Spirituality, Religion and Psychopathology: Towards an integrative psychiatry

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John Cox
Peter J. Verhagen


The concepts of person-centred medicine and of psychiatry for the person offer, perhaps more than any other current biopsychosocial concept, the opportunity to develop a truly integrated approach to the psychiatric patient as a person suffering from mental turmoil. Within this approach to patients as people it is often necessary to give thorough attention to the patient’s spirituality, religious beliefs or worldview. Person centred psychiatry offers a well grounded reason for incorporating spirituality and religion into psychiatric assessment, diagnosis, case-formulation, therapy, and as a component of psychiatric training and continuous professional development.In this paper we consider the need for increased understanding of the nature of religious belief and of the variety of spiritual practice if a truly person centered psychiatry is to be practiced.Psychiatry sits on a three-legged stool of science, art and ethics [1]. Its provenance therefore includes understanding the spirit (soul) of patients, their Weltanschauung (View of the World) and the quality and meaning of their personal and professional relationships.  The bio-psychosocial model of George Engel was based on general systems theory and yet successfully encouraged doctors to consider the social and psychological aspects of patient care in addition to biological parameters. The model however was considered primarily as a causal scientific framework, which could neglect its full potential to promote a humanistic person centered medicine. A biosocial/psychospiritual relationship based approach to health care provision is perhaps therefore closer to the essence of a Psychiatry of the person [2] as it is within this wider perspective that consideration of religious faith and spiritual practice optimally resides.Paul Tournier, pioneer of ‘medicine of the person’, encouraged crossing the boundaries of science, spirituality and psychology within the specific context of the doctor-patient relationship [3]. This bridging of disciplines is facilitated by new knowledge of the complexity of neuronal circuits, and recognition that religious belief has a partial origin in brain function and yet also determined by metaphysical events and transformational experiences. For Tournier, a Genevan family practitioner, there were no contradictions between his understanding of religious belief, the importance of spiritual practice (meditation), the dynamic of personal growth, and the scientific/biological exploration of illness for the optimal practice of medicine.

Article Details

Special Section: Conceptual Bases of Psychiatry for the Person
Author Biography

John Cox, University of Gloucestershire; and Institute of Psychiatry, London

Professor John Cox,  BM  BCh , DM (Oxon), FRCPsych, FRCP, is a Past President and Dean of the Royal College of Psychiatrists. He was elected as Secretary General of the World Psychiatric Association in 2002 for a six year term during which time the secretariat moved from New York to Geneva.He was awarded the Merce Medal in 1986 for his pioneer research and clinical work in Perinatal Psychiatry carried out in Uganda, Scotland and Staffordshire. He holds Honorary Fellowships from the World Psychiatric Association, the Royal College of Psychiatrists, the Royal College of Obstetricians and Gynaecologists and the College of Medicine in South Africa.He retains an active interest in Perinatal and Cultural Psychiatry and more recently in Ethics and the borderlands of religion and mental health.  He was the lead guest editor of a special issue (June 2007) of the International Review of Psychiatry on Mass Violence and Mental Health, and has recently co –edited two books published by Wiley /Balckwell –Personhood and Mental Health: a bridge between infant and adult mental health  and Psychiatry and Religion: beyond boundaries.John  has  co-authored  Modern management of Perinatal Psychiatric Bisorders, and is well known for his work in primary care and in particular for the development of the Edinburgh Postnatal Depression Scale.Currently he is Visiting Professor of Mental Health at the University of Gloucestershire and the Institute of Psychiatry, London; Founding co- chair of the Centre for the study of Faith, Science and Values in Health Care at the University of Gloucestershire, and Professor Emeritus at Keele University.He now lives closer to his family in Cheltenham, where he continues his academic interests as well as his work as a trained singer.