Spirituality in Mental Health Treatments
Spirituality can play a role in any mental health condition in both helpful and unhelpful ways.
In some cases, spirituality may negatively affect a person’s mental wellness. For example, they may have grown up in a strict and punishing religious environment. Because of this, they may never wish to explore spirituality again. They may shut themselves off from concepts or practices that could potentially be helpful.
A person’s past experiences with spirituality and religion can affect the way they think about mental health. For example, someone could consider their depressive symptoms a punishment from God.
Some people have experienced trauma related to spirituality, such as abuse from a religious leader, or exclusion based on their sexual orientation.
Therapists can help patients work through the meaning of such thoughts and feelings without interfering with patients’ personal beliefs.
Moreover, therapists can also help patients tap into their spirituality to develop healthy coping skills, find meaning, and develop human connection—all hallmarks of good mental health.
Multiple spiritually based treatments exist for every disorder and can be used in conjunction with standard therapy. In cases in which a patient’s spiritual needs are beyond the scope of therapy, the therapist can refer the patient to a spiritual leader according to the patient’s tradition. Therapists and spiritual/religious leaders can also collaborate in a patient’s care.
Although not an exhaustive list, the following is an overview of how some mental health conditions are affected by spiritual beliefs and practices, as well as treatments that include spiritual components.
Addiction is sometimes referred to as a spiritual disease. People who experience substance use disorders face feelings of emptiness, shame, and isolation. Spiritual beliefs and practices can give patients a sense of purpose and connection that aids in their recovery.
Many people with mental health challenges first encounter the concept of spirituality when they join a recovery program. Many of these programs are based on the original 12 Steps, first outlined by Alcoholics Anonymous and since adapted to issues involving narcotics, overeating, or being the family member or friend of someone who has a substance use disorder.
Regardless of the condition it addresses, each 12-step process uses a spiritual underpinning in which participants give challenges over to a higher power. This situates the individual within a spiritual framework that helps them overcome their present addiction and live a meaningful life.
Mindfulness is another spiritual practice that can be helpful in treating addiction. People often use substances to avoid pain. By learning to practice mindfulness, people can change their relationship with the present moment.
Instead of reacting to distress by turning to alcohol or other substances, they can respond with more awareness. In doing so, they can cultivate acceptance of unpleasant sensations, thoughts, and feelings. For example, they can more easily recognize that cravings are temporary. They can consider alternate coping methods, such as going for a walk or calling a friend.
Mindfulness-based relapse prevention (MBRP) is a treatment that combines mindfulness meditation with cognitive-behavioral relapse prevention. Treatment consists of eight weekly, two-hour sessions. Participants focus on awareness of triggers and cravings, mindfulness in daily life, and mindfulness in high-risk situations.
Several studies show that spiritual beliefs and practices can alleviate depression. Spiritual coping strategies, such as finding meaning in stressful situations, giving up control to one’s higher power, and seeking support from clergy can reduce despair.
People with spiritual and religious beliefs may also more frequently experience positive feelings of awe, compassion, and hope. In addition, they may be more likely to adopt healthy behaviors that can impact depression, such as exercising, eating healthfully, and abstaining from drugs and alcohol.
Religiously integrative cognitive behavioral therapy (RCBT) is a form of treatment in which clinicians utilize patients’ spiritual beliefs and behaviors as a basis to identify and challenge distorted thoughts. RCBT encourages patients to identify spiritual resources according to their individual faith, meditate on sacred texts, and become involved in a spiritual community.
Certain aspects of spirituality and religion can protect against suicidality.
Spirituality helps with hopelessness and impulsivity. Religious faith encourages the idea that things can get better even when someone is going through a tough time.
Religious beliefs can help an individual reflect on one’s highest values before making a decision or succumbing to a desire.
In a study of approximately 100,000 men and women, attending religious services every week projected a 68% lower risk of ‘deaths of despair’ (suicide, drugs, and alcohol) among females and a 33% lower risk among males.
Research shows that belief and faith in God can be associated with significantly lower suicidality, even among those not aligned with any religion. Recognizing purpose and meaning in life can significantly predict a person’s overall well-being.
If you are suicidal or are a danger to yourself or others, please call 9-1-1 or visit your nearest emergency room immediately.
Some aspects of spirituality and religion have been shown to lessen or prevent eating disorder symptoms.
Research has shown that people who value spirituality are more likely to use prayer and meditation to cope with distress related to body image.
One study found that religious women who read affirmations about God’s love and acceptance of their bodies were less affected than peers when viewing images of “thin ideal” fashion models.
Other studies, like this one on the effects of social comparison on people with eating disorders, report that a secure attachment to God can reduce disordered eating and behaviors.
Spiritual treatments help patients with eating disorders reject the notion of a perfect body and instead focus on connections with fellow humans and the sacred. Interventions include meditation, contemplation, prayer, journaling, and 12-step groups.
Incorporating spiritual treatment with people with psychotic disorders can be complicated. Symptoms of psychotic disorders, such as delusions, can be confused with religious experiences and vice versa.
Research has found that spirituality and religion do not contribute to psychotic symptoms, however. On the contrary, as with other mental health conditions, cultivating spiritual beliefs and practices in patients who wish to do so can be helpful.
Spirituality can enhance a person’s positive sense of self, provide meaning to mental health challenges, lessen the severity of symptoms, and provide a framework for social behavior.
Several forms of spiritual group therapy have been shown to be effective for people with psychotic disorders.
In one model, members of a therapy group discussed spiritual concepts, listened to spiritual music, and were encouraged to offer emotional support to one another. Within six months, all 20 participants in the group achieved their treatment goals.
Obsessive Compulsive Disorder
Spiritual and religious beliefs can be helpful in treating obsessive compulsive disorder (OCD). For example, mindfulness strategies can help people recognize obsessive thoughts and resist getting caught up in such thoughts. They can also help people recognize when distressing thoughts are not true.
People with OCD can also tap into their spirituality when engaging in exposure and response prevention (ERP) therapy, a standard treatment for OCD. For example, patients often struggle to engage in the exposure aspect of this treatment, as it involves facing their greatest fears. However, connecting with spiritual values can be one way to engage in exposure.
A 2018 article on the topic gives the example of a patient whose obsessions and compulsions may involve germs, but who also values nature. The patient can focus on their desire to protect nature by curbing the frequent handwashing and long showers they have been using in their compulsions to avoid germs.
It is important to note that a form of OCD, scrupulosity, involves religious or moral obsessions. According to the International OCD Foundation (IOCDF), common obsessions seen in scrupulosity include excessive concerns about blasphemy, purity, and going to hell.
People with scrupulosity may have behavioral compulsions that can include acts of self-sacrifice and repeatedly seeking reassurance from religious leaders. Mental compulsions of scrupulosity may include excessive praying, repeating passages from scripture in one’s head, and making pacts with God.
The IOCDF points out that scrupulosity can affect people from any faith tradition and can make it harder for those who experience it to practice their religion.
The same therapies used to treat other forms of OCD are used for scrupulosity.
However, members of a person’s faith community may be involved in treatment. A therapist may ask community members to learn ways to help a patient in the recovery process, including clarifying an institution’s stance on particular religious issues relevant to the patient’s symptoms.