The collision of the spiritual and the secular in psychiatric treatment can prove troublesome--even combustible--and some psychiatrists may find themselves uncomfortable when religion takes a seat beside a patient.
For Discussion: How can a patient's religious beliefs and background create barriers to effective treatment? Alternatively, how can a therapist use a patient's faith to help speed progress toward recovery? V/hat strategies can secularly minded therapists adopt to better treat their spiritually minded patients?
Asset Rather Than Liability
If the value system of the psychiatrist is one based on a purely secular view of life and if the psychiatrist is in the tradition of Freud and sees religion as a crutch or even a dysfunctional expression of the patient's life, there is no question that therapy will be aimed consciously or unconsciously at decreasing the viewpoint of religion in a patient's life. The ability of a psychiatrist to evaluate the role of religious or cultural matter in the patient's life is crucial in therapy
In most cases, though not all, religious beliefs and practice tend to add meaning to a person's life.
Religious views are often an asset rather than a liability, depending on the intensity of the control the religion has on the patient's life. Most patients are looking for ways to manage pain, losses, and confusion.
However, we should closely examine harmful religious practices that are extremely rigid, restrictive, and almost antihuman. These include the demands that some fundamentalist practices require, exemplified by women being cast in an unimportant role or the fear of raising appropriate questions as if they were forbidden things.
I have often been asked by secular-minded therapists to explain some aspects of a religious belief to them. When I answer them, I encourage such therapists to have their patients explain the background meaning and role of their religious viewpoint. In this way, the patient feels more of an equal, more of a partner with the therapist.
Samuel Klagbrun, M.D.
Spirituality vs. Religion
I think we need to differentiate spirituality from religion.
The former is an essential part of our psyche, hence our biopsychosocial/spiritual self.
The latter, on the other hand, is more likely organized in nature and reflects the rules, regulations, and rituals of the given faith.
It is very often the patient's religion that "clashes" with the psychiatry. Spirituality, however, is complementary to the behavioral sciences.
Fuat Ulus, M.D.
'The Unspoken Leg' of Therapy
There surely is a spiritual dimension to every person and every problem just as there are physical, emotional, and social components. It is the unspoken leg of every therapy and the completion of the biopsychosocial "spiritual" model of psychiatric illness. I think we would talk about it more in our schools and literature, but it's just real hard to come up with experts or a consensus about religious truth.
I thought Dr. David Larson at the National Institute of Mental Health was doing a good job of sorting this out for us. His death was such a loss. There is a Christian medical/dental subdivision of the American Psychiatric Association that has been a good resource for me.
Dave Stengel, D. O.
Coeur d'Alene, Idaho
Dr. Fink: The separation of church and state is an irrelevant concept when we think about a patient who cannot be separated into parts. One cannot tell the patient to leave his religious background, beliefs, and rituals at the door: "They are barred from the therapeutic chamber!" The patient in therapy is a whole person, and religious and spiritual beliefs are a part of him or her. There are memories, references, words, and metaphors that enter the therapeutic dialogue all the time and need to be understood. …