CLINICAL HANDBOOK OF SCHIZOPHRENIA

CHAPTER 58SPIRITUALITY AND RELIGIONROGER D. FALLOTIn the larger sociocultural context, as well as in behavioral health settings, several factorsin recent years have converged to make attention to spirituality and religion more prominentin mental health and other supportive services for people diagnosed with schizophrenia.Social, political, and cultural movements have offered reminders of the importance ofreligion and spirituality at individual and collective levels. Sociologists, who as recently asthe late 1980s were convinced of the inevitable and progressive secularization of themodern world, now increasingly recognize the tenacity with which many people and culturesmaintain strong religious commitments. In recent years, numerous controversieshave heightened the frequently contentious discussion of the place of religion in publicand political spheres. In the United States, polls consistently find both widespread and intensivecommitment to religious beliefs and activities; identifying oneself as a “religious”person is extremely common. Many other people, including those whose involvement informal, institutional religion may be minimal, understand themselves as “spiritual” peoplewho engage in spiritually oriented, though not necessarily religious, activities. This increasinglynoted distinction between spirituality and religion implies a difference in emphasisthat I adopt in this chapter. Spirituality refers primarily to an individual’s orgroup’s sense of connection to sacred, transcendent, or ultimate reality. Religion, by contrast,carries a primarily institutional or organizational meaning; religions have a more orless identifiable community of believers who share rituals, practices, and beliefs. Understoodin this way, religion may provide the most meaningful avenue for spiritual experiencefor some individuals, whereas it may be virtually irrelevant to spirituality for others.In different areas, then, both religion and spirituality have proven to be more central inmost cultures than secularization theory predicted.In the narrower context of mental health services and allied disciplines, discussion ofspirituality and religion has also taken on greater relevance and urgency. In addition torenewed examination of the relationships between psychotic and spiritual experiencesfrom both philosophical and neurobiological perspectives, several trends in clinical workwith people diagnosed with schizophrenia bear directly on the importance of spiritualityand religion. First, there has been a growing recognition of the value of holistic approaches,those that integrate biological, social, psychological, and spiritual perspectives,592