CLINICAL HANDBOOK OF SCHIZOPHRENIA

596 VIII. SPECIAL TOPICSmore or less intense commitments); the individual’s characteristic beliefs, and sense ofpurpose and meaning; the overall emotional tone of the person’s spiritual or religious life;regular religious activities or rituals; and the extent to which a community of others is involvedin the individual’s spiritual practice. Gaining an understanding of these dimensionsof spirituality enables the clinician to see more clearly the ways in which an individual’sspiritual life is related to his or her overall goals and well-being.SPIRITUALITY AND RELIGION IN RECOVERYAs noted earlier, there is growing evidence that many aspects of religious or spiritual involvementare related to positive mental health and to lower levels of distress. The waysin which religion may be related to recovery from schizophrenia and other severe mentaldisorders have been examined in both qualitative and quantitative reports. Several findingsemerge with some consistency from these studies.Religion and Spirituality as Resources for RecoverySubstantial numbers—the vast majority in some surveys—of people diagnosed withschizophrenia and other severe mental disorders report that religious and spiritual activitiesoffer them important resources for coping with life stressors, including psychiatricsymptoms. Importantly, both activities that are often done alone and those that involveother people have been among the most commonly reported: prayer, meditation, readingscripture or other inspirational writings, listening to religious music, participating in formalreligious services or spiritually oriented groups, and talking with religious professionals.Furthermore, these activities are seen as both generally helpful and specifically usefulin dealing with distressing symptoms. Self-reported benefits range from lessening of troublingsymptoms (e.g., listening to religious music as a uniquely helpful way to deal withupsetting auditory hallucinations) to a broad array of recovery-oriented strengths (e.g.,enhanced inner calm and strength). It is not surprising, then, that some reports indicatean increase in faith after a psychotic episode. One plausible explanation is that acute psychoticsymptoms set in motion both specific, sometimes spiritual, attempts to minimizedistress and, subsequently, more general efforts to give meaning and structure to those experiences,to weave them into a coherent life narrative with purpose and direction.This kind of coping involves not only activities but also ways of thinking about andunderstanding life events. Much of what has been described as “religious coping” in factrevolves around various interpretive schemas that a person may adopt in dealing with lifeproblems. “Positive” religious coping, demonstrably related to better mental health outcomes,frequently entails, for example, affirming that the person sees himself as part of alarger spiritual force or that she works together with God as a partner is dealing withstressors. “Negative” coping and religious strain, linked to poorer outcomes, are reflectedin concerns that God is punishing or has abandoned the individual or, conversely, that theindividual is angry and distancing from God. Religion and spirituality characteristicallyoffer much more than a set of activities and ritualized disciplines. These activities growout a comprehensive interpretive frame that directs a person’s attention to certain eventsas more important and meaningful than others, provides a way of understanding life’scomplexities, and proffers guidelines for how life is to be lived in response to this understanding.For clinicians who want to grasp the place of religion or spirituality in a person’slife, this larger interpretive approach is a key.