Religion and Spirituality in Psychiatry

Religion, Spirituality, and Anxiety Disorders 133to significantly higher phobia scores, while beliefin an afterlife was related to significantly lowerphobia scores. In fact, of the twelve characteristicsmeasured, age was the only characteristic that predictedfewer phobia symptoms more strongly thandid belief in an afterlife.Thus, the particular way that religion is measured,the age of the person, and the specific typeof phobia are all important in determining associationsbetween religion and phobia.4. CASE EXAMPLESThe research above suggests that religiousinvolvement is generally related to fewer anxietysymptoms and less anxiety disorder. However, itis useful to examine individual cases that illustratethe use of religion in either alleviating orexacerbating anxiety. The names below are fictitiousto protect patient confidentiality.4.1. The WorrierJane is a 40-year-old mother of three childrenranging in age from 4 to 10. She has a lifelonghistory of being a “worrier.” Just about everythingseems to make her anxious. As soon as oneproblem is solved, she quickly begins to worryand ruminate about other issues. When undera lot of stress, her worrying gets much worse –to the point that she is unable to function. Priorto seeking psychiatric help, she often had to askher eldest child to watch the younger childrenand even cook supper for the family. Jane simplydidn’t have the energy or the patience to do this.Her constant worrying also interfered with hermarital relationship. She felt an intense need tocontrol all decisions related to family matters andwould not listen to her husband or allow him arole in these decisions. This resulted in frequentand heated arguments.Frustrated with her anxieties and fearful thather husband would leave her, Jane saw a psychiatristwho diagnosed her with generalizedanxiety disorder. He gave her a prescription ofthe medication buipirone, which she was to takethree times per day. Although this medicine waspartially effective, it left her with considerableresidual anxiety. Always a religious person, Janeturned to this source for help with her anxiety. Inaddition to taking the buspirone, she now copeswith her many worries through prayer, readingthe Bible, and help from her faith community.Prayer enables her to give up some of her needfor control to God and consequently makes herfeel more peaceful. When she is in deep, seriousprayer, she finds herself relaxed both emotionallyand physically. Reading positive religiousscriptures also helps to counteract her negative,anxiety-provoking thoughts. Reading storiesabout Biblical figures overcoming their fearsgives her hope, and the promises in scripture ofGod’s continual presence makes her feel calmer.As she began to feel better, Jane also becamemore active in her religious community. Thisincreased her social contacts, which providedher with more emotional support outside herfamily and gave her ways to reach out to othersin need of help. This, in turn, reduced her worrying(or at least got her mind off of herself andher problems). Praying with other church membersand singing hymns during the church servicealso gave her a sense of peace and reducedher sense of isolation. Thus, the combination ofthe medicine prescribed by her psychiatrist andgreater involvement in religious activities hasimproved Jane’s quality of life and reduced herGAD symptoms.4.2. Panic at NightTom, a 28-year-old salesman, sees a psychiatristfor the treatment of panic disorder. Tom originallybegan having panic symptoms at night,when he would awake early in the morning withhis heart racing, short of breath, and feeling likehe was dying. His doctor initially treated him witha combination of paroxetine 40 mg per day andclonazepam 1.0 mg twice daily, with fairly goodresults. Nevertheless, he continued to occasionallyawake with panic-like symptoms. Althoughthey didn’t escalate into a full-blown panic attack,they disturbed him enough that he could oftennot go back to sleep. Switching the clonazepam