Can / Should Psychiatry Save Us From Religion?

As previously stated I advocate the concept of schizotypy over a categorical definition of psychosis though categorical definitions are necessary in order that mentally unwell people might access the best possible care and medication for their mental health needs.

However, the categorical approach to psychoticism can lead to misdiagnosis in the psychiatric patient population – particularly those with overt religious proclivities.

Here is why:
There are many interesting similarities between religiosity and psychosis which can lead to misdiagnosis and often the clinician’s ignorance of social and cultural values of the patient lead to misunderstanding of how the patient presents themselves.

For example:
•Belief in “god” – There is no proof of any “god/s” and logic dictates that you cannot prove a negative therefore the only logical assumption is that there is no god and that this is clearly a belief not based on any factual evidence or physical reference i.e. a delusion.
•Prayer – delusion of grandeur (the ability to bring about physical changes by thought alone)
•Listening to “god” – this can be considered as auditory hallucinations (hearing voices) and is a cardinal symptom of schizophrenia, though arguably not always e.g. Romme & Escher)


A little background:
The experience of psychosis generally features delusions and hallucinations:
A delusion is defined by the DSM-IV as:
“A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture.”

An hallucination is defined as:
“A sensory perception experienced in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. Hallucinations may occur in any sensory modality - visual, auditory, olfaction (smell), gustatory (taste), tactile (physical sensation), or mixed.”

Now there are of course problems with these definitions. For example:
Should the fact that a patient claims to talk to and listen to “god” be cause for concern or is it benign since such behaviour is accepted by that patients’ culture or sub-culture?
After all there is no evidence for any “gods:” indeed many “gods” have come and gone from various human cultures in the past as various rulers of different societies throughout history have influenced the beliefs of their subjects.

Similarly is the person who claims to see the mother of jesus in a slice of toast or jesus himself in the wood pattern of a cupboard door be cause for concern?

It is arguable that from a medical perspective, no, these people are not actually “ill” but is this really reasonable behaviour? After all I used to see shapes of animals in the clouds as a child and with a little imagination I still can today but it doesn't mean there are actually huge white fluffy rabbits flying in the sky.

Which is why I submit that people who do such seemingly innocuous things as praying are not necessarily ill, but are nevertheless found on the same spectrum as those psychotic patients with magical thinking or those who claim to commune with “god” are not very far away from those schizophrenic patients who are at the mercy of command hallucinations.

I’m not saying that religious people are “crazy” (what ever that it is) what I am saying is that just as moderate religious people provide the fuel and ideological protection of religious extremists, so too does the tolerance by society of so-called magical thinking. Those seemingly innocuous beliefs which feature on the lower end of the schizotypy scale are not so qualitatively different to those more florid symptoms seen in e.g. schizophrenia.

There is no proof of any “gods” at all so logically I am forced to conclude that any religious content of a patient’s presentation is merely a product of social conditioning. Also that they are potentially at risk of moving along the scale and developing more severe symptoms if they become more unwell.

I think it is time that psychiatry woke up to the fact that science has been stripping away the myths of religion for years now and it is time that the discipline recognises this by including a more dimensional concept of schizotypy into it’s definitions of mental disorder. This may necessitate a paradigm shift away from the traditional categorical definitions, but there is scope for modification of current classifications systems- particularly in the modern “multi-cultural” climate where cultural ignorance can lead to diagnostic confusion.

In short, I believe trans-cultural psychiatry is a good thing, and it should continue to develop as a field, but religiosity should begin to be pathologised on a dimensional scale. Who knows, perhaps psychiatry may even be the long-overdue arbiter required in the hate-filled arena of religion where families are torn apart and nations are bombed to shreds because of “religious beliefs.” By nullifying religions from a clinical point of view we may be able to show the inherent ridiculousness of some of the far-fetched claims of the modern religions and then we can all begin to accept each other on a human level without appealing to some fictional higher power to advocate the killing of another human being.