Religion and Spirituality in Psychiatry

Models of Mental Illness and Its Treatment 2691. MENTAL DISORDERS THROUGHOUTTHE CENTURIESA brief look into history will allow us to betterunderstand the great number of theoreticalperspectives on mental disorders that have preoccupiedhumanity since the beginning of time.Indeed, in every culture and at all times, theunderstanding of mental disorders, their treatment,and healing had their foundation in religion.In prehistory, illness, suffering, and deathwere probably already being interpreted in supernaturaland magical terms. Therapy and healingwere left to shamans and healers who, thanksto their privileged relationship with their gods,were thought to be able to cure madness and helppeople escape evil forces by using religious andmagical rites (incantation, herbs, and physicaltherapy). (1)During antiquity, while Pythagoras, Hippocrates,and Plato were laying the foundations for diseasebasedpsychiatry, ordinary people would continueto associate medicine with magical practicesand religion. Mental disorders were perceivedas impurity, so healing and salvation were left topriests. (2)During the Middle Ages, religious and themedical approaches to mental disorders coexisted.From a religious viewpoint, some patientssuffering from mental disorders were consideredto be possessed by demons. People sufferingfrom psychosis often thought they were“possessed by the devil,” to the point that theywould proclaim it themselves. Therefore, ratherthan going to the doctor, would entrust their illnessto the saints, who were thought to have thedivine power to chase away the demons. Thus,people suffering from psychosis often foundshelter in monasteries. (3)In terms of health services provided topatients with mental disorders, the Renaissancewas a mere prolongation of the Middle Ages, butit also marked the epoch of the first great humanistdoctors. One of them, Jean Wier (1515–1588),of Belgian origin, defended the medical thesisof mental disorders and strongly rejected thesatanic theory, protesting against “the practice ofburning mad people at the stake.”( 4)During the seventeenth and eighteenth centuries,the religious perspective on diseases continuedto prevail. People believed that diseaseswere sent by God as a warning or a punishmentand that they were meant to guide the spirit toits salvation. So a good Christian was expectedto endure disease with patience and even withjoy. Doctors and priests jointly took care of thepatient; in addition, the doctor even had the dutyto make sure that the patient confessed his sins.In 1712, according to a royal declaration, doctorscould not visit severely ill patients morethan three times, unless the patient provided hisconfession certificate. The priest himself had atherapeutic role. Beside its spiritual effects, theadministration of the unction sacrament wasthought to help restore the body’s health. (5)Along with the nineteenth century came theemergence of psychiatry and the classification ofmental disorders. General psychopathology, psychoanalysis,phenomenology, biologic psychiatry,and sociocultural approaches also developed.However, the major schools of thought as well asthe understandings of the disease and its treatmentremained influenced by various religiousand sociocultural factors. (4)2. THE SOCIAL UNDERSTANDINGSOF DISEASEMental disorders are explained and studiedvia a medical discourse based on classification.However, mental disorders are definitely morethan a mere medical inventory based on scientificresearch.They actually point to a complex reality: Forsociety and for social actors, disease is synonymouswith sorrow or with an event threateningto disrupt one’s personal life, social status, andmeaning of life in general. (6) Suffering peopletend to build their understanding of the diseaseaccording to social constructions collectivelyelaborated, which cannot be reduced to mere