Religion and Spirituality in Psychiatry

Self-Identity and Religion/Spirituality 169useful to attempt to extend this process to otherareas such as hobbies or clothing, for example.It remains to be seen whether the goal of havingthe same hobbies as other young people her age(Muslims or not Muslims), or dressing like otheryoung girls her age would help the patient fightagainst social breakdown and find more confidencein public and in interpersonal relations.Second possibility : Praying helps Ms. T. tomaintain contact with a reassuring figure, thatis, God. In this case, the content of the prayerdoes not necessarily consist in recited formulasbut perhaps rather in a private conversationwith God, or even a silent certainty of being incontact with the divine presence. Praying couldbe a means of recalling the security of previousexperiences, or it could be a kind of psychologicalenvelope created to finally achieve a secureself. From this point of view, the coping processwould result from the activation of the attachmentbond where the divine figure replaces the previousattachment figures. Indications for treatmentwould consist in encouraging the patient to prayevery time she feels nervous and begins to panic,especially when she is confronted with a feelingof emptiness.Being able to distinguish between these twoforms of praying is very important because theycall for distinct coping strategies. Of course, thesestrategies can be combined. During ritual prayer,the Muslim believer can both strengthen herfeeling of belonging to a community of believersand her relationship with Allah. It is also possiblethat praying combines the recitation of the fivedaily prayers with other more personal instancesof praying. It is also possible, however, that theypractice only one kind of praying, which essentiallyentails only one of the processes described.Therefore, if Ms. T.’s praying consists exclusivelyof reciting the five daily prayers, and she doesnot rely on them to experience a secure relationshipwith God, but rather to experience the reassuranceof praying properly and being a goodMuslim, there are strong chances that the suggestionto pray whenever she starts to panic willnot help. As a matter of fact, reciting the dailyprayers means reciting them at precise hours.As for the feeling of panic, it can surface at anytime of day. If, on the contrary, her praying is notcentered around the five daily prayers but ratheraround establishing contact with God at variousmoments throughout the day, especially duringtimes of panic, a “be like everybody else” copingstrategy would not apply. The suggestion to try tostrengthen her feeling of belonging with youngpeople her age by trying to be like them risks nothaving any effect because it is not directly linkedto the coping mechanism she has created throughprayer to face the panic of exams. This is why itwould be more judicious to suggest that she findstrength in prayer every time that she feels helplessduring the day and not only when dealingwith exams. (Later, it was found that this optionwas the correct one.)12.3. Case 3Mr. Z. is an immigrant worker of Muslim originfrom a nonpracticing family environment.When he left his country, he started usingcocaine and LSD. He also lost contact with allreligious Muslim influences. He stopped takingdrugs four years ago when he married a womanwho came to join him from his country of origin.Since then, two children have been born.He claims to have returned to religious practiceat the same time and has become very devotedto it. He goes to the mosque every Friday andrecites his prayers five times a day. He declares,“Thanks to religion, I don’t do anything foolishand I don’t sin.” He complains of auditory hallucinations,mainly insults, and of recurrentheadaches. When he prays, he is attacked by astrong desire to insult God. He stopped workinga few months ago, but is supported by socialservices. He spends a lot of time in bed and saysthat his wife complains about him not takingcare of the children. Regarding his recovery,the issue at hand is to help him take action. Themost important area in which an improvementwould be desirable for both the patient and hisfamily environment is the patient’s involvementin raising his children. We examined therole religion plays among the different resources