A Thought for the Season

Spirituality and Mental Illness

Introduction

Like so much of human history, the relationship between mental illness and spirituality has been uneven. Centuries ago, mental illness was thought to be a sign of spiritual weakness or of being possessed by an evil spirit and was treated with cruelty. By the 19th century, however, the most humane mental health treatment was found in monasteries and other religious institutions. Sigmund Freud, on the other hand, prided himself on his devotion to scientific principles. He was a committed atheist and characterized religion and spirituality as neurotic. Yet with the decline of psychoanalysis in the past half century, the value of religion and spirituality has re-emerged with the ascendance of 12-step programs like AA and NA.

My Story

I am in a strange position to write about religion and spirituality. My family is German Jewish from Manhattan. New York German Jews are different from the people I call “Real Jews”. German Jews came to this country in the 1840’s and are highly assimilated. They tend to become bourgeois, republican bankers and professionals. My parents spent many hours a week volunteering for Jewish charities and completely identified as Jewish but were not observant. My family celebrated Christmas and Easter, not Yom Kippur and Passover. No bagels or knishes. No coming-of-age ceremonies. We hardly ever saw the inside of a Temple or Synagogue. My father believed that it was his father’s identification with the Jews of Europe which precipitated a fatal heart attack in his 50s. It is hardly surprising that my religious education was scant to an embarrassing degree.

It was not until I was 50 or so and we started to take the kids to church (my wife was raised Catholic and remains both religious and spiritual) that I began to have inklings of spiritual ideas. I have come to believe that God is with us before we are born, while we are on earth, and after we die, and that it is our task to be aware of God’s presence and love. I am confused about where organized religion and the Bible fit in.

What I Have Learned from My Patients

I have also been influenced by what I heard from my patients, many of whom have histories of substance use disorders and are committed to following a spiritual path to recovery from addiction. From what I have observed, faith-based recovery like AA and NA is more effective than alternatives like Rational Recovery. I have also seen how my patients who have a strong faith appear stable and resilient. My impression is that faith serves to strengthen people mentally and behaviorally in a way that goes beyond powerful social and friendship patterns. But I do not have the wisdom or experience to explain it.

Research

Research on spirituality and mental illness is thin, but it suggests that such spiritual practices as prayer, attending services regularly, or saying the rosary are variants of meditation and help the practitioner achieve peace and calm and find their place in the universe. And joint spiritual practice (religion) allows for togetherness, a supportive sense of shared beliefs, inner strength, hope, support, and friendship. Religion and spirituality help with self-esteem, satisfaction with life, and a greater sense of purpose and meaning. The result is less anxiety, less loneliness, less depression, and less suicide.

Conclusion

People with faith seem to me to resist not only substance abuse but psychosis, depression, and anxiety with great sturdiness. I am impressed and have taken to saying “God bless you” to people, even though I’m not sure what it really means, because I like the way it sounds. I should ask my friend Jack, who seems to get it.

And so, in this season of faith, God bless you.