Religion and Spirituality in Psychiatry

Spirituality and the Care of Madness 7it has influenced the West, both physicians andlay people, since the time of Constantine, so it isimportant to understand how the Bible presentsmadness. The Bible has several sections that haveshaped views of madness – although in differentways at different times.Th e Bible was written and edited overmany centuries. The Old Testament (or HebrewScriptures), assumed its present form in about90 AD.(7) The New Testament canon wasestablished at the Council of Nicea in 325 AD.All Christian groups accept the parts of theOld Testament that Jews regard as canonical.Roman Catholic, Eastern Orthodox, and CopticChristians, variously, include additional edifyingJewish writings that were not accepted as canonicalby Jews.Madness is portrayed in the Old Testamentin several ways, sometimes in naturalistic terms,sometimes otherwise. Illustrative of the variousways madness is viewed in the Bible are theaccounts of madness in 1 Samuel. In Chapter 21,the young David, not yet king of Israel, findshimself in a dangerous situation in the presenceof Achish, a Philistine king, and his comrades.According to the Bible, “he changed his behaviorbefore them, and pretended to be insane in theirhands and made marks on the doors of the gateand let his spittle run down his beard” (1 Sam.21:13, NRSV). Achish was disgusted and declared,“Do I lack madmen, that you have brought thisfellow to play the madman in my presence? Shallthis fellow come into my house?” (21:15). Davidwas able to escape and carry on unharmed. In thissetting, madness is presented as a natural phenomenonthat is not unusual.The same book of the Bible, five chapters earlier,includes an account of Saul that describes asupernatural cause of madness or, in Saul’s case,despair. The writer records, “Now the Spirit ofthe Lord departed from Saul, and an evil spiritfrom the Lord tormented him” (1 Sam. 16:14).In this story, David was summoned to play hislyre for Saul, because David had musical talent,and David’s music greatly consoled Saul. Saulhired David to work for him, and “wheneverthe evil spirit from God was upon Saul, Davidtook the lyre and played it with his hand. So Saulwas refreshed and was well, and the evil spiritdeparted from him” (16:23).In the New Testament, madness is sometimesattributed to demons. In the Gospel of John,Jesus’s opponents at one point say, “He is demonpossessed and raving mad. Why listen to him”(John 10:20). In another incident, Paul tells therecipients of one of his letters, to make a point,that he is speaking as though he is mad, with noimplication of a supernatural aspect at all.These examples illustrate something that istrue throughout the Old and New Testaments:when madness is portrayed, it is often seen innaturalistic terms, but the Lord often has somethingto do with the madness (for example, Deut.28:28, Jer. 25:16 and 51:7, and Zech. 12:4).Not only does the Bible contain informationon an ancient way of viewing madness in spiritualterms, but it also contains large portions of wisdomliterature that is analogous to modern selfhelpliterature, although religious readers wouldconsider it help from God. Wisdom literatureexists in many writings from the ancient world,and there are parallels in the Bible to Egyptianwisdom literature. The books of Proverbs,Ecclesiastes, Wisdom, and Sirach all containadvice on how to live life and how to understandlife’s difficulties.2 . MADNESS AND RELIGION IN THEANCIENT WORLDTh e ancient world presents a wide range ofworldviews and a number of philosophies ofhealing. Religion, psychology, and medicinewere intertwined, for example, in the ancienthealing cult, the cult of Asclepius. The cult ofAsclepius was the most widespread healing cultin the ancient world, originating with the ancientGreeks and lasting until after the time of Christ.Asclepius was a god of healing whose templeswere places of healing. One of the principalmethods of healing in the temple was making avotive offering of a small replica of the diseasedorgan and waiting for healing. Healing oftencame through dreams in which Asclepius would