Spirituality & Mental Health

The title of this post is also the title of a lecture I had today. I wasn’t really sure what it was going to be like and anticipated feeling mildly/deeply uncomfortable depending on how overtly religious the lecturer was.

The closest psychology really gets to offering some kind of spiritual support during times of mental ill-health is in the area of transpersonal psychology, which integrates psychological concepts with spiritual disciplines. For me personally, this comes rather too close to the murky Freudian world of psychoanalysis, however our lecturer did point out that many people who are deeply spiritual and/or religious might well feel something is missing from the mainstream psychological models of mental illness. These models tend to avoid any mention of the spiritual dimension in terms of health – this is partly due to the fact that there is no clear consensus on what the term “spirituality” actually refers to, but also because we tend to view religion and spirituality as something both intensely personal and private, but also to a certain degree unmeasurable.

How do you quantify spirituality or religiosity? By the number of times someone prays/meditates/goes to church? Is it possible to measure the strength of people’s faith or belief in something? Before I go on, just in case you are, as I was, unclear about what spirituality really means, or at least, what it can mean (I had an image of a serenely smiling individual calmly meditating in lotus position before a nice blue soothing background). Here is Wikipedia’s definition (I know, I know, but it’s so easy):

“Spirituality can refer to an ultimate or an alleged immaterial reality; an inner path enabling a person to discover the essence of his/her being; or the ‘deepest values and meanings by which people live.'”

This definition still somehow seems a bit vague and wishy-washy to me, but anyway.

In addition to this problem, unless you are a truly evangelical believer, most people are extremely cautious about discussing religious and spiritual beliefs, either through fear of offending someone, or because they are afraid of being ridiculed, or simply because they view it as being rather unseemly to declare your religious affiliation in public. This is perhaps more the case here in the UK rather than in the US, where according to our lecturer church attendance can be as high as 80%. I was reminded of this recently whilst watching some programme, I think it was American Idol, with my housemate. Several of the contestants openly acknowledged God as being key to their success – on stage, in front of an audience, who actually applauded – something which I feel would almost certainly be met with a slightly awkward embarrassed silence were that to happen on, for example, the X-Factor. Perhaps I’m wrong, maybe that does happen on talent shows over here, but I’ve never seen it myself.

This unwillingness on the part of mental health professionals to engage with “service users” (not my favourite term, I have to say) on the subject of spirituality is apparently now being viewed with concern. There is a growing sense (in some areas) that the mental health profession has got too caught up in the biological/genetic/medical model of mental illness and needs to start taking a more holistic view of a person’s overall health and wellbeing.

There is also an interesting overlap between religion and psychiatry when considering psychosis. How, for example, would you differentiate between someone hearing the voice of God and speaking in tongues and someone experiencing a psychotic delusion? A substantial minority of people who go to church (particularly the more evangelical “Testify!” kind of groups) are likely to report having spoken in tongues or seen someone else do so. But these people are not seen as being mentally ill – not in the medical sense anyway – deluded maybe, but not actually certifiable. So what is the difference between that person in church and a psychotic patient experiencing religious delusions in a psychiatric hospital?

It is uncomfortable for us to realise that the main difference is in fact how that person is perceived by others around them. The context of a person’s delusions and hallucinations is a strong factor in deciding whether or not that person is mentally ill. In some developing countries the kind of behaviour that we perceive as psychotic (and therefore requiring medical treatment) is much less likely to be seen as  symptoms of an illness.

The third episode of BBC4 documentary Inside the Medieval Mind, which was shown on Monday evening, mentioned a man in the Middle Ages who became possessed by demons, tore off his clothes and ran down into the nearest village, presumably then proceeding to disturb the peace to no little extent. On being caught and bound with rope so he couldn’t escape, he was taken to the local church and left tied up in front of the shrine in the charge of the monks. After three days the demons left him and he was released. Nowadays we would class this as a psychotic episode. Although the villagers’ treatment of him might seem somewhat barbaric, I don’t honestly think it is much different to the way psychiatric patients are treated today. Admittedly we don’t tie people up, but we still restrict their freedom by keeping them in hospitals and even if they are discharged back into the community, they may be on a Community Treatment Order which obliges them to comply with their medication or face being taken back into hospital.

The possessed man in the Middle Ages was presumably tied up both for his own safety and for the protection of others. That is the same justification used for sectioning patients today. The difference is that once the demons had left the man, he was seen as being back to normal again. Admittedly he may well have suffered other episodes later on, but the fact that his behaviour could be attributed to supernatural forces beyond his control probably meant that he would not have suffered the stigma of being labelled a “crazy person”, but seen more as a victim in the eternal struggle between the forces of light and dark.

This is not to say, however, that modern psychiatry is not an improvement on the rather primitive methods of “treatment” used in the Middle Ages. It should also be remembered that whilst bizarre behaviour is more likely to be tolerated in the communities of less well-developed countries today, there is likely to be more stigma resulting from the perceived cause of the behaviour (e.g. a punishment from God), which may cause considerable distress to the sufferer. This is the negative side to religion that I cannot bear.

Bill Bryson writes in his book Neither Here Nor There of his visit to a town in a Scandinavian country (I can’t remember which one at the moment) where the patients at the asylum used to come and mingle with the locals: going into the newsagents to pick up a paper etc. and any behavioural oddities they exhibited were just accepted by the townsfolk and no one batted an eyelid. How on earth they managed to get the locals to agree to this intermingling in the first place I have no idea – I can just imagine the uproar if anyone suggested doing something similar with a local psychiatric hospital in this country. Of course, we don’t know whether this freedom was granted to all of the patients, perhaps they had to be relatively well-functioning anyway. But I still feel that this level of acceptance is a fine example and should perhaps be promoted more. Much of our aversive reaction to odd behaviour – the homeless man shouting in the subway, or the old woman talking animatedly to a lamppost – is caused by embarrassment and our own negative reactions, which only adds to any stigma that people may experience.

Anyway, this blog was supposed to be about spirituality and I have almost completely wandered from the point. I can just about see it, like a little light winking away in the darkness far far away, but I have already written a forest of words and it’s too late for me to fight my way back through them, so you’ll just have to manage with this for now.

I hope you found the ramble at least mildly interesting. Once again, any thoughts or comments, please feel free to leave them below.

Thank you for reading x

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3 Responses to Spirituality & Mental Health

  1. I really enjoyed this blog entry. Thanks for putting this very interesting issue into some perspective. I’m a religious person myself and am well aware that just as religion exists on a dimension that runs perpendicular, so to speak, to science, it also seems to exist outside of scientific notions of sanity/insanity.

    Keep up the great blogging!

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