Spiritual support
involves the degree to which a person experiences a
connection to a higher power (i.e., God or other transcendent
force) that is actively supporting, protecting, guiding,
teaching, helping, and healing. For many people, having
a relationship with a higher power is the foundation
of their psychological well-being. Some researchers
have suggested that the subjective experience of spiritual
support may form the core of the spirituality-health
connection (Mackenzie
et al., 2000). The recent landmark publication Handbook
of Religion and Health reviewed 1600 studies, including
hundreds on mental health. One chapter,"Schizophrenia
and Other Psychoses," summarizes research which indicates
that persons with mental disorders utilize their spiritual
resources to improve functioning, reduce isolation,
and facilitate healing.
The mental health professions have a long history
of ignoring and pathologizing religion (Lukoff
et al., 1992). For instance, Albert Ellis asserts, "The
less religious [patients] are, the more emotionally
healthy they will tend to be" (Ellis, 1980, p. 637).
But the data show otherwise: religion is overwhelmingly
associated with positive mental health.
Because individuals seek meaning when experiencing
severe illnesses, and spirituality is an important
coping mechanism, promoting religious and spiritual
beliefs and practices is highly appropriate. Mental
health professionals can provide spiritual support
to people coping with mental disorders. By devoting
some therapy time to exploring spiritual issues and
asking questions to discover a deeper meaning in life,
they can help to create the spirituality-health connection.
Spiritual support can include:
 Educating
the client about recovery as a spiritual journey with
a potentially positive outcome.
Encouraging
the client's involvement with a spiritual path or religious
community that is consistent with their experiences
and values.
Encouraging
the client to seek support and guidance from credible
and appropriate religious or spiritual leaders.
Encouraging
the client to engage in religious and spiritual practices
consistent with their beliefs (e.g., prayer, meditation,
reading spiritual books, acts of worship, ritual, forgiveness
and service). At times, this might include engaging
in a practice together with the client such as meditation,
silence, prayer, or singing.
Modeling
one's own spirituality (when appropriate), including
a sense of spiritual purpose and meaning, along with
hope and faith in something transcendent.
Mental health programs can, through their structures
and culture, create environments that promote this
spiritual work. New
Recovery Center at Boston University is an example
of a program that has adopted a recovery model incorporating
a spiritual component. Curricular options include such
courses as Connectedness: Some Skills for Spiritual
Health, Hatha Yoga, and a Recovery Seminar. This guided
exploration of personal recovery is the center's flagship
course.
QUIZ EXERCISE 10:
a) developing friendships b) going back to work c) going back to school d) quality of life
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Work is only part of a person's life," says Hutchinson,
SAR adjunct assistant professor and director of services
for rehabilitation counseling. "Recovery has so much
to do with quality of life. And that may not necessarily
mean going back to work or going back to school. It
may mean developing friendships, belonging to a church,
having a healthy body and a healthy min
People recovering from mental disorders have rich
opportunities for spiritual growth, along with challenges
to its expression and development. They will find much
needed support for the task when they are clinically
guided to explore their spiritual lives. Thus directed,
they can begin to create a positive health-promoting
outcome for their spiritual journey in recovery.
QUIZ EXERCISE 11:
a) make sure views of nonreligious staff and patients are respected b) provide clear guidelines for the extent and nature of spiritual support for patients c) elicit input from all staff to identify common values d) all of the above
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Psychiatrically Hospitalized Patients
Studies have found that hospitalized psychiatric patients
are as religious as the general population and they
turn more to religion during such crises In The
religious needs and resources of psychiatric inpatients
the authors found that 88% of the psychiatric patients
reported three or more current religious needs. Psychiatric
patients had lower spiritual well-being scores and were
less likely to have talked with their clergy. They concluded
that religion is important for the psychiatric patients,
but they may need assistance to find resources to address
their religious needs.
QUIZ EXERCISE 12:
a) greater religious needs in the psychiatric patients b) no differences in religious resources c) no differences in religious needs between the two patient groups, but significant differences in religious resources d) greater religious needs in the psychiatric patients
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Another form of spiritual support is to address dysfunctional
beliefs about their disorder that many patients hold.
One study of 52 psychiatric inpatients found that 23%
believed that sin-related factors, such as sinful thoughts
or acts, are related to the development of their illness.
Sheehan W, Kroll J Psychiatric
patients' belief in general health factors and sin as
causes of illness. Am J Psychiatry 1990 Jan;147(1):112-3
This is clearly a guilt-inducing belief for which
there is no evidence, and the vast majority of religious
professionals would challenge. When I was a psychologist
at Camarillo State Hospital, I collaborated with a
rabbi who led groups for patients, and this was one
of the beliefs he regularly encountered. He made a
point of disputing such assertions when they were voiced,
using both old and new testament citations.
But in general, intensity of religious beliefs is
not associated with psychopathology Patients who have
little or no religious commitment are just as likely
to have depression, anxiety or other personality disorders
as patients with higher levels of religious commitment.
In several studies, being highly religious is not a
risk factor for psychopathology, as has been often
taught in mental health training programs. The authors
of one study concluded:
The notion that religion exerts a negative influence
on mental health in patients was not generally supported
by our findings. The primary factor in patients who
display religious conflicts and anxieties seems not
to be the degree of religious commitment itself,
but rather their underlying psychological disease.
Psychopathology
and religious commitment--a controlled study. Pfeifer
S, Waelty U Psychopathology 1995;28(2):70-7
QUIZ EXERCISE 13:
a) no correlation with religious commitment b) a significantly positive correlation with religious commitment c) a significantly positive correlation with psychopathology d) none of the above.
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