Spirituality andSpirituality andRecovery from MentalRecovery from Mental

IllnessIllness

Chris Summerville, D.Min., CPRPChris Summerville, D.Min., CPRP

CEO, Schizophrenia Society of CanadaCEO, Schizophrenia Society of CanadaExecutive Director, Manitoba Schizophrenia SocietyExecutive Director, Manitoba Schizophrenia Society

Six Dimensions of WellnessSix Dimensions of Wellness

The question before us is, “What is therole of spirituality in recovery frommental illness?”

Is it important to know the faithbackground of those we work with?

While some individuals turn toa psychologist, social workeror psychiatrist, others wantsupport and the opportunityto discuss their problems orillness in spiritual context.

Let’s begin by asking several questions.

What is religion?

What is spirituality?

How are they related?

What is recovery?

What is the role of spirituality in recoveryfrom mental illness? Or… recovery towardsmental wellness and health?

How should healthcare providers approachthe subject of spirituality?

What is religion?What is religion?

• It is an organized system of beliefsand practices.

• It is usually expressed by and withina community.

What is spirituality?What is spirituality?

• It is a personal set of beliefs andpractices.

• It is very individual with lesstraditional connotations.

The Royal College of Psychiatrists in the UnitedKingdom and the Republic of Ireland.

“In healthcare, spirituality is identified withexperiencing a deep-seated sense of meaningand purpose in life, together with a sense ofbelonging. It is about acceptance, integration andwholeness.”

“The spiritual dimension tries to be in harmony withthe universe, strives for answers about theinfinite, and comes especially into focus in timesof emotional stress, physical and mental illness,loss, bereavement and death. This desire forwholeness of being is not an intellectualattainment, for it is no less present in people withlearning disability, but lies in the essence of whatit means to be human.”

Are spirituality and religionAre spirituality and religionthe same?the same?

What is the differenceWhat is the differencebetween the two?between the two?

Again the Royal College of Psychiatrists in the UK states:

Spirituality, described as “linking the deeply personal withthe universal”, is inclusive and unifying. It naturallyleads to the recognition that to harm another is toharm oneself, and equally that helping others is to helponeself. It applies to everyone, including those who donot believe in God or a ‘higher being’.…The universalityof spirituality extends across creed and culture; at thesame time spirituality is felt as unique to each andevery person….Religions offer community-basedworship, each faith having its own set of beliefs andsacred traditions. However, when there is a lack ofrespect for differences of belief, religion has been usedas a social and political tool leading to intolerance anddivisiveness.”

• Spirituality can be seen to be moregeneral and inclusive in its nature.

• Religion is seen to be more specificand linked with a particular faithtradition or institution, and a belief inGod.

• Spirituality can occur without specificguidance or codes.

• Religion involves accepting somelevel of guidance or practices fromthe religion that is being followed inthe search for God.

• Spirituality is a personalconnectedness to God or atranscendent reality.

• Religion is an adherence to anorganized body of beliefs andcommunity.

• Spirituality is what you are on theinside.

• Religion is what you are on theoutside.

• Spirituality is experience (personalexperiences of meaning).

• Religion is cognitive (beliefs andritual).

People can be spiritual and notreligious.

People can be religious and not veryspiritual.

Some are both spiritual and religious.

Others say they are neither.

Spiritual

Not Spiritual

Not ReligiousReligious

How religious is Canada?How religious is Canada?

Nearly two-thirds of all Canadians sayreligion still matters.

"The facts of the Canadian religioussituation point to the ongoingimportance of organized religion,where people value their ongoingidentification." Dr. Reginald Bibby

A 2003 Statistics Canada study on thesubject of “Social Engagement”indicated that "involvement inreligion is neck-and-neck with sportsand leisure activities. There is noarea where more groups are activethan the religious sphere."

Bibby cites one of his most recentnational survey: "Out of 2,400people sampled, 62 percent wouldwant to be more involved if theyfound it was worthwhile, andrelevant to their lives."

Political scientist Ronald Inglehartsays, “… in nearly all advancedindustrial societies, spiritual concernsmore broadly defined are notdeclining. In fact, in most industrialsocieties, a growing share of thepopulation is spending time thinkingabout the meaning and purpose oflife."

35 percent of Canadians say that Godis important in their life.

"Selected findings from the BaylorReligion Survey," Baylor Institute forStudies of Religion, BaylorUniversity, 2006-SEP, at:http://www.baylor.edu

Do spirituality and religionDo spirituality and religionhave positive impact onhave positive impact onrecovery from mentalrecovery from mental

illness?illness?

Spirituality is “up there” as to whathelps (among friends, family, workand medication).

Sullivan (1993) interviewed 40persons with serious mental illness.48% identified spiritual beliefs andpractices as being central to theirrecovery process.

Lindgren and Coursey (1995)interviewed 30 persons with seriousmental illness and found 74%reported that spirituality and religionhelped them in the management oftheir illness.

A huge study involving 406 personswith serious mental illness conductedin 2000 by Tepper, Coleman andRogers found that 92% practiced atleast one religious coping strategy.Included in the list were prayer,scripture reading, worship,meditation, singing religious songs,and meeting with a spiritual leader.)

80% used a religious activity orreligious belief to help cope withsymptoms or difficulties.

65% perceived religion to bemoderately helpful or most importantthing that kept them going.

In 2002, the Canadian CommunityHealth Survey obtained data fromabout 37,000 individuals aged 15years or older. It found higherworship frequency was associatedwith lower odds of psychiatricdisorders.

How do spirituality andHow do spirituality andreligion support recovery?religion support recovery?

Spiritual needs encompassSpiritual needs encompassquestions of:questions of:

•Meaning•Value•Relationships

• Coping and problem solving.• Acting as a compass in pointing a person

forward when lost.• Providing authority and guidance.• Giving social support.• Helping with vocation.• Finding a place in community.• Giving coherence, meaning, purpose and

hope.• Experiencing spiritual comfort and assistance.• Providing ritual and practice (visual, auditory

and vocal).• Helping during times of crisis to address

religious delusions from a spiritual angle.• Addressing some of the dysfunctional beliefs

A study of 1,835 participants atconsumer-run drop-in centres andclubhouses in Michigan found that, fortwo-thirds of the participants,spirituality was important in their lives.The authors suggest that spiritualactivities may help one see struggles astemporary, an attitude consistent withthe recovery process.

"Relevance of Spirituality for People withMental Illness Attending Consumer-CenteredServices," Psychiatric Rehabilitation Journal,Spring 2007, 30[4]: 287-294

Can spirituality or religionCan spirituality or religionbe harmful?be harmful?

Yes.

• If toxic, shame-based andjudgmental.

• If completely blames illness on sin orevil spirits.

• If vulnerable person is exploited.

What is recovery?What is recovery?

Fundamentally recovery, “....is a way ofliving a satisfying, hopeful, andcontributing life even with the limitationscaused by illness. Recovery involves thedevelopment of new meaning andpurpose in one’s life as one grows beyondthe catastrophic effects of mental illness,”says William A. Anthony of BostonUniversity’s Center for PsychiatricRehabilitation (Anthony, 1993).

Affinities or similarities sharedAffinities or similarities sharedbetween spirituality and thebetween spirituality and the

recovery model.recovery model.

• Meaning and Purpose. People inrecovery re-visit the age-oldquestion: What is the meaning andpurpose of my life? This is a “soulish”question and a spiritual pursuit.

• Hope. The desire for somethinggood with the expectation that youwill receive it. “A future with hope.”

• Journey as a metaphor of theprocess.

• Strength for the journey. A needfor God, the Creator, a Higher Power

• Wholeness and Personhood.Seeing a person as a whole: body,soul, spirit (emotional, spiritual,mental, relational, physical…).

• Community. Can’t do it alone. No“Lone Rangers.” (whether inmarriage, family, faith community,suffering, growth…).

• ReStorying. “Come and meet aman….”

• From Chaos to Order. Genesis. The“good news.”

• Resiliency as “the keel of the ship.”

• Empowerment. The “paraclete,”the “Comforter,” “The one whocomes alongside of.”

How many service providersHow many service providersask their patients aboutask their patients about

their religion or spirituality?their religion or spirituality?

• What do you do if you are notreligious?

• What is the policy of self disclosurewhere you work?

• Do you know what your own positionis?

• Are you aware of any personal“counter transference”?

– if you’ve had a bad experience.

–be aware of the effects of your ownreligious history.

How do you do aHow do you do aspiritual assessment?spiritual assessment?

• Are you currently involved in aspiritual or religious tradition?

• If so, could you tell me about it andthe role it plays in your life?

• If not, were you ever involved?

• What role doe it play in yourrecovery?

• What keeps you going in times ofdifficulty?

• How does your connection with yourtradition help you cope withsymptoms?

• Do you have a spiritual practice ormeditation practice?

• What does it consist of?

• What gives you hope, what bringsyou a sense of peace, of courage?

• When you are troubled or stressed,what helps you?

• What do you think life is all about?

What are the components ofWhat are the components ofspiritual health care in aspiritual health care in amental health setting?mental health setting?

Service providers can create a safe,welcoming and empathic atmospherewhere people can discuss theirspiritual beliefs and values.

• To explore spiritual and religiousmatters.

• To discuss one-on-one or in asupport group setting their spiritualconcerns and needs as related totheir mental health/illness

• To feel safe and secure in discussionspiritual and religious issues.

• To express spiritual feelings tosympathetic and concerned membersof staff.

• To make sense of, and derivemeaning from, experiences includingillness and permission andencouragement to develop arelationship with God or the Absolute(however the person conceiveswhatever is sacred).

• To engage in supportive friendshipswith others sharing similar spiritualand/or religious aims andaspirations.

• To have a time, a place and privacyin which to pray, reflect, meditateand worship.

• To read religious and/or spiritualmaterial related to the recoveryprocess.

• To receive encouragement indeepening one’s faith and feelinguniversally connected.

• To be involved in purposeful activitysuch as creative art, structured workand enjoying nature.

• To be treated with respect anddignity by allowing one to develop afeeling of belonging, of being valuedand trusted.

Andrea Blanch says:

Today's mental health system is largely aproduct of western science. Like a one-eyedgiant, it has great power, but it lacks thewisdom which makes life sacred andmeaning-ful. The challenge for today's mentalhealth system is to unite East and West; tointegrate wisdom and science; to make roomfor the sacred as well as the practical. One ofthe most critical domains for integration—andone of the most difficult to address—is thearea of religion and spirituality. … [we needto] review the historical tension concerning

the integration of religion and the science ofmental health; to explore current socialtrends that are creating new opportunitiesand pressures to move in this direction;and to discuss strategies for theintegration of religion and spirituality inmental health services and practice.”

“Integrating Religion and Spirituality in Mental Health:The Promise and the Challenge.” PsychiatricRehabilitation Journal. Volume 30, Number 4/Spring2007

For a complimentary word copy of amanuscript of this presentationplease email Chris Summerville atchris@mss.mb.ca