Source: Washington Post
My religious friend once asked me point-blank, “if you don’t believe in God, how can you see someone who does as anything but delusional? As a mental health professional, how do you counsel such a person?”
It’s a tough question for me. I’ve been a psychiatrist for almost 15 years. In that time, I’ve seen thousands of patients. Many are non-believers. But for others, faith is integral to who they are. In these cases, am I in a bad position to give care?
The first time I encountered this question, I was a patient, not a health provider, visiting a therapist in college.
When I walked in, nervous about talking to a stranger, I was taken aback by her gold cross pendant and the Christian picture hanging in her office. I’d been feeling isolated, depressed and unsure about my future; an unrequited crush didn’t help matters. As an Asian-American agnostic-atheist wary of any mental health provider, I feared that the doctor would shove her beliefs down my throat.
But though I wasn’t raised religious, I’d grown up around enough Christians to know how important the values of charity and empathy were in theory, if not always in practice. I hoped that she used these items as symbols of those values and would be kind. Fortunately, she was. I only saw her a few times, but her caring manner was enough to get me back on track.
Religion and psychotherapy have had a rocky co-existence. Sigmund Freud grew up Jewish but developed atheistic views as he founded the tenets of psychoanalysis. Religion, he said, was an illusion, a defense mechanism that civilizations used to institute morality. But Carl Jung, his most famous mentee and rival, believed the opposite. To him, incorporating spirituality and mysticism in psychotherapy was crucial. To heal, the unconscious had to connect to larger, unknowable forces in the universe and approach the divine.
This tension is obvious in many psychiatry training programs. In my training program, questions of religion and spirituality in clients were not openly discussed or taught. We are told to ask about “religious background” as a part of a social history assessment, but it’s not clear what to do with that information.
Even the American Psychiatric Association has laid out only general standards. In a 2006 paper, they advise maintaining respect for patients’ values, beliefs, and worldviews; not imposing one’s own religious beliefs onto patients; and fostering recovery “by making treatments decisions with patients in ways that respect and take into meaningful consideration their cultural, religious/spiritual, and personal ideals.” Psychiatrists are advised to maintain their religious boundaries. Asking a nonreligious patient to pray with you, or denigrating a religious patient’s commitments as “psychopathological,” for example, are no nos.