Religion and Spirituality in Psychiatry

3 Theological Perspectives on the Care of Patientswith Psychiatric DisordersJOEL JAMES SHUMANSUMMARYTh e inclusion of religious considerations inpsychiatry and clinical psychology affords bothclinicians and patients an important resourcein understanding and therapeutically addressingmental illness. Yet that inclusion also presentspotential difficulties that may be avoidedonly by careful theological reflection; that is,by critical consideration of religious belief andpractice from the perspective of one or moreof those historical traditions we call “religions.”To avoid theological reflection is to risk reducingreligion to a technique valued only for itstherapeutic utility, which clearly threatens theintegrity of most religious traditions. In thischapter, I1 offer an account of tradition and explain whatit means to think theologically from within areligious tradition;2 suggest the ubiquity of theological and atheologicalassumptions in the worldviews of everypatient and clinician;3 follow theologian George Lindbeck in likeningthinking theologically to being part of a“cultural-linguistic” system constituting anentire way of life;4 discuss two significant theological difficultieslikely to arise at the intersection of psychiatryand clinical psychology for persons shaped byparticipation in the Jewish and Christian biblicalnarratives;5 suggest the therapeutic significance of somereligious communities as resources to be cultivatedby clinicians.A cursory glance at recorded history suggeststhat conditions like those we now call “mental illnesses”have been with us for a very long time, ashave the attempts of various cultures to accommodateand care for their mentally ill members. (1)And while modern psychiatric medicine has madegreat strides in the recognition and effective treatmentof mental illness and the destigmatization ofthe mentally ill, the discipline arguably has also followeda pattern typical of the applied sciences inmodernity, a pattern characterized by an escalatingspiral of specialization, reductionism, fragmentation,and alienation.(2) Just so, while medicinenow knows more than ever about the neurochemicalaberrations associated with depression, anxiety,psychosis, and so forth, these conditions areincreasingly regarded as individualized pharmacologicalproblems to be resolved clinically, as efficientlyas possible. This slide toward reductionismis one reason the reintroduction into psychiatryand clinical psychology of religious considerationsis, from my perspective as a theologian, so promising,for it calls into question the ready division oflife, so characteristic of our time, into the respectivedomains of ostensibly discrete disciplines.It has become possible once again to see mentalillness as more than a matter to be dealt with bythe clinician and the individual patient in relativeisolation. Clinician and patient alike, along withthe members of their respective communities, maynow understand psychiatric illness as a theologicalmatter as well, one that may be addressed fully onlyin light of a measure of theological reflection.Psychiatrists and other mental health professionalswho wish to take seriously their patients’religious faith need to develop some sense of thetheological issues at stake in such consideration.19