Science
in Christian Perspective
CHRISTIAN
TREATMENT OF THE MENTALLY ILL
M. J. Beukema, M. D.
Pine Rest Sanitatium,
Grand Rapids, Michigan
From: JASA, 2,
1(1950): 24-27.
Presented at Third
Annual Convention of A. S. A., Grand Rapids, Michigan, 9-3-48
It
is indeed a privilege to address a group such as this; especially so when the
topic deals with mental illness. I say this because I believe that the subject
of mental sickness is far out on the periphery of the sphere of your interests
as they are expressed in the purpose of your organization.
I hesitate somewhat in presenting a paper on the "Christian Treatment of
the Mentally IIV to a group of scientifically minded people for I am not at all
qualified to give you a well organized system of thought on this topic nor do I
know of the existence of any. However, your committee assured me that you would
not criticize this paper for its failure to meet scientific standards.
There can be no doubt that today more than ever we are in need of a well
formulated, authoritative Christian system of thought dealing with the entire
field of psychiatry. I say this because the Psychoanalytic Theory has almost
completely captivated both the public and also the professional mind with its
intiguing terminology, its exploitation of the realm of sex and its development
of the concept of a vast unexplored subconscious region in each individual mind.
There is also need because of the increasing demand for a greater degree of
Christian influence upon the world which also includes a greater demand for
hospitalization of the mentally ill in Christian hospitals.
Now I believe, that for my purpose, I can divide the subject, "Christian
Treatment of the Mentally Ill" into two parts. The one part has to do with
the actual physical and social handling of the patient and the other deals more
particularly with the use of psychiatric techniques. I certainly shall not
attempt to give a detailed discussion of either part.
Under the first division, I refer to practical care that is given to the patient
as objectified in providing comfortable living conditions, a congenial social
environment, and adequate provision for bodily needs. When this care is guided
by Christian motives it is of great value, especially for Christian patients
because it provides for them an environment to which they are accustomed and in
which they readily feel at home. This minimizes the degree of adjustment
necessary for these sick people who so often go into a panic of uncertainty when
faced with changes in their environment. It also encourages them to speak more
freely of the religious doubts and fears that they may entertain for they
realize that they are speaking to workers and fellow patients who understand the
things about which they speak.
Another important element included under this part of Christian treatment is the
spiritual atmosphere as it relates to prayer and Scripture reading at mealtime
and also attendance at divine worship on Sunday. There are many patients who
possess positive active Christian faith which needs exercise to remain alive
just as much as the faith of the healthy person requires it.
One of you might at this time raise the question, what is the value of this
treatment for the non-Christian patient--how does he respond to a Christian
environment. Limited observation leads me to believe that such patients do have
considerable difficulty to fit themselves comfortably into such an environment.
On the other hand, they are sufficiently impressed by the gracious care they
receive that the majority are eager to avail themselves of Christian care
because of the patience and kindliness that motivate the Christian worker in
this field.
In order to obtain these conditions it is important to have a staff of nurses
which is well informed religiously and which can recognize opportune moments to
speak of these things.
Some of you may ask, is this treatment? Are not these conditions which we try to
maintain in all the ordinary circumstances of our lives? That is indeed true but
with this difference that to the mentally ill these ordinary values become
extremely important because of the misery and agony they suffer. This may be
compared somewhat to the state of mind of a soldier in front-line combat to whom
a mess kit of warm food and a pair of clean, dry socks mean almost as much as
life itself. So too, the mentally ill cling to the ordinary small human
kindnesses and search for words of comfort.
And now to bring out a few points relating to the other part of Christian
treatment which I referred to before as the psychiatric approach which attempts
to explain, to catalogue, and to treat mental disease. Allow me to repeat that
it would be a great boon to the Christian world if some competent group of
individuals would devote itself to formulating such a system contained in a
volume or two which could be written in a style that all could understand. I am
not able to give you a complete psychiatric treatise on the subject of Christian
treatment nor would a paper of this size contain so large a subject.
I have chosen to center this part of the discussion around the questions,
"Can we use the Christian religion as a cure for mental sickness?" And
"What is the relationship, if any, between the Christian religion and
psychiatric treatment of mental disease?" Many people of Christian faith
give expressions to the feeling that those who become sick in mind, become so
because they are lacking in faith. It is especially when speaking about those
who are depressed that they raise the question, "Don't you think, Doctor,
that if only they had a little more faith and assurance that they would snap out
of it?" Or they will state, "I don't think that he's so very sick but
just that he doesn't seem to have enough faith to believe that he is
saved." Again others will ask, "Don't you think, Doctor, that if you
can just straighten him out about his religious ideas that he will be all
right?" These questions all suggest the thought that if only someone could
make them believe enough in God and could give them assurance of salvation that
then they would be cured. However, when one works with this type of patient one
is soon impressed with their marked inability to rely on the promises and
comforts of Scripture and one soon realizes that this condition represents
something other than a lack of faith or insufficient knowledge of God's Word and
is rather a diseased state of mind which produces a marked change in the
patient's outlook on life affecting his spiritual as well as his mental vision.
As a result, they apply to themselves only those portions of Scripture which
condemn man for his sins and disobedience. The texts dealing with hope and
promise for God's children they believe are true for others but not for
themselves. In their own minds these sufferers have become irredeemable sinners
and they magnify their former sins an hundred-fold. To them all of life is
fraught with evil and in their anguish they try to escape it by suicide even
though they live in dreadful fear of death. The depressed patient apparently
suffers from a marked disturbance of his emotional balance so that the emotional
scale is tipped entirely to the side of depression. As a result these people are
unable to experience sensations of pleasure and no matter what direction they
turn they see only gloominess which deepens their fearfulness and hopelessness.
Or to present this thought somewhat differently, think of these people as first
of all becoming sick with a depressed state of mind. Then because of this
illness they develop a multitude of fears, feelings of worthlessness and a sense
of aloneness with the conviction that they are wholly responsible for their
condition and that they are absolutely without hope. Because of this diseased
condition--this marked emotional disturbance which impairs intellect and
judgment, one is unable to use Scripture or religious doctrines purely as
psychiatric instruments to cure mental illness even though their gracious
promises would seem capable of lifting the most despondent hearts.
In contrast, to this mistaken conception that Scripture may be used to
cure the mentally ill stands the equally erroneous idea of the majority of
non-Christian psychiatrists today who insist that religion is the outgrowth or
remnant of the prehistoric fears of man's ancestors. They teach that religion
with its manifold taboos on man's inner animalistic drives builds up tension in
man which leads him to fear. Therefore they try to do away with religion by
discrediting it to their patients. They will tolerate the beautiful ideals
contained in religion but they oppose those portions that threaten punishment
for man's failure to meet certain laws. The mistake in this premise is this,
that it fails to recognize that the religious element of man's personality is
something innate and not something acquired by contact with others nor from fear
of his surroundings before the dawn of history. They ask the patient to forget,
ignore and destroy an integral part of his personality. As a result of this,
patients come to our hospital who have been greatly upset in mind due to the
attempt of such a psychiatrist to pull even the last support away from them by
advising them that they should set aside their religion which is nothing more
than a terrifying myth. For many patients who have never experienced the power
of the Christian religion this advice may not be traumatic, but certainly for
those who have had that experience such advice would only increase their
confusion and despair. This I believe will help you to see another reason why it
is essential to have a Christian approach to psychiatry which does recognize
man's religious nature as an elemental part of his personality.
Is there any relationship between the Christian religion and the psychiatric
treatment of mental diseases? I have tried to bring out that we cannot use
religion purely as a form of treatment nor can we discard it as some harmful
acquired impedimenta. In general I may state that it should fulfill the same
function in the life of a patient as it does in the life of a healthy minded
Christian. However, there is a difference that for those who are sick, great
care must be exercised in the degree to which they are advised and allowed to
participate in religions activities. As I have intimated in this discussion the
emotional disturbance of patients extends also into their religious life so that
frequently it is necessary to advise them to do less reading of the Bible during
these periods in which they are full of self-condemnation that they ordinarily
would. On the other hand there are forms of mental disease in which the
religious problems have not become so acute and in these cases directing the
patient's thoughts to a more deeply religious outlook on life may be helpful
toward his recovery.
This now brings to mind a question which is often asked, "Are there many
people who become insane over religion?" This question as it is usually
asked implies that there are people who become mentally ill because they have
become too extensively or too deeply religious. I do not believe that it is
correct to speak of mental illness developing out of excessive religiosity. It
is to be looked upon, again, as a result or symptom of illness and not as a
cause for mental illness. The reason that so many Christian people show the most
marked disturbance in their religious feeling and thinking is no doubt chiefly
due to the fact that the religious aspect of their life has been the most
outstanding. I do not mean by this that it was outstanding in the sense that it
was apparent to everyone, but that their religious training during early life
made a lasting and deep impression on them so that they are conscious of the
significance of religion for their temporal and external welfare. In this same
way others are found in whom there is practically no religious distress but
rather a distress of the moral sense which manifests itself particularly in the
role which had the greatest meaning for them such as the family and marital
relationships, business and social dealings or civic and humanitarian
accomplishments. Therefore, it is not correct to speak of people developing
mental disease because of religious, business or social activities.,
I have tried in this paper to bring out that there is a definite need for a
Christian approach in the treatment of patients with a Christian back-ground.
Also I presented a few of the erroneous ideas prevalent with regard to religion
and treatment and pointed out the need for judicious handling of both the
patient and the Scriptures by workers trained to recognize the state of mind of
patients, to handle the Scriptures and to advise the patients carefully
according to their capacity to take in a well balanced diet of spiritual
thoughts. In concluding I wish to have clearly before your minds that this
discussion dealt primarily with mental illness as it appears in a depressed
state. These statements would require modification for other forms of disease
though in general they would be applicable to all types of diseases.