Religion and Spirituality in Psychiatry

Religion/Spirituality and Mood Disorders 111Table 8.2: Brief Summary of Fowler’s Stages of Faith. (51) Stages Printed in Bold Appear to bePrevalent in Adult Samples (Wulff, 1991, pp. 399–402). (52)StagePeriod1. Intuitive-projective faith Imagination and imitation Ages 3 – 72. Mythic-literal faith Story, drama and myth; concretereciprocitySchool age3. Synthetic-conventional faith Shaping of the personal myth; stayingclose to expectations by othersAdolescence4. Individuative-reflective faith Relativism, critical, demythologizing;own responsibility for one’s faithAdolescence5. Conjunctive faith Revaluation of early imagination,narratives and symbols; dialecticaland paradoxical6. Universalizing faith Inclusive of all being; unifying andtransforming; contagious; decentrationfrom selfMidlifeRareof Faith , Fowler theorizes about levels of faithdevelopment that run more or less parallel tocognitive, intellectual, and moral development.Table 8.2 summarizes the stages with keynotes asshort characterizations.The stages of faith can be helpful in estimatingone’s own preferred level of apprehending religionand spirituality and that of others. Recognizingthat others tend to communicate at a differentstage may neutralize feelings of uneasiness to somedegree, because it is apparent that others adhereto different themes and thematic expressions andhave different expectations concerning how tointeract about these themes. Many mental healthcare workers may recognize their own stage offaith as individuative-reflective , allowing for a criticaland sometimes skeptical attitude toward religionand spirituality. Pious church members mayfeel more comfortable with synthetic-conventionalfaith . Awareness of different ways to experiencebeliefs according to a categorization like Fowler’smay make it easier to communicate with thepatient. Using Fowler’s stages, however, entails therisk of a higher stage being equated with higherspiritual achievements or moral qualifications. Inprinciple, a neutral assumption might be that, ateach level, people can experience their spirituallife in optima forma.No research has been conducted yet onwhether patients with mood disorders experiencechanges in their stage of faith. One might imaginehow certain cognitions during depression couldtend to demythologize religious beliefs and leadto disillusionment. Manic patients, on the otherhand, may be convinced of their supreme insightsat the level of universalizing faith, although thismay be at odds with inflated self-esteem.10. CONCLUSIONAs a main principle in the application of religiousand spiritual themes in clinical practice, oneshould not divert from regular treatment strategies.Excessive enthusiasm on the part of mental healthworkers with respect to religion should be examinedas a sign of counter-transference. However,