Religion and Spirituality in Psychiatry

Community Psychiatry and Religion 225to be practiced in “fundamentalist” ways. Whenone modality of care is the “only way to treat,”or when “religious rules” become narrow andoppressive, we are appealing to the desire of averagepeople for a simple solution. In fact, healingmore often occurs (spiritually and medically) ina slow fashion. Of course there are exceptions.But the culture of “quick fix” feeds the way weview healing. Quick prayer would be nice. Oneunqualified pill (with no adjustments next month,please!) would be preferred. Mutually respectfulcollaboration over time between clinicians andfaith leaders can assist in keeping perspective onthis cultural tendency.5. STEP 5: INTENTIONALCOLLABORATION, TRAINING,AND SUPERVISIONCollaboration doesn’t just happen because wehave chosen to work together. Collaboration isan art more than a strategy. If “parity” or mutualrespect is not experienced by both providers ofcare, it may confuse rather than assist the client.In my practice over the years, I have noticedsome pastoral counselors and clergy abandontheir empathic skills when ministering to peoplesuffering with emotional illness in favor ofa more distant approach they feel is appropriateand more acceptable in the medical world. Here itis worth emphasizing that effective treatment andcare does not limit itself to clinical approachesor spiritual approaches. There are many paths tohealing. Good spiritual responses will providehealing outcomes but will likely look a bit differentthan clinical strategies.The best collaboration probably needs twoindividuals who appreciate supervision. I havenoticed how students I teach (spiritual leadersand clinicians) do not often get the kind of supervisionthat might have been available a few yearsago. I mean the kind of supervision that is supportiveand feels safe enough for me to hear whatin me is getting in the way of a good assessment.The idea of getting supervision in this way is foreignto some spiritual leaders, yet it can releasethe great burden they feel as “leaders expected tohave all the answers.” And can we admit that, insome clinical settings, supervision looks more likeadministrative oversight than honest, supportivereflection on our own issues? Supervision, in thissense, is probably much less common than any ofus would admit.It is interesting that the history of some regionsreveals why there is great distance between faithleaders and mental health practitioners. Storiesmay live in a particular region of “turf wars”between those who hold the “authority” to treat,or who can explain human behavior, or who arequalified to offer remedy. Sometimes historicalevents support religion as primary, while otherregions might support medicine or science. Fartoo often the result is not a shared model of caring,but a polarized tension expressed by a criticaleye that someone is not qualified. Lack oftraining or reckless lack of sensitivity can scarthe possibilities of collaboration. However, creativemodels of training that incorporate spiritualand psychological insight matched with buildingrelationships between the helping professionscan go a long way toward forming a collaborativeoption for caregivers.A couple of training models are worth mentioninghere. Both nurture the kind of collaborationthat helps to avoid polarization.If mental health practices/agencies reviewtheir “continuing education” events (conferences,case presentations) as an outreach to local faithleaders who see their work as a pastoral counselingministry, the chances increase for mutualunderstanding and insight. This is especially true,of course, if their insight is sought to understandinga case. This might be the first move towardcollaboration. The required continuing educationupdate in a clinical topic might need someattention to language (allowing for clinical andeveryday language) for such an event. The avoidanceof condescending attitudes will encouragehonest discussion and ideas.A program specifically designed to blendspiritual and psychological insight in trainingand case discussion is a second model thattakes a bit more planning. The pastoral counselingprogram (6) in Connecticut falls into this