Religion and Spirituality in Psychiatry

Introduction: Key Concepts 3of 12-step programs to facilitate the treatmentof patients with alcohol or drug problems (seeChapter 9 ). More recently, religious copinghas been shown to influence the outcomes ofbereavement and major depressive disorders (seeChapter 8 ). Concerning patients with psychosis,the diagnosis of “mystical delusion” has hinderedclinicians from recognizing the positive influencesof religion.(8) However, recent researchfrom Switzerland and other countries has documentedthe powerful benefits in terms of copingthat religion/spirituality can have for psychoticpatients.(9, 10)Thus, although further research on this topicis greatly needed, growing evidence demonstratesthat religion/spirituality is important forpatients with psychiatric conditions and maybe beneficial or detrimental to their illness. Wehope that providing updated information toclinicians about the research in this area anddescribing sensible clinical applications will helpto overcome the reluctance among clinicians toaddress these issues with patients. At a minimum,this book will make mental health professionalsmore aware of an important area ofpatients’ lives that is rarely addressed in clinicalsettings.(11)6. THE ROLE OF CLINICIANSThe role of the clinician is not an easy one. Cliniciansinvolved in psychiatry have many reasons fortheir reluctance to address spiritual/religious issueswith patients.First, clinicians’ own religious involvement (orlack thereof) may influence the value they placeon religious/spiritual issues. We are generally lessinvolved in religious activities than our patientsare (12) and are thus less likely to be interested indiscussing these issues.Second, there is widespread lack of knowledgeabout how to address religion or spirituality inclinical practice. Psychiatric training rarely devotesmuch time to such issues, as described later in thisbook (see Chapter 22 ).Third, as mentioned earlier, there has been historicalconflict between psychiatry and religion.Some authors (Freud) have referred to religionas an “illusion,” merely a neurotic defense againstlife’s vicissitudes.(13) Antagonism remains todaybetween clergy and psychiatrists, because theirdomains overlap and they often share the same“customers.”Fourth, some clinicians may fear that addressingissues pertaining to religion may representwalking into unknown territories, thus riskingharm to patients. In some areas of the world (e.g.,in Europe), clinicians may fear offending patientsby bringing up such issues, which patients maynot wish to address.Fifth, psychiatrists may feel uncomfortablebeing involved in a social/care network in whichroles are not well defined between clinicians, chaplains,and clergy. This is likely to be the case inareas where clinicians and clergy have not workedtogether before.A common factor at the root of most of theseconcerns is a lack of knowledge and tools, whichthis book is intended to help correct.7. WHO SHOULD READ THIS BOOK?Th is book seeks to give knowledge and practicaltools to clinicians taking care of patients withpsychiatric disorders. The goal is to cover issuespertaining to psychiatry and religion/spiritualityin a way likely to engage and maintain theinterest of readers who may not be particularlyinterested in religion. There is a large gapbetween those who are interested in religion,consider it when treating their patients, andare drawn by books or papers on this topic, andthose who have little or no interest in religion,do not broach this topic in clinical settings, andfeel reluctant to “waste time” learning about thistopic. The present text is designed to fill this gapby providing concise, detailed information thatwill help clinicians consider integrating spiritualityinto the care of patients, even if the clinicianis not religious.This book is written by psychiatrists, psychologists,theologians, and pastoral care experts andwill be of use to all clinicians treating patientswith psychiatric disorders.