To The Priests In The Temple Of Neuroscience
The root of psychiatry is psychos, the Greek word for soul. What we today call psychiatric disorder, used to be seen as ailments of the soul, the religious institutions used to be the place to go for its’ treatment- spirituality and community.
When someone tells you they believe in God, what’s your first thought about them? How many therapists do you think would call themselves spiritual, or let alone religious? I haven’t encountered many, and even fewer who would know how to incorporate it into their sessions. Ever since Freud called religion a collective neurosis of mankind, research on the positive effects of religion and spirituality has been pouring in like the proverbial flood, still we see little change in our psychotherapeutic ways. Unless you count the want-to-be spiritual elements out of the east, that have been all the rage since the 90’s. I had an interesting conversation with a fellow Jewish therapist I worked with, and he told me about discovering Mindfulness at a retreat and its powerful effect on him. Every time he would take a bite of an apple, he would take a second and think about how delicious this apple looks and his gratefulness at having food to eat. “So, it’s like making a blessing before you eat?” I said. “Oh gosh no, nothing like that”, and he shook his head at my capacity to misunderstand so comprehensively.
I had one transcultural psychotherapy lecture during my training, and it went like this; look at these strange people, this is how you deal with them and their translators. At one of our weekly hospital-lectures I was at in 2019, the topic was “building resources”. Being a glutton for punishment, I piped up at one point suggesting religion as a personal resource and even a preventive factor against depression. The room went awkwardly silent and people next to me turned their bodies away, so not to be associated with my fanatic idiocy. The lecturer moved on quickly to the next raised hand, and “religion” never made it up on the white board.
Plastered across psychiatric journals in 2022 is the effectiveness of psychedelic drugs on PTSD, depression, anxiety and substance- abuse. The mechanism by which they work is still uncertain, but invariably the participants report spiritual and mystical experiences and changing their worldviews. Spirituality being a sense of transcending human experience in the quest for the ultimate meaning of life. I am in support of anything that will help us treat the mentally ill. After having knocked out God with the fist of science, are we seeking to believe again through the neurochemical machinery of psychedelic drugs? In pinning religion against psychiatry and science, did we throw the baby out with the bathwater?
We are “rediscovering” spirituality through psychedelics by documenting their positive effect on the mentally ill, and walking backwards trying desperately to find the corresponding neuroscientific explanations. After 35 years of intense neuropsychiatric research, you can’t find anyone who can tell you if low or high serotonin causes depression. We also can’t explain why Lithium works, despite it being in use against mania since 1870. In all likelihood, without the language of neurochemistry, the field suffers reputationally and will lose significant authority. Never mind that solid evidence of psychosocial and environmental factors to mental illness is abundant and empirical evidence of psychiatric medication is indisputable.
With the acceptance of psychedelics as a treatment option, we are saying yes to spirituality, as long as it arises from clicking the appropriate brain-buttons. The religious leaders might think we are little late to the party. They have been advertising risk and side-effect free spirituality with long-term effect and the added bonus of belonging to a community with its support system and traditions for dealing with suffering for some time. They have sadly been struggling to stay modern and relevant, in an effort to retain the fleeing congregants. Meanwhile, the influx into psychiatry is beyond anything we can handle, with the breakdown of families and immigration to bigger cities where community ties are weaker. Therapists substitute for parents, spouses and friends, helping the childless fumble after meaning in the dark. Psychiatry is expected to perform the tasks that should be a collective community responsibility. Like catching early warning signs of serious pathological behavior that could harm others. Like providing support in case of bereavement. Like picking up on isolated teens, just one click away from an early grave.
The sea of sufferers, and the months-long waiting lists suggest we are losing the war against psychiatric disorders, so maybe it’s time to expand our arsenal and enlist soldiers with different skills. Bring in the people who are trained to deal with crises of meaning, spirituality and the concepts beyond the brain- our religious leaders. Seeing as we now have scientific evidence that spiritual experiences have antidepressant effect, maybe we start by offering support instead of disdain for the religious? How would be to visit a service together as a part of a session? Or find a prayer that resonates with the struggles of the day? When my husband was very anxious a while back, I suggested he put on Tefillin every morning for a couple of weeks. Sometimes the repetitive action of a ritual can be like a calming balm for an exposed nerve, where talk doesn’t reach.
We cannot afford to scoff at and turn our noses up at religion, when 69% of the Swiss population is member of one, a number hardly reflected in the population of therapists. With one glance at the nearest psychiatric journals, the titles tell the tale of strong cultural influence; effects of the Ukraine war, COVID-19 and racial injustice. Let’s not speak solely with the language of neurochemistry, but use that influence to see if preventive measures such as these might turn the tide.
While we have found some answers through neuroimaging and molecular psychiatry, many disorders are still caused by denying the needs of the soul, and those will not be found at the end of a microscope.