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Spirituality, Mental Illness, and the Wellness Paradigm

Spirituality has a troubled place in the psychiatrist's office. A recent PsychiatricTimes.com article explores the complex reasons. The discomfort starts in "the traditional psychoanalytic view of religion being almost a culturally sanctioned form of neurosis" and continues through the modern diagnostic schema, "it is not uncommon to have delusions with religious or spiritual elements." While the DSM, the manual that guides diagnosis of psychiatric ailments takes care not to label as delusional any thought that is part of the cultural framework of the patient, this fig leaf seems to beg the question - is the patient's culture built on delusion?

Neurotic or delusional - which would you rather?

Honor the physician

The issue is made thornier by the recent development in Christianity that pits faith against science. And I cannot stress enough - this is a recent (also North American) development. Alas, what was once a minority voice within American Christianity has gained political and cultural power and, in this country at least, threatens to drown out the traditional Jewish and Christian view, as expressed in the Book of Ecclesiasticus:

Honor the physician with the honor due him, according to your need of him, for the Lord created him; for healing comes from the Most High, and he will receive a gift from the king. The skill of the physician lifts up his head, and in the presence of great men he is admired. The Lord created medicines from the earth, and a sensible man will not despise them.

Again alas, not a lot of sensible around these days. I don't even want to give you the link to the page that headlines, Psychiatry is a vicious enemy of Christianity and the Bible. In bold type, no less. One can hardly blame doctors for suspecting those who make them choose between religion and the gifts that God gave them.

Now there are plenty of psychiatrists who recognize this choice to be nonsense, among them one of the psychiatrists interviewed in the article above. While president-elect of the American Psychiatric Association, Paul Summergrad "convened a gathering of clergy, other faith leaders, patients, and patient advocates with a group of distinguished psychiatric leaders. [Their] first goal... was to establish a dialogue and recognize common goals. [Their] work group developed a guide for faith-based leaders, which can be found and downloaded... from the APA website. "

A Guide for Faith-based Leaders

This guide has good stuff in it, and I commend it to faith leaders. But there is something about it that bugs me. It bugs me in most stuff that I have read written by people who approach spirituality from a scientific point of view. It is found in their description of wellness.

Wellness means overall well-being. For people with mental health and substance use conditions, wellness is not simply the absence of disease, illness, or stress, but the presence of purpose in life, active involvement in satisfying work and play, joyful. relationships, a healthy body and living environment, and happiness. It incorporates the mental, emotional, physical, occupational, intellectual, and spiritual aspects of a person's life. Each aspect of wellness can affect overall quality of life.

There is a graphic that demonstrates each of these aspects as separate items, presumably of equal weight, with Wellness at the center.

Well, what's wrong with that? I am just not sure that spirituality can be turned into an item among others. I am a priest. Spirituality is my life. But I can't figure out how to use it to promote my wellness. God uses me. I have no idea how to use God. And frankly, I suspect those who do.

Wellness vs. Wholeness

What would that graphic look like if theologians created it? For one, at least for this one, Wellness would not hold central position. Wholeness would. Not exactly the same thing. Wholeness is how to describe spiritual health. It is a translation of the Hebrew shalom or Arabic salaam. It means the kind of peace that comes from completeness and includes the completeness or justice of the community. It does not depend on financial, environmental, nor physical health. How one addresses either presence or lack of financial, environmental, and physical health is a measure of spiritual health.


Doctors are about the business of maximizing wellness. That is their job and, from a spiritual perspective, their calling. That's fine, and this wellness paradigm is fine. Except for the spirituality part. Spirituality is a different paradigm.

Well, I have only stated my starting point here. Perhaps this sounds like nonsense to you? Spirituality is peddled today as something to make you feel good. Okay, let me put it out there. Feeling good, as a life goal, is the goal of a spiritual peanut.

This blogpost will just have to become a book. I would like your help. What are the questions you would like to explore about spirituality and mental illness? Like, can you be whole and mentally ill? Does prayer really work, and how? Does it make a difference what you believe? Add a comment. Thanks.

cartoon from @lectrr

photo of St. Luke (patron of doctors) window by author

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