567325

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JMHXXX10.1177/1557988314567325American Journal of Men’s HealthIsacco et al.

Article
American Journal of Men’s Health

How Religious Beliefs and Practices

2016, Vol. 10(4) 325­–337
© The Author(s) 2015
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DOI: 10.1177/1557988314567325

Catholic Priests ajmh.sagepub.com

Anthony Isacco, PhD1, Ethan Sahker, MA2, Elizabeth Krinock, MSCP3,

Wonjin Sim, PhD1, and Deanna Hamilton, PhD1

Abstract
Roman Catholic diocesan priests are a subgroup of men with unique religious and spiritual roles, beliefs, and practices.
This qualitative study of 15 priests from the mid-Atlantic area of the United States focused on how priests’ relationship
with God and promises of celibacy and obedience influenced their psychological health. Using a consensual qualitative
research (CQR) design, the analysis revealed that participants described their relationship with God as central to their
health and contributing to positive outcomes (e.g., sense of connection and support). The influence of their promises
of celibacy and obedience were linked to both positive outcomes (e.g., decreased stress, improved relationships)
and negative outcomes (e.g., internal conflict, depression/loneliness). This study highlighted the central role that
priests’ relationship with God has on positive psychological health. Future research is necessary to understand how to
maximize the positive effects and minimize the negative effects of priests’ promises of celibacy and obedience, which
would benefit programs aimed at supporting priests’ psychological health.

Keywords
priests, clergy, relationship with God, religion/spirituality, obedience, celibacy

Roman Catholic diocesan priests represent a group of
men fulfilling a religious and spiritual ministry. The role,
function, and ministry of Roman Catholic priests (short-
ened to priests for remainder of the manuscript) is consid-
ered a calling from God that is expressed through service
to others, sacramental duties, and overseeing the admin-
istration of parishes (i.e., organized, geographically-
based faith communities; Hankle, 2010). The
psychological health of priests received little attention
until the international sexual abuse scandal was uncov-
ered in 2002. Since 2002, much of the health-related
scholarship about priests across disciplines such as psy-
chology and psychiatry has focused on identifying and
preventing clergy sexual abuse of minors (e.g., Plante,
2003). Such empirical, policy, and treatment efforts are
needed, warranted, and must be continued to overcome
the terrible damage of the sexual abuse scandal.
The enormity of the sexual abuse scandal and the
widespread media coverage may have created some mis-
conceptions about priests that could negatively bias
health professionals’ treatment of priests (Plante &
Daniels, 2004). For example, one myth that has devel-
oped is that all priests are likely to be pedophiles despite
recent statistics indicating that 2%–4% of priests are sex-
ual offenders of minors (John Jay College Research
Team, 2011). Few empirical studies have been conducted
in the health sciences that address salient aspects of psy-
chological health with a sample of priests that is more
representative of the majority, non–sexual-offending
priest population (Rossetti, 2009). Priests are faced with
several challenges that have increased the importance of
examining and addressing their psychological health.
There are currently 38,275 priests in the United States
compared to 58,632 in 1965, and 49,054 as recently as
1995 (Center for Applied Research in the Apostolate,
2014). Priests are often expected to take on more respon-
sibilities and live alone as a result of the dwindling num-
bers. Basic workplace research has consistently indicated
that increased workloads and decreased supports are cor-
related with negative psychological outcomes such as
burnout (Maslach, Schaufeli, & Leiter, 2001).
1
Counseling Psychology Programs, Chatham University, Pittsburgh,
PA, USA
2
Counseling Psychology Program, University of Iowa, Iowa City, IA,
USA
3
Chatham University, Pittsburgh, PA, USA
Corresponding Author:
Anthony Isacco, Counseling Psychology Programs, Chatham
University, Woodland Road, Pittsburgh, PA 15232, USA.
Emil: aisacco@chatham.edu

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326 American Journal of Men’s Health 10(4)
Indeed, some evidence of burnout and role stress has
been reported in international samples of priests and
related samples of parish-based clergy (Doolittle, 2007;
Raj & Dean, 2005). In addition to burnout, some research
has reported that priests have high levels of depression,
perhaps seven times the rate of the general population
(Knox, Virginia, Thull, & Lombardo, 2005). In addition
to depression, Knox, Virginia, and Smith (2007) discov-
ered evidence of obsessive compulsion, interpersonal
sensitivity, and psychoticism among a sample of U.S.
Catholic priests. Qualitative and quantitative research
has identified that priests experience some common
occupational stressors (e.g., time pressure) as well as
unique stressors such as unusually high self-expectations
and chronic loneliness (Hoge, Shields, & Soroka, 1993;
Isacco et al., 2014). The extant literature on priests’ psy-
chological health is inconclusive, with research also
finding positive outcomes in various samples of Catholic
priests. For example, some research reported that
Catholic priests (as well as brothers and nuns) experi-
enced less vocational strain and more community sup-
port than Protestant ministers (Weaver, Flannelly,
Larson, Stapleton, & Koenig, 2002). Rossetti (2011)
indicated that about 6.3% of the priests in his sample
(n = 2,482) met clinical criteria for a psychological dis-
order (likely depression and/or anxiety), 11% of the sam-
ple endorsed emotional exhaustion (a component of
burnout), and 1.5%–2.3% were reported to be “highly
burnt out”—all of which were lower than a community
sample of men.
Given the religious and spiritual roles, activities, call-
ing, and nature of the priesthood, it makes sense to inves-
tigate priests’ psychological health in relation to their
religious beliefs and practices. However, some studies of
priests’ psychological health have not accounted for their
religious/spiritual experiences, resulting in the absence of
a key factor to their psychological health (e.g., Zickar,
Balzer, Aziz, & Wryobeck, 2008). Aspects of religiosity
and spirituality (R/S) are increasingly being identified as
a pathway toward health and well-being, especially as a
positive coping mechanism and source of support for
men (Garfield, Isacco, & Sahker, 2013). Therefore, any
examination of priests’ psychological health would ben-
efit from accounting for religious and spiritual factors.
This study aimed at understanding how priests describe
their religious beliefs (relationship with God) and prac-
tices (adherence to promises to be celibate and obedient)
as influencing their psychological health.
The Psychological Health of Priests:
The Role of Religious Beliefs and
Practices
Religiosity and spirituality (R/S) is general phrasing, but
the scientific study of R/S in health sciences is composed
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of specific constructs that measure religious practices
(e.g., attending religious services, reading religious
books, praying), religious beliefs (e.g., belief in God or
higher power), and religious attitudes (e.g., importance of
faith in one’s life) among many other constructs, theories,
and variables (e.g., Miller & Thoresen, 2003). R/S expe-
riences have increasingly been studied in health profes-
sions such as medicine and counseling (e.g., Flannelly,
Galek, Ellison, & Koenig, 2010; Worthington & Aten,
2009). The increased attention to R/S factors in the health
professions can be attributed to a growing awareness that
R/S is important to many patients, evidence of new links
to positive health outcomes, and increased importance
placed on health practitioners to enhance their multicul-
tural competence such as attending to and being respect-
ful of their patient’s R/S beliefs and practices (e.g.,
Koenig, 2009; Powell, Shahabi, & Thoresen, 2003).
However, the scientific data is still inconclusive as R/S
constructs have been correlated to both positive and neg-
ative health outcomes in various studies and debates
among scholars persist (e.g., Moreira-Almeida, Neto, &
Koenig, 2006).
The extant literature with priests has not identified a
single R/S construct that is most salient to their psycho-
logical health, but a cluster of constructs has begun to
emerge. Rossetti and Rhoades (2013) conducted a study
with 2,482 Catholic priests and reported that clergy are
less likely to become burned out than people in other
occupations; a strong relationship with God and inner
peace were two factors that were negatively correlated
with burnout. Using the same sample of 2,482 priests in a
different analysis, relationship with God was identified to
be the second highest factor (out of list of 22 possible fac-
tors) related to priests’ happiness (Rossetti, 2011). In a
study with a similar sample, 2,000 Anglican clergy in
England, more positive attitudes about prayer were corre-
lated with decreased instances of burnout (Turton &
Francis, 2007). A smaller, qualitative study reported that
Catholic priests in the United States emphasized the
importance of prayer for their mental health, and their
suggestion to have spiritual activity incorporated into
counseling with priests (Isacco et al., 2014). Other studies
have indicated that religious and spiritual constructs can
have a negative effect or no effect on priest psychological
health. For example, a study of Catholic priests in India
reported that involvement in spiritual activities was not
correlated with reduced burnout and depression, although
this finding may be accounted for by a lack of a strong
measure of spiritual activities (Raj & Dean, 2005). The
latter point raises the important issue of how difficult it
has been for researchers to operationalize and measure
complex religious and spiritual experiences, which sug-
gests that qualitative inquiry may be helpful to examining
such experiences among priests. Qualitative methodology
is well-positioned and designed to investigate complex
Isacco et al. 327
and hard-to-measure phenomena, using the participants’
own words without having to respond to forced-choice
survey items for a specific variable (Hill, Thompson, &
Nutt-Williams, 1997). Using qualitative methodology,
our primary research question was broad and open-ended:
What faith beliefs or spiritual practices of priests influ-
ence their psychological health?
Priestly Promises, Lifestyle Expectations, and
Psychological Health
Although no single R/S factor emerged from the extant
literature as most salient to priest psychological health,
this study specifically examined the priestly promises of
celibacy and obedience. Roman Catholic diocesan priests
(who are participants in this study) make two promises
once they are ordained. Diocesan priests are ordained to a
particular diocese and work in a parish, but do not take
vows (e.g., poverty). Comparatively, religious priests are
ordained, live in a community with other religious priests,
and take vows of poverty, celibacy, and obedience. First,
diocesan priests promise to live a celibate, chaste life that
is prohibitive of marriage and sexual behavior in order to
facilitate priests’ full devotion of service to the Church.
Second, diocesan priests promise to be obedient to the
local bishop in such ways as acceptance of particular
Church teachings and in practical matters of being trans-
ferred to a new parish. The promises of celibacy and obe-
dience for diocesan priests are based in a spirituality and
theology within the Catholic faith tradition. It is beyond
the scope of this article to review the theological basis of
the promises; rather, the focus is an investigation of how
celibacy and obedience may influence priests’ psycho-
logical health.
Much has been written and debated about the role of
celibacy in the Catholic priesthood (e.g., Farrell, 2009).
Recently, Pope Francis made newsworthy comments
about celibacy, which suggested that he may welcome
discussion about mandatory celibacy for priests. Celibacy
has been identified as a contributor to the declining num-
ber of priests in the United States (Conway, 2001). In the
aftermath of the sexual abuse crisis, celibacy was investi-
gated as a possible cause to sexual misconduct by priests
(Adams, 2003). However, there seems to be agreement
among some scholars that celibacy per se is not a cause of
priests becoming sexual offenders of minors (e.g., Doyle,
2006; John Jay College Research Team, 2011; Plante &
Daniels, 2004). Yet, Doyle (2006) argued that celibacy
can be related to a misguided sense of superiority and
psychosexual immaturity among some priests, which can
be linked to sexual misconduct and offenses of minors.
Of the few empirical investigations of celibacy in the
health sciences literature, a more positive trend of find-
ings has emerged. In a sample of 511 Catholic priests in
South India, commitment to celibacy was related to a
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decrease in burnout (emotional exhaustion and deperson-
alization) and positively related to personal accomplish-
ment and positive work-related engagement (Joseph,
Corveleyn, Luyten, & De Witte, 2010). Rossetti (2011,
p. 106) reported that most priests in his study considered
celibacy to be “a personal grace,” a part of their calling
and that their high commitment to celibacy was signifi-
cantly related to their perceived happiness.
Priests make a promise of obedience to the authority
of the Catholic Church when they are ordained. The local
bishop in the diocese represents the authority of the
Catholic Church. Thus, most health science research
about obedience is not about the promise per se but the
priests’ relationship with their bishop. An earlier study
(Hoge, Shields, & Soroka, 1993) indicated that priests
experienced intense stress from closed and aloof commu-
nication patterns with their superior. In a quantitative
study with 190 U.S. priests, support from the bishop was
a nonsignificant factor related to stress, while priests in
this study benefited more from support from parishioners
and fellow priests (Zickar, Balzer, Aziz, & Wryobeck,
2008). Trust in their relationship with the bishop may
play a role in how much stress priests experience due to
obedience. In a qualitative study with 22 priests, most
participants reported that they lost faith in their bishop
after the sexual abuse scandal surfaced as well as other
negative feelings such as betrayal because some priests
felt that bishops were not acting in their best interests
(Kane, 2008b). Distrust of bishops was reported by a few
priests in a qualitative study about mental health help-
seeking, while other priests in the same study reported
that their bishop encouraged them to seek mental health
services (Isacco et al., 2014). Given the mixed and often
individualized findings between the promises and priests’
psychological health, our second research question asked,
how do the promises of celibacy and obedience affect the
psychological health of priests?
Method
The study used consensual qualitative research (CQR) as
the overarching research methodology (Hill et al., 1997).
CQR is a qualitative methodology that is well suited to
answer open-ended research questions about hard-to-
measure phenomena with understudied populations from
a postpositivistic philosophy (Hill et al.). The specific
application of CQR is noted throughout the Method
subsections.
Participants
Participants consisted of 15 Roman Catholic priests, from
a Mid-Atlantic city of the United States, which is at the
upper end of CQR’s suggested range of 8–15 participants
(Hill et al., 1997). All of the priests were White; age
328 American Journal of Men’s Health 10(4)
ranged from 29 to 76 (M = 47), with a range of years in
the priesthood from less than 6 months to 50 years (M =
16.2 years). Nine participants were pastors, 5 were paro-
chial vicars (i.e., assistant priests to the pastor), and 1 par-
ticipant did not report his role. Participants primarily
worked in a parish (n = 13). Some participants served in
multiple roles such as overseeing two parishes simultane-
ously (n = 3), at a parish and school simultaneously (n =
2), and having multiple duties outside a parish (n = 1;
specific duties were not reported to protect the identity of
the participant).
Procedure
Collecting data from priests is a difficult task because of
Catholic Church oversight, skepticism with research, and
the sexual abuse scandal (e.g., Kane, 2008a). Snowball
sampling methodology was used to recruit participants
because it is an effective method to use with targeted
sampling populations and difficult-to-recruit populations
such as priests (Kappler, Hancock, & Plante, 2012;
Sadler, Lee, Lim, & Fullerton, 2010). Snowball sampling
is not incompatible with CQR; CQR places a high empha-
sis on recruiting participants that can speak articulately
about the topics and recognizes that qualitative studies
are often based on nonrandom samples (Hill et al., 1997).
This study was approved by Chatham University’s
Institutional Review Board.
The study utilized a priest as a consultant throughout
several stages of the research process, including data col-
lection. The first snowball-sampling step entailed con-
tacting two priests suggested by the consultant. The study
was described over the phone to the two priests and ver-
bal consent was obtained. After they verbally agreed to
participate, an in-person interview was scheduled over
the phone. Written informed consent was provided in-
person, through a document that was signed by the par-
ticipant and primary investigator. At the conclusion of the
interview, participants were asked if they knew other
priests willing to participate in the study. Participants
listed and provided contact information for two or three
priests. This process was repeated until data saturation
was achieved (Hill et al., 1997). One priest retired before
the interview could take place, 2 priests scheduled inter-
views but backed out, 2 declined upon initial contact, 6
received messages but did not call back, and 14 others
were recommended but not contacted because of data
saturation.
All 15 interviews were conducted in-person and were
audio-recorded for transcription purposes. The interviews
were transcribed for analysis by the research team.
Transcribed data was assigned a numerical value and
identifying information (e.g., name, name of parish,
unique roles) was omitted to protect participant
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confidentiality as much as possible. Participants were
informed that their responses would be presented in
aggregate form, with limited identifying information to
maintain their confidentiality. Participants were asked for
contact information in order to provide them with results
and for follow-up interviews, if needed for more informa-
tion and/or to clarify responses. Follow-up interviews
were conducted by phone with 11 participants. The fol-
low-up response rate was 85%; 1 participant did not
respond and 1 participant retired in the interim and could
not be located. All participants were mailed a debriefing
letter detailing the study’s questions, findings, and pri-
mary products (e.g., academic presentations and papers).
Measure
Qualitative data were gathered through a semistructured
interview, which was developed through a thorough
review of the literature and input from the study’s consul-
tant (Hill et al., 1997). First, an initial pilot interview was
created using the extant literature. The interview was
given to the consultant and three expert reviewers for
feedback. The interview was revised four times based on
their feedback. The completed interview included 22
open-ended questions designed to be 60–90 minutes. The
present study is part of a larger project examining priest
health and well-being; the questions most relevant to this
study were as follows: (a) What faith beliefs and/or spiri-
tual practices of yours most influence your mental and
physical health? (b) Catholic priests take promises of
celibacy and obedience. How do those promises affect
your health and well-being? (c) In what ways do priests
engage in self-care? (d) What contributes to burnout
among priests? (e) How can burnout be prevented? (f)
What do you think your strengths are that help you be a
priest? and (g) How do you cope with stress?
Research Team
CQR requires the use of a diverse research team to collect
and code the data. The primary research team consisted
of eight members. The primary investigator is a 34-year-
old White, Catholic man with a PhD in counseling psy-
chology; he was an interviewer, data analyst, and
coauthor. The other researchers were a 33-year-old White,
atheist man and counseling psychology PhD student
(interviewer, data analyst, and coauthor), a 61-year-old
White woman with a PhD in clinical psychology with a
Christian background but currently religiously unaffili-
ated despite involvement in religious/spiritual activities
(data analyst); a 40-year-old White Catholic woman with
a PhD in clinical psychology (data analyst and coauthor);
a 28-year-old White Christian woman with an MS in
counseling psychology (interviewer and data analyst); a
Isacco et al. 329
36-year-old White Catholic woman with an MS in coun-
seling psychology (interviewer and data analyst); and a
23-year-old White Catholic woman with an MS in coun-
seling psychology (coauthor). The auditor (and coauthor)
is a 34-year-old Asian Catholic woman with a PhD in
counseling psychology. All had extensive training in
CQR methodology. For example, interviewers were
trained in interviewing competences such as asking open-
ended questions, probing, and remaining nonjudgmental
(Hill et al., 1997).
Biases and expectations. CQR suggests that researchers
discuss biases and expectations prior to coding the data
and throughout the research process to ensure the highest
level of objectivity (Hill et al., 1997). Biases and expecta-
tions are personal experiences and beliefs about the
study’s topic that may affect objective data analysis.
Research meetings were initially devoted to discussing
biases and expectations and to equalizing power dynam-
ics between student and faculty researchers. Biases were
focused on differing views of the Catholic Church and
religious experiences, as the researchers are six Catho-
lics, two Protestants, and one atheist. Biases consisted of
(a) negative associations with the Catholic Church (e.g.,
sexual misconduct, hierarchical power and control, rules
and regulations) and (b) positive associations with the
Catholic Church (e.g., spiritual strengths of priests, sup-
ports of priesthood). More specific to religious beliefs
and practices, biases and expectations consisted of (a) an
understanding of a relationship with God that was more
“top down,” simple, and one-sided; (b) belief that a rela-
tionship with God is bidirectional and similar to compan-
ionship and friendship; (c) an expectation that priests
would not talk negatively about hierarchical issues related
to obedience; and (d) a nonbelief in God.
Qualitative Data Analysis Using CQR
Developing domains.  A domain is a broad topic area used
to code large sections of the interview. First, the research
team constructed a domain list based on the prior litera-
ture review, interview questions, and an initial reading of
interviews. Analysis began with each team member cod-
ing domains from the list separately. Team members read
transcripts individually, selected sections of participant
responses, and coded them with existing domains or con-
structed new domains. The team members met to achieve
consensus of the domain coding. Team members rotated
initiating the discussion for each domain and the remain-
ing members agreed or disagreed. Team members stated
their case until consensus was achieved. The consensus
process was continued until a unanimous agreement was
reached for every domain. After the team had gone
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through the first 2 transcripts, additional domains
emerged and the early transcripts were recoded for all
newly emergent domains in a recursive process (i.e., the
constant comparative method). For example, one of the
main domains explored in this study, priests’ relationship
with God, was not on the initial domain list but emerged
in the interview narratives. Each coded interview was
sent to an external auditor and was returned with feed-
back. The auditor provides an objective check of the cod-
ing. The team met to review the auditor’s feedback and
informed the auditor of changes made in response to the
feedback.
Constructing core ideas.  A core idea is a concise and com-
prehensive summary of participants’ words within a
domain. Core ideas provided specific information about
priests’ relationship with God (e.g., health outcomes).
Team members would select smaller sections within
domains and code them as separate core ideas. For exam-
ple, one “relationship with God” domain code may have
a core idea addressing how speaking with God during
prayer reduces their anxiety. After the team completed
coding for core ideas of a few cases and all team mem-
bers had a solid understanding of the coding process, a
modified approach to CQR was used by splitting the team
into two smaller groups and coding for domains and core
ideas simultaneously (Thompson, Vivino, & Hill, 2012).
Team members continued to meet to discuss their indi-
vidual coding of domains and core ideas and to reach a
consensus. The coded transcripts were sent to the auditor
and returned with feedback for both the domains and the
core ideas.
Conducting a cross-analysis.  Group members reviewed all
coded transcripts and developed categories that emerged
from the domains and core ideas across all of the partici-
pants. A cross-analysis is meant to be a higher level of
data abstraction by finding representativeness of catego-
ries in the entire sample (Hill et al., 1997). Team mem-
bers independently developed a coding matrix that
described an in-depth construction of categories and sub-
categories. Categories are developed to describe common
core ideas across participants. For example, participants
described how celibacy affected their psychological
health in positive and negative ways. Positive and nega-
tive effects of celibacy represented two categories and the
specific positive and negative effects of celibacy on their
psychological health emerged as the subcategories under-
neath the two broader categories. The final consensus of
the cross-analysis was sent to the auditor for feedback;
corrections were made in response to feedback. Frequen-
cies of categories and subcategories were calculated and
reported.
330 American Journal of Men’s Health 10(4)
Unique Negative Health Effects
- Internal conflict
- Disrupts relationships
Promise of
Obedience
Figure 1.  Dynamic relationship with god and religious promises: Priest psychological health.
Results
Descriptions of Priests’ Relationship With God
The semistructured interview asked participants to reflect
on what influenced their health and well-being. Please
see Figure 1 for an overview of the findings. Throughout
the interview process and in response to different ques-
tions, 13 priests (86%) emphasized the importance of
their relationship with God to their health and used sev-
eral active descriptors of their relationship. The partici-
pants’ descriptions of their relationship with God were
coded into the following categories: (a) bidirectional/
mutual, interactive; (b) personal, intimate, and unitive;
(c) central/foundational to their lives; and (d) fluid, not
static. The categories are described in more detail below.
As is the case throughout the results section, the percent-
ages provided indicate the number of participants who
reported the theme out of 15. The same priest may be
totaled into multiple themes, resulting in percentages
above 100%. Pseudonyms were used to protect the iden-
tity of the participants while still providing a personal
perspective to representative quotes.
Relationship with God is mutually beneficial and interac-
tive. Eight (53%) participants indicated that their rela-
tionship with God is mutually beneficial and interactive
with bidirectional communication. Their relationship
entails distinct roles that facilitate mutual benefits; God’s
role is to be there and to handle “the big stuff” for the
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Unique Positive Health Effects
- Increases Support
- Decreases negative emotions
- Transforms/empowers
- Enables authenticity
- Creates balance
Dynamic
Unique Negative Health Effects
Relationship
with God - Biological desires
- Depression/loneliness
Shared Positive Health Effects
Promise of
- Increases positive emotions
- Decreases stress Celibacy
- Strengthens relationships and
connection
Unique Positive Health Effects
- Increases focus on vocation
priest and the priest’s role is to be God’s instrument in the
world. Father Henry, a middle-aged priest, stated,
In a prayerful relationship, you hear God saying, “I need
you. I need your hands to continue to bless. I need your lips
to continue to proclaim the gospel and speak the truth. I need
your ears to listen and to absolve sins.” If I did the best I
could possibly do, then that gives praise and glory to God
because I used what he has given me in the best way.
Father Robert, a 41-year-old priest, reported, “I’m the
instrument. I’m trying to do my best and follow him to
see where the results go. He’s got the whole world in his
hands and I have to trust him.”
Relationship with God is unitive.  Eight (53%) participants
reported that their relationship with God is unitive, which
provided a sense of companionship with God and reli-
ance on God during difficult times. Father Jim, an older
priest close to retirement, shared,
I find a sense of peace and calm because I know God is here
and I’m not alone with this [difficulty] or any kind of
situation. Sometimes you walk in to a hospital room, you
don’t know what you’re going to. . . . It’s the thought of
“God be with me.” I’m not alone here.
Father Charlie, a 37-year-old priest, stated, “I’m united
with Christ. It proves I’m His beloved. It is a great com-
fort and allows me to be more hopeful.”
Isacco et al. 331
Relationship with God is central/ foundational.  Four (26%)
participants shared that their relationship with God is
central or foundational in their lives. Their lives grow
around their relationship and communication through
prayer with God. Father Robert, a middle-aged priest,
stated, “It’s just that central focus on Christ, is the main
function, the main faith belief that supports me and I
know he’s with me in whatever I say and do and he’s
always here.”
Relationship with God is fluid. Four (26%) participants
indicated that their relationship with God is fluid because
it continues to change, deepen, and grow rather than
remaining static. Father Charlie, a priest in his thirties,
reported, “I think the answer is a relationship that the
priest has with Christ has to keep deepening. Because I
don’t think any of those things are static.”
Dynamic Relationship With God and
Psychological Health
Of the 15 participants, 13 priests (86%) discussed the
importance of a dynamic relationship with God to their psy-
chological health. Seven psychological health benefits were
linked to their dynamic relationship with God: (a) provides
a sense of connectedness and support, (b) decreases nega-
tive emotions, (c) increases positive emotions, (d) trans-
forms and/or empowers, (e) helps develop strengths, (f)
enables authenticity, and (g) creates a balance.
Provides a sense of connectedness and support.  Eight (53%)
participants indicated that a relationship with God led to
a feeling of connectedness or support. Father Jim
described the importance of this connection as,
I need to be connected with God because you see people so
overwhelmed with life’s problems. Not that spirituality is
going to solve all these problems, but realizing you’re not
alone is helpful. How’s it going to come out? I don’t know. I
don’t worry about the outcome, because God’s there
somewhere and it’s going to be okay.
Father Stew, a 48-year-old priest, shared, “By being able
to have prayer and talk to God, priests have a support
system. They are not alone.”
Decreases negative emotions / Increases positive emo-
tions.  Seven (46%) participants said that their relation-
ship with God helped to decrease negative emotions
(stress, anxiety, pressure, loneliness, burnout) that they
were experiencing and increase positive emotions (com-
fort, peace, joy, hope, and optimism). Father Henry stated,
I think to one degree or another, you know, in celibacy,
you’re going to feel loneliness. But that’s the time in a
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special way to enter into prayer and a deeper relationship
with Christ and you say yes to the call. You recommit to that
call and that lifts you up.
Transforms and empowers / Helps develop strengths. Four
participants (26%) discussed that a relationship with God
transforms them or empowers them to be a better person
and that it helps them to develop strengths such as being
more “like Christ.” Father Charlie made a comparison
between praying to God and choosing good influences in
friends:
The prayer life transforms us and unites us with Christ and
enters us into this relationship. How do we love someone we
don’t really know? It brings us into this union with Christ
and we become more like Christ because you become who
you’re hanging out with.
Father Jim, a 68-year-old priest nearing retirement, stated,
“I need to know that God is with me. This empowers me.”
Enables authenticity. Two participants (13%) discussed
that their relationship with God enables authenticity. In
other words, they feel true in themselves and do not feel
concerned with the thoughts or perceptions others may
have of them. Father Charlie said, “And that’s why prayer
is so important. If you pray enough, if you stop enough
and just spend some time with Him, you’re not gonna get
caught up in who you’re supposed to be. Because what-
ever it is, you’re His beloved, you’re ok.” The relation-
ship with God provides a sense of security for priests. The
ability to feel unconditional love allows the priests to be
self-confident.
Creates a balance. The final theme discussed by two
(13%) participants was that a dynamic relationship with
God creates a balance in their lives by providing a time to
share, a time to relax, and a time to recharge. Father Bran-
don, a pastor with many years in the priesthood, explained,
I know that if I don’t participate in it or if I start to slack I
notice it in other areas of my life. I notice it in my personal
well-being, in my attitude and my moods. That’s something
I can’t explain concretely. Because again that’s all part of the
balance that you have to have in your life. It has to be part of
that mix and if you don’t do it, then life starts to get
unbalanced and it’s like watching a three-legged dog trying
to run.
How the Promises of Celibacy and Obedience
Influence Psychological Health
Participants were asked during the semistructured inter-
view, “Catholic priests take promises of celibacy and
obedience. How do these promises affect your health and
well-being?” The responses were mixed and, thus,
332 American Journal of Men’s Health 10(4)
categorized into positive and negative effects for both
promises with specific subcategories that provide depth
to their responses.
Obedience positively affects health and well-being. Nine
(60%) participants indicated that the promise of obedi-
ence positively affects their health and well-being by (a)
increasing positive feelings, (b) strengthening the rela-
tionships with God and/or the church, and (c) decreasing
the stress of daily life and providing a sense of stability.
Increases positive feelings.  Six participants (40%) cited
positive feelings associated with their promise of obedi-
ence such as happiness, freedom, and a sense of fulfill-
ment. Father Michael, a middle-aged priest, stated,
The right objective obedience is freeing, it frees you, because
you’re doing something the bishop wants you to do to build
up the local church. So when you know you’re doing that
you’re doing it because of the will of the Church in general.
Strengthens relationships with God and the church. Three
participants (20%) shared that the promise of obedience
strengthens their relationships with God and the church
when trust has been established. Father Henry reported,
“I don’t think it’s a blind obedience. You’re working in
conjunction with your bishop, and obedience could be
and should be a dialogue.”
Decreases stress of daily life / Provides stability. Three
(20%) participants reported that the promise of obedience
decreases the stress of daily life and provides a sense of
stability because some big decisions are made for them.
Father Richard, a relatively younger, newly ordained
priest, stated, “The promise of obedience is good for the
health because you don’t have to worry so much. I’m
obedient. It’s up to the Bishop in the end.” Father Stew
added, “Obedience provides a sense of stability because
we know those who are in charge of us know what they
are doing.”
Obedience negatively affects health and well-being. Nine
participants (60%) reported that the promise of obedience
negatively affects their psychological health by (a) creat-
ing an internal conflict and (b) disrupting relationships.
Creates an internal conflict.  Seven priests (47%) indi-
cated that obedience can negatively affect their psy-
chological health by creating an internal conflict due to
uncertainty and strain related to how to manage differing
views from the Bishop (e.g., parish assignments). Father
Tony, a middle-aged priest, described,
Obedience can be a pain in the butt and can be very
challenging especially if obedience is interpreted as you do
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what those above you say. That can really be a strain. It
depends on leadership but we pledge obedience to our bishop
and if there’s no dialogue with your bishop about the
decisions that are being made that so impact your life, that
gives you a feeling of helplessness and resentment sometimes.
Father Thomas, a 40-year-old priest, reported, “Obedience
is a challenge at times, especially if we take obedience to
mean that you are supposed to look at everything as just
‘do your job.’”
Disrupts relationships. Two (13%) participants identi-
fied that obedience can negatively affect priests’ health
and well-being by disrupting relationships. Father
Thomas, a middle-aged priest, reported,
You’re in a place, you put down roots, you get intimate
relationships with your people, and you get a phone call and
say, “Hey in two weeks you’re gonna be in [town] or
something like that.” Yeah, that’s hard because after that
happens a couple of times you start to think, “Oh I’m not
gonna reach out to anybody” because it hurts too much.
Celibacy positively affects health and well-being.  Ten partici-
pants (66%) reported that the promise of celibacy posi-
tively influenced their psychological health based on the
following outcomes: (a) decreases stress without family
obligations; (b) strengthens relationships with the Lord,
the church, and others; (c) leads to positive feelings; and
(d) increases focus on vocation.
Decreases stress without family obligation.  Six partici-
pants (40%) indicated that celibacy is a positive factor
on their health because they have less stress from fam-
ily obligations and are able to focus on the congregation.
Father Douglas, a younger, newly ordained priest, stated,
“It’s a joy to be able to serve the people of God and to be
available to them and not be tied down to a family and
the familial obligations.” Father Luke, an elderly priest
with extensive time in the priesthood, agreed, “Practi-
cally speaking, the ability to exercise your ministry and
not have family responsibilities is wonderful.”
Strengthens relationships.  Four participants (26%) indi-
cated that the promise of celibacy allows them to build
relationships with the Lord, the church, and parishioners
because they are not committed to one single person or a
family. Father Pat reported,
Because we make a promise of celibacy we’re not giving our
whole life to one person, but we’re giving our life to the
church in general. So it frees you to be available and to have
intimacy with a family at large. In a parish, in your diocese.
Leads to positive feelings. Four (26%) participants
reported that the promise of celibacy leads to positive
Isacco et al. 333
feelings (appreciation, happiness, and a sense of balance
in life). Father Robert stated, “Through your life of celi-
bacy, you feel His closeness where it’s almost beyond
‘Thank you.’ How am I even deserving?”
Increases focus on vocation. Four (26%) participants
indicated that celibacy allows the priest to put energy
toward his church and his priestly vocation. Father Matt,
a middle-aged, newly ordained priest, reported, “My idea
of celibacy is making sure that my commitment to the
church, to my parish, and my vocation comes first, above
everything else.”
Celibacy negatively affects health and well-being.  Six (40%)
participants reported that celibacy negatively affects their
psychological health because of (a) difficulty managing a
biological desire to create a family and (b) having feel-
ings of depression or loneliness.
Contributes to difficulty managing a biological
desire.  Three participants (20%) indicated that it is hard
to manage feelings of temptation for intimate relation-
ships or a desire to have and raise a family. Father Tony
reported,
We have to find ways to be in real relationships with people
and to love and at the same time to do that in a way that’s
true to celibacy. That can be a very challenging, a messy
reality because of the human physical side and because of
sexual attractions.
Leads to depression/loneliness.  Two participants (13%)
reported that celibacy leads to feelings of depression or
loneliness because they lack an intimate relationship
with one person or having a family. Father Henry stated,
“There are lonely times. There are certainly times when
you think, ‘Wouldn’t it be wonderful to have a wife and
a family?’”
Discussion
Priests fulfill a specific religious role in a major world
religion (Catholicism), but previous research has yet to
clearly identify what religious and spiritual factors may
impact priests’ psychological health. As a result, this
study investigated what religious practices and beliefs
contribute to priests’ psychological health. This study’s
key finding is that the majority of participants (13/15;
87%) highlighted their relationship with God as a
dynamic, positive influence on their psychological health
and well-being. Promises of celibacy and obedience were
described as impacting their psychological health in both
positive and negative ways. Implications of those find-
ings are further discussed.
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Dynamic Relationship With God:
Measurement, Practical, and Research
Implications
When asked what faith beliefs or spiritual practices most
influence their psychological health, most participants
(13/15; 87%) identified their relationship with God.
Participants reported that their relationship with God is
mutually beneficial, interactive, unitive, central to their
lives, and fluid. The descriptors were action-oriented,
leading the research team to label the construct “Dynamic
Relationship with God.” Participants contended that their
dynamic relationship with God had a positive effect on
their psychological health. The finding fits with previous
research with a larger sample of priests, which found that
a relationship with God was a strong significant, positive
correlate to priests’ happiness (Rossetti, 2011) and a
strong significant, negative correlate to burnout among
priests (Rossetti & Rhoades, 2013). Thus, a primary con-
tribution of this study is adding evidence to the extant
literature indicating a relationship with God is a positive
religious/spiritual factor to priests’ psychological health.
Through the use of qualitative research methodology,
our participants provided a rich conceptualization of how
their relationship with God provided a sense of connect-
edness and support, decreased negative emotions,
increased positive emotions, transformed and empow-
ered their lives, helped to develop strengths, enabled
authenticity, and created balance. Thus, this study extends
the extant literature by identifying some of the mecha-
nisms that underlie the positive association between rela-
tionship with God and psychological health. For example,
participants described not feeling alone during the most
difficult times of their work because they felt united to
God and that God was with them. Participants also shared
that their relationship with God actively promoted posi-
tive emotions and minimized negative emotions, particu-
larly during stressful situations. Participants felt
empowered and transformed by their relationship with
God, which contributed to feeling like a better and more
authentic person. Finally, participants were able to find
balance through their relationship with God, which
enhanced their sense of well-being. Those pathways to
psychological health are important to consider within the
context of previous research with priests that has reported
that priests may experience stress because of juggling
multiple roles, managing increased workloads, and han-
dling negative media attention and reactions from people
because of sexual abuse scandal (Isacco et al., 2014). The
dynamic relationship with God described in this study
may represent a protective factor from stress and burnout
for priests. Future research is warranted to further exam-
ine how priests’ relationship with God may buffer or
334 American Journal of Men’s Health 10(4)
protect against negative psychological processes and
outcomes.
Health practitioners who work with priests may use
the findings about dynamic relationship with God to
inform interventions. Including R/S questions during
assessments has been recognized as an important clinical
strategy to identify salient R/S issues of patients (Koenig,
2000). When working with priests with psychological
concerns, our data indicate that it would be worthwhile to
ask about their relationship with God, which may provide
insight into their psychological concerns and resiliency.
Priests may feel detached from God, which may prompt
the health practitioner to encourage the priest to engage
more in his relationship with God and promote participa-
tion in religious practices such as prayer (Reinert,
Edwards, & Hendrix, 2009). Prayer, which is often con-
sidered the vehicle to talk with God and nourish one’s
relationship with God, has been identified as important to
integrate in mental health services with priests (Isacco
et al., 2014). Health practitioners can explore with priests
how prayer and their relationship with God can serve as a
coping mechanism during times of stress and to buffer
against more severe psychopathology (Bade & Cook,
2008).
Future research that examines the psychology of
priests would benefit from taking into account the impor-
tance of priests’ relationship with God. However, that
task is difficult because relationship with God has been a
difficult construct to conceptualize and measure. For
example, relationship with God (i.e., one’s feeling of
closeness, safety, and love with God) has often over-
lapped with other constructs such as God image (i.e.,
one’s perception of God) and attachment to God (i.e.,
one’s feeling of closeness and affectional bond with God;
Cassibba, Granqvist, Costantini, & Gatto, 2008; Rossetti
& Rhoades, 2013). Narratives from participants in this
study about their relationship with God also included
some aspects of their God image and attachment to God.
Yet, the participants clearly described a personal relation-
ship with their God, marked by four distinguishable com-
ponents: (a) mutually beneficial; (b) unitive; (c) central to
their life and health; and (d) fluid, changing, not static.
Incorporating those components into the conceptualiza-
tion of relationship with God may help to further distin-
guish the construct from overlapping constructs in future
studies with priests.
In addition to conceptual overlap, studies have used
limited items to measure and distinguish such a complex
construct as one’s relationship with God. For example, in
Rossetti’s large study of 2,482 priests, relationship with
God was measured with five items: “I feel that God loves
me personally and directly”; “I feel a sense of closeness
to God”; “I feel thankful for my blessings”; “from time to
time, I feel a joy that is a grace from God”; and “I have a
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relationship to God (or Jesus) that is nourishing me”
(Rossetti & Rhoades, 2013, p. 108). Those five items are
a good start, but lacked psychometric evidence to support
the reliability and validity of measuring the construct. In
order for quantitative research with priests about their
psychological health to progress, a reliable and valid
measure of their relationship with God is needed. A sec-
ondary contribution of this study is the identification of
specific components of relationship with God that can be
used to operationalize the construct in a scale develop-
ment effort.
Promises of Celibacy and Obedience: Future
Research Questions and Hypotheses
Our second research question asked how the priestly
promises of celibacy and obedience influenced priests’
psychological health. For both promises, participants
reported similar positive health benefits such as decreased
stress, strengthened relationships (God and others), and
increased positive emotions. In terms of negative health
effects, participants perceived that celibacy was associ-
ated with some difficulty managing biological urges and
loneliness while obedience was reported as contributing
to internal conflict and disruption in relationships. The
data contributes to an emergent conceptualization of how
the promises of obedience and celibacy affects priests’
psychological health. Such a conceptualization is a prom-
ising addition to the extant literature. Open and frank dis-
cussion of celibacy and obedience within the Catholic
priesthood is limited and often considered controversial
(e.g., Joseph et al., 2010). There are very few empirical
studies with priests that investigate celibacy and obedi-
ence in association with health outcomes.
The conceptualization from this study suggests that
the promises were underlying factors to psychological
health benefits by “freeing” priests from daily stress and
providing a sense of stability to experience positive
aspects of their vocation. For example, the promises of
obedience and celibacy enabled participants to defer/rely
on the “will of the Church” in difficult situations. The
reliance on “will of Church” seemed to deepen the rela-
tionship between the priests and the Church and God.
However, the promise of celibacy was identified as chal-
lenging at times because it cannot always free one from
biological urges and the need for intimate relationships
with people. In a similar way, some participants were
challenged by the promise of obedience because they
may have a different perspective from the Bishop or are
asked to leave parishes after establishing intimate rela-
tionships with parishioners. Thus, the promise of obedi-
ence can disrupt important interpersonal relationships
and create internal conflict for some priests, which may
lead to loneliness and other negative psychological health
Isacco et al. 335
outcomes. Future research would benefit from investigat-
ing moderating variables (i.e., for who?) that may interact
with the negative link between obedience and negative
psychological health outcomes among priests.
The findings from this study provide a preliminary
understanding of how celibacy and obedience influ-
ence priests’ psychological health, which is a meaning-
ful contribution to such an underdeveloped extant
literature. An important contribution of this study is to
use the strengths of qualitative methodology to gener-
ate hypotheses and questions for future research based
on our baseline data with other threads of related
scholarship. McDevitt (2012) examined the associa-
tion between a lack of intimacy and sexual misconduct
among a sample of 484 priests, with limited conclusive
evidence of any association. This study found evidence
of loneliness among some participants stemming from
celibacy. Future research might continue to investigate
possible pathways between loneliness from a celibate
lifestyle and a lack of intimacy, which may develop
into sexual misconduct issues for priests. For priests
similar to our participants that were lonely, in part
because of celibacy, we can hypothesize that they are
more vulnerable to leave the priesthood or disengage
from ministry (Joseph et al., 2010). Some scholars
have contended that positive health outcomes associ-
ated with celibacy stem from an acceptance of their
sexuality, clarity of their sexual identity, and an inte-
gration of sexuality and sexual identity into their per-
sonality (John Jay College Research Team, 2011;
Kappler, Hancock, & Plante, 2012). As Kane indicated
(2008a, p. 582), “there is an insufficient amount of rig-
orous and methodologically sound research that inves-
tigates priests, their sexuality, and their sexual
behavior.” Further research would be a valuable con-
tribution to the extant literature.
The limited research on obedience has produced
mixed findings that future research can clarify. Priests
considered the relationship with their bishop to be a key
factor to their happiness, but priests have lost respect and
trust for their bishops in the aftermath of the sexual abuse
scandal, resulting in strained relationships (Kane, 2008b;
Rossetti, 2011). Similarly, our participants reported that
obedience can lead to internal conflict between following
the bishop and their own desires. Thus, future research
could clarify how the strained relationships between
priests and bishops can be healed and healed in a manner
that would contribute to priest psychological health. For
example, would a forum that allowed priests to voice
concerns and feelings to bishops be beneficial, as Kane
(2008a) suggested? Given that priests will continue to
promise obedience to their bishop, clarity into how that
promise affects their psychological health and what can
facilitate a more positive relationship is needed.
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Limitations
Limitations to this study should be noted. First, partici-
pants were obtained using a snowball sampling of
Catholic priests. The original selection of participants,
based on recommendations from the study’s consultant,
may have biased the recruitment toward priests with more
positive views of the topics under examination in this
study. Yet, participants may have been suspicious and/or
distrustful of this research study, or certain questions in
the interview, and may have filtered their responses
(Kane, 2008a). The sample used was small and consisted
entirely of Catholic priests who were White, middle-
aged, and living in the United States. The homogeneity of
the sample limits the ability to generalize these data to
diverse populations of priests. In addition, all of the
priests who were interviewed reported a positive relation-
ship with God and a positive impact on their psychologi-
cal health. This did not allow researchers to learn about
the components of an anxious or avoidant relationship
with God in Catholic priests. It would be interesting to
explore which common themes (or different themes)
arise among the Catholic priests who have less positive or
insecure relationships with God.
Conclusion
This study provided useful information about Catholic
priests’ dynamic relationship with God and promises of
celibacy and obedience. The research highlighted key,
measurable components to a relationship with God and
the positive impact on their psychological well-being.
Future research in this novel area is ripe with many
opportunities to better understand the experience of
priests and to enhance their psychological health.
Transforming the measurable components of DRG into a
valid and reliable scale will facilitate better assessment
and investigation of priest psychological health at a quan-
titative level. Practitioners are urged to integrate findings
into their assessment and intervention efforts with priests
as priests’ DRG seems important to their psychological
health. Continued empirical and clinical efforts can fur-
ther clarify how R/S beliefs and practices impact the psy-
chological health of priests.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
336 American Journal of Men’s Health 10(4)
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