Simon Dein

Does being religious help or hinder coping with chronic illness? A critical literature review

This paper reviews a number of studies relating to religion and coping with chronic illness, emphasizing those aspects relevant to palliative care. After pointing out that religious and existential needs are common in chronic illness, a critical examination is made of those studies which purport to demonstrate associations between spiritual beliefs, religious practices and psychological prognosis. Recommendations are made as to how religious issues can be dealt with in clinical practice, with particular relevance to the multidisciplinary palliative care team.

Jinn, psychiatry and contested notions of misfortune among east London Bangladeshis.

This study examines understandings of misfortune among east London Bangladeshis, particularly with respect to the role of jinn spirits. It reports on the findings of ethnographic interviews among 40 members of this community. Appeal to jinn explanations is commonplace at times of psychological disturbance and unexplained physical symptoms. Resort to traditional healers is frequent. These explanations are contested by different groups in the community. The findings are examined within the context of a discourse on tradition and modernity with particular emphasis on Islam and modernity.

Religion, spirituality, and mental health: current controversies and future directions.

Abstract Although studies examining religion, spirituality, and mental health generally indicate positive associations, there is a need for more sophisticated methodology, greater discrimination between different cultures and traditions, more focus on situated experiences of individuals belonging to particular traditions, and, in particular, greater integration of theological contributions to this area. We suggest priorities for future research based on these considerations.

The stresses of volunteering in a hospice: a qualitative study

Objectives: This study examined the stresses associated with hospice volunteering, ways of coping and perception of available support. Methods: Two focus groups were conducted comprising 17 volunteers. The data obtained were transcribed and analysed using thematic analysis. Results: Reported stressors included losing patients and dealing with disfigurement. However, informants generally reported the work as satisfying and generally stress free. Coping strategies ranged from keeping a distance from clients, religious faith, to the realization that death was a merciful end and was not necessarily painful. Informants generally perceived support to be adequate. Conclusions: The implications of these findings for training volunteers are discussed, especially the need to educate volunteers about the symptoms and signs of cancer.

Ethnicity and religious coping with mental distress

Background: There is a growing evidence base for how people use religious and spiritual coping, and how coping patterns differ between ethnic groups. Aims: To describe what constitutes religious coping and compare patterns of religious coping across ethnic groups. Methods: In-depth interviews were completed by 116 people recruited from six ethnic groups. Subjects described how they cope with mental distress; their accounts were recorded, transcribed and subjected to the “Framework” approach to qualitative data analysis. Results: Formalized religion was not always necessary for individuals to make use of religious coping. Religious coping was most commonly practiced by Bangladeshi Muslims and African Caribbean Christians. Coping included prayer, listening to religious radio, using amulets, talking to God, having a relationship with God and having trust in God. Cultural or spiritual coping practices were indistinguishable from religious coping among Muslims. There was a greater degree of choice and personal responsibility for change among Christians who showed a less deferential and more conversational quality to their relationship with God. Religious and spiritual coping practices were frequently used, and led to a change in emotional states. Conclusions: People use religious coping, and this has implications for promoting resilience and recovery.

The Use of Traditional Healing in South Asian Psychiatric Patients in the U.K.: Interactions between Professional and Folk Psychiatries

The use of traditional healing and traditional healers among ethnic minority psychiatric patients remains little explored in the U.K. Using qualitative and quantitative methodology, this article examines the use of traditional healing among 25 South Asian psychiatric patients in the London Borough of Waltham Forest. Twenty-eight percent of the sample had resorted to a traditional healer during their psychiatric illness. Five case studies are presented which illustrate the various forms of traditional healing used. Although the numbers are small, the study suggests that South Asian psychiatric patients in Britain do resort to traditional forms of healing in collaboration with western psychiatric treatments. Asian patients use a number of treatments concurrently, although they may often not always understand how the treatments work. Humoral theories are commonly posited to explain mental illness and foods are commonly used in treatment. Only the age of the patient was significantly related to the use of a traditional healer. These findings are discussed in relation to globalization.

THE SPIRITUAL VARIABLE IN PSYCHIATRIC RESEARCH

Foolish as the theory of Durkeim may be in confusing what is religious with what is social, it yet contains an element of truth; that is to say that the social feeling is so much like the religious as to be mistaken for it. (Simone Weil, 1951). Psychiatrists concern themselves with human mental suffering. Behind the consulting room door they reflect with their patients on questions of meaning and existence, issues that concern philosophy and religion as much as psychiatry. It is striking, therefore, that psychiatrists regard spirituality and religion as, at best, cultural noise to be respected but not addressed directly, or at worst pathological thinking that requires modification (Larson et al . 1993). Despite two millennia of debate we are little nearer a consensus on the meanings of spirituality and religion. The word ‘religion’ has as many definitions as writers. Spirituality and religion are often used interchangeably. Spilka (1985) doubts that a single definition is even possible. Dittes (1969) argues that religion contains so many unrelated variables that it cannot be considered as a unidimensional concept in research. We would argue that religion is the outward practice of a spiritual system of beliefs, values, codes of conduct and rituals (Speck, 1988). Religious groups may function like any other with codes of behaviour, political alliances and ‘in’ and ‘out’ group member ideology (Sherif et al . 1966). Unfortunately, a concentration on the religious variable has led to a failure to appreciate the broader concept of spiritual and the presumption that if someone does not profess a recognized, religious faith, they have no spiritual discernment or need (Speck, 1988). We propose a definition of ‘spiritual’ as a persons experience of, or a belief in, a power apart from their own existence. It may exist within them but is ultimately apart. It is the sense of relationship or connection with a power or force. It is more specific than a search for meaning or a feeling of unity with others. People may use the word ‘spiritual’ to describe intense emotional pleasure when moved by natural beauty or by an important relationship. Spiritual belief is more specific than that. Some people may use the word ‘God’ to describe this power; others may be less specific. Spirituality differs from belief in other powers, such as nuclear power or magnetism, in its ‘set apart’ quality and the degree to which it is revered and ritualized, the quality which Durkheim (1915) refers to as the sacred.

The voice of God

Prayer and verbally answered prayer would seem to offer powerful evidence in relation to the question of human agency. Forty members of an English Pentecostal group completed a questionnaire on prayer: 25 reported an answering voice from God, 15 of them hearing Him aloud. The latter groups were interviewed and characteristics of phenomenology and context elicited. The voice of God cannot be held to be ipso facto pathological and many reported its utility in situations of doubt or difficulty.

The effectiveness of words: Religion and healing among the Lubavitch of Stamford Hill

Testimonials of miraculous healing offered by Lubavitch Hasidim evoke images of exile and restitution which derive from Kabbalistic texts. Mediated practically through the person of the Rebbe, these testimonials articulate both immediate affliction and ultimate meaning, physical embodiment as well as symbolic representation, each constituting the other. Both Kabbalah and medical anthropology attempt to transcend not dissimilar epistemological dualisms: those characteristic of monotheism and contemporary science. Yet the ‘lower root’ of Kabbalah affirms a material reality known through immediate sensory experience which recalls the rationale of biomedicine.

Detachment: gateway to the world of spirituality.

Mystical states are common cross-culturally. Here we examine the prevalence and general characteristics of these states. We then proceed to critically examine the theories purporting to explain these states: psychoanalytic, cognitive and neurobiological, all of which attempt to explain the breakdown of the boundaries between the self and external world. We conclude by exploring the implications of mystical states for cultural psychiatry.