Religion and Spirituality in Psychiatry

Religious and Spiritual Assessment 237status. Inquiries about life-changing spiritualexperiences or religious practices are especiallyimportant to understand the impact of religionon mental health status. This initial investigationmay uncover that drastic changes have occurredin the patient’s spiritual and religious biography,such as significant growth or loss of faith, conversion,or apostasy.3.2. How the Illness Affects Spiritualityand/or ReligiousnessThe experience of the illness may also affect spiritualityand religious practices. This is why thepsychiatric interview inquires about relationshipsbetween the illness and changes in spirituality/religiousness. When confronted with mental illness,as with other stressful events, some peoplelean on their religious background to cope.Religious coping is not always effective; it canalso lead to negative outcomes. (14) Some peoplemay endow their delusions or hallucinations withspiritual meaning (see Chapter 7). Some peoplemay seek spiritual healing in various religiouscommunities (see Chapter 18). Some people mayquestion or lose their faith when confronted withadversity.of the appropriate spiritual language to use, makingit possible to adapt subsequent questionsaccordingly.3.4. Private Religious PracticesPrivate religious practices are individual religiousbehaviors occurring outside the context oforganized religion, and not always at a set time orplace. Praying, reading holy scriptures, listeningto religious radio programs, watching religioustelevision programs, or meditation are commonprivate religious practices.3.5. Religious PreferenceAsking about religious preference elicits whichreligious community or tradition the patient identifieswith. This preference doesn’t imply currentreligious practices but rather a social or culturalidentity. This cultural identity is of clinical interestbecause it may affect the patient’s attitudes andbehaviors toward substance use, sexuality, family,suicide, and other issues. It also indicates whichreligious community may support the patient ifneeded.3.3.Current Spiritual/Religious Beliefsand PracticesExploring the spiritual and religious historyleads to inquiries about current religious andspiritual status. Beliefs belong to the cognitivedimension of spirituality. By definition, beliefsdiffer from religion to religion. However, beliefsabout the meaning of suffering and death are insome way central to all religions and thereforemay be related to mental health status becausethey provide a framework of interpretation andexpectation. Beliefs not only vary across religioustraditions, but also among believers sharing thesame tradition. For patients who believe in Godor in a deity, it can be informative to ask abouttheir image of God and their relationship withhim. Asking the patient about his or her spiritualbeliefs gives the clinician an understanding3.6. Community Religious PracticesUsually, community religious practices includeorganizational religiousness that encompassesbehaviors such as membership in a congregation,frequency of attendance at religious services,involvement in other activities in the religiouscommunity (for example, choir practice, volunteeractivities, participation in a special interestgroup). It is also important to find out if thepatient meets individually with one or severalreligious leaders of the community and the frequencyof nonorganizational social contacts withother members of the congregation. This leads tothe question about the patient’s relationships withmembers of the religious community. Becausesocial isolation is so often associated with mentalillness, this item focuses on religious practicesthat the patient shares with others.