Trauma, Psychosis, and Spirituality: What’s the Connection?
January 8, 2011They don’t want you to conclude that shrinking brains is a bad thing
February 7, 2011In modern religions, people are taught to hope for some spiritual experiences in the future (heaven) and to fear other sorts of spiritual experiences (hell.) But if you actually have a spiritual experience in the present, they call a psychiatrist and determine that it is all a biochemical imbalance……
Recent research shows that people in the psychiatric system often strongly prefer to have professionals talk about spiritual concerns:
Huguelet, P., Mohr, S., Betrisey, C., Borras, L., Gillieron, C., Marie, A. M., et al. (2011). A Randomized Trial of Spiritual Assessment of Outpatients With Schizophrenia: Patients’ and Clinicians’ Experience. Psychiatric Services, 62(1), 79-86.
doi: 10.1176/appi.ps.62.1.79
Abstract
Objective: Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues, such as religion and spirituality. However, there is evidence that psychiatrists rarely address such topics. This study examined acceptance of a spiritual assessment by patients and clinicians, suggestions for treatment that arose from the assessment, and patient outcomes–in terms of treatment compliance and satisfaction with care (as measured by treatment alliance).
Methods: Outpatients with psychosis were randomly assigned to two groups: an intervention group that received traditional treatment and a religious and spiritual assessment (N=40) and a control group that received only traditional treatment (N=38). Eight psychiatrists were trained to administer the assessment to their established and stable patients. After each administration, the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion. Baseline and three-month data were collected.
Results: The spiritual assessment was well accepted by patients. During supervision, psychiatrists reported potential clinical uses for the assessment information for 67% of patients. No between-group differences in medication adherence and satisfaction with care were found at three months, although patients in the intervention group had significantly better appointment attendance during the follow-up period. Their interest in discussing religion and spirituality with their psychiatrists remained high. The process was not as well accepted by psychiatrists.
Conclusions: Spiritual assessment can raise important clinical issues in the treatment of patients with chronic schizophrenia. Cultural factors, such as religion and spirituality, should be considered early in clinical training, because many clinicians are not at ease addressing such topics with patients.
14 Comments
Ron,
My thoughts on spirituality are simple.
I believe we are spirits living in temporal bodies.
We are connected to a higher Spirit.
This is an eternal connection.
We are here on this earth for a brief moment.
One breath.
For those who are fortunate, two breaths.
And then we’re gone.
We are here for a reason
To learn to connect to this higher Spirit.
To learn to love one-another.
That’s it.
We know very little about our own brains.
We know even less about our own minds.
We weren’t meant to know a great deal.
We were only meant to learn to love more.
And to connect to the higher Spirit.
The Spirit is Love itself.
In the words of Carole King –
“Only love is real.”
“Everything else illusion.”
That’s what I believe.
Call me “crazy”.
Been called worse.
Duane
The last thing mental patients need is the administrations of religious idiots who believe in spirits and other risible fairy tales. Schizophrenia victims already suffer from delusional thinking from within so the influence of people infected with delusions about god can only make things worse.
I have been dealing with recovering Schizophrenia patients for ten years and have found that there is an urgent need to keep the religious well away from this vulnerable group.
John, I think your opinion is fairly common, but it is very different from my own. I could list a number of reasons why my opinion is different. One is that in my own experience of working with people, and in research on recovery, it has been found that people often credit positive spiritual experiences as being helpful in recovery. Another is simply that people have learned to see things in a spiritual way as children, and we don’t totally change that just by not talking to them about that aspect of their experience. Also, there is research that suggest that recovery rates are higher in cultures that still see mental health issues in spiritual terms, and most traditional insights into mental health issues are framed in spiritual language. And then there is the research such as that mentioned in my post, that shows that if we don’t talk to people about spiritual issues, that they tend to talk less to us, not show up, etc. And that isn’t so helpful either.
It can be interesting to sort through what seem to be helpful spiritual beliefs or insights, from those that lead people further into psychosis. Some mental health workers may be so averse to anything that sounds religious or spiritual that they can’t tolerate such a process, but if one can find a way to do this, I think it opens the door to some deeper communication.
There is also actually a growing body of scientific evidence that shows that the human psyche, consciousness, what happens in our minds, cannot be reduced to the electrical and chemical processes in our brains. These days, Danish TV runs a series about the research done in this field. Mind-blowing. Much of the results truly correspond to my own experience with “psychosis”, to what it has taught me about myself, and the world.
IMO, our biggest mistake is that we tend to think of ourselves as perfect, the “Crown of Creation”. This then leads us to believe that nothing but what we can perceive and understand with our actually extremely limited perception and intellect does exist. Huge mistake. Or huge misunderstanding. It’s not human beings as such who are the “Crown of Creation”. The “Crown of Creation” is consciousness.
Hello Ron,
In this, I totally agree with you. I would say that a spiritual approach was what made the difference in curing myself of schizoaffective and ptsd. Where psychotropic drugs failed, meditation and a yoga/tai chi lifestyle won. However, spirituality can mean a lot of different things to people.
Some people consider the pursuit of and belief in both religion and mythological archetypes to be spiritual. I can tell you right now that a Christian-centered spirituality did not help (which I grew up with during my childhood as my mental and spiritual health conditions were worsening) and would not have helped me during my agnostic teens and twenties.
I’ve heard some people in this day and age complain that the voices and imagery of schizophrenia or psychosis is because of demonic influence. Check out the website of James Stacey, the man behind PUSH (Pray Until Schizophrenia Heals). Check out his article “KNOW YOUR AUTHORITY IN JESUS
BEFORE EXPELLING THE DEMON OF SCHIZOPHRENIA” and he segues into a talk about Satan and demons, temptation…
http://www.schizophreniadefeated.com/1.html
We have space stations and satellites in orbit, you’d think we’d all be beyond “the devil influenced me” at this state of human evolution. I think this only retards a secular and science-based understanding of what psychiatrists called ‘schizophrenia’. This kind of fear-based spirituality I, and I suspect many others also, can do without.
Hi Jane,
I hear that a Christian approach didn’t work for you, and I know that is often the case. And I know that approaches associated with Christianity have historically at times been very destructive: for example I have heard some accounts that said the medical model in Europe got started as good people tried to protect some accused people from the Inquisition, by saying they were really ill, and not in cahoots with the devil.
At the same time, others have found healing through very different understandings of Christianity. It can all be in the interpretation. For example, some people use the term “devil” to mean any active tendency within themselves to twist the truth around into some kind of error, There is a sense that the devil is a deceiver. This is not that “crazy” a viewpoint, because people often do have within them an active and even cunning pattern of thinking or “voices” that twists things around into all sorts of errors, which can lead to horrible problems.
From a more “scientific” point of view, I might notice this same tendency to twist things around into errors, and see it as a self organizing pattern within the mind that exists for various reasons, and with which a person can learn to cope. It could even be seen as beneficial, since as Camus pointed out, “One recognizes one’s course by discovering the paths that stray from it.”
Of course, when people are freaked out by thinking the devil is seeking power over them, and are thinking of this devil as supernatural and much more powerful than them, they are not likely to be doing well. But this is not the only viewpoint possible within Christianity. Instead, there is also the alternative of seeing that one doesn’t have to fight the devil, but merely turn toward what is true, and then one is saved from the devil. This can be seen as very consistent with what cognitive therapy and especially Acceptance and Commitment therapy says is the best approach to unwanted mental experiences be they emotions or thoughts or impulses or voices: just accept that the various experiences exist, but then commit to turning toward and acting on one’s own values, or sense of what is true (in Christian terms, this would be living a life consistent with what God wants.)
I think all spiritual or religious traditions arise at least partly out of attempts to point toward the truth. This means that they all point toward the same thing, if one understands them correctly. Of course, sometimes one might have to dig through layers of misinterpretation to get there, and find that another tradition seems to work for oneself in a more direct way, etc.
It seems to me that every religion, Christian or other, has two conflicting aspects about it. On the one hand there is the Church with its literal belief in God and Satan as external powers — and here I actually see a parallel to psychiatry’s belief in “psychosis”/”schizophrenia” as an external power –, on the other there’s mysticism with its understanding of entities like God and Satan as symbols, images of two sides of the same thing, very much like Buddhist/Taoist thought (and I don’t regard Buddhism and Taoism as religions, but as philosophies). A belief in God and Satan as external powers can only be disempowering to those who hold this belief. It’s a means of controlling the masses through fear, yes. A belief in these powers as internal, as one’s own powers, though, is obviously the most empowering. Personally, I find just as much truth in Christian mysticism as I find in the Tao.
RE:”an urgent need to keep the religious well away from this vulnerable group”
As a paranoid schizophrenic , I agree we should keep the religious away from the schizophrenics. The religion of magical chemicals AKA psychiatry. They believe that chemicals can magically find and attack just the psychotic thoughts in the brains of schizophrenics.
From the outside it occurs to me that the whole religious experience has been more confusing than comforting to my son. Having said that I really don’t understand what goes on in his head so my judgment may be a little presumptuous.
Most of his religious experiences have manifested themselves as grandiose thoughts. “I am god” was a theme for a long time earlier on. Recently it has been I am no longer an atheist, I am a christian, then I am a hindu, and recently I am a muslim. I think all of this reflects a state of confusion and a search for identity, a place to belong, and purpose and direction in life.
I can diistinguish that if he changed his beliefs and his thoughts that his behaviours would change. He cannot distinguish this as readily. It’s a blind spot and until the self awareness is acquired it prevails.
Alan, I think the confusing aspect originates from taking thoughts like “I am God” literally, and there’s a tendency to take everything literally in “psychosis”. I wouldn’t say that the thought itself is grandiose. If you interpret “God” as a metaphor for consciousness, then, yes, then your son, just like everybody else, is God in as far as he is conscious. Nevertheless, taking the thought literally might be seen as a sign of him not being conscious, as consciousness would realize the metaphorical nature of the thought. On the other hand, that he thinks the thought is also a sign of him being in the process of becoming conscious, and thus you might say he’s both spiritually ahead of people, who do not even think the thought, and he’s on the right track. What he would need is some guidance to show him the metaphorical nature of these concepts. My guess is that he’s (unconsciously?) searching for this guidance in the different religions he engages in. I’m not sure, he will find it there, unless he turns his attention to the mystical side of these religions, Christian mysticism, Sufism, etc.
BTW, a couple of years ago, I had an experience that lasted for about 2 weeks, the immediate effects that is, set off by me intensely contemplating the truth or untruth of the sentence “You can be anything you want to be”, or the possibility of complete freedom, complete mastery of free will. So, one evening I had the experience of sensing the truth of the sentence both in my mind, and in my body. For some reason, and I suppose it is because flying is the metaphor for freedom, the thought “I can fly” repeated itself in my head, over and over again, to the point where I was on the point of believing I could literally fly, and felt a strong urge to do so. What kept me from doing it was my previous experience with “psychosis”, the insight that I’d come to through this experience that these things aren’t to be understood literally, but metaphorically. So I undertook a reality check: Does my body have wings? Am I a bird, literally? No? Then I better not try to fly, literally, but limit myself to practice metaphorical flying. With my body not being that of a bird, I can’t fly, I cannot be anything I want to be, my possibilities are limited. But which is not limited is consciousness. And to the extent that I’m conscious, I can fly, and be anything I want to be. So while the experience I had certainly by psychiatry would be labelled and devalued as “mania”, I value it highly as a revelation of a profound truth about being.
Thanks Marian, for your perspective on this and for sharing your experience, where you had to sort out what was truth in your experience from what could have been a “delusional” interpretation of it.
What I think is necessary for adequately dealing with the challenges of what we call psychosis, is having people around who understand how to help people sort out what might be valuable in their revelations from what might be misguided or a misinterpretation.
For example, a mental health worker with some understanding of mysticism would know that perceiving oneself as God is common in many mystical traditions (when I did Sufi dancing for a bit, in one of the dances part of it involved acknowledging each other as God, or Allah.) This involves seeing oneself as not separate from ultimate reality.
While it may make sense to see a statement like “I am God” as a metaphor, I would think that saying “I am not God” could also be seen as metaphorical. One metaphor captures the way we are not separate or that we are all one, the other metaphor captures the way we are separate. Neither statement captures the whole truth, where we are connected in some sense, separate in another sense. But our modern culture prefers metaphors of separation, so metaphors of connection seem “crazy.” And of course they can be taken in a “crazy” way, as in “I’m God but you aren’t,” but they can also be part of a deep understanding.
Unfortunately, our modern culture, so obsessed with the separate identity of everyone, is headed toward ruin because we mostly focus on the separation, and we don’t fully relate to each other, to our environment, to the generations that come next. This is itself a form of craziness, but it is common and so of course never treated by psychiatry. As David Oaks likes to say “normal people are destroying the planet.”
And seeing all religious traditions as pointing at the same truths is also common to the mystical vision. So while switching religious traditions may in some sense look like “confusion” it is in some ways much less confused than those who firmly identify with their tradition and can’t see good in the others. There again, what seems “mad” or confused may make a kind of sense that people might not get until there is some time to reflect on it, a reflection that can be encouraged if there are people available who are aware that the stuff of apparent “madness” may be more sane in some way than”normal” sorts of perspectives.
I am trying to come to terms with having had psychotic depression with borderline traits on and off for 17 years, and spending the past 10 years trying to fit into the Christian community. I would be interested to know if anyone knows of websites or counsellors that are Christian but don’t automatically assume things like this are demonic.
All I know is that I don’t seem to make progress or make little progress. The trouble is that my illness has been about good and bad – possibly because i saw so many horror movies as a child. I really need help from someone with a lot of discernment.
Hi Rachel,
You may be able to find a good Christian counselor in your community if you ask around. There are good ones out there. I don’t know about websites, so I hope if anyone else does that they will let you know.
This mental disease such as schizophrenia and bipolar is caused by demon’s possession. We have cured many patients by spiritual cleansing. For those who would believe and have their love ones suffering may contact this email: cexorint@gmail.com