Clinically significant religious impairment

Recent psychodiagnostic practice, as embodied in the DSM IV, requires that psychopathological features result in a "clinically significant impairment" to qualify as a "mental disorder" in many cases. The impairment must be in social, occupational, or other important areas of functioning. The current proposal is that clinicians should consider the potential impairment in religious functioning arising from mental disorders in diagnostic process. It is suggested that psychopathology may result in a clinically significant religious impairment that is defined as a reduced ability to perform religious activities, achieve religious goals, or to experience religious states, due to a psychological disorder. Various existing approaches to studying the relationship between religious functioning and psychopathology are briefly reviewed and roughly categorized as either focused on 'symptomatic religiosity' or reflecting a 'religiously sympathetic' posture. Yet, in both of these approaches, religion has predominantly been construed as an exogenous variable contributing to mental health in some fashion (for good, for ill, or for both). The current proposal suggests that clinicians should also consider religion in endogenous perspective. So construed, religion is a significant domain of adaptive functioning, which may be adversely impacted by psychopathology. A discussion of various clinical, research and ethical issues involved in realizing the proposal is provided.     

The expanding role of the minister as community health services develop

Conclusion In summary, we have suggested in this brief discussion that (1) clinical pastoral training has established itself firmly in our culture and will be an important resource in the function of community mental health centers; (2) there will also be need for many clinically trained pastoral ministers who will serve importantly in the prevention of mental illness and promotion of mental health; (3) that standards of training in the clinical pastoral field are very much needed and should be nationally unified and coordinated; and (4) that the Association of Mental Hospital Chaplains might well exercise the leadership in developing a national resurgence of interest in a dynamic religion which will better meet the needs of our people as we move forward in this complex scientific age. For myself, I have no doubt that religion can provide many of the positive elements of good mental health, and I believe that this concept will grow to full maturity in the years ahead.Delivered at Annual Anton T. Boisen Banquet, Association of Mental Hospital Chaplains, Los Angeles, California May 6, 1964.     

Pastoral counselling: an American perspective

While pastoral counselling is a function of pastoral ministry in religious communities, it is also a specialised ministry requiring professional training that extends well beyond a pastoral/ theological education for ministry, as well as beyond the confines of religious communities. This article is an American perspective on Certified Pastoral Counsellors as mental health care providers for individuals, couples, and families, generally on a fee-for-service basis, with many qualifying for reimbursement by private and federal third party payers. It demonstrates that pastoral counselling as practised in the USA is spiritually integrated counselling and psychotherapy, requiring graduate academic and clinical work in these disciplines as well as graduate education in religious studies. It offers an American perspective on this specialised ministry of mental and relational health and discusses its identity and function, methodology, supervision requirements, and the clinical use of religious resources, including a case illustration.     

Psychiatry and religion circa 1978: Analysis of a decade,part II

Prior tensions between science and religion have dissolved and coalesced into new alliances based on ideology and philosophy. This general cultural pattern is reflected in the realignment of interests and interactions between paychiatry and religion. There are increasing numbers of mental health professionals with devout religious commitments and involvement in religiously oriented mental health activities; while clergy have developed new organizational structures to reflect many diverse mental health interests, including pastoral counseling, community mental health chaplains, hospitals chaplains, and expanded parish ministries. Clinical and research literature has continued to rapidly proliferate, while a unique genre of pastoral care and counseling literature has emerged. A decade ago there was hope for an amicable alliance between specialists in psychiatry and in religion. That irenic quest has shifted into overlapping goals and roles, with tensions between those engaged in universalistic norms and those seeking to develop particularistic norms.Dr. Pattison is Director of Training, Orange County Department of Mental Health and Professor and Acting Chairman of the Department of Psychiatry and Human Behavior, University of California Irvine Medical Center, 101 City Drive South, Orange, California 92668. Part I of his article appeared in the Fall, 1978 issue ofPastoral Psychology.     

Religious Coping and Church-Based Social Support as Predictors of Mental Health Outcomes: Testing a Conceptual Model

This study assesses religious coping and church-based social support as mechanisms explaining religious benefits to mental health. We build on recent research and test an explanatory model using the 1998 General Social Survey. The model considers both institutional and individual aspects of religiousness, and their interrelations, as predictors of mental health outcomes. It considers negative effects of religion along with the well-known positive effects. We found that benefits of attendance, a measure of institutional participation, are mediated by church-based social support. Benefits of prayer, an individual form of religiousness, are mediated by the similarly privatized religious coping. Institutional measures of religion were found to impact individuals' religious coping styles. Implications are suggested for the scientific study of religion as well as for the applied efforts of clergy, pastoral counselors, and lay church members concerned with improving religious benefits.     

Gods and REMS: The implications of recent dream research for the psychology of religion

Throughout history dreams have been primarily the province of religion. People in many cultures have looked to dreams as sources of spiritual insight and divine revelation. The relationship between traditional religious views of dreams and modern psychological views of dreams has long interested psychologists of religion—for dreams are a uniquely fertile subject for comparing religious and psychological understandings of human experience. In recent years there have been many revolutionary discoveries in dream research, discoveries that have taken us far beyond the seminal works of Freud, Jung, and the early sleep laboratory researchers. This essay describes the work of three leading contemporary dream researchers (neurophysiologist J. Allan Hobson, psychologist Stephen LaBerge, and anthropologist Barbara Tedlock) and evaluates the implications of their findings for our understanding of the religious dimensions of dreams. The essay concludes with some reflections on the valuable role of dream study in the psychology of religion. The primary claim is that recent dream research can make important contributions to current psychology of religion discussions about such issues as interdisciplinary inquiry, hermeneutics, the cross-cultural study of religious experience, the cultural and religious context of modern psychology, and the practical concerns of pastoral counselors.This essay is based on a paper presented on November 25 at the 1991 Annual Meeting of the American Academy of Religion, Kansas City, Missouri.     

Psychiatry and religion circa 1978: Analysis of a decade,part I

Prior tensions between science and religion have dissolved and coalesced into new alliances based on ideology and philosophy. This general cultural pattern is reflected in the realignment of interests and interactions between psychiatry and religion. There are increasing numbers of mental health professionals with devout religious commitments and involvement in religiously oriented mental health activities; while clergy have developed new organizational structures to reflect many diverse mental health interests, including pastoral counseling, community mental health chaplains, hospital chaplains, and expanded parish ministries. Clinical and research literature has continued to rapidly proliferate, while a unique genre of pastoral care and counseling literature has emerged. A decade ago there was hope for an amicable alliance between specialists in psychiatry and in religion. That irenic quest has shifted into overlapping goals and roles, with tensions between those engaged in universalistic norms and those seeking to develop particularistic norms.Dr. Pattison is Professor of Psychiatry and Human Behavior, Social Science, Social Ecology; Acting Chairman, Department of Psychiatry and Human Behavior, University of California, Irvine; Deputy Director, Training, Consultation, Education Division, Orange County Department of Mental Health. His address is UCI Medical Center, 101 So. The City Dr., Orange, Ca. 92668. Part II of this article will be published inPastoral Psychology, Volume 27, No. 2.     

Religion and obsessive-compulsive disorder (OCD) among young Muslim women in Saudi Arabia

Fifteen young women suffering from OCD in Saudi Arabia were interviewed about their experience of the illness and the roles played by religion. Religion was not perceived as a cause of the illness, but the illness can show itself in religious symptoms – notably with respect to prayer, and in a phase in which the young women were very strict and literal-minded with themselves and their families, with respect to religious observance. Religious symptoms were reported as more upsetting than other symptoms – being seen as damaging to the sufferer's piety. Other facets of the importance of religion in the experience of OCD were shown in help-seeking, in choosing to go first to religious healers for treatment, and only when these were unsuccessful were mental health professionals consulted. At this point, it was very important that the professional should be seen as trustworthy, and the criterion of trustworthiness was religiosity, specifically the use of pious, Qura’anic quotations, and a covered face (for a woman)/long beard (for a man). The accounts of the roles of religion in the experiences of the young women interviewed suggest that religion is an arena – but not the sole arena – for the expression of OCD symptoms. Religion plays an important role in determining the acceptability of treatments and treatment providers.     

Advances in the conceptualization and measurement of religion and spirituality. Implications for physical and mental health research

Empirical studies have identified significant links between religion and spirituality and health. The reasons for these associations, however, are unclear. Typically, religion and spirituality have been measured by global indices (e.g., frequency of church attendance, self-rated religiousness and spirituality) that do not specify how or why religion and spirituality affect health. The authors highlight recent advances in the delineation of religion and spirituality concepts and measures theoretically and functionally connected to health. They also point to areas for areas for growth in religion and spirituality conceptualization and measurement. Through measures of religion and spirituality more conceptually related to physical and mental health (e.g., closeness to God, religious orientation and motivation, religious support, religious struggle), psychologists are discovering more about the distinctive contributions of religiousness and spirituality to health and well-being.     

Religiousness and Mental Health: Systematic Review Study

Many people use religious beliefs and practices to cope with stressful life events and derive peace of mind and purpose in life. The goal of this paper was to systematically review the recent psychological literature to assess the role of religion in mental health outcomes. A comprehensive literature search was conducted using medical and psychological databases on the relationship between religiosity and mental health. Seventy-four articles in the English and Arabic languages published between January 2000 and March 2012 were chosen. Despite the controversial relationship between religion and psychiatry, psychology, and medical care, there has been an increasing interest in the role which spirituality and religion play in mental health. The findings of past research showed that religion could play an important role in many situations, as religious convictions and rules influence the believer’s life and health care. Most of the past literature in this area reported that there is a significant connection between religious beliefs and practices and mental health.     

Religiosity,coping, and suicidality within the religious Zionist community of Israela thematic qualitative analysis

The relationship between religion and mental health has been the subject of extensive research, particularly in recent years. The issues of coping and suicidality have also been widely studied. Significantly, however, how religious people cope with harsh life situations is an area which has been overlooked. The present study based on 18 semi-structured interviews, analyses have members of the Religious Zionist community in Israel cope with harsh life situations. Although the study confirms the conclusions of previous research – in general religion creates a buffer to suicide – the results showed a relatively low impact of religiosity on coping: in general these religious interviewees found it difficult to access their religiosity during harsh life situations. The paper suggests a range of explanations, for example the complexity of personal and collective identities which characterise this group, or – more significantly – the possibilty that religious coping is not actually absent but is only available in a second, later stage of coping.     

Considerations of the religious dimensions of emotional disorder

This author seeks to investigate some of the possible forms of relationship between religion and emotional disorder-instances in which a person's religious life appears to have been one of the sources of an emotional disorder, the influence of faith as an organizing center for one's life even in the midst of emotional disorder, and delusional systems and hallucinatory experiences in which traditional religious material in some form is an obvious component. The conclusion is drawn that while religious factors may be interwoven with the etiology of disorder they are neither predisposing nor precipitating causes per se, that the religious material exhibited in a pathological form is basically unrelated to earlier religious life, and that religious faith and its practice may in fact be ego-supportive. Implications of these findings for individual psychotherapy, for pastoral consultation, and for worship are discussed.     

Focused on the Family? Religious Traditions,Family Discourse,and Pastoral Practice

The relationship between religion and the family has recently reemerged as an important object of sociological inquiry. However, research has largely overlooked the ways in which the family discourse produced by specific religious traditions is connected to family-focused pastoral practices of congregations. Using data from the National Congregations Study, we find that family discourse and pastoral practice are only "loosely coupled" to one another. Ideological differences among mainline Protestant, conservative Protestant, and Roman Catholic congregations do not translate directly into differences in family ministry offerings. These findings help explain why research often finds that religion exercises uniform effects on family life, insofar as most congregations offer a similar package of ministries even though their family discourse is markedly different .     

What Do the Spiritual and Religious Traditions Offer the Practicing Psychologist?

There has been a remarkable amount of interest in the relationship among spirituality, religion, psychology, and health of late. Contemporary interest in spirituality and religion is hot among not only the general population but among professionals in the mental and physical health disciplines. While most people believe in God and consider themselves to be spiritual, religious, or both, most mental health professionals have little if any training in this area. Psychologists can use spiritual and religious principles and tools to better serve their clients even if they do not share the same religious interests. The purpose of this article is to offer thirteen spiritual and religious tools common among all of the major religious traditions that can be used by contemporary professional psychologists in clinical practice to enhance the already high quality professional services that they provide. Examples of spiritually and religiously integrated treatment along with several ethical precautions are noted as well. This article is based on book project by Plante currently in press.     

THEOLOGY AND SCIENCE OF MENTAL HEALTH AND WELL‐BEING

The approach to mental health and well‐being taken here illustrates the complementary perspectives approach and assumes that there are useful and intersecting contributions from science (including medicine) and from religion and spirituality. What counts as poor mental well‐being depends on the interaction of relatively objective criteria with culturally contingent value judgments. I then discuss theological perspectives on depression, including a consideration of sources of hope and tolerance of dysphoria, and argue that depression can be part of a spiritual journey. I then look at the relationship between psychosis and religion, including the work of Isabel Clarke, arguing that a spiritual approach to psychosis can complement a medical approach. Finally, I present a pastoral case study illustrating the interface between neurological and spiritual aspects of the sense of presence. A religious perspective can challenge and complement current assumptions about mental health in a potentially fruitful way.     

Observations of Muslim Physicians Regarding the Influence of Religion on Health and Their Clinical Approach

Although most patients report wanting their physicians to address the religious aspects of their lives, most physicians do not initiate questions concerning religion with their patients. Although religion plays a major role in every aspect of the life of a Muslim, most of the data on the role of religion in health have been conducted in populations that are predominantly non-Muslim. The objectives of this study were to assess Muslim physicians' beliefs and behaviours regarding religious discussions in clinical practice and to understand the factors that facilitate or impede discussion of religion in clinical settings. The study is based on a cross-sectional survey. Muslim physicians working in a tertiary care hospital in Saudi Arabia were invited to complete a questionnaire that included demographic data; intrinsic level of religiosity; beliefs about the impact of religion on health; and observations, attitudes, behaviours, and barriers to attending to patients' religious needs. Out of 225 physicians, 91% agreed that religion had a positive influence on health, but 62.2% thought that religion could lead to the refusal of medically indicated therapy. Over half of the physicians queried never asked about religious issues. Family physicians were more likely to initiate religious discussions, and physicians with high intrinsic religiosity were more likely to share their own religious views. Residents and staff physicians tended to avoid such discussions. The study results highlight the fact that many physicians do not address patients' religious issues and that there is a need to clarify ethically sound means by which to address such needs in Islamic countries. Medical institutions should work to improve the capacity of medical personnel to appropriately address religious issues. The training of clinical religious advisors is a promising solution to this dilemma.     

Erikson,psychology, and religion

The writings of the late Erik H. Erikson (1) have contributed directly to the psychological study of religion, (2) were amenable to the efforts of others to develop normative theological arguments, and (3) might be seen as themselves examples of contemporary, nontheological accounts of the religious dimension of human existence. This paper begins by reviewing the principal contributions that Erikson made to the psychological study of religion, followed by a review of the uses that have been made of Erikson's work for normative/constructive activities in such areas as practical theology and pastoral counseling. I will then argue that Erikson's writings — when viewed in the vein of William James's radical empiricism and functionalist accounts of human religiosity — identify an irreducibly religious dimension to normative human functioning. Erikson's functionalism constitutes a form of nontheological religious thinking that speaks directly to concerns presenting themselves in contemporary culture.     

Implicit theories of intellectual virtues and vices: A focus on intellectual humility

Psychological science has consistently highlighted links between gratitude and religion, however mediating pathways by which religion relates to gratitude remain ambiguous. Further, it is unclear whether religious gratitude (e.g., gratitude to God) is more related to well-being than general gratitude. To address these gaps, we assessed for both religious and general dimensions of gratitude alongside measures of religious commitment and mental/physical well-being in a diverse sample of n?=?405 adult individuals. Consistent with previous research, gratitude was positively correlated with religious commitment (r?=?0.45, p?<?0.001). This relationship, however, was fully mediated by gratitude towards God. Using hierarchical linear regression, results further found that the interaction of religious commitment and religious gratitude added unique variance in predicting mental well-being, over and above general gratitude. This suggests that being grateful to God enhances the psychological benefits of gratitude in accordance with one's level of religious commitment.     

Being one with the spirit: dimensions of a mystical experience

Mystical experience has intrigued both religious and non-religious persons for centuries. Several elements of mystical experience have been identified by scholars of the psychology of religion. This essay explores those critical elements and appropriates them in developing a theological anthropology. This understanding is expanded using the framework of the mystic, Howard Thurman, who argued that true mysticism leads to responsible action. Together these components form the basis for a pastoral theological framework for mystical experience.     

Mental health in Christian life

Conclusion The influence of mental health upon the perception, assimilation, and expression of religious values is very apparent. As the precision of our knowledge increases, there is no lack of evidence for an affirmative answer to the question posed for the second part of this report.If the proper methods for studying the influence of religion on mental health have seemed to us to be full of ambiguity, it has also seemed to us that the future development of our scientific knowledge relative to the influence of mental health upon religion is entirely feasible and highly desirable.To work for better mental health is to permit believers (and this is equally valid for all religions and all faiths) to gain better understanding of the call of their religion in all its authenticity. The very perception of the religious message, in its richness and complexity, would be enhanced if one could raise the level of balance and of psychological maturity in a population. Mental health does not automatically make men more religious (we have no interest in an automatic, conditioned religion), but it prepares a better background in which the word of God may be heard, received, and more fully assimilated.It is in this perspective that we all must work together—doctors, psychologists, educators, priests—toward improvement of mental health. Let us, however, avoid unenlightened enthusiasm; let us keep ourselves from undertakings of which the practical applications would be directed toward illusory purposes. An effective program demands precise objects: these can be formulated only on the basis of methodically conducted research and scientifically established conclusions.