental illnesses encompass a wide spectrum of conditions—from reactive depressions to severe forms of congenital or acquired intellectual disability. In some cases, the cause of a mental disorder lies in a psychologically understandable reaction to difficult life circumstances, while in others it lies in structural-functional damage to the brain. At the root of mental disorders is a varied interplay of biological, social, and psychological factors.
3.2. Within the broad spectrum of mental disorders, five basic groups may be distinguished: borderline, endogenous, organic, addictive, and developmental disorders. The most common are borderline mental disorders, which include conditions caused by psychogenic factors, pathological character anomalies (personality disorders), neurotic illnesses (obsessions, anxiety-phobic conditions, etc.), as well as psychosomatic disorders.
Endogenous illnesses (various forms of schizophrenia and affective disorders) are caused by serious dysfunctions of the brain, grounded in genetic anomalies. Organic mental illnesses result from structural damage to the brain (epilepsy, senile dementia, mental disorders following trauma and brain tumors, consequences of neuroinfections, etc.). Developmental pathology includes various forms of intellectual disability and disorders from the autism spectrum. Addictive disorders (alcoholism, drug addiction, substance abuse, and non-chemical addictions—such as gambling, internet addiction, computer addiction, etc.) are characterized by the development of pathological dependency with pronounced medical and social consequences. A separate group is constituted by disorders in the sexual sphere, which conflict with the God-established norms of human nature.
4. Fundamental Principles of Pastoral Work with the Mentally Ill and Their Families
4.1. The Church testifies that a patient with a mental disorder is a bearer of the image of God, that he or she remains our neighbour and brother or sister in Christ, in need of compassion and help. Despite disorders in thinking, perception, behaviour, emotional life, or memory, the mentally ill person in most cases does not lose the capacity to feel love and to respond to it, nor does he or she entirely lose the ability to discern good from evil with the heart. Within the mentally ill there remain preconditions for spiritual life. No illness can contradict a person’s desire to strive for Truth and a virtuous life. Although people suffering from mental illnesses are often limited in their capacities, they are nonetheless, with the help of the Church, able to walk the path of Christian and moral growth.
4.2. The priest’s goal in contact with a mentally ill person is to support the awareness of Christ’s love and the dignity of the image of God within him or her, to accompany the person on the path of spiritual growth, and to lead him or her into the fullness of Church life. When dealing with a person suffering from mental infirmity, the pastor’s primary task is to help the afflicted one humbly accept the very fact of the illness and to strive, insofar as possible, towards healing. Mental illness does not signify abandonment by God, nor does it close the gates of the Kingdom of God or prevent participation in the life of the Church; it is a cross given to man for his salvation. The pastor should encourage the afflicted—often persistently—to consult a psychiatrist, undergo the necessary examinations, and, if needed, begin systematic treatment. The centuries-long experience of the Church, as well as modern scientific knowledge, testify that mentally ill persons, through ecclesial life and participation in the Holy Mysteries, can attain improvement in their psychological condition. For many mentally ill persons, the Orthodox faith constitutes one of the key personal resources enabling them to overcome the symptoms of illness and preserve their human dignity.
4.3. The Church clearly emphasizes the necessity of distinguishing the spheres of responsibility between the priest and the psychiatrist. The priest must not interfere with the therapeutic recommendations and procedures of the psychiatrist. At the same time, the Church considers it morally unacceptable to employ psychotherapeutic methods that suppress the patient’s personality, make use of altered states of consciousness, or manipulate behavior—whether performed by physicians or by clergy (including the manipulations exercised by false elders or “young elders” over their so-called “spiritual children”). The priest should take part in the dialogue between the patient, his or her family, and healthcare workers, with the aim of helping the patient in the search for the meaning of life, in attaining inner peace with God and neighbour, and in overcoming the symptoms of illness. Priest and physician must assist the patient in harmony and mutual trust; otherwise, their intervention may result in additional temptations and, at times, an unbearable burden for the afflicted person and his or her loved ones.
4.4. In pastoral practice, the priest encounters instances of distortion and deformation of spiritual life in certain forms of mental disorders, including manifestations of religious fanaticism, incapacity to understand the essence of Church tradition, lack of critical self-reflection, and the formation of pathological religious behavior that suppresses the striving for an authentic spiritual life. At the same time, some non-believers may interpret every form of religiosity as a kind of mental disorder. In this regard, educational work is essential, including the instruction of medical students and psychiatrists.
4.5. Parish communities should show special concern for their mentally ill members, offering them full support in overcoming social isolation and assisting in their integration into the life of the ecclesial community. They must be enabled to feel themselves full-fledged members of the Church, who have brothers and sisters in Christ that love them, for “if one member suffers, all suffer together” (1 Cor. 12:26).
4.6. The priest must pay careful attention to the spiritual and psychological condition of the family members of mentally ill persons, since for many of them the illness of a loved one often represents the collapse of certain life plans and hopes. On the one hand, the priest should explain that mental illnesses in many cases have a favorable course; on the other hand, he must point out that this trial bears spiritual meaning. At the same time, he must always keep in mind that what is expected of him is compassion, instruction, and support, while also guiding the family to professional medical and other appropriate assistance.
4.7. The gravest consequence of mental disorders is suicide. When considering requests from families for the Church commemoration of those who have voluntarily taken their own lives, if there is no official medical record of mental illness, it is necessary to carefully investigate the circumstances preceding the suicide, especially the final months of the person’s life. In cases of well-founded suspicion of a mental disorder, it is advisable to recommend that relatives turn to the diocesan bishop. In such cases, the priest must dedicate himself to offering consolation and support to the family and loved ones of the one who has committed suicide. If there is no confirmed evidence of mental illness, the pastor may suggest the reading of the “Prayer Rule for Relatives of One Who Has Voluntarily Ended His Own Life.”
5. Participation of the Mentally Ill in Liturgical Services, Holy Mysteries, and Rites
5.1. Due to the particularities of their mental state, many mentally ill persons find it difficult to fully participate in the liturgical services or to pray regularly according to the morning and evening prayer rule. In each concrete case, the priest, guided by the principle of oikonomia (pastoral discretion), should make an individual decision concerning the regime of prayer and attendance at church. It is desirable that the pastor who provides spiritual care for the mentally ill person remain in contact with the psychiatrist, so that together they may determine in which periods the patient is best prepared to receive spiritual assistance, and to what extent. With the greatest patience, without demanding quick comprehension, the pastor should help the afflicted person become aware of the importance of the Holy Mysteries to which he or she approaches.
5.2. Mental disorders in themselves do not constitute an obstacle to participation in the Holy Mysteries of Baptism and Chrismation, except in cases where the mentally ill person blasphemes against the name of God or by his or her behaviour might treat the Mystery irreverently. Catechism for the mentally ill is carried out in accordance with their individual capacity for spiritual enlightenment and education. In cases of pronounced congenital or acquired intellectual disability, the sick person may be baptized on the faith of the sponsors, with the consent of relatives or guardians.
5.3. In approaching the Holy Mystery of Confession, persons with mental disorders may at times be unable fully to recognize the moral consequences of their sinful actions. The priest’s task in such cases is to assist the person, within his or her capacity, to come to an awareness of personal sinfulness, so that the pastor may assess the degree of readiness of the penitent for participation in the Holy Mysteries of Christ. The mentally ill may be released from canonical responsibility for certain actions committed in this condition. Where there is awareness of the gravity of sin, an epitimia (penance) may be assigned, adapted to their psychophysical state. Persons with severe forms of congenital or acquired intellectual disability may be communed without confession, in the manner of children, whereas in milder cases confession may be conducted as with older children, limiting it to a minimum of elementary questions.
5.4. Preparation for the Holy Mystery of the Eucharist presupposes the practice of preparatory and Eucharistic fasting, as well as the observance of a prayer rule. In cases of mental disorder, by pastoral oikonomia, fasting and prayer rules may be shortened. Exceptions to the generally accepted tradition of Eucharistic preparation are determined by the spiritual father, based on the individual characteristics of the sick person and his or her understanding of ecclesial life. The priest decides concerning the communion of mentally ill persons who are prone to inappropriate actions. The basic criterion for their participation in the Eucharist is the safeguarding of the sanctity of the Holy Mysteries of Christ. Accordingly, it is not permitted to commune sick persons who are in a psychotic state and who might desecrate the Mystery. It is necessary, where possible, that members of the family of the afflicted person approach Communion together with him or her, so that in the consciousness of the mentally ill the awareness of the necessity of participation in the Eucharistic Banquet may be strengthened.
5.5. The Holy Mystery of Unction may be performed for the mentally ill in a shortened form. The Mystery should not be celebrated over agitated patients who, by their behavior, might treat the holy rite unworthily, until a state of inner calm has been attained. The Mystery of Unction should be celebrated over the sick who do not present an obstacle to the proper performance of the rite.
5.6. Certain mental disorders may constitute an impediment to the celebration of a church marriage. The Church does not permit the marriage of persons who, under current civil law, have been declared legally incapable due to mental illness, although in exceptional cases the diocesan hierarch may decide on the possibility of such persons entering into marriage. The inability to live together and raise children due to the mental illness of one spouse constitutes a canonical ground for the dissolution of a church marriage. According to the document “On the Canonical Aspects of Church Marriage”, an incurable severe mental illness of one spouse, arising during marriage and confirmed by the appropriate medical documentation, renders further cohabitation impossible. The dissolution of a church marriage on the basis of mental illness is a right, but not an obligation, of the other spouse. Furthermore, in today’s pastoral practice it must be taken into account that, due to advances in medical science, new possibilities for the treatment even of the most serious mental illnesses are appearing, and also that there are no universal and precisely defined medical criteria that would determine what, and in which exact cases, is to be regarded as an “incurable severe mental illness.” These questions require joint consideration by Church representatives and specialists in psychiatry on a case-by-case basis.
5.7. Certain mental disorders may constitute an impediment to receiving the Holy Mystery of Ordination. In this regard, it is essential that the administrators of theological schools pay particular attention to the mental health of candidates at the time of their admission to theological institutions. At the same time, the very fact of having consulted a psychiatrist or having undergone treatment in a psychiatric facility cannot automatically be considered an impediment to ordination, since some mental disorders are transient and temporary in character.
5.8. The presence of mental disorders may be an obstacle to admission into a monastery, as well as to the fulfillment of monastic rules and vows.
6. Preparation of Clergy for Pastoral Care of the Mentally Ill and Their Families
6.1. Pastoral care for the mentally ill requires constant awareness that, in addition to the usual difficulties of communication, there is always a medical component for which the priest must be specially prepared. The priest is not tasked with diagnosing specific mental disorders but is obliged to distinguish ordinary human emotional states from pathological ones and to build his pastoral relationship with a person in light of his or her mental condition. The ability of the priest to recognize the presence of mental illness, as opposed to other emotional problems, determines not only the correctness of spiritual guidance but, in some cases, even the very life of the person. The priest must know how to distinguish between the passions that enslave man and the manifestations of mental illness. Moreover, in some cases mental illnesses may present as peculiar spiritual-mystical states, which may be misinterpreted and lead to serious scandals and spiritual temptations. It is particularly important that priests be trained to recognize acute forms of mental disorders that may endanger both the life of the afflicted and those around him. The priest must be acquainted with situations in which it is necessary to provide urgent assistance, including referral for involuntary hospitalization.
6.2. One of the tasks of contemporary theological education is to prepare students of theological schools, clergy, and monastics with the fundamentals of psychiatry, by introducing a special course into the curriculum entitled “Pastoral Psychiatry.” Pastoral psychiatry represents an interdisciplinary course on the basic manifestations, development, causes of mental illnesses, and the particularities of pastoral care for those who suffer from them. The aim of this course is to prepare future priests for pastoral care of people afflicted by mental disorders.
6.3. In order to acquaint clergy and monastics with the fundamentals of pastoral psychiatry, it is necessary to organize specialized pastoral training seminars, as well as to introduce lectures on this subject within the framework of the continuing education programmes for clergy.
6.4. It is recommended that Church media outlets conduct educational work with the aim of destigmatizing the mentally ill within the Church environment, overcoming their social isolation, assisting their integration into the life of the Church, and encouraging timely recourse to professional psychiatric assistance.
7. Practical Recommendations for Church Care of the Mentally Ill
7.1. Priests and social workers of Orthodox communities, in their contact with mentally ill persons, should demonstrate patience, devote sufficient time to them, and enable their interlocutors to feel that their problems are not met with indifference. It must be borne in mind that, whatever “mad” state a mentally ill person may be in, he or she perceives very subtly the attitude of those around them, especially of those who are most important to them—often the priest or physician. Only when a person feels respect, serious and attentive concern for himself or herself, and realizes that others relate to him or her with love, will he or she be prepared to build a constructive relationship of cooperation with the priest and mental health specialists, accepting their counsel, recommendations, and therapeutic interventions.
7.2. Priests, monks, nuns, and parish social workers, in their interaction with mentally ill persons, should pay special attention to the following signs of mental disorders, in which case the afflicted person must be persistently encouraged to seek help from a psychiatrist:
States in which the intake of food and fluids is excessively restricted (even under the guise of fasting); expressing ideas of particular sinfulness accompanied by self-imposed prayer rules; loss of obedience to the spiritual father concerning spiritual life; conviction of one’s own special righteousness.
Depressive states with pronounced feelings of anxiety, hopelessness, despair, loss of life perspective, ideas of self-accusation, self-deprecation, worthlessness, and exaggerated guilt.
Depressive states accompanied by thoughts on the meaninglessness of life, anti-life attitudes, suicidal thoughts, and intentions.
Depressive states accompanied by a sense of abandonment by God, loss of meaning in life, loss of hope in God’s mercy, and spiritual numbness.
References to “voices” in the head or from outside—insulting, commenting, or commanding in character.
States of pronounced retardation, “wakeful sleep” during which the person does not respond to others or to attempts to attract his or her attention, prolonged immobility in one posture, refusal of food and drink, absolute silence.
Ideas of personal chosenness, messianic or prophetic mission, accompanied by surges of strength and energy, shortened sleep time during the night.
States of baseless euphoria with disorganized hyperactivity, uncontrolled flow of thoughts, overestimation of personal abilities, inappropriate ideas about restructuring social or church life.
Episodes of unmotivated aggression toward others, risky and antisocial behavior uncharacteristic of the person, gross disturbances of drives (theft, vagrancy, sexual deviance, drug abuse, alcoholism).
Expression of unfounded ideas of persecution, influence of hypnosis, radio waves, radiation, mind control, or threats to life (especially when accompanied by active behaviour consistent with these ideas, seeking “persecutors,” and expressing the desire for contact with them).
Feelings of unreality and artificiality of the surrounding environment; feelings of being at the centre of a struggle between good and evil; strong and recurrent states of “illumination,” “revelation,” or visions; ideas of demonic possession with the feeling of loss of control over one’s body, thoughts, and actions.
Appearance of obsessive ideas marked by fear of contamination; frequent washing of hands; excessive checking of actions; compulsive ritual behaviours; obsessive blasphemous thoughts.
Progressive loss of working capacity, excessive exhaustion, progressive decline of memory and intellectual abilities, loss of basic self-care habits (in elderly and very elderly persons).
Pathological conviction of personal excess weight; deliberate starvation for the sake of weight loss leading to increasing physical exhaustion and the emergence of suicidal tendencies (especially in young people).
Delays in speech development, intellectual disability, behavioral disorders in early childhood, delayed formation of self-care habits for physiological needs, inappropriate behavior in kindergarten or school, chronic academic failure.
7.3. There are certain mental states that require urgent, immediate hospitalization of the patient in a psychiatric facility without his or her consent, in spite of his or her will or desire. The procedure for involuntary hospitalization is regulated by state legislation and is applied in cases where the mental state of the person poses an immediate danger to his or her own life (real threat of suicide) or to others, as well as in situations of extreme incapacity (when the person is unable to meet basic life needs). In some cases, priests, social workers, or members of monastic communities may find themselves in a situation where they must make the decision to call for emergency psychiatric assistance.
8. Recommendations for the Organization of Church Care for the Mentally Ill
The organization of church care for mentally ill persons is carried out at the pan-Church, diocesan, and parish levels.
At the pan-Church level
The Synodal Department for Church Charity and Social Ministry, through the person responsible for the organization and coordination of church care for the mentally ill, should implement the following:
provide methodological support and coordination of the work of those responsible for the care of the mentally ill in the dioceses (within diocesan departments for social and medical activity);
organize their training and systematic professional development in the field of psychiatry;
cooperate with state structures towards the improvement of legislation and by-laws concerning the interests of mentally ill people and their families;
prepare methodological materials and teaching manuals, educational films, and other necessary literature for clergy who provide pastoral care for the mentally ill, both in parishes and in psychiatric institutions;
collect and analyze existing experiences of ecclesial and secular, domestic and foreign organizations engaged in the care of the mentally ill.
To enhance cooperation between clergy and mental health professionals, an expert committee consisting of representatives of the academic community and church structures should be established under the Synodal Department for Church Charity and Social Ministry.
Develop programmes of pastoral psychiatry for theological schools and professional development courses for clergy. Prepare and publish methodological manuals, educational films, and other necessary materials for the participants of these programmes.
At the diocesan level
Within diocesan medical departments or departments for social ministry, a person should be appointed who is responsible for the organization of care for the mentally ill. The duties of this person include the organization and coordination of the pastoral care provided by clergy in psychoneurological institutions and psychiatric hospitals; the organization of professional development courses in the field of psychiatry for clergy; and the collection and distribution of new information and methodological materials concerning pastoral care of the mentally ill.
For the pastoral care and catechesis of those undergoing inpatient treatment in psychiatric hospitals, efforts should be made to open hospital chapels or designated prayer rooms within such institutions, where services would be regularly celebrated by clergy who have received special training regarding the specific aspects of pastoral care for the mentally ill.
At the parish level
Clergy are obliged:
to possess basic knowledge of psychiatry, as well as information about possibilities for treatment and hospitalization of mentally ill persons (when necessary) in acute conditions;
to foster among parishioners an attitude towards the mentally ill as towards fully fledged members of the community and to encourage their integration into parish life;
to provide special spiritual support to mentally ill parishioners and to members of their families.
9. Conclusion
The accelerated development of society and the problems it faces present new challenges to both the Church and the medical community, challenges that demand proper reflection. The Church is concerned with the fact that the moral crisis is increasingly and more deeply reflected in the state of mental health among the population, which testifies to the profound falling away of society from moral norms: “For when they had taken liberty, they despised the Most High, thought scorn of his law, and forsook his ways. Moreover, they have trodden down his righteous, and said in their heart, that there is no God…” (3 Ezra 8:56–58). Christians are firmly convinced that mental health is impossible without the spiritual well-being of the human person. Therefore, the issue of improving the state of mental health is directly connected with the mission of the Church in the world. It is precisely the Church of Christ that is called to help society walk the demanding path of transformation and healing in order to attain the fullness of life.
Appendix
Mental Illness and Demonic Possession
The Church regards as equally unjustifiable both the identification of all mental disorders with demonic possession—which leads to the unwarranted performance of exorcisms—and the attempt to treat all spiritual disorders exclusively by clinical methods. Moreover, the influence of demons upon man is not limited to possession. The devil may exert influence on a person’s mental health directly through the soul but also through the body (Job 2:6). Demonic action upon the human soul is often manifested precisely through the body, for after Baptism the devil loses his authority over the soul of a Christian—although man, through sin, may again open himself to demonic influence.
Demonic possession most often manifests itself through aversion to God, icons, the Cross, the smell of incense, and other holy things. Contact with the sacred in such cases produces restlessness, fear, aggression, and sometimes loss of consciousness. The possessed may display abilities uncharacteristic of him—for example, unusual physical strength, the ability to see distant or hidden things. Outside of such attacks of “demonic madness,” the person does not differ from the mentally healthy. Possession may also be manifested in the form of an apparent ability to “see” the illnesses of others and to “heal” them without recourse to medical means. Such pseudo-healing can cause irreparable harm to health.
The image of God never disappears in the possessed, which leaves open the possibility of turning to God. The possessed, like the mentally ill, remain our brothers and sisters, whom it is impermissible to reject or despise. Demonic possession represents a trial permitted by God that helps a person to discover the existence of the real spiritual world. The Communion of the possessed must be conducted according to canonical rule: if a believer is possessed by a demon, but “does not desecrate the Mystery, nor blaspheme against it in any way—let him receive Communion.” The possessed are not admitted to Holy Communion if they blaspheme against God or if their inner mental state renders them unworthy of approaching the Mystery.
The Church expresses concern that among the faithful there is widespread recourse to the rite of exorcism. Often, people insufficiently rooted in the Tradition of the Church, lacking the capacity for a holistic perception of spiritual life, strive to participate in exorcism services, while neither they nor those who conduct such services have an adequate understanding of the nature of these ecclesial rites. Moreover, not only do they themselves attend such so-called “exorcisms,” but they also bring along minor children. In our time such rites are misinterpreted—not as a possibility of receiving miraculous deliverance from demonic possession as a response to one’s inner spiritual struggle, but as a ritual that guarantees deliverance from suffering simply by participating in it.
The Church affirms that it is impossible to distinguish demonic influence from mental illness solely by medical methods, for the religious experience of communion with God and the knowledge of God cannot be adequately expressed in terms of scientific knowledge. Such discernment is possible only within the Church—by spiritually perfected persons, the saints, who have received from God the gift of discerning spirits (1 Cor. 12:10). In the words of St Anthony the Great: “We need much prayer and ascesis, in order that, having received from the Spirit the gift of discerning spiritual things, we may be able to distinguish the demons—some of whom are less evil, while others are worse—what goal each seeks to achieve, and how each may be overthrown and expelled.” Christ Himself cast out demons and entrusted to the Church the authority to expel them as part of His mission (Mk. 3:13–15; 6:6–13). Yet only clergy who are prepared by spiritual experience for an encounter with demons may participate in healing from possession, and this with the blessing of the diocesan hierarch.
(Document of the Commission of the Inter-Council Presence on Church Enlightenment and Diakonia, 2020)
Translated from Russian by Stanoje Stanković
