Religion and Spirituality in Psychiatry

12 Self-Identity and Religion/SpiritualityPIERRE-YVES BRANDT , CLAUDE-ALEXANDRE FOURNIER , AND SYLVIA MOHRSUMMARYSelf-identity results from construction. Selfconsciousnessis achieved in several steps. Basedon the attachment bond, the infant’s self is constructedwithin the framework of the first dyadicrelationships, particularly the relationship with themother. It successively enriches itself with new selfsenses (Stern). By language and by the access to thesymbolic function, infants get more directly in contactwith cultural constructs, reference points theycan identify with. Thus, religious figures replaceattachment figures and play the role of substituteof the parental figures. Based largely on a definitionof self-identity by Ricoeur, this chapter showshow the religious dimension of the self stems fromthe interaction between processes one can identifywith, present ever since infancy, and the culturalenvironment the individual comes into contactwith. Religious traditions carry reference pointsone can identify with especially via accounts, rites,and roles. Highlighting the aspects one must takeinto consideration when providing therapeutictreatment, we illustrate these processes of identificationby three case studies. Religion can helprestore identity but it can also weaken it. When thepatient and the therapist come from very differentcultural contexts, it is important for the therapistto try to integrate the patient’s reference system tosupport the therapeutic alliance.1. INTRODUCTIONSince the beginning of the twenty-first century,narcissistic issues have become quite meaningfulin the clinical picture. The increased fluidityof reference points has rendered identities moreunstable, more blurred. For a certain number ofour contemporaries, this context weakens the constructionof the relationship with the self. Whenthis situation is experienced in a painful manner,it results in a feeling of identity loss with a depressivecomponent, or even in identity disorders withpsychotic characteristics (identity confusion in themanic form of a grandiose self or schizoid organization,for instance). The need to relieve this sufferingmanifests as a quest for landmarks, in thehope of reassurance or even confirmation of one’strue self (for example, in the fields of sexual orientation,intergenerational relations, professional,or vocational choices). This expectation applies toall systems that provide a sense of purpose, amongwhich religions play a special role.2. THE ROLE OF RELIGION/SPIRITUALITY IN THE CONSTRUCTIONOF SELF-IDENTITYHow can a religious system or spiritual frameworkaddress this need? Let us note from the startthat individual identity is not an automatic given.It results from development during which psychologicalprocesses are at work. Based on initialfigures of attachment, the infant’s and then thechild’s self is constructed according to parentalmodels. Afterwards, by progressive socialization,the child gets in contact with an increasingly vastcircle of figures to identify with (potentially). Inadolescence, some of these figures (peers, adultrole models, or idealized historical or fictionalcharacters) will play a decisive part in finding thestrength to break away from the family environment.All these processes at work from birth until158