Fathers' Helper
How the Church used psychiatry to care for—and protect—abusive priests.

By Barry Unsworth
New Yorker
June 9, 2003

In 1860, the Hartford Retreat for the Insane hired Frederick Law Olmsted to redesign the grounds of the sanitarium, which had been founded in 1824 as the nation's third mental hospital. Olmsted had presented his design for Central Park in 1858, and his views about the healing powers of nature meshed with the retreat's philosophy of providing "moral treatment" for those with mental disorders. "The enjoyment of scenery," he wrote, "employs the mind without fatigue and yet exercises it, tranquilizes it and yet enlivens it; and thus gives the effect of refreshing rest and reinvigoration of the whole system."

After the Civil War, during which Hartford had emerged as the wealthiest city in America, the retreat became a showcase for civic aspirations. Situated on a sloping greensward above the Connecticut River, its Victorian-style main building, embellished with turrets and gingerbread trim, was a Currier & Ives vision of an asylum, a place where errant behavior was tolerated rather than punished. In the twentieth century, the retreat competed with a small number of nationally known private sanitariums for patients who could afford months, sometimes years, of expensive care; prominent among them were the Menninger Clinic, then in Topeka, Kansas, and McLean Hospital, outside Boston, whose grounds were also landscaped by Olmsted.

During the Great Depression, the retreat cultivated an elite image as—in the words of its chief psychiatrist—"a combined hospital, country club, and university campus." In 1931, the board of directors changed the name to the Neuro-Psychiatric Institute of the Hartford Retreat. By 1943, the name had been changed again, to the Institute of Living. Over the years, the facilities were expanded to include private cottages, research buildings, separate club facilities for men and women, and a Tudor-style mews featuring a beauty salon, boutiques, and fashion shows. Patients had at their disposal a fleet of chauffeur-driven Packards, Lincolns, and Cadillacs. An in-house magazine, The Chatterbox, advertised "Summer at the Institute" with a Saturday Evening Post-style cover illustration showing well-coiffed patients lounging around a pool.

In 1951, the institute hired as its psychiatrist-in-chief Dr. Francis J. Braceland, one of the country's most influential leaders in the new field of "mental health." Like William Menninger, a co-founder of the Menninger Clinic (with his father, C. F. Menninger, and his brother Karl), Braceland had been prominent as a wartime military physician; he had served as the Navy's top psychiatrist, and he had also been a physician to President Roosevelt. After the war, Braceland resolved to liberate psychiatric treatment from the murkiness of Freudian psychoanalysis. Braceland, who had been a dean of the School of Medicine at Loyola University, in Chicago, and a professor at the Yale School of Medicine, set about transforming the institute's reputation as a sanitarium for the rich and famous into that of a nationally respected hospital for the seriously disturbed.

Braceland was a vigorous proselytizer on moral and cultural subjects; he characterized rock and roll as a "communicable disease," and he championed the creation of a federal agency to deal with a postwar society that he viewed as a cauldron of psychic ills. "The numbers of sick and suffering people are legion," he wrote, with a co-author, Dana L. Farnsworth, in 1969. Braceland and Farnsworth estimated that there were more than five million alcoholics in the United States, that the population also contained countless drug addicts, and that beyond the million or so citizens languishing in psychiatric wards were millions more who suffered from "crippling emotional disorders." He believed that psychiatrists, like clergymen, constituted the nation's front line against a crisis that was becoming pandemic, and he advocated a rapprochement between religion and psychiatry to combat it.

A staunch Roman Catholic, Braceland called on the nation's Catholic bishops to shed their traditional antipathy to the teachings of psychiatry and to seek medical help for troubled priests. He was named a knight by Pope Pius XII and served as president of the American Psychiatric Association in 1956 and 1957. His twin callings were the subject of two books that he and Farnsworth edited—"Faith, Reason and Modern Psychiatry" and "Psychiatry, the Clergy and Pastoral Counseling"—and he served as the key conduit between the Church and secular psychiatry throughout the fifties and sixties. By 1970, the Institute of Living had become the nation's largest private psychiatric hospital, with four hundred beds. In the early nineteen-eighties, the institute started admitting priests who had been sent by their archdioceses in the hope that they would be cured of one or more disorders, including the sexual molestation of minors.

Early last year, as the American Catholic Church was engulfed in sex-abuse scandals involving priests and children, the quiet, mutually beneficial relationship between the Church and the Institute of Living became a matter of public concern. The Church's use of psychiatry—or, more precisely, the bishops' policy of sending priests suspected of having molested minors to psychiatrists and psychologists rather than reporting them to the police—has become one of the most disturbing, and costly, elements of the scandal.

Last spring, on March 17th, the Hartford Courant reported that Cardinal Edward M. Egan, the head of the Archdiocese of New York, had, as the bishop of Bridgeport, knowingly allowed several priests accused of multiple acts of sexual abuse to continue working. The Cardinal responded with a pastoral letter to New York's two and a half million Catholics in which he denied the allegations. His policy in Bridgeport, he said, had been to require accused priests "to be sent immediately to one of the most prominent psychiatric institutions in the nation"—the Institute of Living—"for evaluation." If the conclusions were favorable, Egan said, the priest was returned to ministry; if they were not favorable, he was not allowed to continue functioning as a priest. Egan's attempt to shift the accountability for abusive priests prompted an indignant rebuttal from officials at the institute, who, in effect, accused Egan and other Church officials of bad faith. In a subsequent article in the Courant, the institute's director, Dr. Harold I. Schwartz, was quoted as saying that in "many instances" Church officials had concealed information about past complaints of abuse against priests sent to Hartford for treatment. Schwartz added that the Church had also disregarded disclaimers that the institute was unqualified to determine whether a priest, once released, was fit for parish work. "In some cases, it would appear that our evaluations have been misconstrued in order to return priests to ministry," he said.

[For the materials referenced in the previous paragraph, see Egan Protected Abusive Priests, by Elizabeth Hamilton and Eric Rich, Hartford Courant (3/17/02); Statement, by Cardinal Edward Egan (3/23/02); and Doctors: Church Used Us, by Eric Rich and Elizabeth Hamilton, Hartford Courant (3/24/02).]

In a prescient book, "Sex, Priests, and Power," published in 1995, A. W. Richard Sipe, a psychotherapist and former Catholic priest, wrote, "The current sexual crisis finds the church in an interesting double bind with the psychological sciences. Being forced to face the problem of child sexual abuse by priests, the hierarchy has been quick to run for cover under the psychiatric umbrella—'these men are sick.' '' Yet, as Sipe points out, the more that psychiatrists have investigated the problem of sexually abusive priests, the more the Church has lost control over individual cases, and the harder it has become to handle them in secrecy. "Not only will the extent of abuse of children be exposed," Sipe predicted eight years ago, "but all of the sexual activities and the mechanisms by which they are rationalized, denied, and defended will inevitably come to wider and wider public attention."

The origins of the Church's dilemma can be traced to the early Eisenhower years, when a Catholic prelate, Bishop Fulton J. Sheen, had his own TV show, "Life Is Worth Living," and men like Boston's beloved Cardinal Cushing ruled an immense "state-within-a-state," as the historian Charles R. Morris called it in his authoritative book "American Catholic." For decades, Catholic clergy with serious emotional problems had been sent automatically by bishops and their superiors to church-run asylums such as Seton Psychiatric Institute, in Baltimore, where, according to Sipe, thousands of priests were referred for treatment. Reports of abuse of minors by priests were sporadic, and the incidents were generally viewed as "lapses" brought on by excessive drinking. The Church dealt with such incidents internally, through pastoral counselling. Officially, the Church regarded psychiatry as anathema—confession without absolution. Bishop Sheen exhorted millions of TV viewers to seek forgiveness for their sins "on their knees in prayer, rather than on their back on a couch."

The Church's attitude toward Freud began to change in 1953, when St. John's University, in Collegeville, Minnesota, established an institute for mental health and invited prominent psychologists, psychiatrists, and Catholic clergymen to summer workshops. One of the forces behind the program was Francis Braceland. "Braceland was very close buddies with Cardinal Cushing," Sipe, who helped organize the summer sessions, told me recently. "In the summer of 1955, he got Cushing to fund one of our programs at St. John's. Bishops and religious superiors attended a series of workshops. I was allowed to sit in another room and listen in. They were discussing the problems of clergy."

Because of Braceland's high standing among the bishops, the Institute of Living began receiving referrals that had previously gone only to facilities with an official connection to the Church. For the bishops, whose basic teaching was "Nothing is impossible with God," the arrangement had tacit appeal. If an errant priest found it too shameful to confess to another priest, he might be induced to do so to a lay psychiatrist, who wouldn't judge him on moral grounds, and who was ethically bound not to report his actions. At the heart of confession is forgiveness: by telling the truth and showing contrition, the sinner is absolved and, presumably, goes forth determined to resist further wrongdoing. So it is with psychiatry—or so it was hoped. In the interest of forgiveness, of retaining good men who had faltered, of keeping the problem secret, most bishops made it a policy to send wayward priests to residential facilities for evaluation and treatment.

"Psychiatry and psychology were used to treat the offending cleric, contain scandal, and to placate the legal system if the cleric ran afoul of the law," Sipe wrote in a 1996 consultant's report for three cases in Dallas, including one in which the diocese was found liable for failing to supervise a priest who was running a "sex club" for teen-age boys and was ordered to pay a record hundred and twenty million dollars. "Victims and their families were usually reassured by Church authorities and subsequently ignored: 'Father is our problem and we will take care of the problem.' "

Statutes that made the sexual abuse of minors a felony had been on the books since the thirties, but it wasn't until the mid-sixties that states began to pass laws requiring that suspicions of sexual misconduct with minors be reported to authorities. By 1968, all fifty states had adopted such laws, and by 1974 the duty to report suspected sexual activity with children was covered under federal statute. Because psychiatrists and clergy were sometimes exempt from mandatory reporting, however, those who knew the extent of sexual abuse by priests reported only to one another.

In the mid-seventies, Sipe and his mentor, Dr. Leo Bartemeier, a psychiatrist and psychoanalyst, made the first attempt to quantify the extent of pedophilia among priests. According to their estimate, six per cent of the clergy had been sexually involved with minors, including both prepubescents and adolescents. (No formal study has been done on pedophilia in the general population, but experts generally agree that the figure for abuse of prepubescents is below four per cent.) Meanwhile, in 1976, two priests who belonged to a small Catholic order called the Servants of the Paraclete started a treatment center at Jemez Springs, New Mexico; its aim was to deal specifically with sexual misconduct through psychotherapy, sex education, prayer, medication to reduce sex drive, and other therapies. Bishops who faced complaints of sexual misconduct by priests sent them to the center, which returned them to their parishes several months later, usually with recommendations for a followup program of treatment and the stipulation that they not minister to minors without supervision.

In 1981, Michael Peterson, a priest and psychiatrist who had been openly gay before joining the clergy, founded St. Luke Institute, near Washington, D.C, for priests struggling with alcohol and drug addiction. Two years later, largely in response to the case of Gilbert Gauthe, a Louisiana priest who was sentenced to twenty years in prison for sexually abusing thirty-five youths, St. Luke's began counselling clergymen who had been accused of molesting children.

The Gauthe case spawned numerous lawsuits. Criminal investigations revealed that Gauthe's superiors had known of his activities for a decade before his arrest; soon after his conviction, victims' families brought suit against the diocese, and they eventually collected more than twenty million dollars in settlements. As Sipe observes, the bishops' "secret system" had abruptly been breached.

For the Institute of Living, the bishops' need for clinical cover in the face of these costly lawsuits came at an opportune time. "The eighties were a decade of ruin for the institute," a former senior staff psychiatrist told me. In 1981, he said, the institute had three hundred and eighty beds, drew patients from around the country, kept them for months, and had a six-month waiting list. By 1990, after H.M.O.s had rewritten the rules for private in-patient care throughout the Northeast and elsewhere, the institute had become a cash-strapped regional facility with a hundred and twenty beds, many of them available. Amid fears that the institute might go out of business, the board of directors aggressively expanded its programs for priests and other professionals—doctors, lawyers, judges, executives—whose care could be provided for by generous third-party payments. "With priests, of course, the pocket was bottomless," this psychiatrist recalls. "The Church would pay what it took, for as long as was necessary." He added that the treatment of troubled priests, some of whom had been accused of pedophilia, soon became one of the institute's most lucrative services, in a program called the Impaired Professional and Clergy Program of the Retreat.

The institute already employed a priest from the Hartford Archdiocese, Father John Kiely, to counsel patients in spiritual matters and conduct daily Mass. In the late eighties, it expanded its program for members of the clergy and religious orders to fifteen to twenty beds. The senior consultant to that program was Dr. James Gill, who had published and lectured widely on psychosexual issues. "Gill had a virtually unique position," Sipe told me. "Only nine Jesuits were psychiatrists at the time—Gill, I think, was the first. He had apartments in Switzerland, Boston, and San Francisco. He consulted with everybody."

After Braceland died, in 1985, Gill became the institute's chief emissary to the bishops. Last spring, I met with him in a small, sparsely furnished library on the second floor of the Braceland Building. Gill, who is seventy-seven, is bald and cherubic. Peering through rectangular bifocals and speaking in a voice of practiced patience, he seemed a throwback to the benign movie priests of the forties and fifties. I'd been told that Gill had advanced prostate cancer, but he seemed lively and alert. He told me that his role at the institute has been to interview all incoming clergy and religious and conduct special counselling sessions that "emphasized the humanity of the patient." He added, "Of course, I had a P.R. function, too. I had developed a good relationship with a lot of bishops. If I said this was a good place to send a person, most of them would take my word for it."

I asked him to describe the institute's approach to treating sexually abusive priests. "No. 1," he replied, "we do a comprehensive assessment of what's going on. Did he molest? How many times? Most are not ready for confession and find ways to deny or rationalize their behavior." He continued, "Once they acknowledge what they've done, we're very concerned about teaching them to set boundaries, to live with self-control—to be expressive in ways that aren't destructive to themselves and others. You've got some who transgress because they're immature and some who transgress because they're sick. Our job is to figure out what's immaturity and what's pathology. When you actively violate the vow of celibacy with a child, when you step over that line, we know that you have stepped into pathology."

In 1986, Bishop Robert J. Banks, an assistant to Cardinal Bernard Law, until recently the head of the Boston Archdiocese, learned that a complaint of sexual abuse had been made against Father John Geoghan, a priest in the parish of St. Julia, in the town of Weston, near Boston. Within the archdiocese, Father Geoghan's problems with pedophilia were well documented. He had been removed from four other parishes because of charges that he had molested children, and he was currently undergoing treatment by a psychiatrist chosen by the archdiocese. When the psychiatrist warned Banks to "clip the priest's wings before there is an explosion," Banks sent Geoghan for evaluation to St. Luke's, where he was diagnosed as a homosexual pedophile. Banks told Geoghan to leave the ministry, but instead the archdiocese placed him on sick leave and referred him for further treatment to the Institute of Living, where he remained for three months.

According to Geoghan's discharge summary from the institute, which was first made public in January, 2002, in the Boston Globe, he had been admitted on the basis of three separate allegations of abuse from "several years ago." It is unknown whether the 1986 complaint or others in the Church's locked files were reported to the institute, because Church and hospital officials have refused to comment on the matter. In any case, the discharge summary, which describes Geoghan's stay at the institute as "uneventful," is notable for its sympathetic tone and its reliance on Geoghan's own accounts of his past behavior. "During certain stressful, vulnerable points during his priesthood, the patient did focus on immature sexual objects," his psychiatrist, Dr. Robert Swords, wrote. "It was not a classical case of pedophilia, in that the abuse was sporadic and eventually did stop and had a playful, childlike quality to it. It was not sexually stimulating or eroticized, and it was not sadistic nor without remorse."

Geoghan saw Swords three times a week for private fifty-minute sessions, in addition to attending a thrice-weekly unit group, a twice-a-week human-development group, a clergy group, and an assertiveness group. He confessed to fondling the genitals of prepubescent boys between 1975 and 1979. However, Swords wrote, "The patient reassured us that these impulsive episodes of pedophilia were now under control and he had integrated his life in a more constructive way, since he began getting involved in psychotherapy and seeing a psychiatrist ten years ago."

Dr. Leslie Lothstein, who is director of the institute's psychology department and an internationally known expert on sexual disorders, also evaluated Geoghan. According to Swords's report, Lothstein "found the patient quite defensive and somewhat concealing, but did not feel that the patient presented any classic pedophilic symptoms, and that basically his problems centered around immaturity, intimacy, childhood deprivation and having a chronic dependent personality structure."

Geoghan's discharge diagnosis was "atypical pedophilia, in remission"—a rare ad-hoc piece of medical nomenclature. For determining treatments, psychiatrists rely on the Diagnostic and Statistical Manual of Mental Disorders, a reference book compiled by the American Psychiatric Association. DSM-III, which was published in 1980, defined pedophiles as those who seek sexual activity with children "as a repeatedly preferred or exclusive method of achieving sexual excitement." Lothstein, however, believed that a variety of factors—mainly celibacy and the idea that sexual desire for women is evil—inhibited some priests from having a "healthy acknowledgment of their heterosexual interests," which caused them to refocus their interests on boys, who could be controlled and thus were seen as safer. He has written that men who abuse prepubescents are, for the most part, incurable. At the same time, he has suggested that a sexual fixation on adolescents can be overcome through intense therapy and "rigorous" supervision and followup. In any event, Geoghan, who later admitted to abusing prepubescents as well as adolescents, left the institute with instructions for stress reduction and "leisure-skills management."

By the end of the eighties, most experts had concluded that pedophilia was virtually incurable. Still, there was general agreement about how to minimize relapses. First, the offender had to acknowledge the deviance—and harmful consequences—of his behavior. The most effective treatments were aimed at restraining both the pedophile's access to children and his ability to hide, rationalize, and deny his actions. Along with libido-inhibiting drugs and diagnostic devices like the penile plethysmograph—a device attached to the genitals that measures arousal and is often considered a "sexual lie detector," despite questions about its reliability—specialized sex-offender therapy began to include compulsory twelve-step therapy. (Many specialists now believe that the only way to insure that chronic pedophiles accept what they've done is to have their treatment adjudicated—legally mandated—so that they know that those who treat them are obligated to talk openly with law-enforcement authorities, who can hold them to account with the statements of victims and the threat of imprisonment.)

The report, for all its guardedly positive tone, stopped short of recommending that Geoghan be reassigned to parish work. A few days after receiving it, Bishop Banks wrote to Dr. Vincent Stephens, the director of the retreat program, "I am a bit disappointed and disturbed. When I met with Father Kiely, Father Gill and Dr. Swords, I was assured that it would be all right to reassign Father Geoghan to pastoral ministry and that he would not present a risk for the parishioners whom he would serve. It was on the basis of that assurance that I went forward with his assignment." (Banks had already authorized Geoghan's return to St. Julia's Parish, beginning in November, 1989.) Banks requested a clarification from the institute.

Swords complied with a placating letter whose tone was markedly more positive than that of his initial report: "Let me first say that we judge Father Geoghan to be clinically quite safe to resume his pastoral ministry after observation, evaluation and treatment here for three months. The probability that he would sexually act out again is quite low. However, we cannot guarantee that it could not re-occur. It is both reasonable and therapeutic for him to be reassigned back to his parish." He added, "The clinical decision to have him resume his pastoral ministry was ours, but the final administrative decision had to be yours." This apparently satisfied Banks, who, in a reply to Swords, called the clarification "very helpful."

A year later, Swords had a followup meeting with Geoghan at the institute, after which he wrote to Banks, "From what I could gather he continues to do well and remains psychologically fit for pastoral work in general, including children. He monitors himself well and from what he tells me has his sex drive under firm control."

In October, 1991, the Boston Archdiocese received a complaint that Geoghan had "proselytized" a ten-year-old boy at a swimming pool in Waltham, using language that seemed "open to prurient interpretation" to the Salvation Army volunteer who witnessed it. During the next three years, the archdiocese received three more complaints about him from parishioners, including one from a single mother who maintained that he had molested her four sons and made obscene phone calls to them. Church officials sent Father Geoghan to Massachusetts General Hospital for observation, and then for evaluation at St. Luke's, which has a reputation for treating abusive priests in a far less forgiving manner than the one that prevailed at the institute. Patients at St. Luke's were stripped down, hooked up to plethysmographs—"peter meters," the priests called them—and videotaped. In this atmosphere, Father Geoghan admitted to having been a pedophile since the nineteen-sixties.

On January 18, 2002, Geoghan was convicted on charges of indecent assault and battery in connection with the 1991 swimming-pool incident. In February, he was sentenced to nine to ten years in prison. After the verdict, Law explained, "However much I regret having assigned him, John Geoghan was never assigned by me to a parish without psychiatric or medical assessments indicating that such assignments were appropriate." In September, 2002, the Archdiocese of Boston settled eighty-six lawsuits against Geoghan, paying damages of ten million dollars. After Law's resignation, in December, the Boston Archdiocese threatened to seek bankruptcy protection to avoid paying claims arising from Geoghan's crimes and those of another priest, Paul R. Shanley, who was treated at the institute in 1993.

In the fall of 1989, when Cardinal Egan was the bishop of Bridgeport, he transferred a priest named Charles Carr to a new job as boys' spiritual director at Central Catholic High School in Norwalk. Prior to the appointment, a parishioner alleged that Father Carr had made sexual advances on her eleven-year-old son in 1982. Alarmed by the news of Carr's new posting, she met with Egan's aide the Reverend Laurence Bronkiewicz, a monsignor in the Bridgeport Diocese. Egan subsequently sent Carr to be evaluated at the institute, where he denied that he had abused the boy.

In late January of 1990, Dr. Howard Iger, who had succeeded Stephens as director of the retreat program and who supervised Carr's evaluation, wrote to Bronkiewicz, who was handling the matter. "It is my feeling that psychiatrists are in a particularly weak position when trying to make judgments about whether or not an individual is lying," Iger wrote. "We are certainly in a weak position when we try to make predictions about future behavior. . . . It is important that a separate administrative procedure, or internal due process procedure, be established within an organization to deal with concerns about aberrant behavior."

Despite Iger's warnings and disclaimers, Carr was returned to his job at Central Catholic. When Bronkiewicz received another complaint, from a man who said that Carr had fondled his eleven-year-old son in 1981, Egan sent Carr back to the institute for treatment. Again, Iger was asked to advise the diocese about how to handle the accusation. In a long, confidential letter that is included in sealed court records obtained by the Courant, Iger reiterated his view of the retreat's role. " Although this further report does increase the likelihood that Fr. Carr has, in fact, acted in a sexually inappropriate manner in the past," Iger wrote, it was up to the diocese alone to decide what to do with him. "I believe that it is necessary for you to take some administrative action to protect both Fr. Carr and the public from the possibility of lapses in his judgment and behavior in the future." Iger urged Church officials to confront Carr with their concerns about his ability "to honestly acknowledge" past actions, and to consider transferring him someplace away from children. (Carr consistently denied the accusations against him.)

Egan followed Iger's advice, in part. He allowed Carr to return to Central Catholic, but barred him from activities that involved children. Five years later, in March of 1995, the first lawsuit against the diocese in connection with Carr's alleged abuses was filed in court.

A decade of post-Gauthe lawsuits challenged the Church to review its policy of sending sexually abusive priests for counselling rather than to the police. In 1993, persistent news accounts about James Porter, a former priest accused of raping and molesting at least a hundred children in several states, including Massachusetts, forced Cardinal Law to admit publicly what he called "the sin of sexual abuse" among priests. The following May, Law invited several nationally known lay experts on sexual abuse to lunch at his residence to discuss what to do in the event of further sexual revelations involving priests. "We told them that the way they had handled these cases was wrong and was endangering children," Carolyn Newberger, a psychologist and former research director of the family-development program at Boston's Children's Hospital, recalled last year. "We stressed the importance of reporting these cases to the civil authorities. And we told them that, no matter what they thought about priests having been cured or having put these problems behind them, there was a strong likelihood of a repeat of this behavior." In 1995, the Servants of the Paraclete's treatment center in Jemez Springs was closed down, after it became mired in sexual-abuse lawsuits against priests who had been treated there.

In this climate, Church officials began quietly to reassess their relationship with the Institute of Living. In April of 1996, the Reverend Brian M. Flatley, an assistant to Cardinal Law, attached a memo to Geoghan's file after Geoghan refused to return to St. Luke's for further treatment, asking instead for permission to reenter the institute's retreat program: "Father Geoghan feels that he was treated much more professionally at the Institute of Living. . . . I do not have confidence in the institute ."

In 1992, the institute's role in the evaluation and treatment of troubled priests was reduced to that of an outpatient program, and in 1994 it became a subsidiary of Hartford Hospital. Nonetheless, the pedophilia scandal has undermined what had once been a solid marriage of convenience. When I asked Dr. Harold Schwartz, the current director of the institute, to comment on the Church's charge that the retreat's doctors had been too optimistic in their reports, he expressed indignation "that the Church would point its finger at us to deflect attention from its own culpability."

And, as Iger realized during the Carr case, both partners were hobbled in their ability to make accurate judgments. "You had to know what you didn't know in order to know if you had incomplete information," he told me recently at his office in Hartford. "And, of course, the Church didn't have a proper investigative arm. They haven't had one since the Inquisition."

Last June, I sat in the near-empty gallery of a courtroom in Norwich, Connecticut, at a pretrial hearing in one of the hundreds of civil cases that involve priests accused of pedophilia. The plaintiff, a male nurse living in New York—he was identified only as "John Doe"—had brought suit against a former priest named Richard T. Buongirno, charging that the priest had molested him when he was nine years old, in 1987, and again as a teen-ager. In 1994, the Norwich Diocese sent Buongirno to the Institute of Living for treatment after he admitted to having had sex with a sixteen-year-old boy when he was a seminarian, in the early seventies. The plaintiff's lawyer, Robert I. Reardon, Jr., argued that by failing to report the earlier offense against his client, the diocese had skewed a psychiatric evaluation at the institute, thus enabling Buongirno to return to his position and continue abusing the plaintiff.

Reardon, a successful personal-injury lawyer, had made a blanket request for the names of all the priests the institute had ever treated for sexual misconduct, along with any "contracts, agreements, memorandums of understanding, policies, procedures, correspondence, memos, notes or other documents" regarding them. The judge allowed into evidence just one heavily abridged record of correspondence between the institute and an unnamed diocese. A few weeks later, Reardon argued several more motions to uncover the diocese's relationship with the hospital, and this time the judge was more agreeable, permitting him to depose Dr. Lothstein. "Nothing particular to the treatment of Father Buongirno," he said, "but you're free to inquire about the professionals program."

For the Institute of Living, which guards its long tradition of discretion so rigorously that it refuses to make public the names of patients admitted nearly two centuries ago for "religious terror," "fanatical insanity," or "metaphysical hairsplitting," the judge's ruling constitutes a devastating invasion of medical privacy. In September, after denying the Church's attempts to have the suit dropped, Judge Ian McLachlan ordered all sides to consult with a federal mediator. In March of this year, the parties settled, with the Diocese of Norwich and Buongirno agreeing to pay three hundred and fifty thousand dollars each. Neither the priest nor the diocese admitted wrongdoing.

Last spring, the institute took steps to distance itself from the Church by responding to potential clients with a form that requires them to reveal "the full facts and circumstances" leading to a referral, including all prior complaints, disciplinary actions, treatment records, and criminal and civil allegations. "Since then," Dr. Schwartz told me, "we've had very few inquiries" from the Church. Looking back, he acknowledged that as long as the goals of psychiatric treatment were intertwined with the Church's determination to return priests to duty, the system was severely flawed. However, what is required, he said, is not greater scrutiny of psychiatric methods but greater outside regulation of the Church—the sort of monitoring that governs teachers, social workers, doctors, day-care providers, and child psychologists and which the Church has historically resisted. "It gets down to the issue of how the Church conducts itself within the larger society," Schwartz said. "We're talking about something a lot bigger than psychiatry."


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