Spirituality, Religiosity and Mental Illness
“The miserable have no other medicine, But only hope” well said by William Shakespeare in his play measure for measure. The word “Hope” is a key for person’s survival, which helps in facing the obstacles of the life without hope person would not survive or drown into the darkness of life. Developing hope and providing meaning to the life is the foremost function of the religiousness and being spiritual and having faith in God provide strength for living and coping in the difficult ways of life (Wnuk, 2014).
Spirituality is a universally acknowledged concept; people’s belief and follow the most superior force and having hope on that force. When spirituality is institutionalized called as religion (Verghese, 2008). There is a very strong and positive relationship between religiosity, spirituality and mental illness. It is proved by studies that religion and spirituality act as a shield in mental illness and provide positive coping for bearing the austerity of disease process and help to remain compliant to treatment regimen (Weber & Pargament, 2014).
Previously, Spirituality and Religiosity were always considered as a hurdle in treating mental illness .As Sigmund Freud and Jean Charcot connected religion with neurosis and illusion. Recently, researchers are proving that there is a very strong and positive relationship between spirituality, religiosity and mental health. So this shows that the society and health care workers need awareness regarding this positive relationship. This is noticed that the health care workers focus more on the pharmacotherapy. Though 700 studies done on the relationship between mental health and role of spirituality, nearly 500 of them accepting it as a positive relationship. (“What Is the Role of Spirituality in Mental Health Treatment?”, 2009)
On the clinical at Karwaan- e –Hayat, I was encountered with a middle-aged female patient appears to be alert and diagnosed with schizophrenia. While interviewing and performing mental status examination and asking a detailed history, I get to know that she is having suicidal ideations with complete plan, as she had a delusion that she is married with one of the staff of the hospital and now her husband wants to divorce her and she had already made those delusions a major part of her life. So, to stop her, I found that she is having a very strong belief on religion so I tried to take her in the way of Islam that suicide is considered as a bad act and is forbidden in Islam and that she may be penalized for it by the God for this act After saying this line she internalized it well and decided to fight with the problem. So in my patient’s mental illness, religiosity and spirituality had impacted positively. And act as a protective factor for her.
Amalgamating, the scenario with BMSEST model which was introduced by Anandarajah (2008). According to which spirit, mind and body is closely interconnected with each other which means one component is impacting other two components. Similarly, in the above mentioned scenario the spiritual component (spirit) is impacting the component of mind and body both and preventing the patient from attempting or committing suicide (body) and helps in cessation of suicidal ideation (mind). A healthy individual needs to maintain the equilibrium in these three components.
Generally, in stressful situation people tends to take wrong decisions which eventually putting them in a more stressful or defeating situation. In mentally ill patients these stressors or self-defeating thoughts because of their altered thought process leads them to frustration or harming others or themselves as in one of the study it is documented that psychiatric in-patients face more stressful situations in life which increase their susceptibility for suicide (Zhang, Wang, Xia, Liu, & Jung, 2012). Moreover, attachment theory originally given by Bowlby and modified by Kirkpatrick, states that in stressful situations people who are connected to God experience security, support and confidence (K.W., 2012) likewise, in the above mentioned scenario the patient acquire hope from the religion and succeeded in coping her stress consequently suicidal ideations were given less priority than religious and spiritual beliefs.
In the society it is considered that the treatment is only linked with medicines and health care workers may feel that spiritual aspect is not at all linked with the spirituality and religiosity but in reality studies shows that the spirituality is a core aspect of treating religious patients with the mental and physical illness as it helps in adhering to the treatment plan and give hope, strength and coping for fighting with the disease. According to a comparative study by Rebecca Probst, religious cognitive behavioral therapy considered more useful than the standard cognitive behavioral therapy in the religious clients (Hefti, 2011).Furthermore, Religious Cognitive- Emotional Therapy (RCET) is another therapy newly introduced in mental health in which insight and elementary religious beliefs are being considered in psychotherapy (Reza, 2010).
Spiritual care is a fundamental approach of nursing care. In an individual level, a nurse should consider spirituality as an essential part of the mental status examination (Ramezani, Ahmadi, Mohammadi, & Kazemnejad, 2014). Identification of religious conflicts is another significant nursing responsibility to help patient. It provides a chance to an individual to practice their religion in hospital care setting, thus encouraging them to practice religion recurrently. Eventually, it will help them to utilize spirituality and religiosity as a coping mechanism.
On institutional level awareness can be raised on importance of spirituality and religiosity in mental health by teaching staff of the hospitals for incorporating religious/ spiritual aspect in treatment and care. On community level awareness sessions related to spiritual well-being and its relation with mental health can be given .Government should work on the preservation of the rights of minorities, taking care of spiritual needs in governmental institutions for example: government hospitals. Society should avoid discriminating people on the basis of religion or religious practices or not to interfere with others religious beliefs or practices and use pluralistic approach and create acceptance for minorities.
In conclusion, Spirituality and religiosity is a protective factor and a healing source that needs to be incorporated in lives to ensure hope and to practice it as a coping mechanism to face many problems in life to maintain mental wellbeing. Health care workers need to apply it as a mental/psychological treatment regimen.
- Wnuk, M. (2015). Religious–spiritual sources of hope and the meaning of life in alcohol co-dependent subjects receiving support in self-help groups.Journal of Substance Use, 20(3), 194-199.
- Weber, S. & Pargament, K. (2014). The role of religion and spirituality in mental health.Current Opinion In Psychiatry, 27(5), 358-363. http://dx.doi.org/10.1097/yco.0000000000000080
- Verghese, A. (2008). Spirituality and mental health. Indian Journal Of Psychiatry, 50(4), 233. http://dx.doi.org/10.4103/0019-5545.44742
- What Is the Role of Spirituality in Mental Health Treatment?. (2009). J Psychosoc Nurs Ment Health Serv, 47(3), 8-9. http://dx.doi.org/10.3928/02793695-20090301-05
- Anandarajah, G. (2008). The 3 H and BMSEST Models for Spirituality in Multicultural Whole- Person Medicine. The Annals Of Family Medicine, 6(5), 448-458. http://dx.doi.org/10.1370/afm.864
- Zhang, X., Wang, H., Xia, Y., Liu, X., & Jung, E. (2012). Stress, coping and suicide ideation in Chinese college students. Journal Of Adolescence, 35(3), 683-690. http://dx.doi.org/10.1016/j.adolescence.2011.10.003
- K.W., Y. (2012). Positive effects of Spirituality on Quality of life for People with Severe Mental Illness. The International Journal Of Psychosocial Rehabilitation, 16(2), 62-77.
- Hefti, R. (2011). Integrating Religion and Spirituality into Mental Health Care, Psychiatry and Psychotherapy. Religions, 2(4), 611-627. http://dx.doi.org/10.3390/rel2040611
- Reza, A. (2010). Religious Cognitive–Emotional Therapy: A New Form of Psychotherapy.Iran J Psychiatry., 5(3), 81-87.
- Ramezani, M., Ahmadi, F., Mohammadi, E., & Kazemnejad, A. (2014). Spiritual care in nursing: a concept analysis. Int Nurs Rev, 61(2), 211-219. http://dx.doi.org/10.1111/inr.12099
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