religion, spirituality, psychopathology, phenomenology
Late nineteenth-century psychiatry distanced itself from religion (and spirituality) for good reasons. Psychiatry needed to assert itself as a physical science that was in no way related to the rudely unscientific and irrational "faith healing" emblematic of pre-modern procedures for treating mental illness. It strove for the authoritative status enjoyed by the successful physical sciences and their offspring, modern physical medicine. Yet, historians of psychiatry have pointed out that this aloofness from religion and spirituality has never been entirely successful. One could make the case that talking cure therapies have employed a "mixed narrative" that, while using the theoretical nomenclature of natural science, have in clinical practice been something not entirely different from the faith healing procedures that preceded contemporary naturalistic medicine. In their seminal study "Persuasion and Healing," Jerome and Julia Frank (1961/1993) argued that all talking cure therapies involve a common constellation of constituents: (1) a demoralized person with (2) demoralizing assumptions of the world and (3) a healer. Both healer and demoralized person must believe in the power of this common therapeutic frame of reference if healing is to succeed. Most crucially, the demoralized persons must believe in their healer's competence within a shared therapeutic paradigm if they are to be persuaded to change their demoralizing assumptions about the world. This placebo-like belief in the healing powers of the therapist and the shared therapeutic paradigm is essentially a rhetorical process that, despite such technical terminology as "placebo," "transference," or "therapeutic relationship" has, in practice, shared these religiomagical qualities of faith healing. To put this another way, "personal reality" is itself a matter of belief and faith. The quality of our faith in the reality of the world is a personal meaning-making process that will never be fully satisfied with the results of wet laboratory neuroscience, breakthroughs in physics, or the solving of mathematical problems. In contrast with the purely naturalized branches of science and medicine, psychotherapy specializes in this domain of the reality-positing dimension of the human condition. Thus, as psychotherapists, we may be deluding ourselves if we think we can circumvent the very sticky issue of the place of religion and spirituality in clinical diagnosis and treatment. Psychiatry ignores the spiritual at its own peril. It is for this reason that I warmly welcome this article as the beginning of a very important dialogue for which Philosophy, Psychiatry, and Psychology is the most appropriate forum.
Agneta Schreurs' article reflects a growing consensus within the clinical world to acknowledge spirituality within the physical and mental healing process, but in a manner that distinguishes "spirituality" from religious institutional dogma. Here, [End Page 201] "spirituality" refers of "an individual's ideals, attitudes, thoughts, feelings and prayers directed toward the Divine" or, as I would rephrase it, one's "direct experience" of the sacred or numinous. This focus on experience is, in fact, in consonance with the projects of such scholars as William James (1902/1994), Rudolf Otto (1958), Mircea Eliade (1959, 1971), and most recently Richard Kearney (2001), who have made groundbreaking efforts to forge a "phenomenology of religious experience" independent of religious ideology and doctrine. Unfortunately, these remarkable researchers have had much more impact on theology than psychiatry or philosophy. But the question must yet be asked: Can we really distinguish our personal direct experience of the sacred from the pervasive cultural institutions and religious doctrines that engulf us? Is there a purely "spiritual" standpoint?
This question of a purely spiritual perspective parallels the problem of philosophical phenomenology when it perpetually asks itself if a purely presuppositionless experience is possible. Although most contemporary existential phenomenologists do not believe a purely detached standpoint is possible, there is consensus that a more humble "impure" self-reflective form or interrogation of experience is very much possible. So, to use a hackneyed cliché, "the baby need not be thrown out with the bathwater." It is a noble and necessary effort to distinguish "religious experience" from the mindless violence and suffering that is almost always the inevitable consequence of religious dogma. But how we can distinguish it from "the culture of religion" is a complex problem that is...