Religion and Spirituality in Psychiatry

36 Armando R. Favazzaatonement and a return to holiness were alsopossible through prayers and repentance. Thus,Samuel 15:22 states, “Does the Lord delight inburnt offerings and sacrifices as much as in obeyingthe voice of the Lord? To obey is better thansacrifice, and to heed is better than burnt offerings.”And Hosea 6:6 states, “For I desire mercy,not sacrifice, and acknowledgment of God ratherthan burnt offerings.”In the N.T. Jesus overthrew the Levitical lawsand expanded on the Ten Commandments in hisSermon on the Mount (Matt. 5–70) as well as onthe concept of sin. For him, the one unpardonablesin was blasphemy against the Holy Spirit.The N.T. Epistle of Paul to the Romans notes,“For the wages of sin is death, but the gift of Godis eternal life in Christ Jesus our Lord.” The N.T.firmly established the concepts of hell and heaven.Differing interpretations of the N.T. by variousChristian groups hold that heaven can be reachedonly by the grace of God, or by a combination ofgood works in addition to the grace of God, orby being fortunate enough to be a person predeterminedby God for heaven. People can be reconciledwith God through baptism, following hisrules, prayers, and acts of contrition.A common result of sin is guilt, the remorsefulfeeling of having done something wrong leadingto self-reproach and even self-hatred. Becausehuman beings are imperfect, it is impossible forthem to consistently fulfill the expectations ofJudaism or Christianity, for example, one of theTen Commandments states that it is sinful tocovet a neighbor’s wife or possessions. Thus, evenfantasies may be sinful. Both religions rely partlyon a guilty conscience to control the behaviorof its members. People regard their conscience,which in psychodynamic terms is the consciouspart of their superego, as if it were a guide or ajudge that is better than themselves and evenseparate from themselves. It reflects a society’sethical and moral standards that, in great part,derive from religious teachings. Behaviors, suchas committing a sin, that are disapproved of byone’s conscience result in anxiety, guilt, and loweredself-esteem. A saying commonly attributedto the Jesuit Order of Catholic priests is, “Giveus control of a child until he is six years old andhe will be ours forever.” The reasoning here isthat the basic structure of the conscience is set inearly childhood but will affect people for the restof their lives.The conscience is an important stabilizer inpeople’s lives. Persons with a limited conscienceare sociopaths and moral monsters, but personswith an overly strict conscience may experiencechronic guilt. Dythymic persons experiencetheir guilt by feelings of inferiority, depression,and worthlessness, while obsessive-compulsivepersons experience their guilt by attempting todeny and to magically counteract it through theirsymptomatic rituals that, like a religious service,must be performed flawlessly. People whose consciencesare unbearably harsh may develop apsychotic depression with suicidality and cometo regard themselves as truly great sinners whoare condemned to hell.Because the conscience reflects a society’smoral and ethical standards, cultural changesover the past century have diminished thepotency of sin as a regulator of behavior and ofhell as an actual, eternal reality. True sin is basedon the notion of a free will choice, but this notionhas been undermined by alternative explanationsfor behavior, for example, genetics, chemicalimbalances in the brain, defective neuralcircuitry, child-rearing practices, peer pressure,and the influence of advertising. As far back as1850, the incredulous congregation in NathanielHawthorne’s novel The Scarlet Letter had alreadylost its ability to comprehend the heartfelt confessionof their adulterous minister. “Ye, that havedeemed me holy! Behold me here, the one sinnerof the world.”The reality of hell was based on the visions andaccounts of persons who claimed to have seen it,but this was undermined when the two greatestevocations of hell were described centuries ago inDante’s Inferno and Milton’s Paradise Lost, whichwere published as poems that sprang from thewriters’ imaginations. Today, sin has been transformedinto mental illness and criminality, whilehell has been transformed into accounts of toxicdumps and drug-induced stupors, and in the