Dr. Samuel Pfeifer

Religious patients in psychotherapy – how can we

minister to their special needs?

Aarhus 2003

The needs of religious patients

• Acceptance of a person in his or her specific religious world of assumptions and values.

• Validation of stabilizing factors in personal faith and the religious structures, where a person is looking for help.

• Helping to understand major psychological crises, combining Biblical aspects and models of scientific psychiatry.Example 1 - Depression despite faith: Examples of depression in Biblical figures.Example 2 - delusional distortion of religious values.

A systemic view

• Supporting the family: systemic view, including relatives; improvement of their understanding, helping them to support the patient with patience.

• Empathic working through with respect for personality factors and socio-cultural context. Strengthening stabilizing aspects of religious culture.

Dealing with pathological faith

• Knowledge about negative (“pathomorphous”) influences of religion with false premises; distorted images of God. IMPORTANT: Understanding subcultural peculiarities of religious styles.

• Creative discussions of irrational causal attributions (“Has God taken his blessing from me?” “Is this psychosis a demonic manifestation?”)

• Dealing with religious defenses -- TRANSFERENCE AND COUNTERTRANSFERENCE.

Integrating religious elements

• Encouragement to seek help through familiar religious rituals and forms of counseling, e.g. prayer, word of wisdom, the Lord’s supper, laying of hands, anointment etc. -- cooperation with a counselor of the patient’s church.

• Admit your own limitations of understanding

• Acquire personal experience with positive faith which stabilizes and conveys meaning to human suffering.

Guidelines for religious interventions

• Informed consent includes religious intervention

• Assessment

• Relationship of trust

• Establishing the indication

• Describe interventions before applying them

• Respectful approach

• Value framework

• Flexible approach

• Seeking spiritual guidance

Scott & Bergin 1997, p. 256

“Heart Religion” in Therapy

“I plead not for a religious psychotherapy or a psychotherapy only for the religious, but rather for a therapy that takes the phenomenon of religion seriously as one of the specifically human forms of expression. I plead for a therapy that does not merely take note of the patient’s confession of faith or denomination or inquire perfunctorily into his or her orthodox beliefs.

Rather, therapy should try to explore in detail an individual’s very personal, often very unorthodox religion, which usually undergoes great changes in the course of a lifetime: the patient’s “heart religion”.”

(Hans Küng, p.155)

Healthy Religion (Hans Küng)

We should work for a religion• that supports self-acceptance without regression;• that can serve the individuation of the individual with its

symbols, convictions, and rites;• that can provide spiritual guidance and ethical standards• that guarantees freedom of decision, identity and dignity• that is able to conquer fears and to justify trust,

understanding, and respect -- the basis for friendship and love;

• that encourages and guides sensitivity and emotionality, thus promoting creativity and more humanity