Religion and Spirituality in Psychiatry

Personality, Spirituality, Religiousness, and the Personality Disorders 185attitude toward themselves and the world byexamining the spiritual dimensions of life.Piedmont (31) examined the predictive role ofspiritual transcendence as a predictor of outcomefrom an outpatient substance abuse treatmentprogram. Participants were long-term drug andalcohol users from an inner city, mostly homeless,population. The group’s overall personalityprofile showed low levels of both agreeablenessand conscientiousness, a pattern characteristic ofthe antisocial PD (see Table 13.2). The six-weekintensive program was fundamentally a spirituallyoriented intervention that included a numberof other modules (for example, vocational training,AA/NA groups, health awareness, and grouptherapy). Participants attended the programfive days week, for six hours a day. Individualscompleted a number of psychosocial measuresand the STS. Over the course of treatment,individuals experienced significant reductionsin emotional distress, improvements in copingabilities, and increased levels of spirituality.Interestingly, the STS facet scales of Universalityand Connectedness were the most robust predictorsof self and therapist ratings of outcome.Both of the facet scales stress one’s relationshipsto others. Universality reflects a recognition of lifeas being interconnected. Individuals are part of alarger social reality, a community of “oneness” thattranscends the many differences we experience inthis life. Connectedness stresses the importanceof the individual and his or her responsibility incaring for, responding to, and being involved withthe many social communities that a person is part(for example, family, neighborhood, and community).Enabling individuals to emotionally investin supporting communities may lead to generativebeliefs that provide a motivation for change.For those with an antisocial PD, creating anawareness of social responsibility works againstthe more manipulative, selfish orientation thatcharacterizes this disorder. As Piedmont (31)(p. 220) noted, “Spirituality’s therapeutic effectmay be in its ability to reintroduce [individualswho have been socially marginalized] asmeaningful players in the larger human polity.Spirituality stresses the value of people despitetheir brokenness; it emphasizes the importanceof each person’s life in maintaining the integrityof the fabric of human experience.”8. THE CURATIVE POWEROF SPIRITUALITYWhy does spirituality present as a useful therapeuticresource for treating personality disorders?There are certainly many answers to this questionranging from a belief in the healing powerof God’s grace to the perspective that spiritualityrepresents a “master motive” that organizes thepersonality and brings coherence to its strivings. Itis my opinion that the value of spirituality is that itserves as an antidote to narcissism. A materialistic,self-centered approach to life, where one is alwaysconcerned with obtaining gratification of personalneeds and wishes, leads to an impulsive style thatcan be easily frustrated by the demands of life.Here, life goals are usually oriented to the shortterm and relationships are usually manipulativeand emotionally superficial. Spirituality, on theother hand, represents a lifestyle that is transpersonalin nature, where one recognizes a transcendentreality that calls individuals to set personalgoals along an eternal continuum. A spiritual perspectiverecognizes that birth and death are onlydevelopmental signposts along a much longerontological process. Recognizing one’s connectionsto all life and embracing one’s responsibilitiesto care for others create relationships that are emotionallydeep, generative, and mutually satisfying.Being able to step outside of oneself and to putone’s life into a larger interpretive context can beemotionally healing and liberating. Committingto this larger vision allows individuals to find personalstability and coherence, even during timesof fluidity and disjuncture. For individuals lockedinto their own narrow worlds of emotional pain,personal ineptitude, and interpersonal inadequacy,this broader meaning may provide waysof coping with stressful events or creating buffersagainst negative feelings. It may also represent ahigher level of personality maturity.It is interesting to note that in reviewing theliterature on spirituality and the Axis II PDs, the