Using religion to treat mental illness

In this month’s Southern Medical Journal (where else?), a new study into the efficacy of a prayer-based treatment for depression and anxiety-related ‘mental disturbance’ (the abstract isn’t clear about what, exactly, was wrong with them – presumably they were mildly symptomatic and not clinically diagnosed as ill). The good news is that they got better.

It’s a terrible study for several reasons. The participants were self-selected, not randomized to treatment. Worse, the comparator group was individuals who received no counselling at all. It’s well known that simply giving some attention to people with mild symptoms of depression and anxiety can have a significant benefit. The interesting (and unanswered) question is whether prayer is better than (or even as good as) standard therapy.

This is a weakness common to most studies of the effects of religion on mental health. Religious affiliation brings with it a number of life changes that can help people with mild mental illness – most notably, membership of a support group. Because these studies are usually done in the US, they rarely consider the possibility of using non-religious means to the same end.

This particular study was also alarming because it used the “Steps to Freedom in Christ” treatment program. This is a program that actively encourages participants to believe in the presence of supernatural forces that dominate their life and to which blame for their problems can be ascribed. According to this analysis from the Christian counselling service Pathways Psychological Services, it encourages:

• reality of the “Excluded Middle” (cf. Paul Hiebert, Trinity Evanglical Divinity School), which is the spiritual realm in which there is interaction between supernatural forces, both good and evil, and natural forces. The Western world tends to exclude this middle realm and sees the world as only naturalistic. It relegates the spiritual realm to a far off, distant heaven with no impact on daily life. Non-Western cultures, however, understand the spiritual realm to be on a par with, and even more influential than, the material realm.
• presence of spiritual forces of darkness in the supernatural realm.
• influence of spiritual forces of darkness on thoughts, feelings, and behaviors.

In other words, it attempts to treat vulnerable patients by inculcating delusional beliefs. Their problems are blamed on demonic intervention, and ‘cure’ is achieved by renouncing the devil.

In a FA both the Encourager and the client are alert for the demonic presenting as an internal voice inside the client’s mind revealing untruth. When the client reports its presence, the client is then asked to renounce the presence and send it away.

This doesn’t seem very ethical to me, especially given that there are perfectly good reality-based counselling interventions available to help these patients.

Ref:

Hurst et al. Faith-Based Intervention in Depression, Anxiety, and Other Mental Disturbances. South Med J. 2008 Mar 19 [Epub ahead of print]