THINK ABOUT something that is very important to you. Like the ability to walk, or your vision. Now carefully visualize an entire day without it. Think about getting out of bed, getting ready for the day. See, in your mind’s eye, every obstacle you would face, every frustration, all the situations that would be more difficult. Imagine how you would feel at the end of the day without this thing – how you would feel about a life without it.
Then think about this thing that is important to you, and consider this: God has given it to you. Think about all the things God has given you.
This is not something that most mental health professionals would be likely to suggest – and that is unfortunate. For a deeply religious patient experiencing anxiety, repeating a gratitude exercise like this could help.
Modern psychology has a serious God problem. America is a deeply spiritual country. More than half of Americans say religion is “very important” to them, and more than 90 percent profess a belief in a higher power. Yet psychology, as a scientific endeavor, has done almost nothing to understand how spiritual beliefs shape psychological problems, or affect treatment. When a person with deep religious convictions comes in for professional help, they will find, more often than not, a therapist who is not fully prepared to help.
“I think we need to wake up and realize how many people come into our offices and have spirituality as a part of their life,” says McLean Hospital’s David Rosmarin.
Rosmarin is part of a small cadre of people seeking to bridge the worlds of religion and evidence-based mental health. Operating under the banner of “spiritually integrated” therapy, Rosmarin and his colleagues are working to understand how religious beliefs interact with conditions like depression and anxiety, and how to modify the tools of psychology to treat the devout.
Relations between psychology and religion have a troubled history. Putting psychology on a scientific footing meant, in part, rejecting the notion that mental illness is a spiritual phenomenon, that madness implied possession by demons or foul spirits. Freud famously diagnosed religion as a psychological problem. To believe, in his view, was to be neurotic.
Today, there are many religious communities that regard psychology with some suspicion, as an enterprise that is not relevant – or, worse, that actively seeks to undermine the spiritual life.
It is a divide with a personal aspect. In one survey of members of the American Psychological Association, 48 percent said religion was not important in their lives. For those who are not religious, it is hard to understand how important religion may be to a patient, and how off-putting it can be when a therapist steers the discussion away from the spiritual.
Rosmarin recently published a paper describing an example of how spiritually integrated therapy could work. In a survey of Christian and Jewish believers, he found that those who “trust in God” – who believe that the supreme deity is safeguarding their interests – tended to be more tolerant of uncertainty about their future, and were thus less prone to worrying.
Then, working with a group of ultra-Orthodox Jewish community leaders in New York, he designed a simple 30-minute video program to treat anxiety. The video included a gratitude exercise as well as inspirational stories and tasks designed to bolster a Jewish believer’s trust in God, and diminish any feelings of mistrust they might be experiencing. The video was designed using scientific principles, drawn from the psychological literature, but expressed in the language of religion.
Participants were asked to watch the video once a day and, after just 14 days, they were measurably less anxious.
The approach can clearly work, but there has been little research devoted to expanding it – and scant governmental interest in supporting it. What’s important to understand is that this is not about proselytizing. It’s about offering a treatment option to the deeply faithful. It’s about the field of psychology shedding its prejudices and preconceptions and returning to the first principle of therapy: meeting patients where they are.