Religion and Spirituality in Psychiatry

78 Philippe Huguelet and Sylvia Mohrreligious healers, it is attributed to the influenceof Satan. “Allopathic” healers (that is, psychiatristsand specialized nurses) have few resourcesand provide limited services, usually psychotropicmedication. The authors investigated healers’attitudes toward their peers who practice a differentapproach. Indigenous and religious healerswere often tolerant of “allopathic” medicine.Psychiatrists’ attitudes were characterized byboth tolerance and conflict.In Brazil, Redko (67) studied young peoplesuffering from first episodes of psychosis in poorneighborhoods. Religion allowed them to expresstheir personal and interpersonal re actions topsychosis through the manipulation of religiousreferents. Religious idioms and signifiers wereuseful to label or describe what they experienced,indicated attempts to cope with psychosis, andreflected the quest to reinforce one’s own existenceand sense of self. The authors discuss thefact that religion can heal, in terms of the descriptionsabove, but also can act in a “regressive” way,for instance, when patients remain absorbed bytheir delusions.Bilu and Witztum (68) report their experiencein Jerusalem with Jewish, ultra-orthodox,severely ill patients. These patients turn tothe clinic as the very last resort, after havingattempted – and failed – to employ religioushealing. They try to incorporate religiouslycongruent elements into their secular treatmentmodalities. The authors found that medicationssuch as antipsychotics, initially ineffective,turned out to be quite potent when accompaniedby a religiously informed intervention,when “drugs are presented to create a mysticalwall against demonic assault” (p. 208).Interestingly, ethnic minority groups maysearch for spiritual methods of healing whenbeing treated in Western countries. Khan & Pillay(69) reported that patients from South Asia withschizophrenia living in the United Kingdom preferredhome treatment, primarily so they couldpractice their faith and retain the possibility ofadding faith healing to their psychiatric treatment.The authors explain their motivationsnot only as a desire to maintain their culturalidentity, but also as a means of having access tomore holistic treatment.Overall, it appears that in developing countriesor in areas where religious paradigmsmay be applied to health issues, religious and“allopathic” care coexist for treating psychosis.Interestingly, some separation appears betweenthese approaches, as it does in more developedcountries (even if treatment of psychosis basedon religious principles is less common in theoccident). Without being naïve – by claimingthat religious worldviews can perfectly fit intoour medical model – there appear to be opportunitiesfor dialogue between “modern” psychiatryand religious healers.(66) As in Western countries,this could be done while keeping in mindthe principles of recovery. Both psychiatristsand religious healers should admit that patientsneed good medication, psychosocial counseling,and something more, something related to lifegoals but also to a sense of one’s identity, whichis sometimes strongly rooted in religion andculture.20. CONCLUSIONPsychosis is often associated with persistentsymptoms and/or social disabilities. In this context,recovery, which aims to achieve a life worthliving rather than a “cure” for all symptoms, maybe an important goal. That’s where religion/spiritualitycan come into play in the lives of individualswith psychosis. Research has shown thatreligion/spirituality, rather than triggering psychoticsymptoms, can provide powerful copingmechanisms. Indeed, it can help patients copewith symptoms such as hallucinations, depressivethoughts, and suicidal ideations; it may preventsubstance abuse; and it can help patientsto set life goals. Clinicians organizing individualand group treatments should integrate religion/spiritualityin nonjudgmental and neutralways. In particular, religious involvement mayhelp patients to socialize, and they should beassisted in that pursuit. Therapy may include atleast some religious components as they relate toidentity, relationships, contextual issues, and so