Religion and Spirituality in Psychiatry

168 Pierre-Yves Brandt, Claude-Alexandre Fournier, and Sylvia Mohrof the charismatic group played an intermediaryrole as an attachment figure, or if the securebond was directly established with God withinthe protective framework of the praying group.At the monastery, however, the attachment relationshipwas established with the Virgin Marythrough prayer. This was how she developed asecure relationship through which she was ableto identify herself with Saint Benedict, founderof the Benedictine order she wanted to join. Theconstruction of her monastic identity was shoredexclusively upon exemplary figures from the past.There was also a human religious figure, presentat her side: the novices’ superior. She representedboth an identification figure for Sister B., becauseshe entered the convent before her, and a possibleattachment figure, because she was dedicated tohelping the novices as a guide. At the convent,Sister B. built her identity by depending not onlyon saints’ figures, but also on the nuns around her,especially the novices’ superior, called “MotherSuperior.” In this role, the superior served as amother, an intermediary for attachment, andsimultaneously, as a sister, an intermediary foridentification.12.2. Case 2Ms. T. is 27 years old. She is a university student.She has been diagnosed as suffering fromschizophrenia following a social breakdown andhospitalization. Her parents are both nonpracticingMuslims. Her mother comes from an Arabiccountry and her father is English. The patientreports that she prays many times a day, alone athome, but that she never goes to the mosque. Shealso says that her beliefs help her find comfort,although she says she is not sure of her creed.“They are MY beliefs; I find it difficult to answeryour questions.” One of the present difficultiesshe identifies is failing her university exams.When in an exam setting, panic and anxiety preventedher from performing satisfactorily. Aftera period of treatment, she returned to her studiesand succeeded in passing the exams two years ina row. She says that prayer helped her to overcomeher panic and anxiety. During a controlsession, questions were asked about the form andthe content of this prayer to identify the copingprocess employed. It was obvious that the patientwas talking about her own act of prayer, and notabout others praying for her. It was also obviousthat she was talking about the act of prayer thatshe reports practicing many times a day. It wasnevertheless impossible to determine conclusivelywhat kind of prayer she was practicing:the ritual Muslim one, five times a day, or a morepersonal one. This case allows us to highlight twoapproaches to coordinating religion/spiritualitywith the self and with individual identity.First possibility : She draws her strength fromritual practice of Muslim prayer. In this case, itis the identification with a reference group thatstrengthens her personal identity. In stressfulsituations, the feeling of being a good Muslimmakes her feel secure. While not sure of herselfwhen articulating her beliefs, she could havefound a means of leaning on a firm point of reference:all Muslims recite prayers five times a day.Because her parents are not practicing followers,she doesn’t have the opportunity of being taken tothe mosque. Social breakdown is one of the characteristicsymptoms of schizophrenia. Recitingthe five prayers at home could be a means ofestablishing a link with a reference group andtherefore reducing the feeling of isolation. Fromthis point of view, the coping process can bedescribed as a support found in the possibilityof being like everybody else. The indications fortreatment would therefore consist in extendingthis process onto other ways of “being like everybodyelse.” Knowing that psychological illnesshas a tendency of being experienced as a loss ofcommonality with the other humans (“Am I normal?”),and knowing as well that the paranoia incertain ideas attack the consistency of the subject’sidentity, knowing that one is “like everybodyelse” can be reassuring. Of course, in a Westerncountry, practicing the daily five prayers does notpermit identification with the entire society. Thesubjects will identify themselves with the groupthey feel they belong to. By reciting the dailyprayers, Ms. T. can feel she belongs to the Muslimcommunity. Regarding her recovery, it could be