Religion and Spirituality in Psychiatry

10 Samuel B. Thielmanon supernatural explanations. Reginald Scott’s(d. 1599) book, Discoverie of Witchcraft (1584)reflects a point of view that grew in the sixteenthcentury: that people who are sad or distressedsuffer from a natural malady and not from supernaturalinfluences. Scott was a surveyor, not aphysician, and was active in the county governmentof Kent, England. Discoverie of Witchcraftis primarily an extended and entertaining argumentagainst the notion that witches actuallyhave supernatural powers. In the process, Scottreveals a lot about charlatanism in the sixteenthcentury, and the book even explains a numberof card-and-ball deceptions that in our time areconsidered to be magic tricks. Scott also toucheson the treatment of the insane and, in so doing,reveals how religious reasoning was used byfamilies to help those suffering from religiousdelusions.Scott recounts the case of Ade Davie, wife ofSimon Davie, a farmer from Scott’s home countyof Kent, and a person known to Scott. At sometime in her early adulthood, Ade, who had noprior history of any sort of melancholy or madness,“grew suddenlie (as her husband informedme … ) to be somewhat pensive and more sadthan in times past.” Simon was worried, but didnot tell anyone for fear that he would be thoughtguilty of “ill husbandrie.” But Ade became worse.She could not sleep, she cried, she began sighingand “lamenting,” and although her husbandpressed her, Ade would not provide any reasonfor her sadness. Finally, Ade fell to her kneesand confessed to Simon that she was depressedbecause she had sold her soul to the devil. Herhusband replied, “Thou has sold that which isnone of thine to sell … Christ … paid for it, evenwith his bloud …, so as the divell hath no interestin it.” The husband reasoned with her in this fashion.His wife then told him, “I have yet committedanother fault and done you more injurie: forI have bewitched you and your children.” But herhusband reasoned with her, “Be content … by thegrace of God, Jesus Christ shall unwitch us: fornone evill can happen to them that feare God.”With time, Ade recovered, “and remaineth a righthonest woman … shamed of hir imaginations,which she perceiveth to have growne throughmelancholie” (pp. 31–32).(16)Scott’s account and his general view of melancholyand the supernatural indicate that bythe latter part of the sixteenth century, naturalisticexplanations for mental disorders wereprevalent even among educated laymen. In fact,naturalistic explanations for melancholy wereprevalent among physicians throughout theMiddle Ages, although spiritual/religious factorswere acknowledged as playing a role in mentaldistress as well.(17)By the seventeenth century, a rather sophisticatedpractical way of dealing with psychologicaldistress emerged from the thinking of Puritanwriters. These writers, because of their concernwith spiritual experience, conversion, andthe inner spiritual life, were often very attunedto the existence of states of mental distress anddespair. Many offered pastoral advice that reflectsa concern for the psychological well-being of theindividual and provides a variety of spiritualexplanations and remedies.Among the most influential of the Puritanwriters on emotional distress was Richard Baxter(1615–1691), an Anglican priest who, in thosetumultuous times, became a “dissenter.” Becausehe could not in good conscience comply with theBritish Act of Uniformity, he could not preach,and so he had a lot of time to write. Baxterwrote prolifically about many aspects of livinga Christian life, and he also wrote about depression.During the 1660s, Baxter wrote A ChristianDirectory (1673), a gigantic compendium ofthoughtful and well-organized spiritual counselon a range of topics, including marriage, businessethics, lawsuits, government, dealing with sicknessand dying, church government, recreation,and, most of all, how to lead a spiritual life.(18)In A Christian Directory , Baxter wrote alengthy set of instructions on identifying andtreating melancholy. He thought of melancholyas a “diseased craziness, hurt or error in imaginationand consequently of the understanding”(p. 294).(19) It was characterized by preoccupationwith having irreparably sinned, perplexingthoughts, and the inability to divert thoughts to