Description
Loss of faith is specifically mentioned in the DSM-IV definition
as a religious problem. There are several forms that loss
of faith can take. Shafranske
[1] described a man of professional accomplishment
whose life was founded upon the conservative bedrock of
Roman Catholic Christianity. He came to doubt the tenets
of his religion and, in so doing, declared he had lost
the vitality to live.
Some crises of faith are recognized as part of spiritual
development James Fowler,hD, building on the work of
Piaget, Kohlberg, and other developmental theorists,
has proposed that there is an invariant order of faith
development in six recognizable stages. Problems may
arise in the transition from one stage to another, often
experienced as a crisis of faith. (James
Fowler, Stages of Faith).
A similar problem can occur when a person is ostracized
by their religious community. One such crisis was created
when a Jehovah's Witness elected to have a medically
necessary heart transplant despite his family's and religious
community's objections on religious grounds:
His family and church community subsequently refused
any contact with him. Ultimately, the patient became
suicidal and required psychiatric hospitalization.
(p. 476)
Waldfogel S, Wolpe PR. Using
awareness of religious factors to enhance interventions in consultation-liaison
psychiatry. Hosp Community Psychiatry. 1993 May;44(5):473-7.
Associated
Clinical Problems
For some individuals, loss of faith involves questioning their whole way of
life, purpose for living, and source of meaning.. In addition, their social
world can be affected since religion is for many an important part of their
social network. Barra, Carlson and Maize [2]
conducted a survey study and also reviewed the anthropological, historical,
and contemporary perspectives on loss as a grief-engendering phenomenon. They
found that loss of religious connectedness,
whether in relation to traditional religious affiliation
or to a more personal search for spiritual identity,
frequently resulted in individuals experiencing many
of the feelings associated with more "normal" loss
situations. Thus, feelings of anger and resentment,
emptiness and despair, sadness and isolation, and even
relief could be seen in individuals struggling with
the loss of previously comforting religious tenets
and community identification. (p. 292)
In summary, these are the clinical sequalae that can
result from a sudden loss of faith.
 anger
resentment
emptiness
despair
sadness
isolation
Since this type of loss is typically not acknowledged
by others, the authors described this phenomenon as "disenfranchised
grief." They cite one case of a graduate student who
stopped believing in her religion of origin. She reported
feeling alienated, fear, anxiety, anger, hopelessness,
and even suicidal ideation, the common sequallae of a
grief reaction.
The American Psychiatric Association's "Guidelines
Regarding Possible Conflict Between Psychiatrists' Religious
Commitments and Psychiatric Practice" mentions a case
where a psychiatrist provided interpretations to a devoutly
religious man. "In doing this, however, she denigrated
his long-standing religious commitments as foolishly
neurotic. Because of the intensity of the therapeutic
relationship, the interpretations caused great distress
and appeared related to a subsequent suicide attempt" [3]
This is an iatrogenic effect
of culturally insensitive treatment.
Studies have found that struggling with religious beliefs
during an illness diminishes the chances of recovering.
Persons whose faith is shaken when they fall ill are
at greater risk of dying, thus documenting the consequences
of a loss of faith. Kenneth Pargament,PhD of Duke University
and colleagues studied 596 patients from 1996 to 1997
Participants were 596 patients aged 55 years or older
on the medical inpatient services of Duke University
Medical Center or the Durham Veterans Affairs Medical
Center, Durham, NC. Patients who reported that they felt
alienated from or unloved by God and attributed their
illness to the devil or said they felt abandoned by their
church community had a 19 percent to 28 percent increase
in the risk of dying within the next two years, compared
with those who had no such religious doubts, even after
controlling for the patients' health, mental health and
demographic status. Those who indicated that they "Wondered
whether God had abandoned me" and "Questioned God's love
for me" had a higher mortality rate. Dr. Pargemant indicated
that these results highlight the need for spiritual assessment
and pastoral interventions for patients whose faith is
shaken by illness.
Pargament KI, Koenig HG, Tarakeshwar N, Hahn J. Religious
struggle as a predictor of mortality among medically
ill elderly patients: a 2-year longitudinal study.
Arch Intern Med. 2001 Aug 13-27;161(15):1881-5.
Treatment
Michael
Washburn, PhD has noted a possible focus for therapy
by focusing on the change as a turning point in faith
which offers the potential for personal exploration and
discovery:
If, later in life, we suffer a profound disillusionment
in our experience of the world, we may find ourselves
turning back towards psychic resources that previously
we had repressed. This is the beginning of what I have
called "regression in the service of transcendence",
which I think most people would know better using the
term of St. John of the Cross, "the dark night of the
soul". It can be a very long, difficult, and trying
period.
For people who find themselves in this passage --
as I did 20 years ago -- it is helpful to know that
it is a passage. It's helpful to know that perseverance
and patience are important, and that it is a time to
grow in faith. Frequently it may not look like faith,
because the old idols have disappeared, and the old
god-ideas have fallen by the wayside. It therefore
can look like a loss of faith, and a loss in
one's life-direction generally. But this can really
be a turning point in faith, the beginning of a mystery,
a movement towards an "I know not what" that, though
distressing, can also be the real stuff of spiritual
experience and of a spiritual relationship.
The therapist can view loss of faith as an opportunity
for the patient to grow into a new relationship to the
mystery of life. For some who are experiencing loss of
faith, work with a religious professional might help
them to reconnect with their faith.
Others may not want to get involved with an organized
religion. The creation of a new personal mythology as
described in Lesson 6.2 is
a psychotherapeutic priority in working with clients
who have experienced a loss of faith.
Case Examples
S. is a 58-year-old European-American single client who has had progressive
liver disease for 2 years. Before her illness, she attended church regularly
and volunteered her free time to church-related charity organizations. When
given the diagnosis, she ceased her involvement with the charities and attending
church services because she says she "has no need to worship a fantasy." During
her fourth hospitalization, she was informed that the disease process was
not responding to treatment and that her death could occur in the next few
weeks. Upon discharge, she became clinically depressed, refused to take any
medications, ceased eating, spent her time gazing out of her room or reading
books, and complaining that "God had abandoned her." A relative
notified a mental health professional. At the intake, she ignored most questions
and complained that life seemed so meaningless.
Emma
Bragdon has described a similar crisis of faith
around her spiritual path of Buddhism.
WWW Library of Religion
and Spirituality
The WWW
Library contains a directory of sites on losses of all kinds and articles
by James Fowler and Michael Washburn.
References
1 Shafranske, E. (1991). Beyond countertransference:
On being struck by faith, doubt and emptiness. American Psycholgical
Association, New Orleans, LA. 
2 Barra, D., Carlson, E., & Maize,
M. (1993). The dark night of the spirit: Grief following
a loss in religious identity. In K. Doka & J. Morgan
(Eds.), Death
and spirituality. Amityville, NY: Baywood.
3 APA Committee
on Religion and Psychiatry (1990). "Guidelines regarding
possible conflict between psychiatrists' religious commitments
and psychiatric practice." American Journal of Psychiatry
147: 542.
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