Religion and Spirituality in Psychiatry

Models of Mental Illness and Its Treatment 277recommended therapy and on the prognosis ofthe disease in addition to influencing their copingwith its symptoms. Several studies have shownthat there is a negative correlation between a negativerepresentation of illness and the acceptanceof the recommended therapy. (52, 54, 55)6.7. Religious DeliriumIn our research study, six to 10 percent of thepatients with psychosis presented manifestationssuch as delusions or religious hallucinations,which obviously can influence the patients’understanding of their psychological processesand their understanding of illness and treatment.Some of these manifestations may be aggressiveand lead to feelings of guilt, thus being a discouragingfactor that can negatively influence theprognosis of the disease. A 30-year-old patientsuffering from paranoid schizophrenia said, “Iam transparent; everybody knows my thoughts,my feelings and my dreams. God wants to killme; He wants to kill my soul. Everybody knowsthat God is planning to assassinate me. They’retalking about it on the TV and on the radio too.I have tried to kill myself twice, but now I havegiven up, God will do it for me anyway.”( 52)Other manifestations of this kind may have apositive impact on the patients’ coping with theirillness. A 40-year-old patient suffering from paranoidschizophrenia said, “My illness opened mymind to spirituality. I do not talk about it to psychiatristssince they do not believe me. Before Ireceived medication, I heard voices. Once I tookrefuge in a church, I prayed to the Virgin Maryand the voices felt silent. Since that day, she hadprotected me. Sometimes she appears to me; it isnot a hallucination.”(52)6.8. Spiritual Understanding of TreatmentThe understanding of medical treatment mayalso be influenced by religious beliefs. As shownearlier in this chapter, certain patients may considermedical treatment and psychotherapy asa divine gift intended to cure the disease. Godis thus enlightening humans, whereas doctorsare perceived as God’s instrument. Thus, therecommended treatment will be more easilyaccepted. For others, treatment related to religiousbeliefs may be seen as destructive, beingoften perceived as a foreign body or as poisonor even as a straitjacket. What they are tryingto highlight is that the recommended treatmentand their religious beliefs are not compatible.A patient said, “Only God can control people’sthoughts. Doctors and drugs cannot do that.”Another patient said, “People are the way theyare because God wanted them to be this way, sowe shouldn’t try to change this through medication.Another said, “God thinks that this is notnecessary.” Some patients seek spiritual healingonly, as often dictated by their religious leader.Other patients emphasize the incompatibilitybetween what is being transmitted to them duringpsychotherapy sessions and their religiouseducation. Taking care of oneself and learning tosay no and to aspire toward self-accomplishmentmay enter into conflict with certain religiousteachings. These teachings often encourage serviceto others and the community and the subordinationof one’s personal needs. Suffering andbenevolence may be perceived as salutary. (54)7. RELIGION AND MEDICAL TREATMENT:INTERFERENCE OR MUTUAL BENEFIT?Over the last forty years, several articleshighlighted the relationship between spiritualityand understandings of illness. They also emphasizedthe need to take spirituality into account inthe development of health-care services, especiallyaiming at improving the acceptance of therecommended therapy by the patient and themedical relationship with the patient. This issuewas closely looked at in research studies concerningpatients suffering from severe chronicsomatic diseases (56–60) and patients with unipolaror bipolar mood disorders, (55) schizophrenia,(54) or substance addiction. (61) In mostcases, a positive impact of religious beliefs onadherence to the treatment was reported, whichfacilitated the current integration of a spiritualapproach into many health-care services. This