Spiritual aspects

Spiritual Aspects of Medicine and Psychiatry 

When I was younger, I took up psychiatry because I enjoyed it and seemed quite good at it. However, I was not only naïve but also deeply influenced by my protected Christian upbringing. The consequences were not only that I found it easy, and often enjoyable, to speak in depth and make sound sense with people reckoned mad, or reckoned to have serious psychological problems, but also that I was reluctant to make psychiatric diagnoses. Some people have since accused me of having been rebellious for not having made the same judgements as my professional peers, for not having called this a sign of schizophrenia, that a sign of depression, this personality disordered, that person in need of treatment, and so on. But the Bible says “mercy triumphs over judgement” (James 2:13) and “in our God all things hold together” (Colossians 1:17). So I found employment by combining general practice and psychotherapy.

I was reluctant to judge it invalid for the person consulting me to be seeing things their way. I wanted them easily to open their hearts to me. In order that healing may come to their souls and bodies, I wanted to meet them in dispassionate love and truth so that we could begin to ascertain where we stood with each other with regard to issues that seemed relevant. I wanted prejudices to be dissolved, deceptions to go away, and relationships to be put right in order that God may have room to heal them (1). For me, this is part of the art of medicine.

I remember instances of physical illness that distinctly improved through sorting one’s life out with God, such as, for example, a man with severe chronic diabetes whose requirement for insulin was drastically reduced. Furthermore, it was often easy to see connections between life events, decisions made or attitudes adopted and the onset of physical illness. For example, I remember a young girl who developed acute diabetes immediately after her father had smashed up the house and left. The condition of the patient could be helped by finding healing for the past. And because psychiatric conditions are not accompanied by any gross physical pathology, improvement was often much more pronounced provided people were not too set in their ways. When the Holy Spirit is present there is unconditional love and truth and real power for soundness of mind (2 Timothy 1:7). Hopelessness and confusion tend to go and people find sufficient encouragement and hope to work through their issues and dispel their demons. The process of healing often takes time and the job of the physician is to keep faith and protect, like a shepherd.

Although this sort of personal and meaningful way of generally practising medicine was particularly made respectable by some psychoanalysts around Sigmund Freud (2), there is little or no place for it in modern evidence-based medicine now. In the past 15 years or so spiritual and personal elements have largely been removed from medical practice. Government services, which have the effective monopoly for provision and hence for regulation (3) of health care, will not pay for time taken in professional personal relationships. Accredited plans of treatment are necessary for actuarial approval.

It is both assumed by government and accepted by most Christians that the academic classification of the ills of those who suffer, of those who are distressing to live with and of those who are judged to be criminal, and the academically accredited treatment of them, are the only reasonable responses to them. However, to judge treatment to be necessary can often be to stop meaningful dialogue which could lead to change and healing. Treatment alone, without attention to personal change and getting right with God, can become a means of social control and political manipulation by offering relief from indigence without any apparent need to submit to God in repentance and faith (4).

By embarking on treatment as a matter of course we fail to listen to people at our peril (Luke 8:18) because reality is thereby hidden. By believing the diagnostic name given to the condition to be the only meaningful explanation, the significance of what is to be repented of in order to be reconciled to God can be disguised and silenced by being made into the business of the academic and professional specialists who apply the treatment. There is always an accredited remedy to make the symptoms go away. But it may be both cheaper and better in the long run to seek God for His direction and healing whilst using medical expertise carefully as necessary. This way, however, it will be necessary to find time and space to search one’s soul, accepting that suffering has meaning to God that He may make known or use for His glory (John 9:3). And it requires loving people willing to be supportive and truthful. If the ills of the body are only to be the business of medical and psychological science, and if spiritual affairs are deemed to have no relation to the physical body and no relevance to its ills, we are guilty of the Nicolaitan heresy (Revelation 2:6 and 2:15) (5).

Without the breath of God there is no living biochemistry or physiology, the body is lifeless (Genesis 2:7) and there is decay. Our life is spiritual. Personality is essentially a spiritual entity. The spirit of life indwells every aspect of our living bodies to form the soul. Thus the soul is not only mind, emotion and desire but also the living functioning of the lungs, the heart, the liver, the sensory, motor and autonomic nervous systems, the endocrine and excretory systems, the genetic apparatus, and so on. We are influenced and affected in our living bodies by other contingent spiritual beings and events (1 Thessalonians 5:26). Knowledge of this influence is received directly into the soul and may be spiritually discerned (Isaiah 11:3). Sometimes the effect of what is going on may make us ill.

So I am writing about personal relationships (which are spiritual) rather than about interventions and outcomes. Although such considerations may perhaps most readily fall into the category of theology, I am suggesting that many disciplines could take them up, especially psychology and medicine. (I have not been able to find much modern psychosomatic research really relevant to this position.) Furthermore, it follows from this perspective that the place of medicine, psychology and sociology, and other related disciplines, is to debride and to hold safe whilst God heals (as assumed in 1 Timothy2:1-4).

The sort of healing I am discussing is exclusively the ministry of Christians, including Christian medical professionals. Although other religions address healing, they will inevitably be challenged by specifically Christian aspects. The Christian God is the God who heals (Exodus 15:26), who grants repentance (Acts 11:18) and who sent His only begotten Son Jesus to die on the cross and to rise from the dead so that we may become holy and without blemish (Colossians 1:22, 1 Thessalonians 5:23, Romans 8:11). Jesus healed and He still heals. For a Christian in medicine, the art is so to attend to people that God may heal them; and the agent of healing is always God, not medicine. Healing is always spiritual (Exodus 15:26).

The Bible exhorts us to relate truthfully to each other and to minister healing to one another (1 John 1:6-7, Ephesians 5:8-14, Colossians 3:16, James 5:13-20). God’s truth in unconditionally loving relationship brings repentance, peace and healing (John 8:32). You can have this sort of relationship with people who are not Christian (John 4:1-42) as, particularly, in the practice of psychodynamic psychotherapy.

The point is when does it become necessary, in this sort of relationship, to “treat” someone, to do something to them? What about issues that cannot be spoken about and that remain in the dark? What about any relation between such issues and distressing physical and psychological conditions? Considering that “in our God all things hold together” (Colossians 1:17) at what point in our meeting do I have to regard you objectively, classify your condition and do something to you by way of treatment that involves you putting your trust in my expertise?

There is no Biblical evidence for the common supposition that “when referring to mental distress the Bible is more likely to be referring to entirely reasonable responses…than it is to what we would call mental illness” (quoted from another C.A.N. Perspective). Rather, the Biblical evidence seems to be that Jesus met and healed those with what we would call mental illness, indeed those with any illness, with dialogue, person with person, in which His spiritual authority was evident and deliverance and healing followed (Luke 8:26-39, Luke 9:11, Matthew 12:22, John 4:1-42, note also Mark 3:21 and 2 Timothy 1:7). And He said anyone with real faith in Him would do similar things (John 14:12).

I am drawing a sharp distinction between soul (science) and spirit (Hebrews 4:12 refers). Traditionally science relies on sense perception, which is of the soul, in order to be certain of results. But the sort of influence and knowledge that may be discerned spiritually is also necessary for healing. Health and healing are better when caring people are involved (6). It is the good Samaritan and the inn-keeper on the Jericho road (Luke 10:25-37) that apply the science but unless the person we follow in worship can be absolutely trusted, and unless we hear His voice (John 10:4), we may be led astray despite our science. When Jacob went to his blind and ageing father Isaac deceptively to claim the blessing that would naturally have gone to his brother Esau (Genesis 27) Isaac inadvertently allowed himself to be deceived through checking against his senses, in this case his senses of smell and of touch.

In this case it was the will of God that he should be so deceived. Presumably God could not get through to him any better way. However, when God is able to speak personally to individuals and be heard this changes the direction and quality of their lives. Jesus says “those who hear will live” (John 5:25 etc.). Sometimes God’s word is received through other human beings. It is always received personally and it is more likely to be received when there is less resistance to it, that is when whatever may get in the way of receiving it has been cleared away. I do not know whether or not God’s personal word can ever be accepted academically as “specifiable”, as science demands for an outcome to be measured so that the “treatment” can be “accredited”. However, I believe God’s word can change the lives of unbelievers as well as of believers, and that people sometimes have an ability to recognise the rightness (“Aha!”) of a revelation so that it enables them to find healing. Sometimes God totally heals people of the most dire conditions.
Therefore Christian healing work should always be complementary to scientific and technological medicine. Even when someone is under the doctor the intimate process of being reconciled to God should be able to be facilitated regularly and in detail, provided the patient wants it, by people in the Christian church. And academic justification of healing does not need to be sceptical.

Footnotes:
1. The dictum “I tend them, God heals them” is attributed to the sixteenth-century French surgeon Ambroise Paré.
2. In particular see Groddeck G. (1977) “The Meaning of Illness: Selected Psychoanalytic Writings” London, Hogarth Press; Balint M. (1957) “The Doctor, His Patient and the Illness” London, Pitman; see also Tournier P. (1954) “A Doctor’s Casebook in the Light of the Bible” London, SCM Press Ltd.
3. Although the British medical profession remains in theory self-regulating, the Government provides a health service in response to the demand for “care”, to keep people working, and public safety is a political issue that demands publicly accessible accountability. You cannot be certain of personal relationships for they demand an element of faith and what transpires can be contested, which makes litigation risky. So it has seemed more efficient to pay for scientific protocols in order that what may be expected can be clear. Meaningful personal professional relationships have been replaced by impersonal technology with a smile.
4. I find The Order for the Visitation of the Sick in the 1662 Book of Common Prayer to be essentially relevant.
5. Irenaeus Adv. Haer. I.26 and III.10.7. The heresy is to believe body and spirit to be two separate realms.
6. Comstock, G.W. and Patridge, K.B. “Church Attendance and Health,” Journal of Chronic Diseases 25 (1972) 665-672, quoted in Lynch, J.J. (1977) “The Broken Heart” New York, Basic Books, Inc.

John Gordon, MA.MB.BChir.(Cantab.) DPM.,
Retired Psychoanalytic Psychotherapist,
Licensed Minister in the Order of Jacob’s Well.
October 2006.