Chapter
4 The Bible: Relevant Issues for Clinicians
1. BASIC FACTS ABOUT THE BIBLE
2. PROBLEMATIC BIBLICAL THEMES
5 Religion/Spirituality and Neuropsychiatry
2. SEROTONIN (5-HT) AND OTHER NEUROTRANSMITTERS
2.1. Serotonin or 5-hydroxytryptamine (5-HT)
3. NEUROBIOLOGICAL BASIS OF MEDITATION AND SPIRITUAL EXPERIENCES: ANATOMICAL PATHWAYS AND STRUCTURES
3.1. Frontal Lobe, Limbic System, and Parietal Lobe
3.3. Autonomic Nervous System and Other Related Systems
3.4. Meditation, Spiritual Experiences, and Psychiatry
4. GENES, PERSONALITY, AND SPIRITUALITY
4.1. Spirituality as a Personality Trait or Endophenotype
4.2. Neurotransmitter Receptor
4.2.1. The Serotonin Receptor 1A (5-HT1A)
4.3. A Genetic Polymorphism
4.3.1. Insertion-Deletion in the Promoter Region of the Serotonin Transporter Gene (5-HTTLPR)
4.3.2. Single Nucleotide Polymorphisms in the 5-HT Receptors and Spirituality
4.3.3. Other Polymorphisms Associated with Measures of Spirituality: The Dopamine Transporter and the Activating Protein-2 (AP-2)
4.3.3.1. Dopamine receptors
5. GENE-ENVIRONMENT INTERACTION AND CORRELATION
5.1. Gene-Environment Interaction
5.2. Gene-Environment Correlation
5.3. Religious Activity as an Environmental Factor?
6 Religion/Spirituality and Psychosis
1. THE RELATIONSHIP BETWEEN PSYCHOTIC DISORDERS AND RELIGION/SPIRITUALITY
4. RELIGION AND PSYCHIATRY IN THE HISTORY OF PSYCHOSIS
5. THE CAUSES OF PSYCHOSIS – THE RELATIVE CONTRIBUTIONS OF BIOLOGICAL VERSUS PSYCHOSOCIAL FACTORS
6. THE IMPACT OF PSYCHOSES IN TERMS OF COST OF CARE AND HUMAN SUFFERING
7. A PARADIGM FOR UNDERSTANDING PSYCHOSIS
8. INDIVIDUAL TREATMENT AND COMMUNITY PROGRAMS
9. THE ROLE RELIGION/SPIRITUALITY
10. ASSESSMENT OF RELIGION/ SPIRITUALITY
11. RELIGION AS A PRECIPITANT OF ACUTE PSYCHOTIC CONDITIONS
12. STUDIES ON RELIGION AND PSYCHOSIS SHOWING A HARMFUL INFLUENCE
13. THE IMPACT OF RELIGION ON OUTCOME
14. THE ROLE OF RELIGION IN COPING
14.1. Positive Religious Coping
14.2. Negative Religious Coping
14.3. Clinical Correlates
15. RELIGION’S INFLUENCE ON OTHER BEHAVIORS
15.1.1. Protective Role of Religion
15.1.2. Exacerbating Role of Religion
16. TOWARD AN INTEGRATIVE VIEW
18. IMPLICATIONS FOR GROUP THERAPY
19. A MULTICULTURAL PERSPECTIVE
7 Delusions and Hallucinations with Religious Content
1. DESCRIPTION OF THE PHENOMENA
1.2. Religious Delusions Not Restricted to Schizophrenia
1.3. Religious Delusions Associated with a Poorer Prognosis
2.1. What is Religious Delusion?
2.3.1. Formation and Conservation of Delusions
2.4. Hallucinations and the Role of Abnormal Perceptual Experiences
2.4.1. What Is a Hallucination?
2.5 Association of Delusions and Hallucinations
3. CLINICAL IMPLICATIONS: HOW TO DEAL WITH RELIGIOUS DELUSIONS
3.1. Disentangling Religion and Psychopathology
3.2. Delusion as a Dysfunctional Belief
3.3. Religious Delusion: A Confusing Category for Clinicians
3.4. Religious Delusion: A Stigmatizing Category for Patients
3.5. Functional Impact of Delusions
3.6. Psychodynamic Considerations
3.7. Treatment Considerations
8 Religion/Spirituality and Mood Disorders
1. RELIGION AND DEPRESSION: A CHESSBOARD IN BLACK AND WHITE
2. RELIGIOUSNESS AS A MULTIDIMENSIONAL CONSTRUCT
3. RELIGION AND DEPRESSION: MAIN LINES AND PROTOTYPICAL FINDINGS
3.3. Recovery from Depression
3.4. Type of Symptoms (and Syndromes)
3.5. Pietistic Orthodox Calvinism
3.7. Religious Discontent
4. LIFE COURSE PERSPECTIVES
4.1. The Varieties of Religious Development
4.2. Children and Adolescents
5. RELIGION AND BEREAVEMENT
6. RELIGION AND BIPOLAR DISORDER
8. A SUMMARY OF EMPIRICAL FINDINGS PERTAINING TO MOOD DISORDERS
9. APPLICATIONS TO CLINICAL PRACTICE
9.1. Why Raise the Subject of Religion and Spirituality in Clinical Contacts?
9.3. Connect: Abridging Personal Styles
9 Spirituality and Substance Use Disorders
3. THEORETICAL RATIONALE FOR THE RELATIONSHIP BETWEEN SPIRITUALITY AND ADDICTION
3.1. The Role of Spirituality in the Development of Addiction
3.2. The Role of Spirituality in Recovery from Addiction
4.1. Categorizing Research on Spirituality and Addiction
4.2. Twelve-Step Programs: A Spiritual Approach to Recovery from Addiction
4.3. Spiritual Transformations in Recovery from Addiction
4.4. Moving Beyond Twelve-Step Programs: Research on Spirituality as a Protective Factor
4.5. Research on Spiritual Disciplines in the Treatment of Addiction
5. WHAT ROLE DOES SPIRITUALITY PLAY IN SUBSTANCE USE REDUCTION?
5.1. Spirituality as an Independent Variable
5.2. Spirituality as a Dependent Variable
5.3. Spirituality as a Moderator Variable
5.4. Spirituality as a Mediator Variable
6. SPIRITUALITY IN THE CLINICAL CONTEXT
6.1. Why Should Spirituality Be Discussed with Patients with Substance Use Disorders?
6.2. Who Should Discuss Spirituality?
6.3. How to Raise the Issue of Spirituality
6.4. When to Raise the Issue of Spirituality
10 Religion, Spirituality, and Anxiety Disorders
3. RELIGION AND SPECIFIC ANXIETY DISORDERS
3.1. Generalized Anxiety Disorder
3.3. Post-Traumatic Stress Disorder
3.4. Obsessive-Compulsive Disorder
4.4. Devout and Prayerful
4.5. Trouble Crossing Streets
5. APPLICATIONS TO CLINICAL PRACTICE
6.3. Using Beliefs in Therapy
6.5. Cognitive-Behavioral
7. ENCOURAGING/PRESCRIBING RELIGION
8. CHALLENGING UNHEALTHY RELIGION
9. PASTORAL REFERRAL OR CONSULTATION
11 Religion/Spirituality and Dissociative Disorders
2. A HISTORICAL PERSPECTIVE
3. DISSOCIATIVE DISORDERS AND POSSESSION IN DSM-IV AND ICD-10
4. POSSESSION IN VARIOUS CULTURAL CONTEXTS
5. THE DISTRIBUTION OF DISSOCIATIVE DISORDERS
7. ANTHROPOLOGICAL CRITICISM
8. COLLABORATION BETWEEN PSYCHIATRISTS AND RELIGIOUS PROFESSIONALS
9. ETHNOPSYCHIATRIC CONSULTATIONS
12 Self-Identity and Religion/Spirituality
2. THE ROLE OF RELIGION/ SPIRITUALITY IN THE CONSTRUCTION OF SELF-IDENTITY
4. DEFINITION OF SELF-IDENTITY
5. DEVELOPMENTAL ASPECTS OF IDENTITY CONSTRUCTION
6. THE PROCESS OF IDENTIFICATION
7. ATTACHMENT AND IDENTIFICATION
8. RELIGIOUS FIGURES AND ATTACHMENT
9. RELIGIOUS FIGURES PLAYING THE ROLES OF PARENTAL FIGURES
10. THE INDIVIDUAL AND THE GROUP
11. COLLECTIVE SYMBOLIZATION OF THE INDIVIDUAL IDENTITY
12. CASES WITH RELIGIOUS/SPIRITUAL ASPECTS
13. RELIGION CAN ALSO WEAKEN IDENTITY
14. MULTICULTURAL PERSPECTIVE
13 Personality, Spirituality, Religiousness, and the Personality Disorders: Predictive Relations and Treatment Implications
2. DEVELOPMENT OF THE FIVE-FACTOR MODEL OF PERSONALITY
3. THE FFM AND THE PERSONALITY DISORDERS
4. DEFINING AND MEASURING SPIRITUALITY AND RELIGIOUSNESS
5. FOUR KEY VALIDITY ISSUES FOR THE ASPIRES
6. SPIRITUALITY, RELIGIOUSNESS, AND PSYCHOPATHOLOGY
7. THE ROLE OF SPIRITUALITY IN TREATING PERSONALITY DISORDERS
7.2. Borderline and Narcissistic PDs
8. THE CURATIVE POWER OF SPIRITUALITY
9. THE DARK SIDE OF THE NUMINOUS
14 Religion, Spirituality, and Consultation-Liaison Psychiatry
1. REASONS FOR PSYCHIATRIC CONSULTATION
2. COPING WITH MEDICAL ILLNESS
2.1. Loss of Health and Vigor
2.2. Loss of Energy and Sleep
2.3. Acute or Chronic Pain
2.4. Increase in Disability
2.5. Change of Roles in Family and Society
2.6. Loss of Social Relationships
2.7. Loss of Ability to Work
2.8. Loss of Opportunities to Meet Life Goals
2.9. Loss of the Ability to Make a Difference
2.10. Loss of Purpose and Meaning in Life
3. ROLE OF RELIGION/SPIRITUALITY
3.1. Religious Belief as a Symptom
3.2. Religious Belief as a Cause
3.3. Religious Belief as a Coping Behavior
4. RELIGION AND DEPRESSION
5. SUICIDAL THOUGHTS AND BEHAVIOR
5.1. Timely Psychiatric Care
6. ANXIETY IN MEDICAL SETTINGS
9. DEMENTIA, AGITATION, BEHAVIORAL DISTURBANCE
11. RELIGION AS A DETERRENT TO PSYCHIATRIC CARE
12. RELIGION AS A FACILITATOR OF PSYCHIATRIC CARE
13. WHAT SHOULD PSYCHIATRISTS DO?
13.1. Take a Spiritual History
13.2. Take a Spiritual History from Other Sources
13.3. Anticipate Religious Resistances
13.4. Acquire Psychodynamic Insights
13.5. Respect Religious Beliefs
13.6. Support Religious Beliefs
13.7. Use Religious Beliefs in Counseling
13.8. Prescribe Religious Beliefs/Activities
13.9. Collaboration with Chaplains, Pastoral Counselors, and Community Clergy
15 Community Psychiatry and Religion
1. STEP ONE: REALIZE PEOPLE ACCESS CARE THROUGH MANY PATHWAYS
1.1. Reflection from India: Father Thomas Puthiyadom, Catholic Priest
1.2. Reflection from Nigeria: Father Elias N. Menuba, Catholic Priest
1.3. Reflection from Arab/Muslim Countries: Sameera Ahmed, The Family Youth Institute
2. STEP 2: GET TO KNOW SPIRITUAL CARE PROVIDERS
3. STEP 3: STRENGTHEN QUALITY AND EXPAND ACCESS
3.1. Reflection from the Republic of Trinidad: Reverend Elton Adams, Protestant Minister
4. STEP 4: IDENTIFY REASONS TO REFER
5. STEP 5: INTENTIONAL COLLABORATION, TRAINING, AND SUPERVISION
6. STEP 6: BUILDING A REFERRAL NETWORK
7. STEP 7: IDENTIFY COMMON ISSUES IN SPIRITUALITY AND PSYCHIATRY
8. STANDARDS OF PASTORAL COUNSELING
The American Association of Pastoral Counselors
Confidentiality Statement of AAPC
16 Religious and Spiritual Assessment in Clinical Practice
1. WHY SHOULD SPIRITUALITY/ RELIGION BE SYSTEMATICALLY ASSESSED?
1.1. Religion/Spirituality as a Component of Cultural Sensitivity
1.2. Religion and Mental Health Are Interdependent Phenomena
1.3. Motive for Psychiatric Consultation
1.4. Satisfaction with Psychiatric Care
2. WHAT SHOULD BE ASSESSED?
3. HOW TO CONDUCT A SPIRITUAL ASSESSMENT IN CLINICAL PRACTICE
3.1. Religious/Spiritual History
3.2. How the Illness Affects Spirituality and/or Religiousness
3.3. Current Spiritual/Religious Beliefs and Practices
3.4. Private Religious Practices
3.5. Religious Preference
3.6. Community Religious Practices
3.7. Support from the Religious Community
3.8. Subjective Importance of Religion
3.9. Importance of Religion in Coping with Illness
3.9.1. The Spiritual Meaning of the Illness.
3.9.2. Coping with Symptoms
3.10. Synergy of Religion with Psychiatric Care
4. S/R ASSESSMENT: OTHER ELEMENTS
17 Integrating Spiritual Issues into Therapy
1. SPIRITUAL PERSPECTIVES ON MENTAL ILLNESS
1.1. General Considerations
1.2. Spirituality and the Recovery Perspective
1.3. The Voice of Persons Suffering from Mental Illness
1.4. Religious and Nonreligious Therapists
2. A HOLISTIC AND INTERDISCIPLINARY MODEL FOR THERAPY
2.1. The Extended Bio-Psycho-Social Model
2.2. Religion and Spirituality as a Main Resource
2.3. Religion and Spirituality as a Burden
2.4. An Interdisciplinary Approach
3. RELIGIOUS AND SPIRITUAL COPING IN MENTAL DISEASE
3.1. The Key Role of Religious Coping for Patients
3.2. The Key Role of Religious Coping for Family Caregivers
3.3. The Key Role of Religious Communities (Faith-Based Organizations)
4. MENTAL HEALTH CARE PROGRAMS INTEGRATING RELIGION/SPIRITUALITY
4.1. An Overview of Past and Recent Programs
4.2. “Spirituality Group” at the Hollywood Mental Health Center, Los Angeles
4.3. “Spirituality Matters Group” at the Nathan Kline Institute, New York
4.4. “Spiritual Issues Psychoeducational Group” at a Community Center
4.5. The Integrative Concept of the SGM-Clinic Langenthal (Switzerland)
5. RECOMMENDATIONS AND GUIDELINES
5.1. Recommendations Based on Patients’ Perspectives
5.2. Recommendations Based on Professional Perspectives
5.3. Recommended Books, Addresses, and Web Sites
18 Explanatory Models of Mental Illness and Its Treatment
1. MENTAL DISORDERS THROUGHOUT THE CENTURIES
2. THE SOCIAL UNDERSTANDINGS OF DISEASE
3. MENTAL DISORDERS IN DEVELOPING COUNTRIES
4. CONTAINING THE FLOOD OF UNDERSTANDINGS
5. ALTERNATIVE THERAPY USE BY PATIENTS WITH MENTAL DISORDERS
6. EXPERIENCES OF PATIENTS IN RELATION TO THE SPIRITUAL ASPECTS OF BEING ILL
6.1. Religious Beliefs and Views on Life
6.2. Goal in Life and Life Balance
6.4. Courage, Hope, and Growth
6.6. Spiritual Understandings of Disease
6.8. Spiritual Understanding of Treatment
7. RELIGION AND MEDICAL TREATMENT: INTERFERENCE OR MUTUAL BENEFIT?
8. CONCLUSION: THE ROLE OF THE MEDICAL PRACTITIONER
19 Psychiatric Treatments Involving Religion: Psychotherapy from a Christian Perspective
1. ANALYZING PSYCHOTHERAPIES
3.1. Prime Concern and Concept of Pathology
3.4. Time Approach and Focus
3.6. The Therapist’s Task
3.7. Primary Tools and Methods
3.9. Nature of Relationship
3.10. The Therapist’s Role and Stance
5. CHRISTIAN INTERVENTIONS
5.7. Confession, Repentance, and Forgiveness
5.10. The Holy Spirit and Christian Psychotherapy
20 Psychiatric Treatments Involving Religion: Psychotherapy from an Islamic Perspective
2. COMMON FACTORS AND INITIAL ASSESSMENT
2.1. Countertransference and Therapist’s Misunderstandings
2.1.1. Female Muslim Client
2.2.2. Admiring Strong Points
2.2.3. Admitting to One’s Lack of Knowledge
2.2.4. Paying Attention to Negative or Positive Cues
2.2.5. Predicting and Anticipating Reactions
2.2.6. Similarities and Differences
2.3. Two Important Questions Before Using Religious Techniques
3. ISLAMIC CONCEPTS USEFUL IN PSYCHOTHERAPY OF DEPRESSION
3.1. Believing in an Afterlife
3.1.2. Death of a Beloved
3.1.3. Diseases and Disabilities
3.1.4. Reward for Daily Usual Activities
3.2. Prayer and Asking God
1) All prayers have effect.
2) We may pray against ourselves!
3.3.1. There Is No One Who Does Not Sin
3.3.2. Mercy and Beneficence of God
3.3.3. Number of Good and Bad Deeds
3.3.4. Thoughts Are Not Punished
3.3.5. Feelings Are Not Sins
3.3.6. Physicians’ Credit in Islam
3.4. Hopelessness and Suicide
3.6. God’s Wisdom and Love
4. ISLAMIC CONCEPTS USEFUL IN PSYCHOTHERAPY OF ANXIETY
4.1. Afterlife: Causing or Preventing Anxiety
4.1.2. Probable Punishment
5. ISLAMIC CONCEPTS USEFUL FOR INTERPERSONAL PROBLEMS
5.1. Sensitivity to the Opinions of Others
5.2. Oppression and Forgiveness
5.3. Doing Good in Response to Evil
5.4. Duties in a Muslim Marriage
5.5. Muslim Women and Extended Family
21 Psychiatric Treatments Involving Religion: Psychiatric Care Using Buddhist Principles
3. THERAPEUTIC FOUNDATIONS
6. THERAPEUTIC ELEMENTS AND ROLES
6.3. The Therapist-Friend Relationship
6.6. The Phenomenon of Group Windhorse
22 Teaching Religious and Spiritual Issues
1. RATIONALE FOR TEACHING RELIGION-SPIRITUALITY
1.1. Scope of Issue and Rationale for Teaching
1.1.1. For the Mental Health Field
1.1.3. For our Colleagues in Training
1.2. Why Focus on Students and Trainees?
2. EDUCATIONAL STANDARDS FOR TEACHING RELIGION-SPIRITUALITY
2.1. International Standards for Psychiatric Education of Medical Students
2.2. Standards for Education of Psychiatrists
2.2.1. Guidelines for American Psychiatrists
2.2.2. Guidelines for Canadian Psychiatrists
2.2.3. Guidelines for United Kingdom (UK) Psychiatrists
2.3. Standards for the Education of Psychologists
2.3.1. American Psychologists
3. WHAT TRAINEES ARE ACTUALLY BEING TAUGHT
3.1. Limitations of Available Data
3.2. Religion-Spirituality Training: Psychiatry and Psychology
3.2.1. North American Psychiatry Training: Canada
3.2.2. North American Psychiatry: United States
3.2.3. Psychology Training: United States and Canada
3.2.4. European Psychiatry Training: United Kingdom
3.2.5. Australian Psychiatry Training
3.2.6. Australian Psychology Training
3.2.7. African Psychiatry and Psychology Training: Uganda
3.2.8. African Psychiatry and Psychology Training: Tanzania
3.2.9. African Psychiatry and Psychology Training: Kenya
3.2.10. Psychiatry Training: South Africa
3.2.11. African Psychiatric Training: Malawi
3.2.12. African Mental Health Training: Morocco
3.2.13. Psychiatric and Psychological Training in the Middle East
3.2.22. United Arab Emirates (UAE)
3.2.23. Palestinian Territories
3.3. Training of Medical Students
3.3.1. United States and Canada
3.4. Training of Primary Care Physicians in Religion-Spirituality
4. WHO SHOULD BE TAUGHT RELIGION-SPIRITUALITY IN MENTAL HEALTH CARE?
5. WHAT SHOULD BE TAUGHT?
6. WHEN SHOULD RELIGIONSPIRITUALITY BE TAUGHT?
7. HOW RELIGION-SPIRITUALITY CAN BE TAUGHT: TEACHING FORMATS
7.1. Post-Learning Evaluation of Educational Effectiveness
8. WHO CAN TEACH RELIGION-SPIRITUALITY TO TRAINEES?
9. DEALING WITH LIMITATIONS AND RESISTANCE TO CURRICULAR INTEGRATION
23 Conclusion: Summary of What Clinicians Need to Know
2. HISTORICAL CONSIDERATIONS
7. HALLUCINATIONS AND DELUSIONS
8. MOOD DISORDERS AND BEREAVEMENT
11. DISSOCIATIVE DISORDERS
13. PERSONALITY DISORDERS
17. INTEGRATINGS SPIRITUALITY INTO THERAPY
18. EXPLANATORY MODELS MENTAL ILLNESS AND ITS TREATMENT
19. PSYCHOTHERAPY FROM A CHRISTIAN PERSPECTIVE
20. PSYCHOTHERAPY FROM AN ISLAMIC PERSPECTIVE
21. PSYCHIATRIC CARE USING BUDDHIST PRINCIPLES
22. PSYCHIATRIC EDUCATION
Religion and Spirituality in Psychiatry
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