Thursday, May 7, 2015







The Modern American Nursing  Home:
Should it (or could it)  be more than custodial?  Is it really just babysitting while awaiting death ?

Recently I visited a self described  “ state of the art”  Nursing home in one of the North eastern states to  greet an old  time friend who has been  placed  there by family   because of indications  of the dreaded plague,  Dementia. This facility lists on Its webpage Gourmet dining for residents,  careful, professional and regular  treatment for the improvement  of the various levels of the disease, stimulation, multiple occasions  for interaction with  games, music concerts and in general  a kind of edenic living.
Situated on a busy avenue loaded with garages, gas stations, hot dog stands and  businesses selling  tires and accessories, the Home is a large attractive building  with a sweeping driveway. When I arrived, there were several elderly people seated on the porch in rocking  chairs sunning  themselves. They looked at me with empty vacuous eyes and instantly dropped their gaze, reminiscent of cows munching on grass  who are distracted momentarily by a passing railroad rain. Those who are residing there for dementia care live in a confined locked area cheerily  called   the Reminiscence area.
When I was ceremoniously admitted through the coded locked doors, my first reaction was of oppressive temperature. No open windows. The air was heavy, perhaps, because older people like warmer room temp. Yet, the general sense was of cleanliness with no trace of urine odor so offensive in poorly kept institutions. However, there was a sense of total enclosure which can be so deadening and crushing  in time. I was told that once a week the residents are taken outside the enclosure for “ice cream”, an event viewed by the residents with greatly anticipated joy. This “lock up” seems quite proper for those whose dendrites have been destroyed. Those patients who are in the Alzheimer  “bubble” must be protected from the  “wandering” possibility which could result  in major damage  to  themselves. Quite clear.
 Staff  try mightily. The  fault is not  theirs. The error in this facility, as in many others, is failing to recognize that all dementia patients are not in the same severe level of the disease. These patients should be treated in terms of where they are medically at the present time .  In spite of the hoopla of “interaction” there are huge chunks of the day which the residents spend alone, a bellringer for depression possibiliies. Confinement, unfortunately, makes for flattened personalities. Prisoners readily attest to this and while all nursing home administrators try, sometimes desperately,  to provide stimulating activities,  the structures make it exceedingly difficult. Placement and diagnosis are sometimes made hurriedly without sufficient over all analysis, Experienced diagnosticians know that mildly depressed residents can experience more rapid deterioration when plunged abruptly into what they experience as a total life change with a concomitant sense of confusion and futility.  The sadness is that what little opportunity for “happiness” one possessed has now been quickly abolished  with confinement in the deadening atmosphere of the severely  afflicted..

The staff was warm and cheery, a bit artificial, but generally pleasing. They greet one well and are perfectly pleasant.  I was ushered into a room for “general” purposes. It had a large television  screen which no one was watching but seven or eight dementia residents of various levels of awareness  were present.  It was apparently acceptable that they sit and watch me visit my friend. One gray haired woman who seemed to be at least eighty sat hugging a toy doll and treating it as if it were human and living. A senior man with arms folded and eyes closed sat silent when he suddenly got up and began to pace the floor slowly but repeatedly. He was like the Indian psychotic inmate in “One flew over the cukoo’s nest.” A woman seeing my clerical collar dashed over to say, in a surprisingly deep guttural voice that she owned the place . I felt a bit cowed and reminded myself to behave appropriately.   Three or four senior women almost sprawled in chairs while they “looked out there” at something or nothing. No conversation. No smiles. When eyes would meet it was a momentary connection of no-life. They just “sat” there. The heaviness of mood was powerful.
 I managed to contact a 92 year old woman who had lost her husband 9 months ago  and whose 5 sons agreed that she could not live alone so  they  gathered her up and deposited her in this facility. With tears In her eyes she told me none of them came to visit her in this facility which she described as “ I hate it.”   One of the dominant reasons for her low feelings was not only abandonment, but more, the sense that she had lost all control or decision sharing in her life. Others decided for her. Coming to such a facility  like this actually aggravates this feeling  of being overwhelmed. She is told when to retire and get  up. When to eat.  To take medications when others decide for her. She is allowed very little in the way of personal decision making.   Furthering her depression she got the impression that they confined her for their own convenience. They say they  feel better. They don’t worry about her any more so they  can  go on with their respective lives with relative peace  of mind and enjoyment.  Every one is happier except her, and that realization is painful  and is enormously  hard to carry alone.    Did she tell me truth or was it distorted perception? I don’t know but one factor is indisputable.   The cookie cutter dimension.
As noted, institutions do what they can. There is no perfect solution. That is why cookie cutting resolutions can be very damaging and unfair. Each patient has to be assessed individually. Some of these patients might do well if incorporated into the more “normal” populations.  For example, there are some dementia patients who can, at present, enjoy and benefit from more free living, even if lightly supervised by competent and caring  people. Does it help a partially functioning dementia patient to be totally immersed in a very sick environment or would it be worth a chance to allow that person to move even limitedly in a more normal population? To my psychologist’s mind the question is academic.
Recently, some friends of mine  described their treatment of their  aged mother who was in dementia  and living in a Nursing home. The mother had difficulty speaking   complete sentences and finding words  to express her thoughts. They brought her to  their home  four days over the Christmas holidays. They report that the return to more instant   comprehension and ease of speaking  was  markedly  obvious. She was stimulated by conversation which was more than discussions about showers or  takings pills.  Total immersion in the numbing atmosphere of a confined area will take its inevitable and terrible toll.       
 It is fairly clear that dementia type diseases are irreversible, When dendrites die, they do not regenerate. Surely the Facility knows that elemental point. So when they suggest, relative to my friend, that IF she improves at 86, they will move her into assisted living, are they telling less than the truth?  Don’t all of us unconsciously seek the easy solution? To reduce “memory units” to custodial levels might be fair enough but to pretend that they are rehab designed is really pushing the envelope!!
Relative to my friend.   The reality is that her few times left of enjoyable living are fleeting each day as she stays  in the Memory unit.  Her last happy moments have been stolen on behalf of the peace of mind of others. She has been there six weeks with rapid negative consequences. She has fallen twice, the second with some significant injury to her leg, has had three serious episodes of vomiting twice accompanied by loss of  consciousness. I rode with her in the ambulance to the local hospital where after 8 hours of testing  she was discharged with no findings. CT scan, EKG, BP,  total blood work up and observation. Is this not obvious psychological messaging of rejection and rebellion? Her heart begins to act up after all the excitement but more so her deep unhappiness. She cries herself to sleep. On her third vomiting episode, again with ambulance transport to the local hospital, after heavy  testing, she was sent  to another hospital in another city. She was discharged again to resume living in the Lockup. Will she vomit again? She did not vomit once when living in New York.  What does one make of this?  One legitimate question is obvious. Not all problems are purely and only physical. Patients sometimes communicate nonverbally   through bodily symptoms. It is known as psychosomatic reactions.
In 6 weeks she has not had ONE therapy session in spite of the alleged programs so colorfully described. In six weeks her mentation is worse. Her confusion seems compounded. Her word search has become painful. She says she feels: degraded----demolished---in prison. Her words. In a kind of Stockholm syndrome she fears to tell others what she is feeling.  She fears, probably aggravated by her hours of  being alone or by the garbled conversation of  the dementia population, that the staff will “punish”  her  if  she  speaks up and says what she is really thinking .  She resists taking showers because of the (from her point of view) Nazi like attitudes of handlers who are usually  aides  who are under a nurse overseer.
Dementia is a  terrible disease.  Not much has been found to date which offers substantial hope for cure but all researchers recommend  that caregivers do as much as possible to maintain at least the present level of self esteem which the patient possess. Dementia care is stressful  for caregivers but who for the most part   sincerely wish to safeguard   the limited reservoir of peace these unfortunate patients  cling  to. The spiritual, the emotional, the social factors are at least as important as the physical factors so necessary in the final days of those we have loved who themselves  took care of  others in  the past . Psychological  factors are serious dynamics which ought to be acted on. At least they should be seriously considered.






The Modern American Nursing  Home:
Should it (or could it)  be more than custodial?  Is it really just babysitting while awaiting death ?

Recently I visited a self described  “ state of the art”  Nursing home in one of the North eastern states to  greet an old  time friend who has been  placed  there by family   because of indications  of the dreaded plague,  Dementia. This facility lists on Its webpage Gourmet dining for residents,  careful, professional and regular  treatment for the improvement  of the various levels of the disease, stimulation, multiple occasions  for interaction with  games, music concerts and in general  a kind of edenic living.
Situated on a busy avenue loaded with garages, gas stations, hot dog stands and  businesses selling  tires and accessories, the Home is a large attractive building  with a sweeping driveway. When I arrived, there were several elderly people seated on the porch in rocking  chairs sunning  themselves. They looked at me with empty vacuous eyes and instantly dropped their gaze, reminiscent of cows munching on grass  who are distracted momentarily by a passing railroad rain. Those who are residing there for dementia care live in a confined locked area cheerily  called   the Reminiscence area.
When I was ceremoniously admitted through the coded locked doors, my first reaction was of oppressive temperature. No open windows. The air was heavy, perhaps, because older people like warmer room temp. Yet, the general sense was of cleanliness with no trace of urine odor so offensive in poorly kept institutions. However, there was a sense of total enclosure which can be so deadening and crushing  in time. I was told that once a week the residents are taken outside the enclosure for “ice cream”, an event viewed by the residents with greatly anticipated joy. This “lock up” seems quite proper for those whose dendrites have been destroyed. Those patients who are in the Alzheimer  “bubble” must be protected from the  “wandering” possibility which could result  in major damage  to  themselves. Quite clear.
 Staff  try mightily. The  fault is not  theirs. The error in this facility, as in many others, is failing to recognize that all dementia patients are not in the same severe level of the disease. These patients should be treated in terms of where they are medically at the present time .  In spite of the hoopla of “interaction” there are huge chunks of the day which the residents spend alone, a bellringer for depression possibiliies. Confinement, unfortunately, makes for flattened personalities. Prisoners readily attest to this and while all nursing home administrators try, sometimes desperately,  to provide stimulating activities,  the structures make it exceedingly difficult. Placement and diagnosis are sometimes made hurriedly without sufficient over all analysis, Experienced diagnosticians know that mildly depressed residents can experience more rapid deterioration when plunged abruptly into what they experience as a total life change with a concomitant sense of confusion and futility.  The sadness is that what little opportunity for “happiness” one possessed has now been quickly abolished  with confinement in the deadening atmosphere of the severely  afflicted..

The staff was warm and cheery, a bit artificial, but generally pleasing. They greet one well and are perfectly pleasant.  I was ushered into a room for “general” purposes. It had a large television  screen which no one was watching but seven or eight dementia residents of various levels of awareness  were present.  It was apparently acceptable that they sit and watch me visit my friend. One gray haired woman who seemed to be at least eighty sat hugging a toy doll and treating it as if it were human and living. A senior man with arms folded and eyes closed sat silent when he suddenly got up and began to pace the floor slowly but repeatedly. He was like the Indian psychotic inmate in “One flew over the cukoo’s nest.” A woman seeing my clerical collar dashed over to say, in a surprisingly deep guttural voice that she owned the place . I felt a bit cowed and reminded myself to behave appropriately.   Three or four senior women almost sprawled in chairs while they “looked out there” at something or nothing. No conversation. No smiles. When eyes would meet it was a momentary connection of no-life. They just “sat” there. The heaviness of mood was powerful.
 I managed to contact a 92 year old woman who had lost her husband 9 months ago  and whose 5 sons agreed that she could not live alone so  they  gathered her up and deposited her in this facility. With tears In her eyes she told me none of them came to visit her in this facility which she described as “ I hate it.”   One of the dominant reasons for her low feelings was not only abandonment, but more, the sense that she had lost all control or decision sharing in her life. Others decided for her. Coming to such a facility  like this actually aggravates this feeling  of being overwhelmed. She is told when to retire and get  up. When to eat.  To take medications when others decide for her. She is allowed very little in the way of personal decision making.   Furthering her depression she got the impression that they confined her for their own convenience. They say they  feel better. They don’t worry about her any more so they  can  go on with their respective lives with relative peace  of mind and enjoyment.  Every one is happier except her, and that realization is painful  and is enormously  hard to carry alone.    Did she tell me truth or was it distorted perception? I don’t know but one factor is indisputable.   The cookie cutter dimension.
As noted, institutions do what they can. There is no perfect solution. That is why cookie cutting resolutions can be very damaging and unfair. Each patient has to be assessed individually. Some of these patients might do well if incorporated into the more “normal” populations.  For example, there are some dementia patients who can, at present, enjoy and benefit from more free living, even if lightly supervised by competent and caring  people. Does it help a partially functioning dementia patient to be totally immersed in a very sick environment or would it be worth a chance to allow that person to move even limitedly in a more normal population? To my psychologist’s mind the question is academic.
Recently, some friends of mine  described their treatment of their  aged mother who was in dementia  and living in a Nursing home. The mother had difficulty speaking   complete sentences and finding words  to express her thoughts. They brought her to  their home  four days over the Christmas holidays. They report that the return to more instant   comprehension and ease of speaking  was  markedly  obvious. She was stimulated by conversation which was more than discussions about showers or  takings pills.  Total immersion in the numbing atmosphere of a confined area will take its inevitable and terrible toll.       
 It is fairly clear that dementia type diseases are irreversible, When dendrites die, they do not regenerate. Surely the Facility knows that elemental point. So when they suggest, relative to my friend, that IF she improves at 86, they will move her into assisted living, are they telling less than the truth?  Don’t all of us unconsciously seek the easy solution? To reduce “memory units” to custodial levels might be fair enough but to pretend that they are rehab designed is really pushing the envelope!!
Relative to my friend.   The reality is that her few times left of enjoyable living are fleeting each day as she stays  in the Memory unit.  Her last happy moments have been stolen on behalf of the peace of mind of others. She has been there six weeks with rapid negative consequences. She has fallen twice, the second with some significant injury to her leg, has had three serious episodes of vomiting twice accompanied by loss of  consciousness. I rode with her in the ambulance to the local hospital where after 8 hours of testing  she was discharged with no findings. CT scan, EKG, BP,  total blood work up and observation. Is this not obvious psychological messaging of rejection and rebellion? Her heart begins to act up after all the excitement but more so her deep unhappiness. She cries herself to sleep. On her third vomiting episode, again with ambulance transport to the local hospital, after heavy  testing, she was sent  to another hospital in another city. She was discharged again to resume living in the Lockup. Will she vomit again? She did not vomit once when living in New York.  What does one make of this?  One legitimate question is obvious. Not all problems are purely and only physical. Patients sometimes communicate nonverbally   through bodily symptoms. It is known as psychosomatic reactions.
In 6 weeks she has not had ONE therapy session in spite of the alleged programs so colorfully described. In six weeks her mentation is worse. Her confusion seems compounded. Her word search has become painful. She says she feels: degraded----demolished---in prison. Her words. In a kind of Stockholm syndrome she fears to tell others what she is feeling.  She fears, probably aggravated by her hours of  being alone or by the garbled conversation of  the dementia population, that the staff will “punish”  her  if  she  speaks up and says what she is really thinking .  She resists taking showers because of the (from her point of view) Nazi like attitudes of handlers who are usually  aides  who are under a nurse overseer.
Dementia is a  terrible disease.  Not much has been found to date which offers substantial hope for cure but all researchers recommend  that caregivers do as much as possible to maintain at least the present level of self esteem which the patient possess. Dementia care is stressful  for caregivers but who for the most part   sincerely wish to safeguard   the limited reservoir of peace these unfortunate patients  cling  to. The spiritual, the emotional, the social factors are at least as important as the physical factors so necessary in the final days of those we have loved who themselves  took care of  others in  the past . Psychological  factors are serious dynamics which ought to be acted on. At least they should be seriously considered.

Wednesday, August 20, 2014

The Mess at Gaza



                                          
The wise old Sigmund Freud said among other witticisms that nothing is all that it seems. The Hamas/Israel tragedy, for example, fairly screams  “complication.”

To Israel, it is an obvious “given” that they are  a duly, lawfully constituted nation with an indisputable right to a peaceful existence equal to the United States, England or Pakistan. Consequent to that right is a further one which is not only a right but a duty. That consequent right and duty is the protection of the lives, properties and liberties of its citizens, even, if by severe military force. This is, to them, non-negotiable.
To Hamas, however, Israel has stolen Arab land. Israel is an occupier. The land  must be returned.   Unless this happens there can be no peace. This is, to them, non-negotiable.  
                                    
In any event, a necessary point must be noted. All rights have real limitations. The response against an unprovoked attack has to be measured and cannot morally go beyond the minimum damage, collateral or otherwise.           
                       
The defending nation will claim that that such force is necessary for legitimate  protection. This factor similarly operates in the difficult area of the “just war” analysis. What is the criterion whereby one can justly argue that the force used is beyond the restraint of the common moral position?

When non-combatant civilians, including children, women and senior citizens are killed or seriously injured in large numbers, when their lives are totally uprooted, when their homes are devastated, it would appear, even though in war there is often unavoidable collateral damage, that the force used was beyond “measured.” 

However, on the other hand, if the attacking  force, in this instance  classified by many as “terrorist” hides its rockets in  schools, hospitals, mosques, residences as  behind a  “human shield”, Israel is placed in the intolerable position of simply enduring the cascade of rockets  from these protected places with no defense but their own  “dome” system, awesome but not perfect. This means that civilian  Israeli lives are not only endangered but open to widespread death.   Hence, the “other side” morality of the Israelis. Yet, Hamas publicly denies any kind of   human shield activity claiming that the charge is manufactured for American propaganda. What does one do with such a dilemma? Whom does one believe?

Of course,  the placing of armaments in such nonmilitary places is highly unethical and would suggest,  if true,  that the Hamas cares  little for human lives, even of their own people. There has been some grotesque reporting that   civilians are advised NOT to leave a building designated for attack so that the incident can be used as an anti-Israeli propaganda tool. 

While Israelis claim that they notify Palestinian residents before the destruction of a certain building which houses rocketry, by leaflets, radio, internet, the question then arises:  Where do the endangered local Palestinians go? Get out, they are told, to place of safety the existence of which is nebulous.

Some truth is to be found everywhere. But is one side all right and the other all wrong? To listen to the debate, depending on which side speaks, one could believe that there are not two sides to this story. As frustrating as it is, more talking and listening are required. There have been so many “peace” talks in the past that one becomes some what cynical of the whole  situation. We have seen the warm cozy handshakes in the past with “sincere” hopes of a peaceful side by side arrangement. Again and again the agreement is broken and hate, not peace, emerges.

The reality of life teaches that rarely does one get all that one wants. Legitimate compromise does not diminish nations.  Intractability does.   When nations write into their charters that Israel is to be eliminated from the face of the earth, it forces that Nation into a defensive national posture with heavy emphasis on a powerful military, ready to fight in a moment for survival.

When Israel constructs a world for Palestinian Arabs who whereby are (in their view) deprived of a just share in the world’s goods, when they are subjected to what they see as an unfair, harmful and unjustified embargo, when  they suffer perceived disrespect and discrimination, they rise in protest. When, however, that protest is co-opted by fanatics such as Hamas, the legitimacy of the protest is sullied when otherwise the protest might have some credibility. Further, Israel contends that the embargo is necessary to inhibit the flow of arms from hostile nations willing to underwrite the attacks on Israel.

In a world of intractability, hopes for peace are scant if not impossible. The catastrophic possible outcome is that there is no solution except unconditional war. The war will be ever present until one side is totally crushed and eliminated. This is a horrendous possibility. This carries the frightening possibility of an expanded, world wide conflict which would make past wars seem puny by comparison.  This is why efforts for a resolution must be pursued. As useless as it may seem, the talking must continue. And the listening.

And the praying. The Pope must be involved and the President and the Queen and all people of good will. And the essential question must be answered:  Do the two sides really want a resolution of the tension?  How serious is the concrete desire for peace?

Some media say: If Israel lays down its arms, the next day Israel ceases to exist. If  Palestinians lay down their arms, the next day we have peace. Is this so? In spite of what I write, I am sure if I lived in Tel Aviv, I would be with the majority who seek survival. I would be all for  aggressive  but defensive action. The first law of  human nature is probably self survival. The Manhattan liberal may proclaim lofty platitudes but as the old Indian adage goes:  Don’t judge until you walk in the other’s moccasins. Sermonizing is counterproductive. So is “Second guessing.” Israel is a strong ally. Our leaders should refrain from criticism of Israel as they fight for their very existence.  But on the other hand, if I am Muslim and Palestinian,  I see my people diminished and brutalized, I go with the other side since I feel there is no way to justice and peace in the present arrangement.  So I fight and sacrifice and protest!!

It will take the wisdom of Solomon and the patience of Ghandi and the help of God/Allah to craft a fair and lasting agreement.  I wish them well.  I am content that they do not ask me for an answer! 

Tuesday, May 27, 2014

Chastity and the Anger of the Catholic Left



                       Chastity and the Anger of the Catholic Left



          

                       It is and always has been the explicit and unequivocal position of the Catholic Church that Chastity, as considered under the Virtue of Temperance, is the obligation of everyone. There is no exception.  Fully aware of the failures of  some of its own members,  even those of  very high  standing,  nevertheless the Church  has taught perennially that it is the Will of the  loving and provident Lord that all persons must restrain, and correctly direct but not repress,  the sexual drives which all human beings possess.
“Catholic”  anthropology  (and, of course, theology) believes in a great aboriginal calamity , technically termed “Original sin” which is  deep in and integral to fallen human nature. It is described by the Blessed apostle Paul as doing what I do not want to do and not doing what I want to do.   It has been likened to an inner tension which must be  properly controlled or even in Plato’s thought as the powerful horse one strides which needs the  strong management of the rider. It is described as one font of seven negative inclinations called “Capital sins” one of which is lust or the inappropriate use of sexual drives. Lust is considered as antithetical to love in Catholic thinking. Actually, these inclinations are merely inclinations and not sins as such but which can incline the person to actual sin. Hence, Catholic spirituality has always been sensitive to “occasions of sin”, i.e. those specific factors such as  people, places, things and which are to be assiduously avoided because  their specificity  might lead a person to sin.   This is a basic, elementary Catholic attitude and very deep in the Catholic psyche.
In the light of the above, it is difficult for the average, especially well educated Catholic to fathom  the anger or what borders on rage which surfaced in Toronto, Canada, about a chastity  focused activity offered at the Catholic Student Centre ( or Newman Centre). This Centre while not sponsored in any way by the University of Toronto, offers a wide variety of optional programs to students which are meant to foster deeper relationship with Jesus Christ and His own Catholic Church.
Surprisingly, though clearly distinct from the University, one of the academic Vice Presidents strongly urged the Parish to drop this basic Catholic activity which is totally congenial to the Church’s thinking and simultaneously optional to students. One wonders what led this academic to invade religious space with the weight of a high Campus position.  The activity is a religious and optional program, called Courage, presenting a Chastity program for Same Sex Attracted persons.   Courage was personally blessed by Blessed Pope John Paul ll and Cardinal Trujillo of Family Life Office in Rome. The anger/rage reaction comes from persons portraying themselves as “Catholic” with protestations only of concern for the well being of the local Parish.
The negative reaction is surprising because of the clarity of the official Catholic thought (Catholic Catechism) which is as follows:
   A)  Under no circumstances can they (homosexual acts) be approved CCC 2333
   B)   Every sign of unjust discrimination in their regard should be avoided. CCC 2358
   C)   Homosexual persons are called to chastity  CCC 2359
   D)  Sexuality is ordered to the conjugal love of man and woman CCC2360
   E)   Sexuality by means of which man and woman  give themselves to one another through acts which are proper and exclusive to spouses is not something simply biological…….it is an integral part of the love by which man and a woman commit themselves totally to one another until death…
To ignore the Church’s teaching is surely one form of disrespect for Christ and His Church but to misquote, misinform and even calumniate is totally unacceptable. A former helper from the parish of St. Thomas Aquinas and an openly homosexual Catholic is quoted with a series of appallingly false allegations about the Church approved  movement of Courage.
He is quoted in the local newspaper with the following  allegations:
  1.   Courage people are taught that they should pray to be made “straight.”
This is utterly false. A few seconds perusal of Courage literature would enlighten him that Courage works for the attainment  of Chastity. It does not “re-make’ people psychologically. Should some one pursue heterosexual orientation possibilities, such a choice is personal and not any stated goal of Courage which seeks only the attainment of living out God’s will for living chastely. The basic human needs for friendship, intimacy and love are accomplished in chaste relationships with God’s grace and the sanity of sexual sobriety.
  2.   Courage teaches the young, confused and frightened that they are damned, i.e. going to eternal hell.

This is also false. Deep in the structure of Courage, as in the  universal Church, one finds the  palpable awareness of the Mercy of the loving God. Courage, like the Church, always speaks of the ever present welcoming by God Who yearns to offer forgiveness for any sin. Like the Church, Courage will speak of the mercy offered to the woman caught in adultery but always with the necessary and often omitted requirement of Jesus---“Sin no more..”  or don’t do it again. Renovation of sinful ways is necessary. This is quite different from saying that being homosexual by orientation sends a soul to hell. Again nowhere in Courage does one find anything even remotely resembling the charge published in the paper.

One wonders if the person quoted is simply following his own agenda. Some persons can twist facts, realities or truth attempting to harmonize their personal behavior which conflicts with universal Catholic norms. Perhaps, they do not accept the Catholic teaching as noted above that homosexual acts are sinful. If that is the case, then, they are in real trouble with conscience strictures and integrity issues. This involves moral dissonance which ultimately, under honesty, demands either submission to what The Lord teaches or personal severance from the Church whose teachings one rejects.

 Such inner confusion and turbulence is sometimes found even among clergy who struggle personally for the homeostasis of inner drives, One such sad priest whom I knew insisted that he would stay in the priesthood with the hope that he could change Church teaching from the inside. He was totally blind to the whole notion of unchanging truth. We hear constantly from the Holy Father, now Emeritus, Pope Benedict XVI, that the true modern danger is Moral Relativism, and that there is Truth beyond evolution or personal desire. There is an Absolute Truth woven into the very existence of God. Overall we are facing the creeping advance of De-constructionism which means, ultimately a world of no essences, disorientation and  an idea/emotion Tower of Babel.
   3.   The same person mentioned above claims that Courage teaches     homosexuals that they are defective.
If the accuser attended even a backwoods school of journalism, he might remember the elementary rule of “checking your sources and facts.”  Courage ( in other words reflecting the official Church teachings) teaches that  homosexual persons have a disordered  tendency which is disordered only because it  can lead to that  which is intrinsically evil, i.e. homosexual acts. Again tendency does not mean sinful any more the tendencies stemming from the Great Aboriginal Calamity, called original sin are sinful. Tendency to anger or laziness or greed or lust or envy is not sin. It is merely tendency which does need struggle, with God’s grace, for pursuing His holy Will.
Courage, then, specifically notes that the tendency in itself is not evil, nor is the person, only the behavior. Nowhere does the Church, nor Courage, say that the homosexual person is defective any more than is anyone else. For further research on this point, the accuser might consult Cardinal Ratzinger ( who later achieved an even more clarifying stature on this point) in  his Pastoral Letter to Bishops on the Pastoral Care of Homosexual Persons (PCHP).
The meaning of Courage is the same meaning as the Official Church, love of God and fellow human beings. Courage exists to help persons who wish it the support that Christ can give to open hearts. It is not suppression or discrimination Courage offers but Love. It is an offering accompanied by the Cross which some reject as impossible. When Jesus offered His own Body and Blood, some walked away murmuring  “This  is a hard saying” Jesus did not modify His Words to stem their walking.  The Eucharist is here to stay no matter how hard it is. Analogically, so is Courage.