This Condition Was Described In Writing Long Before Psychiatry

The Earliest Of Those Records Came From Outside Medicine

No Diagnosis Existed For What They Were Recording

The Word They Used Instead Was Scruple

Doctors Described The Same Behaviour Over A Century Later

Each One Renamed What The Writers Before Them Described

This Part Covers Who Wrote It Down And What They Called It

THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.

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Robert Burton Published The Anatomy Of Melancholy In 1621

One Passage In It Describes A Man Sitting In A Silent Congregation

Burton Wrote That He Is Afraid He Shall Speak Aloud At Unawares

The Feared Words Are Something Indecent Unfit To Be Said

Nothing In That Passage Involves The Man Wanting To Speak

The Fear Is Of The Speaking Rather Than The Wish

Jeremy Taylor Wrote About Scruple In 1660

Taylor Called A Scruple Trouble Where The Trouble Is Over

He Added That It Is A Doubt When Doubts Are Resolved

Both Halves Of That Sentence Describe A Question Already Answered

Answering It Again Is What The Sufferer Cannot Stop Doing

John Moore Preached On The Same Problem In 1691

Moore Described Naughty And Sometimes Blasphemous Thoughts

Those Thoughts Start In Their Minds According To Him

Starting Is The Word That Matters In That Phrase

None Of These Accounts Describes A Person Wanting The Thought

The Writers Were Clergy Rather Than Physicians

Their Setting Was The Church Rather Than A Consulting Room

Scruple Was The Term Available To Them

Medicine Had No Word Of Its Own For Well Over A Century

Jean Etienne Dominique Esquirol Wrote About It In 1838

Esquirol Described The Problem As A Form Of Monomania

Monomania Meant Partial Insanity In The Language Of That Period

Esquirol Was Not Describing A Total Loss Of Reason

The Rest Of The Person Was Understood To Be Intact

Wilhelm Griesinger Published Three Cases In 1868

He Termed The Illness Grubelnsucht

That German Word Means Ruminatory Or Questioning Illness

Rumination Is Repetition Rather Than Delusion

Karl Westphal Used The Term Zwangsvorstellung In 1877

Zwangsvorstellung Translates As Compelled Presentation Or Idea

In Britain The Word Became Obsession And In America Compulsion

The Current Name Emerged As A Compromise Between The Two

Pierre Janet Wrote Les Obsessions Et La Psychasthenie

Janet Explained Obsessions Through Insufficient Psychological Tension

He Called That Tension A Form Of Nervous Energy

Sigmund Freud Gave The Same Symptoms A Different Cause

Freud Linked Them To Unconscious Conflict And Defence Mechanisms

Several Explanations Now Existed For One Set Of Behaviours

None Of Them Agreed On Where The Symptoms Came From

All Of Them Were Describing People Who Could Not Stop

Historical Description Is Not The Same As Historical Diagnosis

Paul Cefalu Made That Argument In The Journal Of Medical Humanities

His Essay Appeared In 2010

Psychologists And Cultural Historians Have Argued A Particular Case

That Case Concerns Martin Luther And John Bunyan And Ignatius Loyola

Those Figures Are Said To Have Shown Religious Scrupulosity

Scrupulosity Was Classified By The DSM Four As A Subtype

Cefalu Accepts That Early Modern Theologians Do Manifest It

His Objection Concerns What Follows From That

That Religiosity Was Culturally Acceptable Inside Their Own Period

It Was Even A Recommended Component Of Spiritual Progress

Believers Understood It As A Means Of Receiving Unmerited Grace

A Behaviour A Culture Recommends Is Judged Differently Inside It

Cefalu Uses The Case To Point Out A Limitation

The Limitation Is In Current Criteria Applied Retrospectively

Retrospective Diagnosis Of Historical Figures Is What He Questions

That Caution Does Not Change What Burton And Moore Recorded

What Those Two Men Wrote Down Was Description Rather Than Diagnosis

Precision About A Symptom Is Not A Claim About Pathology

The Naming Kept Changing While The Descriptions Did Not