Religion and Spirituality in Psychiatry

274 Laurence Borras and Philippe Huguelet5. ALTERNATIVE THERAPY USE BYPATIENTS WITH MENTAL DISORDERSIn Western societies, patients feeling that theirunderstanding of the disease and their personalperception of being ill are not properly understoodhave many different reactions, and we, asdoctors, have to deal with them. Classical medicinedefines diseases as a general or local failurewithin a complicated system of a physical andchemical nature. The spiritual factors related tohealth conditions are generally left out of thisinterpretation. Given this context, it is only naturalfor the patient to turn toward alternative andcomplementary medicine. A survey published in2002 in the United States stated that 36 percent ofthe population resorts to “alternative and complementarymedicine.”( 36) Chinese and ayurvedicmedicine, acupuncture, meditation, hypnosis, taichi, qi gong, chiropractics, praying, and spiritualhealing are among the many practices that generateseveral billion dollars per year, which patientsspend without hesitation and without any financialsupport. This is true for most Western countriesbecause, according to surveys, the numberof consumers seeking alternative health servicesvaries between 20 percent and 50 percent, oreven 65 percent in Japan.( 37 , 38 ) Chronic mentaldisorders represent a major reason why patientsturn toward alternative therapies. (39) This is inresponse to their lack of satisfaction with conventionaltherapies, their desire to seek controlover their health-care decisions, and their desireto include their philosophical values and religiousbeliefs in these therapies.( 40 , 41 ) Severalstudies revealed that health professionals tend tounderestimate the extent to which patients turnto such therapies, which, in some cases, mayworsen medical compliance and interaction. (42)On the other hand, as shown earlier, more andmore general practitioners have been willing toentertain the idea of spiritual healing and includeit in their daily practice or referral network. Theyhave understood that recognizing patients’ beliefsin the face of suffering is an important factorin health-care practice. The counseling methodsincorporated in these medical approachesemphasize the person’s concept of God, his orher sources of strength and hope, and the significanceof religious practices and rituals for thatperson. (43) Twenty-five percent of the medicalpractitioners in the United Kingdom, 50 percentin Canada, and 80 percent in Victoria, Australia,regularly refer their patients to complementarymedicine practitioners. In Victoria, 20 percentresorted to meditation, 5 percent to prayer, and50 percent expressed their intention to attendtraining programs. A significant number ofhealth professionals in the United States actuallypray with their patients, because praying is recognizedas an efficient coping strategy. (42) Thetreatment of alcoholism has historically includedspiritual considerations. (44) Such treatments foralcohol abuse were often a composite of physicalmethods of relaxation, psychological methods ofsuggestion and autosuggestion, social methods ofgroup support and service to the community, andspiritual techniques of prayer. Such proceduresare still in use today and have been extendedinto the realm of chemical dependency and drugabuse. (45) Spiritual healing groups increase innumber every day. In some regions of the world,they have organized themselves into confederationsto practice in hospitals and take referralsfrom physicians. Their code of conduct coverslegal obligations and emphasizes full cooperationwith medical authorities. (46) Spiritual healing ispracticed throughout Western Europe and theUnited States and occurs in two different ways.The first involves hands-on contact or near contactbetween the healer and the patient, similar tothe church ritual of the laying on of hands. Thesecond is distant healing, where a healer or groupof healers pray or meditate for the absent patient.There are various explanations for how spiritualhealing works, including metaphysical, magnetic,psychological, and social. Most spiritualhealers maintain there are divine energies thatare transferred from the spiritual level by thehealer and that produce a beneficial effect on theenergy field of the patient. The notion of theenergy field is a source of disagreement betweenorthodox researchers and spiritual healers. (46)Researchers argue that, if such a field exists,