Religion and Spirituality in Psychiatry

17 Integrating Spiritual Issues into TherapyRENÉ HEFTISUMMARYThe task of this chapter is to give recommendationson how to integrate religious and spiritualaspects into the treatment of persons sufferingfrom mental illness, based on the evidencefrom past and recent research and from clinicalexperience.Religious coping is highly prevalent amongpatients with psychiatric disorders. Surveys indicatethat 70 to 80 percent use religious or spiritualbeliefs and activities to cope with daily difficultiesand frustrations. Religion helps patients tomaintain hope, purpose, and meaning. Patientsemphasize that serving a purpose beyond one’sself can make it possible to live with what mightotherwise be unbearable.Religious coping is also prevalent among familycaregivers and enhances emotional adjustment,lowers levels of depression, and fostersself-care. A substantial proportion of familymembers of persons with serious mental illnessmobilize religious and spiritual resources to copewith their situation as caregivers.Programs that successfully incorporate spiritualityinto clinical practice are described anddiscussed in detail. Studies indicate that theoutcome of therapy in religious patients canbe enhanced by integrating religious elementsinto the therapy protocol and that this can besuccessfully done by religious and nonreligioustherapists alike.1. SPIRITUAL PERSPECTIVESON MENTAL ILLNESS1.1. General ConsiderationsPrevious chapters of this book have demonstratedthe importance of religious and spiritual aspectsin psychiatric disorders providing evidence ofthe therapeutic potential for integrating spiritualityinto mental health treatment. Neverthelessspiritual approaches in mental health care arestill in their infancy, certainly in Europe butalso in the United States. Due to concerns aboutharmful effects, a controversy is ongoing regardingwhether or not to integrate spiritual elementsinto the treatment of persons suffering from mentalillness. At the same time, a growing body ofevidence shows beneficial outcomes of religiousand spiritual approaches to psychiatric disorderswith regard to the following aspects: seeing spiritualityas a unique human dimension, ( 1) makinglife sacred and meaningful, ( 2) being an essentialpart of the physician-patient-relationship, ( 3)and the recovery process.(4 , 5 )1.2. Spirituality and the RecoveryPerspectivePersons suffering from mental illness have beenexploring spiritually based approaches to mentalhealth for decades. Most importantly, they emphasizethat psychiatric diagnosis does not affect thedeepest human drives, that is, to live with purposeand to flourish as a human being. Understanding244