Psychiatry Section Blog
Faith, Mental Illness and Psychiatry
August 28, 2019
By, Psychiatry Section Contributor
Is mental illness a spiritual issue (the result of sin), or is mental illness a medical issue? Is a person with mental illness struggling spiritually or are they physically sick? Is a Christian supposed to have mental illness? Can’t God cure mental illness?
Tim Keller wrote in his May 2010 booklet Four Models of Counseling in Pastoral Ministry that we “must beware of giving people the impression that through individual repentance for sin they should be able to undo their personal problems. Obviously, we should not go to the other unbiblical extreme of refusing to acknowledge personal responsibility for sinful behavior as well...While we can't fall into the reductionism of believing all problems are chemically based and require medication, we also cannot fall into the reductionism of believing all problems are simply a matter of lacking spiritual disciplines. Schizophrenia, bipolar depression, and a host of other psychological problems are rooted in physiological problems that call for medical treatment, not simple talk therapy.”
In his article “Their Religion May Differ, But Goals Are the Same” in the March 16, 2007 issue of Psychiatric News published by the American Psychiatric Association (APA), Mark Moran discusses spiritual beliefs and their utility in the treatment of mental illness. In part he discusses an Orangeburg, New York psychiatrist who practices Buddhism, a Syrian-born Muslim psychiatrist and an Orthodox Jewish clinician, and how each utilize aspects of their spiritual beliefs in their treatment of mental illnesses. They are part of a trend in “patient-centered” care and an emphasis on cultural sensitivity that has expanded to include the awareness that a patient's beliefs—about the meaning and purpose of life and the nature of the universe—are crucial to understanding a patient, as well as to a patient's health and illness.
In the article, John Peteet, MD, chair of APA's Corresponding Committee on Religion, Spirituality, and Psychiatry, is quoted to say that "recognition of the value of religious and spiritual beliefs and practices in mental health treatment has grown…many patients seek out like-believing clinicians."
“I regularly hear from potential patients who are looking for a Christian psychiatrist, and I first try to assess if this is something they need, as opposed to something they can find better in a church or secular mental health setting,” Dr. Peteet said. “My faith informs the values and vision that guide my view of people as created in God's image and therefore valuable. It also informs my view of full health as relational and is marked by effectiveness in meeting existential life tasks, versus simply an absence of symptoms.”
Dr. Peteet believes the sensitivity like-believing therapists can bring to their religious patients is clinically valuable. “Sharing a belief system can be an asset or a liability depending on what it means to the patient and clinician and how they handle it,” he said. “Potential advantages include greater understanding, trust, and the ability to draw on recognized and/or shared spiritual resources. Fundamentalist patients may be able to trust themselves to a psychiatrist only of the same faith or one they find through a trusted religious authority. Potential liabilities include negative reactions or struggles based on prior experiences with religious authorities; collusion to focus on religious or spiritual issues instead of on needed psychological work, some of which might require confrontation; and unwarranted assumptions based on a shared or similar identification.”
So, how does a clinician successfully navigate in both the religious and clinical arena? What does the clinician need to know or incorporate in treatment to be effective? What should today’s clinicians consider?
In his article “American Christian Engagement With Mental Health and Mental Illness” from the September 14, 2015 issue of Psychiatric News, Warren Kinghorn, MD, ThD, writes that “although religious belief and practice are relevant to mental health outcomes, many clinicians lack knowledge of particular religious traditions required to make informed judgments about referral to and collaboration with faith-based organizations and clinicians. This Open Forum examines five diverse American Christian approaches to mental health and mental illness—pastoral care and counseling, biblical counseling, integrationism, Christian psychology, and the work of the Institute for the Psychological Sciences—that are relevant for contemporary mental health service delivery. Each of these movements is briefly described and placed in historical, conceptual, and organizational context. Knowledge of the diverse and varied terrain of American Christian engagement with mental health care can inform clinicians’ interactions with faith-based providers, clarify opportunities for responsible collaboration, and provide important insight into religious subcultures with faith-based concerns about contemporary psychiatric care.”
So, do faith-based professionals readily accept the help of clinicians and reinforce the idea that they offer medical treatments which are acceptable and can result in successful management of mental illnesses? Is the collaboration discussed by Dr. Kinghorn, happening routinely and successfully or does the church still place a stigma on mental illness which complicates treatment?
In his article “Approaching Religiously Reinforced Mental Health Stigma: A Conceptual Framework” in the June 12, 2019 issue of Psychiatric News, Dr. Peteet examines the stigma of mental illness in the church and its role in the treatment of mental illnesses. He writes that “religious reinforcement of mental health stigma is a widespread obstacle to treatment. Understanding its principal causes—fundamentalist thinking, communal bonding, misattribution of psychopathology, traditional beliefs and healing practices, and adverse experiences with secular providers—is a prerequisite to effective mitigation. This requires a sensitive search for common ground, efforts to work within community values, attempts to address both psychiatric and spiritual concerns, and educational interventions tailored to these challenges. Addressing religious reinforcement through collaboration between providers of psychiatric and spiritual care requires further study.”
Each member of the CMDA Psychiatry Section desires to appropriately integrate faith into the treatment of mental illness. Each realizes the need to be a part of a believing church where we do life together with other members. Does our church stigmatize mental illness? How do we minister and educate in the midst of erroneous views when present? How do we identify and address the effects of these stigmas in our patients? How do we assess the best methodology and degree faith and spiritual beliefs should be incorporated in treatment? The answers will differ with each clinician and patient. Click on the links above and read Dr. Kinghorn’s and Dr. Peteet’s thoughts and findings. Seek to collaborate with others in the section and find out what they are doing and what they are finding successful. Share your thoughts with us on this blog.
Recent Psych Blog Posts:
A few weeks ago I was doing weekend rounds in a psychiatric hospital in rural Kentucky, and met with a 53 year old male patient struggling with severe treatment resistant depression. The gentleman was struggling with what appeared to be delusional guilt over the belief that he had committed ‘the unforgiveable sin’ of blaspheming the Holy Spirit 14 years ago.
Lifelong Learning as a Christian in Psychiatry involves developing Levels of Understanding. Lifelong spiritual growth as a Christian in psychiatry can be described as progressive transformations to higher levels of wisdom and deeper levels of understanding of God. Our annual conference this year was centered by the theme of “Spiritual Calling in Psychiatry.”
We were pleased to host Kay Warren, of Saddleback Church, as the plenary speaker for our Psych Section Annual Meeting on May 23rd. Mrs. Warren, who lost her son to suicide four years ago, delivered a sobering account of her family’s difficult experiences with providers who appeared to lack compassion and a system that not only failed him, but also contributed to the torment of his mental illness.