Religion and Spirituality in Psychiatry

298 William P. Wilsonforgiveness does not have the effect of spiritualforgiveness. The following is a case that illustratesthe healing power of forgiveness.This patient was a Vietnam veteran who hadbeen regenerated early in life, but in time becauseof cultural influences became an alcoholic andaddicted to marijuana. He also, while stationed inKorea for a short time, got a woman pregnant butthen deserted her when sent to Vietnam. He hada wife and two children back in the United States.He was sent to Vietnam in a noncombat role. Intime he was issued a new rifle that he took witha friend to the rifle range to learn how to shootit. He was drinking a pint of whiskey a day andsmoking two to four joints of marijuana at thetime. On their way back, they stopped by theroadside to shoot at random targets. They sawan old man and woman approaching them. Hisfriend said, “Hey look, there’s a couple of targets.”With that, he fired two shots and killed themboth. The next day, he was a psychiatric casualty.Eventually, he was evacuated to Okinawa,Honolulu, San Francisco, and finally dischargedto a Veterans Administration (VA)hospital wherehe spent six months. Finally he was dischargedfrom the VA, essentially unchanged, and returnedhome, but soon he chose to move and work inour community. For eleven years he lived withhis guilt and shame. A month of treatment tenyears later did not help, and one year later duringa vacation he finally came back to our local VAhospital to find out if anything else could be donefor him. The resident felt he did not know whatto do. His supervisor then suggested he presenthim to me because I had done research on posttraumaticstress disorder (PTSD).When I interviewed the patient he admittedto his sins. I asked if he felt he could be forgiven.He said no. He said he had prayed that someonewould kill him to punish him for his sins.When reminded that he could commit suicidehe said, “No I deserve to be punished for whatI did.” I chose not to debate the issue with him,but instead dismissed him. I then discussed theexistential despair of morality and death that hesuffered from with the residents and medical studentswho were in attendance.After my teaching session, I told the residentthat I had unfinished business with the patient,and wanted to see him again. In the company ofthe resident and a medical student, I took himin an office and asked why he said he could notbe forgiven. He said that he had committed anunpardonable sin. I told him that it was onlyunpardonable if he attributed his murder of thetwo people to God. He responded, “No, I didit.” I then told him that if Jesus could forgive hismurderers as they were crucifying him, surely hecould be forgiven. Then I said, “In Jesus’ nameand by his power you are forgiven.” Big tears teeteredon his lower lids for a moment and thentrickled down his cheeks. With this he beganto sob and weep profusely. He spontaneouslyembraced me and laid his head on my chest saying,“Are you sure?” “Yes,” I replied. “The Biblesays that if we confess our sins he is faithful andjust to forgive us of our sins and cleanse us of allunrighteousness”(1 John 1:9). After he wept forat least ten minutes and thoroughly soaked myshirt with his tears, he asked me if there was anythingelse he needed to do. I told him he neededto rededicate his life to the Lord. He did and wastotally healed.5.8. ExhortationExhortation was commonly practiced in the earlychurch and is still considered a gift of the Spirit.Exhortation as a gift is the ability to help others toreach their full potential by means of encouraging,challenging, comforting, and guiding. Christiantherapists should remember that they are not tobe neutral when transforming minds. To achievethe change they have to positively exhort a patientbecause it is difficult to refute many misbeliefs.Exhortation (strong encouragement) was usefulin a woman with three children who consultedme because her husband was divorcing her. Heleft her to marry a much younger woman. Thisman was obsessed with building an estate, so hewanted to divorce her and not have to pay anyalimony or child support. The woman was verydepressed and hopeless so she wanted to agree tothe settlement that he proposed. This would have