Religion and Spirituality in Psychiatry

134 Harold G. Koenigto 2.0 mg at bedtime helped to control these episodes,but they did not go away. Whenever hewas stressed out over a big sales deal, the paniclikesymptoms at night would return, overridingeven the medication.Knowing that Tom was a religious man fromtaking a spiritual history, the psychiatrist suggestedthat he try meditation. The psychiatristdescribed several different kinds of meditation:Hindu-based transcendental meditation,Buddhist-based mindfulness meditation, andChristian-based centering prayer. Tom said hewould try the Christian-based centering prayer,but as a devout Catholic, he was not interested inEastern religious practices. His psychiatrist suggestedhe try centering prayer for twenty minutesbefore going to bed at night and then again fortwenty minutes on arising in the morning. If heawoke with panic-like feelings, he was instructedto go through his centering prayer routine fortwenty minutes. After about four weeks of thispractice, Tom noticed that the frequency of hispanic feelings at night began to decrease. Evenwhen they appeared, the centering prayer causedthem to quickly subside. Tom eventually combinedcentering prayer with repetition of theLord’s Prayer, which continues to work for himand is more consistent with his faith tradition.4.3. Lost FaithJohn, a 23-year-old soldier, was on his third tourof duty in Baghdad, Iraq, when his best friendJoe, riding next to him in a jeep, was killed by aroadside explosive device. The two men were veryclose. Joe had saved John’s life, once pulling himout of a burning building after he had lost consciousnessfrom smoke inhalation and anothertime dragging him to safety out of the line of fireafter he had been wounded. John couldn’t believethat his friend was now dead. “Why hadn’t thebomb killed me instead?” thought John. It justwasn’t fair. For nearly three years, he and hisfriend had been inseparable partners. Bothhad strong religious faith and prayed regularlytogether for protection over each other and theirfamilies. Why would a loving God have allowedthis? It didn’t make sense. If God allowed this,thought John, then he didn’t want anything to dowith God. He would simply make it on his own.Doing that, however, would prove to be more difficultthen he imagined.After he returned home from Iraq, he discoveredthat his wife had fallen in love with someoneelse and asked him for a divorce. On top of that,he couldn’t find work anywhere, particularly sincehe had only partial use of his left arm where hehad been wounded during his last tour of duty.He was able to drive an army jeep, but that wasabout all, and this skill now was hardly somethingthat someone would hire him for. Shortlyafter returning home, John began having nightmaresand flashbacks of his war experiences,found himself avoiding news programs reportingon war events and action-type TV shows, andnoticed that he startled easily whenever someonecame up behind him or surprised him. Life hadbecome painful and was losing meaning for him.What reason did he have to continue living? Overtime, the emotional burden that he was carryingbecame heavier and heavier. He sought help at theVeterans Administration (VA) hospital in the psychiatricoutpatient clinic. The psychiatrist he sawdiagnosed him with depression and PTSD fromhis war experiences and started him on medication.The psychiatrist also scheduled him to see asocial worker for counseling. John stabilized afterabout three to six months of this treatment, but hedid not return to his usual self. For the past severalyears, he has continued to seek help at the VAfor his emotional problems. Although the medicinehas been helpful and the counseling useful,no one has asked him how his wartime experiencesaffected his religious faith.4.4. Devout and PrayerfulRoberta is a 60-year-old accountant. Two yearsago her husband suffered a fatal injury at his workplace.She now lives alone and, other than drivingback and forth to work, lives a pretty quiet life.Members of her congregation, family, and friendshave long known Roberta for her religious devotion.She attended religious services before work