Religion and Psychotherapy

There seems to be a prevailing misconception that psychiatrists, clinical psychologists and clinical social workers do not take religion and spirituality seriously. While it is true that there is widely varying assortment of beliefs among this large group of practicing mental health professionals, it is unrealistic to paint all of them with broad brush strokes. Yes, there are those who scorn religion. On the other hand, there are those who, themselves, are active members of churches, synagogues and mosques. There are even those who are pastoral counselors, combining religious convictions with psychological principles.

As one of those mental health professionals, I have an appreciation of the role of religious beliefs and activities in the lives of large numbers of people. Many people find spirituality and religiosity extremely comforting. Some of those  comforted by religious practices are members of my own family.

As a mental health professional, I know the importance of respecting the religious faiths of those who seek psychotherapy with me. It is not the job of the therapist to try to dissuade a patient from their religious orientation.

It is also clear to me that, despite their faith, many of these people consult me or others for psychotherapy because there is something wrong in their lives that their faith does not help them with.

For example, the Judeo-Christian heritage focuses on the biblical story of the Garden of Eden and the fall of human kind because of "original sin." Large numbers of people enter treatment because they are burdened with over whelming feelings of guilt. They feel guilty for their sexual thoughts and fantasies. They feel guilty because their sexual orientation is homosexual. They feel guilty if they have been abused. How is that possible? They believe they deserved punishment for being a "bad seed." In fact, the list seems endlessly long with regard to the things people feel guilty about.

Thirty years of practice has taught me that even those who are religious come to psychotherapy because they want to learn to cope better with their problems without the fear of being judged as sinful. These are people who have been all too skillful at self punishment for their self perceived crimes and sinful ways.

Another observation of mine is that those who are seeking mental health services are not attempting to feel "normal." Most professionals do not subscribe to the notion that there is such a thing as "normal." Rather, therapists are attempting to enable people to cope better with such problems as their feelings of depression, existential angst and anxiety, and all of the other external problems that affect the world, nation, economy and their daily lives.

There are also a number of areas of life where I have found that certain religious practices actually interfere with the ability of a person to function at home or at work. For example, there have been several occasions where female patients reported awful abusive situations at home. However, they choose not to leave their abusive husbands because their faith teaches them that marriage is permanent and divorce is not allowed.

I have also met people who are depressed because they happen to be homosexual and have deep faith but fear the disapproval of their religious leaders. It has not mattered whether these individuals were Catholic, Jewish, Protestant or Muslim. All of them were keenly aware that their faith regarded homosexuality as an abomination.

I have also encountered people who struggle with the entire issue of abortion. Here, too, it matters not which of the faiths they come from, because all disapprove of abortion. Yet, circumstances forced these people to have abortions. In all cases, the experience was fraught with feelings of depression, guilt and loss. These are understandable reactions to something as wrenching as abortion. However, for those women with deeply religious backgrounds, the feelings of guilt were complicated by the underlying fear of having angered G-d and of having committed a terrible sin.

The list goes on and even includes those young couples who, despite coming from different faiths, fell in love and wanted to marry one another. In addition to fears that they would incur parental disapproval, there were fears of incurring the wrath of G-d.

There are even those faiths that look upon depression as an affront to G-d because their religion teaches that life is a gift and harboring unhappy thoughts is a sin.

Finally, there are religious prohibitions against the many sexual fantasies and strivings with which people try to cope. All faiths have rules, regulations and prohibitions against such things as masturbation, pre marital sex, extra marital sex, or, sex during a woman's menstrual cycle and etc. In fact, among the orthodox of one particular faith, there is opposition to psychotherapy because it allows patients to discuss sexual issues of all types, something that is forbidden.

So, the basic themes of this discussion of religion and psychotherapy are:

1. Some from religious communities bash psychotherapy because they misunderstand the field and its many practitioners.

2. Religion and faith are great sources of comfort to millions of people and that is a good thing.

3. There are also major areas of life where religious faith can become a complicating problem for many people. These problems include such things as divorce, abortion, homosexuality, inter faith marriage, depression and many heterosexual practices.

Despite all of this, I do not see a conflict between faith and psychotherapy. Used wisely, they are each provide helpful resources and support.

Your opinions and observations are strongly encouraged on this controversial and difficult topic.

Allan N. Schwartz, PhD