COMMENTARY

Religion and Psychiatry: Clinicians Are Talking

Ronald W. Pies, MD; Cynthia Geppert, MD, PhD, MPH, MSBE

Disclosures

June 10, 2013

In This Article

Readers Respond to Ms. A's Dilemma: Take the Lithium and Trust in God

I've never seen any data re G-d against lithium. Like all medication, it carries risks but it also has saved countless lives.
Dr. Charles Hirsch

Approximately 100 thoughtful and moving comments have currently been made by readers who took the time to post a response to our article, "Ethical Issues in the Psychiatric Treatment of the Religious 'Fundamentalist' Patient," published on Medscape on March 19, 2013. The article presented the case of a young, devout Christian woman with bipolar disorder, Ms. A, who has been so stable on lithium that she is now attending a Christian college. Ms. A's fundamentalist psychology professors chastise her for using medications rather than relying on faith to treat her illness. Ms. A comes to an appointment with her new psychiatrist asking for guidance in this ethical and spiritual dilemma.

Ms. A's conflict generated so many appreciative inquiries from readers that we felt that a follow-up article was in order. We are grateful to our editor, Bret Stetka, MD, for encouraging us to address some of the more significant ethical issues and concerns presented by readers. Because space will not allow us to explore each individual posting, we hope to capture here some of the most important and related themes of a subject that resonated positively with many mental health practitioners.

Religion and Psychiatry: Common Ground

By far, the most common idea that readers expressed was that religion and psychiatry should not be adversaries, but allies, in the care of mental and spiritual distress. Thomas W. rejected the historic conflict between the 2 healing traditions and soundly endorsed synergistic collaboration:

For centuries, Christians of different denominations have maintained hospitals to care for the sick. Against this historical legacy, the argument that the practice of medicine is against God's [will] seems an especially dangerous kind of nonsense. Religious health practitioners usually argue that they are acting according to God's will by using their rational capacities to help those in need. Fundamentalists opposed to psychiatry and other fields of medicine, on the other hand, do not only deprive people of urgently needed help, but also blame the sick and their alleged "lack of faith" for the illnesses they suffer from -- making their beliefs a truly inhuman creed.

Several readers, such as Charles Nagel, a physician's assistant, also rejected the dichotomy between mind and body implicit in the professor's advice, challenging the psychologist with analogies drawn from medical treatment:

I think that it's okay to take lithium as a Christian. You can pray for healing, but only God can heal and he may not do that. What about the diabetic Christian who's insulin-dependent? What about the patient with HIV? God created medicine and healers. It is biblical to take medication for chemical imbalances, infections, and pain and to trust physicians. There are many Christian psychiatrists who prescribe medications, so don't feel afraid. Pastors, elders, deacons, and family members are all sinners and fall short, so you are in good company."

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