RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications
-
Upload
elvis-gilbert -
Category
Documents
-
view
23 -
download
2
description
Transcript of RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications
![Page 1: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/1.jpg)
RELIGIOUS INTERPRETATIONS
OF MENTAL DISTRESS
empirical findings and clinical implications
![Page 2: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/2.jpg)
Heinrich Füssli(1741 - 1825)
Nightmare
![Page 3: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/3.jpg)
Overview
A) DefinitionsB) Causal attributionsC) Psychodynamics and Spiritual
InterpretationsD) Clinical Implications
![Page 4: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/4.jpg)
Spirituality
an attitude directed towards the intangibly transcendental (God). For the spiritual person this is the source and the goal of his or her life, fundamentally influencing his or her way of living, responsibility and ethics.
(modified after Scharfetter 1999)
![Page 5: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/5.jpg)
Spiritualization
incidents and experiences are interpreted in a religious context
The interpretation relates to causality and change (therapy) of problems.
Subjective experience is perceived in a comprehensive spiritual context
![Page 6: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/6.jpg)
WH
Y?W
HY
?Causal attribution
Locus of Control
• Internal (spiritual life, personal effort)• External (affliction, oppression, curse)
Stability• Stable (personal discipline, effective
protection)• Variable (actual condition, reliability of
others)
![Page 7: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/7.jpg)
Effects (Weiner)
• Coping or
• Hopelessness
• Cooperation and Empathy or
• Blame and Rejection
![Page 8: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/8.jpg)
STUDY: Causal Attributions in Schizophrenia (Angermeyer & Klusmann, 1988)
Five areas:
• Psychosocial burden
• family
• Personal problems
• Biological factors
• „Esoteric“ factors
Eur Arch Psychiatr Neurol Sci 238:47-54 (1988)
![Page 9: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/9.jpg)
Family Broken home lack of parental love father was too strict parents had too high expectations overprotective mother hostile-rejective attitude of parents
evading daily problems lack of will power alcohol and drugs too intelligent too ambitious general failure
Personal Problems
Eur Arch Psychiatr Neurol Sci 238:47-54 (1988)
![Page 10: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/10.jpg)
«Esoteric Problems» Lack of vitamins Environmental pollution Possession by evil spirits Detrimental radiation Divine punishment Unfavorable Horoscope
Open Question 1,0 % Possible Cause 54,9 % (Very) Probable Cause 22,3 %
Evil spirits: Possible Cause 10,9 % (Very) Probable Cause 3,1 %
Angermeyer & Klusmann (1988)
Eur Arch Psychiatr Neurol Sci 238:47-54
![Page 11: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/11.jpg)
“Occult Bondage”
343 Patients (114 m, 229 f) all were religious mainline church (cath, ref.) 139 Trad. free churches (TFC) 164 Char. free churches (CFC) 40
Schizophrenia 60 Depression 87 Anxiety Disorders 56 Personality Disorder 65 Adjustment Disorder 75
Pfeifer S. (1994)
Belief in demons and exorcism. An empirical study of 343 psychiatric patients in Switzerland. British Journal of Medical Psychology 67:247–258
![Page 12: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/12.jpg)
“Occult Bondage”
Occult Bondage 37,6 %
as possible cause
Ritual of deliverance 30,3 %
performed
Significant correlation with Diagnosis (p < 0.01) Religious affiliation (p < 0.005)
Pfeifer S. (1994)
Belief in demons and exorcism. An empirical study of 343 psychiatric patients in Switzerland. British Journal of Medical Psychology 67:247–258
![Page 13: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/13.jpg)
Belief in demonic causality
(in percent)
0
10
20
30
40
50
60
%
PSY
MO
OD
AN
X
PE
RS
AD
J
DemonicCausality
Rituals ofDeliverance
Nondelusional Disorders
![Page 14: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/14.jpg)
Bio-psycho-socialModel
Mosaic of Causal Attributions
Conflicts fromIndividual
Experience Cultural Traditions
Alternative Body Theories
and DietsReligious
Convictions
Spiritual and Magical Beliefs
Pfister, S. & Thiel, S. (1999). Religiosität und subjektive Krankheitstheorie. Eine empirische Untersuchung bei 53 psychiatrischen PatienInnen. Dissertation Medizinische Fakultät der Universität Bern.
![Page 15: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/15.jpg)
Spiritualinterpretation
Spiritualinterpretation
The Bio-Psycho-Social modeland Spiritualization
![Page 16: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/16.jpg)
Forms of Spiritualization
Spiritual forms of intrapsychic communication: „I talk to God; God talks to me.“
Spiritual interpretation of natural desires and unadjusted behavior
Spiritual interpretation of distress (mentally and somatic); i.e. causal attribution without delusional aspects
Religious delusions
![Page 17: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/17.jpg)
Functions of Spiritualization
Interpretation (Causal attribution)e.g. „oppression“ as a reason for sleep disorders
Defense mechanismse.g. prayer meeting instead of behavioral change --- e.g. spiritual justification of wishful thinking
Copinge.g. prophetic words of encouragement / subjective relief through “rebuking spirits”
![Page 18: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/18.jpg)
A continuum of intensity
Empathy possible failure to attain a religious ideal:
e.g. „I am not praying enough!“e.g. „I feel abandoned by God“e.g. „I am damaging my Karma!“
Extreme demon of pride, lust etc. (unacceptable drives and
behaviors are attributed to demons) Demons as cause of sleep disorders, nightmares,
obsessional thoughts etc.
![Page 19: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/19.jpg)
Forms of Spiritual Therapy(in the Christian context *)
Traditional and common: Prayer, Confession, Communion / Eucharist, Blessing through the Laying of Hands.
Transitional Objects and Protection against Evil: Pictures of Saints, Amulets, Holy Cross, protecting objects etc.
Religious Activities: Pilgrimage, participation in religious festivals, religious exercises, visiting special healers.
Forms of Counseling: „Imagery“, Prophecy, Deliverance, „Rebuking evil forces“ (self or others), Exorcism.
*) wide variations
in other religious cultures
![Page 20: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/20.jpg)
Contamination
Mixture of spiritual support
with popular superstition (especially in catholic and orthodox context)
with Psychoanalytic Popular Psychology (e.g. in the charismatic literature)
![Page 21: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/21.jpg)
Dealing with Spiritualization
1. Assessment “Approaching the unfamiliar with respect
helps us to gain understanding”
Explanatory Model or secondary phenomenon? Delusion or Subculture? Psychodynamics: Positive Coping or
Dysfunctional Defense Mechanism? Which therapeutic consequences result from the
religious interpretation of the problem? (traditionally Christian, magical, dramatic)
![Page 22: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/22.jpg)
Dealing with Spiritualization - 2
2. Evaluation
In cooperation with the client / patient Different forms of “religious style” Personal integrity of the therapist Theological evaluation is not
primary concern of therapy
IMPORTANT QUESTION: What is the influence of religious interpretations
on symptom relief, coping with life events and psychosocial development of the patient / client?
![Page 23: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/23.jpg)
Sym
pto
m R
elie
f
Personal freedom -- Interpersonal Relations -- Coping
Outcomenegative
Outcomepositive
Results of Spiritualization
![Page 24: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/24.jpg)
3. Therapeutic strategies
Develop a supportive therapeutic setting in collaboration with the patient
Spirituality as part of a comprehensive model of illness and coping.
Cooperation with counselor / pastor (if possible) Psycho-education: Religious life can be affected
by mental illness (e.g. depression) Image: out-of-tune piano Determine functional and dysfunctional aspects
of spiritual interpretation „Agree to disagree“
![Page 25: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/25.jpg)
Indicators of functional spirituality
Improves self-confidence (based on confidence in God)
Enables mature patterns of relating to others
Enhances coping with life’s demands
Preserves the awareness and the awe of the ultimate spiritual reality, God.
![Page 26: RELIGIOUS INTERPRETATIONS OF MENTAL DISTRESS empirical findings and clinical implications](https://reader035.fdocuments.us/reader035/viewer/2022062408/56813673550346895d9dfe8b/html5/thumbnails/26.jpg)
Emic / Etic Conceptin Transcultural Psychiatry
derived from linguistic concepts
"emic" describes specific intra-cultural perspectives of social behavior and individual distress (e.g. "kufungisisa" = thinking too much, Zimbabwe)
"Etic" describes universal, transcultural concepts (e.g. „Depression“)