Santa Ana, USA - - When actor Tom Cruise spoke out in June against psychiatry, his controversial remarks underscored a little-known but notable conflict: the tension between some religious beliefs and mental-health treatments.
The Church of Scientology, of which Cruise is a member, considers psychiatry a pseudo-science that promotes unproven mind-altering drugs.
Some Christian churches, such as the Cornerstone Bible Church in Garden Grove, Calif., and the True Light Christian Church in Buena Park, Calif., teach that people are afflicted with problems of the soul, not illnesses of the mind.
Such conflict can place people whose minds feel unwell in a health quandary.
Are religious beliefs and mental-health treatments so oppositional that people have to choose one over the other? Or can people find a compromise?
And when religious beliefs oppose psychiatry or psychology, do religious institutions have the ability to address their congregations' mental-health needs, especially severe illnesses?
The answers are a work in progress.
For Mike K., the quest for answers began in early 2003.
In the weary hours of dawn after pulling an all-nighter on a church project, he suddenly awoke from a nap on the floor of his office. He thought he was having a heart attack. (Mike, 28, asked for his last name to not be used in this article because he works in a medical-related profession and does not want to lose his patients.)
"I was graduating from school, starting a business, was newly married, had a boatload of debt and was stepping up responsibilities at church," he said. "Life was full to the brim. I wasn't sleeping."
Bouts of panic attacks followed day and night. His heart would start pumping fast. His hands would turn clammy. Feelings of fright, disconnection from reality and powerlessness would take over all at once.
"I thought that my life as I knew it was over," he said. "I thought, `I can't function like this.' Death would be preferable to going through more episodes like this."
Mike eventually went to an urgent-care clinic, where a doctor diagnosed him with anxiety disorder and prescribed Xanax, an anti-anxiety drug. He took the medication for about a year but found that he had to increase the dosage when the original doses failed to quell the panic attacks.
In the meantime, he sought help from two people: his pastor, James Shin, at the Cornerstone Bible Church, who referred him to the church's pastoral counselors; and Mike's brother-in-law, a primary-care physician, who told him that Mike had a more effective tool than medication: a better relationship with Jesus Christ.
Mike began researching his church's teachings about conditions of the mind. His church teaches that what the medical profession considers panic attacks are actually the result of failure to trust God.
"I realized that what I was anxious about was losing my business," he said. "I didn't trust God enough to take care of me."
Mike said he found strength and healing in prayer and in biblical passages about God's providence.
Over several weeks, he weaned himself off Xanax and start working on his faith in God with prayer, introspection and encouragement from other believers.
It's been more than a year since his last panic attack.
Psychotherapy was not an option for him, he said, because he believed that the practice of psychology and Christianity were not compatible, even among Christian psychologists. "Are they Christian first, or a psychologist first?" he said.
Mike does not discount the short-term value of psychiatric medications. "It bought me time to get my soul under control," he said.
The Cornerstone Bible Church and True Light Christian Church's teachings are rooted in the belief that the answers to problems that do not have a physical or organic explanation can be found in the Bible. This religious doctrine is taught at The Master's College and Seminary in Santa Clarita, Calif.
"We believe that there is no such thing as `mental' health but all these issues are `soul' issues," Shin said.
"If a person was struggling with `depression' then we would discuss what the Bible says are causes for being `downcast.' The reasons can be varied, so we would continue to work through the issue until we have some insight as to the source of his `depression.' One cause might be sinful thinking or behavior. We would then confess our sins to God and to each other and I would continue to meet with him and help him in his relationship with God."
Members of the church are not referred to psychiatrists and psychologists. "After they have been cleared by their doctor for any physical reasons for their problems, we care for them with biblical instruction, prayer, fellowship and accountability to help them follow through on right thinking and right behavior," Shin said.
Pastor Bernie Hong of the True Light Christian Church agrees. "Unlike conditions such as cancer, depression is observationally based," Hong said. "During biblical counseling, I explain that depression is not a disease. The reason is to give them hope. To call it a disease would mean that people would have to take medications for the rest of their life."
Psychiatric drugs don't address the source of the problem, Hong said.
That's also the contention of the Church of Scientology, which takes a vehement stance against psychiatry, psychology and psychiatric medications. The church founded the Citizens Commission on Human Rights in 1969 to investigate psychiatric abuses.
The commission questions, among other things, the validity of the psychiatrists' reference book "Diagnostic and Statistical Manual of Mental Disorders." Scientologists are highly skeptical of the concept of "chemical imbalance," an explanation doctors sometimes give for a mental-health condition.
Instead of being quick to label a person's condition as a mental illness and prescribe drugs, doctors need to conduct thorough medical examinations that may uncover a true cause, such as exposure to a toxic substance, underlying chronic pain or allergies, according to the commission.
The mental-health community not only has defended itself against these positions, but also pointed out its hard work with religious institutions.
Religion and mental health need not be mutually exclusive, said Dr. Joseph English, professor and chairman of psychiatry at the New York Medical College. "Good mental health is a means to achieving spiritual health in life," English said.
Although religious beliefs can be helpful, they can be detrimental when they inhibit patients from dealing with mental illness. "The thing we have to be careful of is not to turn spirituality into another pill," English said.
For many years, the relationship between religion and psychiatry/psychology has been uneasy at best, adversarial at worst, especially when religious leaders found Sigmund Freud's brand of psychology anti-religion and an incursion into the spiritual domain.
But much has changed, say some in the mental-health community.
"We're in a transition time and it's been going on for the past 15 years," said Gunnar Christiansen, co-chairman of FaithNet NAMI. The organization consists of members of the National Alliance for the Mentally Ill trying to build bridges between the religious and mental-health communities. It is more common now for religious institutions to encourage their members to seek mental-health services, Christiansen said.
At the same time, more psychiatrists and psychologists are educating themselves about religion and spirituality, said Dr. Michael Torres, a member of the American Psychiatric Association's committee on religion, spirituality and psychiatry. Such knowledge helps them become attuned to spiritual and religious clues and cues from their patients.
Religious practice can be effectively integrated into therapy, said Kenneth Pargament, professor of psychology at Bowling Green State University in Ohio.
"I worked with a Roman Catholic woman who had been raped and was suffering from post-traumatic stress disorder," he recalled. "She was having a difficult time coming to terms with her trauma. One of the issues she faced was she felt she was being punished for the earlier sins she had committed. When I asked her about that feeling, she said she had some things that were unforgivable. I talked to a colleague who is a priest, who mentioned the sacrament of reconciliation. I helped her get in touch with a priest who heard her confession and administered the sacrament."
While Pargament acknowledges that pockets of exclusivism continue in religious and mental-health communities, he says the ideal of pastoral counselors working together with psychologists and psychiatrists for a patient's mental well-being is not out of reach.
One can learn from the other, he said. "There is so much diversity and richness in both worlds."
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Questions to ask
If you're struggling to reconcile religious beliefs with mental-health needs, here are some questions to ponder:
Have you been thoroughly evaluated by a doctor?
Do you have a thorough understanding of your religious institution's teachings about mental-health concerns?
If not, have you brought up your concerns with your religious counselor for clarification?
What kind of counseling does your religious institution offer?
If you have tried this counseling but it has not addressed your needs, have you considered pastoral counseling at another related religious institution?
If you are undergoing therapy or psychiatric treatment, have you brought up your religious or spiritual concerns with your psychologist or psychiatrist?
If you have, has your psychologist or psychiatrist adequately addressed the importance of your religious or spiritual beliefs?
If there's no progress, have you considered going to another mental-health care provider?
Have you asked your psychologist or psychiatrist and your religious counselor if they're willing to meet to discuss your mental-health needs?