Religion and Spirituality in Psychiatry

Religion/Spirituality and Psychosis 73and it has no meaning” (20-year-old man, paranoidschizophrenia).Religion may also help to reduce anxiety,depression, and negative symptoms. As onepatient said, “I am spiritual in my heart. Myway of meditating is to sing. There is a linkbetween breath and spirit. When I sing, I don’tfeel as depressed and I am more enthusiasticabout doing things” (44-year-old man, paranoidschizophrenia).At the social level , religion provided guidelinesfor interpersonal behavior, which led to reducedaggression and improved social relationships. Asthis patient said, “Believing in Jesus helps me tocontrol my actions. That means not striking myfellow man when he upsets me!” (31-year-oldman, paranoid schizophrenia).Unfortunately, in spite of the subjective importanceof religion, only one-third of the patientswho were using religious coping in a positiveway actually received social support from a religiouscommunity. Some patients didn’t receiveany support from their communities due totheir symptoms. As one patient said, “I’ve goneto church every Sunday since childhood; I listento the sermon; I don’t speak to anyone” (50-yearoldman, paranoid schizophrenia). More often,symptoms hindered religious patients from practicingwithin their religious communities.However, for some patients, religious communitiesprovided social support. One patient said,“I am a single woman; I have a lot of problems.At church, I meet a lot of people. It comforts me.I participate in every church activity: the serviceon Sunday, the intercession prayer group and Ising in the choir. The pastor and church memberspray for me” (39-year-old woman, paranoidschizophrenia).Religion may also play a role in decreasing orincreasing adherence to psychiatric treatment.(See Chapter 18 on this topic.)14.2. Negative Religious CopingFourteen percent of patients reported negativeeffects of religious coping. For those patients,religion was a source of despair and suffering.Four patients felt despair after the spiritual healingthey had sought was unsuccessful. As onepatient said “I didn’t get any comfort from psychiatry.So I turned to Christian Science, whichhas healed many people. Prayer is an assertionthat healing is already there and to see it. I triedfor years. It comforted me when it was new,but I didn’t succeed, so they told me that I wasa negative person and a bad influence on others.I was not worth their attention. Since then,I’ve been drinking alcohol” (41-year-old woman,hebephrenic schizophrenia). Others used religionto cope, but with a negative outcome. Asan example, one man said, “I suffer from beingso isolated. I wasn’t a believer, but I went tochurch in order to meet people. But when Iread the Bible, it disturbs me. I begin to think Ihave behaved wickedly and then I believe I amthe devil” (47-year-old man, schizo- affectivedisorder). Although religion was meaningfulfor these patients, it always carried negativereligious connotations. In some cases, religiouscoping increased delusions, depression, suiciderisk, and substance intake. One patient foundcommunity support, but this led to a loss of faithand increased medication compliance. “I wentto church to be healed and to meet a woman. Ibelieved Jesus would help me, but this is a lie.More problems came, like a curse. Evil has thepower on earth. God is a cruel God. I want todie because I suffer too much. It is not Jesus whohelps me, but people; at least, medication helpsme for anxiety” (43-year-old man, paranoidschizophrenia).14.3. Clinical CorrelatesAt the time of the study, sixteen of the patientswith positive or negative religious coping presentedreligious beliefs mixed with their delusionsor hallucinations. At a psychological level,they experienced religion either as negative (sixcases) or positive (ten cases). However, none ofthese patients actually participated in communityreligious practices.Overall, it appears that religion can serve asa powerful coping mechanism for patients with