CLINICAL HANDBOOK OF SCHIZOPHRENIA

58. Spirituality and Religion 597Three themes warrant special attention in considering the positive place of religionand spirituality in recovery for people diagnosed with schizophrenia. First, people in recoveryfrom the often devastating reality of, and profound stigma associated with, schizophrenianeed to construct and reconstruct a sense of meaning and purpose in their lives.Severe mental disorders, and the social isolation and conflict that often accompany them,frequently raise “ultimate” questions—about the nature of reality, about the trustworthinessof other people, about good and evil, about the role of the divine in human suffering,and about sources of hope and a meaningful personal future. At a psychosocial level, theimportance of establishing valued day-to-day goals—involving, among others, meaningfulwork, relationships, housing, leisure—has become increasingly understood as centralto recovery. At a spiritual or religious level, however, these goals depend on a larger understandingof self that makes a meaningful future possible and worth pursuing. Formany, spirituality offers a way to piece together and make sense of what has happened tothem; to place these experiences and events in context; to gain a sense of perspective; andto develop hopefulness about the future. As an example, in some religious traditions, peoplefrequently recount what they refer to as “wilderness” experiences: difficult periods ofstruggle and pain that must be endured before reaching a more sanguine state. Placed inthis sort of interpretive frame, psychotic experiences may be seen not as permanently disabling,but as temporary states through which one passes on the way to a more positivefuture. Very importantly, in such stories, the power of the divine is on the side of helpingthe individual (and often the community) to find their way through the wilderness; thereis good reason to be hopeful. For individuals who find meaning in these narratives, religiousand spiritual realities may bolster recovery.Second, spirituality and religion often provide vivid reminders of a robust and complexpersonal identity, that people diagnosed with schizophrenia are “whole people.” Inthis way, spiritual understandings and practices serve as antidotes to a reductionism thatnarrows a person’s identity to a psychiatric diagnosis. Many individuals report that oneof the most painful, angering, and still all too common, experiences in dealing with a diagnosisof schizophrenia is professional overemphasis on the labeling of pathology, symptoms,and deficits. Furthermore, this overidentification of the person with his or herproblem-defined label is often reinforced by socially stigmatizing communities. Spirituallyand religiously informed identities, though, are characteristically both more holistic(involving strengths and skills, as well as weaknesses) and more positively toned (eachindividual has unique worth and value). Especially for those who have frequent and longstandingcontact with the mental health service system, it is difficult to overstate theimportance of the reminder that they are not to be identified with their illness label. Spiritualand religious perspectives often offer powerful countermessages in two ways. First,they offer direct, alternative identities. Metaphors of being a “child of God,” or moregenerally, a valued and full-fledged member of the human race, are common. In addition,these identities may be reinforced by spiritual practices that deepen an individual’s senseof wholeness and self-acceptance. Religious communities can also reinforce this more expansivesense of self, going far beyond illness-based identity to that of valued member ofa caring community. Taking on a meaningful role in a faith community is one means ofcementing more positive self-understanding.The third theme is somewhat more concrete and often closer to the immediate experiencesof people diagnosed with schizophrenia. Spirituality and religion may helpfullybolster the emotional life by offering energy for engagement with life and, at other times,calmness in the face of chaotic disruption. In terms of the usual categorization of positiveand negative symptoms, then, spiritual activities and beliefs may offer resources for cop-