Adaptive religion and spirituality
This section of the paper will discuss the different positive religious coping techniques used, along with the benefits that religion and spirituality bring to the treatment of psychological and physical ailments. The complexity that arises from trying to measure religiosity and spirituality lies in the fact that it is comprised of cognitions, emotions, behaviours, interpersonal factors, and psychological aspects (Hill and Pargament, 2003). Some of the reasons why individuals may turn to religion during times of great difficulty, according to Pargament and Lomax (2013), is that religion may serve as a way to make meaning of the pain endured, instead of rejecting it; further, another reason could be its strong capacity to satisfy a wide range of human needs (Pargament & Lomax, 2013). It is important to highlight that several research studies find results demonstrating the positive and negative effects of religion and spirituality on mental health. Thus, the first section will solely focus on the positive consequences, which will then be followed by the negative consequences, and thus will likely have the same references.
To begin, Pargament, Koenig, Tarakeshwar and Hahn (2004) conducted a two-year longitudinal study examining the effects of religious coping on psychological, physical and spiritual health in an elderly population suffering from medical issues. The authors found that there were several positive religious coping strategies that were linked to the development of stress-related growth and ‘spiritual outcome’, in other words, finding meaning and sense of their experience with strategies such as seeking spiritual support, religious helping to others, seeking spiritual connection, among many others. Further, these outcomes were present at baseline and were maintained at follow-up, indicating that they not only had short-term benefits, they had long-term health advantages for the participants as well (Pargament et al., 2004). Continuing with the idea that religion has a positive impact on health, a study was conducted to explore religion’s function in how patients manage psychosis and other facets of their lives. The authors found that 71% of patients utilized religion as a positive coping strategy. It was found that their psychological health increased, in that religion brought on a good sense of self, hope, comfort, meaning of life, enjoyment of life, love, compassion, self-respect and self-confidence. For more than half of patients, religion provided meaning to their disorder, principally by way of positive religious significances (i.e. a grace, a gift, God’s test, a spiritual acceptance of suffering), versus a more negative undertone (the devil, demons, God’s punishment) (Mohr, Brandt, Borras, Gilliéron, & Huguelet, 2006). In addition, in regards to psychotic symptoms, religious coping decreased positive symptoms by either diminishing the emotional and behavioural responses to delusions and hallucinations, by decreasing hostile behaviour, or both, along with a decline in negative and general symptoms. In terms of social health, religion seemed to have given guidance on how to behave interpersonally, resulting in lowered aggression in patients and overall better relationships (Mohr et al., 2006). Other positive benefits from religion seen in this study include keeping patients away from substance abuse, compliance to psychiatric treatment, by way of viewing it as being created by God, and from the assistance of religious leaders who helped bring together psychiatric care and religious faith to form a cohesive unit (Mohr et al., 2006).
To continue with the idea that religion has a positive impact on treatment compliance in Schizophrenia, a literature review was conducted and found that having a religious faith increased following their psychiatric treatment care plan (Gearing, Alonzo, Smolak, McHugh, Harmon, & Baldwin, 2011). Similarly, another study found that faith in God, not including religious association with an organization, was linked to a higher probability of treatment response, along with stronger decrease in depression and self-harm, and a growth in psychological health. Interestingly, other possible factors such as support from religious community and emotion regulation were not found to play a role in treatment credibility and expectancy, demonstrating the unicity and powerful effect that belief in God has on treatment results. These findings have important implications for treatment, in that patients can make use of faith in a healthy way in terms of the gains obtained from treatment, as their faith reinforces and increases their hope for successful treatment (Rosmarin, Bigda-Peyton, Kertz, Smith, Rauch, & Björgvinsson, 2013). However, it is important to note that religion and believing in God were not determinants in the severity of symptoms or patients’ functional level before being treated – in that religiosity did not help in diminishing symptoms and did not increase their capacity to function well. These findings would seem to indicate that religion does not serve as a shield against the development of severe mental health issues (Rosmarin et al., 2013).
Be that as it may, another study examining differences among Schizophrenic patients with religious delusions or identifying as religious versus patients who were not or who had different sorts of delusions found contrasting results. Namely, the authors were unable to find a difference between patients who identified themselves as religious and those who were not religious. Further, patients who were religious did not acquire greater advantages from their treatments in comparison to patients who were not religious. Interestingly, the only aspect that was determinant of whether a patient would not adhere to treatment was gender; specifically, men displayed a weaker adherence to treatment. Between the two groups, patients with religious delusions were found to be suffering greater than patients with different kinds of delusions (Siddle, Haddock, Tarrier, & Faragher, 2004).
On a similar note, in terms of treatment preferences and association to a religious organization, patients belonging to a religious organization felt less inclined to participate in psychiatric treatment compared to those who were not part of a religious group. However, both groups of participants had a comparable degree of satisfaction regarding psychiatric and magico-religious healing treatment (Huang, Shang, Shieh, Lin, & Su, 2011). In addition, participants suffering from religious delusions and hallucinations experienced less satisfaction from psychiatric treatment and underwent magico-religious healing to a greater extent compared to participants who were not exhibiting religious delusions and hallucinations (Huang et al., 2011). Continuing with the idea that certain treatments may be more beneficial than others, a study that was conducted examined the differences between Religious Cognitive Behavioural Therapy (RCBT) and Conventional Cognitive Behavioural Therapy (CCBT) in patients suffering from major depression and chronic illnesses. The authors found that RCBT, rather than CCBT, had a greater effect on individuals who were depressed and more religious, and that the opposite was also true for individuals who were less religious – namely that CCBT had a greater effect on them compared to RCBT. Interestingly, the authors also found that for individuals who were diagnosed with moderate major depression, a significant variation was not found when measuring effectiveness among the two types of therapies, especially when concepts of Mindfulness were incorporated in the treatment, signaling that religious CBT may not be more beneficial than traditional CBT (Koenig et al., 2015). Although highly religious individuals may feel warry towards psychiatric treatment, there seems to be benefits in adopting or modifying a type of therapy to include religion and spirituality. In offering this option to patients and by explaining the potential benefits that can be obtained from RCBT for individuals who identify themselves as religious, they may feel more comfortable and less reticent about psychiatric treatment. ***
Religion and spirituality have been found to provide a better sense of self. There seems to be a link between a better sense of self and religion being a large presence in these individuals’ everyday life, as these persons demonstrated an improved reaction to negative symptoms, which was correlated to increased quality of life and meaning in life, helping patients better manage their symptoms which lead to an improved evaluation of clinical and functional status overall. Of importance is the rate at which patients practiced their religion in their community, including their community’s support, which did not influence their treatment outcome. In this way, a favorable spirituality and religion can change the development of schizophrenia by encouraging psychological improvement by way of hope and meaning, by virtue of coping skills used to deal with numerous symptoms, while maintaining compliance to treatment (Mohr, Perroud, Gillieron, Brandt, Rieben, Borras, & Huguelet, 2011). Another study that looked at the effects of religion in schizophrenia found that religion was not correlated to the lifespan of the illness, the number and length of hospitalizations, present clinical overall impression, and the way they viewed their life condition. In addition, patients who experienced a healthier social adjustment, while at the same time experiencing more symptoms overall, were found to be increasingly comfortable with discussing their religion with their psychiatrist. The frequency at which patients used religion for the purpose of managing their illness was found to be relatively high, specifically two-thirds of participants (Mohr, Gilliéron, Borras, Brandt, & Huguelet, 2007).
*Link this in somewhere* Attachment theory
It is likely that an explanation for the positive effects that religion brings to so many individuals is the attachment that it generates. In the same way that a child depends on their parents for protection, individuals can lean on God for safety, a presence that provides caring and stability during difficult moments. Attachment theory proposes that those who have a secure attachment to God will also have more encouragement during anxiety provoking circumstances and additional courage and belief in oneself in day to day life (Hill and Pargament, 2003). On the other hand, individuals may seek out God because of a lack of security, and as a result of an insecure attachment to their parents. Specifically, a study by Drinnan and Lavender (2006) found that participants who suffered from religious delusions had repeatedly lived without the presence of their parents, with the authors speculating that having an absent parent to relate to could intensify the need to discover a role model, someone outside of the family, to look up to. Still, on the other hand, participants characterized their connection to God which appeared to be parental in nature, as it gave safety and direction (Drinnan & Lavender, 2006). There is a certain amount of trust involved, and it would seem logical that if we do not have trust in our parents, why should we have trust in God? Specifically, a research study was conducted, examining the effects of mistrust and trust in God. The authors found that confidence in God was linked to a decrease in symptoms seen in Christians and Jews alike. Inversely, distrust in God was correlated with more symptoms in Jewish participants, however this was not seen in Christian participants (Rosmarin, Pirutinsky, & Pargament, 2011). These results demonstrate the variance among different religious groups, while highlighting some negative consequences from religiosity, which leads us into the next section of this paper – maladaptive religion and spirituality.
Maladaptive religion and spirituality
Firstly, a maladaptive religion and spirituality, as reported by Pargament (2007), is “dis-integrated”; in other words, it is poorly prepared to manage the vast array of intrinsic and extrinsic life challenges, as it does not possess wholeness, insight, adaptability, dynamism, balance, and consistency. The following paragraphs will demonstrate to what degree an unhealthy religion and spirituality can have negative, and even life threatening consequences on human beings.
To begin, a study that was presented in the previous section found that, although a large portion of participants used religion in a positive manner to deal with life stressors, they also found that 14% of patients used religion in a negative manner. Further, even those whom used religion positively and who identified its significance in their lives, only one third of the participants of that group in fact obtained social support from their religious group. In addition, a portion of individuals did not obtain any help at all from their religious support system as a result of their symptoms, despite the fact that they participated repeatedly in their religious community by way of religious practices. For these reasons, symptoms recurrently prohibited religious patients from engaging in their religious congregations (Mohr et al., 2006; Mohr, Gilliéron, Borras, Brandt, & Huguelet, 2007). Continuing with this same study, it was found that 14% of patients stated that they suffered negative consequences from religious coping, and even that religion was a cause of hopelessness and pain. Some participants sought out religion as a way to cope, however they were met with adverse effects: for example, a patient recalled being disturbed by what he had read in the Bible. Despite the fact that religion was highly important for the participants who were placed in the negative religious coping group, it consistently came with adverse religious meanings. For some, religious coping heightened the rate of delusions, depression, suicide risk, and substance use (Mohr et al., 2006).