When Good Clerics Go Bad
Who's more prone to depression: a Pelorian or a Desnan?
A hobby of mine happens to be keeping up on the literature on physician burnout. It's a bit of a morbid topic, to be sure, but as a healer with an interest in mental health, I'm naturally curious about what drives other healers to the point where they can't take it any more. The general public is broadly aware of the fact that physicians, as a population, are more likely to suicide than most groups of non-physicians, and certain specialists are even more likely to have severe mental health problems, including extremely high rates of substance abuse. There's no way to know if this literature holds true for healers in a fantasy setting; in many ways, one might imagine that the stresses faced by modern healers are very different from those faced by their spell-casting counterparts. Obviously, though, there is a population we can peek at to get a bit of insight: modern religious leaders, such as priests, rabbis, and imams. It turns out that there's actually been quite a lot of research done on the mental health of modern clerics, and in particular, the last five years or so have seen a small but meaningful boom in work on burnout in priests. The good news is that their suicide rate isn't as high as that of their doctors, but it turns out they're an at-risk population in their own way.
One very interesting but not terribly shocking paper on the topic came out in 2011. The authors looked at a small sample of clergy and studied them in terms of four traits: success-oriented, over-striving, self-protecting, failure accepting. As one might imagine, a poor capacity to accept failure and a tendency towards over-striving predicted a higher rate of burnout. Another paper looked at some of the same traits in a slightly different way and came up with some similarly seemingly-obvious findings: clergy who have interests and activities outside of their faith are better equipped to prevent burnout. This paper also pointed out how, just like for non-clergy, physical fitness is protective of mental health, a finding which presumably bodes well for the adventuring cleric who can't help but get plenty of exercise. Perhaps most interestingly, the burned-out clerics tended to be of younger age and earlier in their careers; we can only speculate whether this suggests that today's adults are less inclined to follow a spiritual path or whether youth predisposes to more crises of faith.
An article published last year showed that vicars who have less control over their job environment, higher workloads, and less time for pleasure and relaxation generally suffered from more stress-related symptoms and complaints. These are, of course, pretty much the same predictors of burnout and poor job satisfaction that one would find for any job. Being a cleric ay be different from other jobs in some ways, however. For example, one team published a study demonstrating that forced termination from a church position had a meaningful association with post-traumatic stress disorder, which is not commonly seen after people are fired from other jobs. The authors note that being forced to leave a clerical post is associated with tremendous social pressure and humiliation, whereas losing other jobs might not be, but the authors give surprisingly little attention to the question of what factors led to the clergy being forced out and whether there may have been other reasons for them to develop psychological symptoms.
The most recent paper that I found on the topic used a term I had never read before: "spiritual dryness," the condition of having a "lack of positive spiritual feelings." It's an evocative term for what one would have to imagine is a severe problem for many clerics in a world where you don't get to witness frequent miracles. Their study was conducted primarily as a means of testing out a new questionnaire as opposed to rigorously studying their population (catholic priests), so the conclusions that can be drawn from their work are limited, but they did show some findings. Almost half of their sample reported what the authors considered to be significant spiritual dryness at least occasionally, and this appeared to predict depressive symptoms, emotional exhaustion, poorer work performance, and variance in perceived importance of religious activities in general. The obvious implication: lack of faith predicts clerics who a harder time doing their jobs happily and effectively.
Sadly, despite a little bit of digging through the literature, almost all the studies I found dealt specifically and exclusively with Christian clerics. I couldn't find a single study which looked at Jews or Muslims and burnout or various related terms. I would have to imagine that a large part of this is simply a question of there being more Christian clerics available for study in Western countries, but it would be interesting to find out if the burnout rates were actually different in different religions, and if so, why.
The obvious limitation to everything I'm saying here is that modern priests may not be comparable to fantasy clerics any more than modern doctors are. Modern priests face dwindling faithfulness and their own crises of belief, whereas a cleric in a fantasy world has the power of their god literally at their fingertips, and one has to imagine that this is has the effect of reaffirming faith quite powerfully. In all likelihood, fantasy clerics are partway between modern healers and priests, and have to learn to live with carrying both the spiritual and physical burdens of their congregations in their own ways. In any event, a single burned-out cleric can have significant implications for a community when they're the provider of both spiritual care and life-saving magic, the data here can hopefully help guide the storyteller to create NPCs at all stages of their lifespan and to show how some men and women of the cloth hold up well in the face of their challenges, while others may fall far.
Four years ago, Dr. Eris Lis, M.D., began writing a series of brilliant and informative posts on RPGs through the eyes of a medical professional, and this is the one that appeared here on July 20, 2013. Lis is a physician, gamer, and author of the Skirmisher Publishing LLC OGL sourcebook Insults & Injuries, which is also available for the Pathfinder RPG system.
