Journal of Religion and Health, Vol. 13, No. 2, 1974

Psychiatry and Religion: A Variable History , E. L. LOSCHEN

Next day an evil spirit from God seized upon Saul; he fell into a frenzy in the house, and David played the harp to him as he had before.

I Samuel 18:10

With the growing importance of the social sciences and psychiatry in the world today have come new ways of looking at old social institutions. Among them has been religion. All too of ten perhaps the emphasis has been on the viewpoint of a science studying a social phenomenon as it exists apart from itself. Rarely does one see the science study this phenomenon as a part of the science's own history and development. Yet in many instances religion has had a substantial influence upon psychiatry. If one is to evaluate religion objectively, the influence of religion upon the history of the science must be a part of the study.

A look at religion and psychiatry begins before recorded history. Studies of present-day nonliterate cultures reveal that a significant number of these cultures view mental illness in terms of demonology, as did prehistoric man, in all likelihood. A recent excavation at the Shanidar Cave in Iraq revealed flower pollen in close relation to Neanderthal burial sites 48,000 years old. ~ If flowers are needed for burial, it is not unreasonable to assume the existence of at least a rudimentary theology. Later, primitive man viewed unusual behavior as being controlled by animistic spirits, 2 much as he viewed the world as a whole where existence was threatened at every turn by the unknown.

At the beginnings of recorded history, unusual behavior was viewed as a result of control by spirits. In Persia and much of the area in the eastern Mediterranean, healing was a part of religion carried on by priests who used a variety of methods including exorcism and trephining. Mental illness was an intricate part of the religion of the day. The early Greeks and the Egyptians abandoned cruel t rea tment for music, seclusion, and comfor t as therapy, but the emphasis on spirits and religion remained. 3

With the Hebrews came the change from polytheism to monotheism.

E. L. Loschen, M.D., is Staff Psychiatrist at the Nebraska Psychiatric Institute and Assistant Professor of Psychiatry in the University of Nebraska College of Medicine, Omaha, Nebraska.

The author wishes to thank Irvin Blose, M.D., of the Nebraska Psychiatric Institute, for his comments and assistance in the preparation of this paper.

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Accompanying this was a change in the view of disease. The Hebrews saw cure of disease as an at tr ibute of God. Likewise, the purpose of disease and insanity was to punish man for his sins. Many examples of this concept are present th roughout the sacred writings of the Hebrews, including the Talmud. A notable example is King Saul, who suffered from depression and finally commit ted suicide as described in I Samuel. With the emphasis on religion, it was still the priest who treated mental illness. 4

With Hippocrates came the first real departure from the supernatural view of causation of mental illness. He brought to life the view of biological causation, noting the origins of mental disorders arising from within the person. This became a major separation between religion and psychiatry. Now the mentally ill were subjects for physicians, not priests. Medical management, not exorcism, was the t reatment . Although destined to fade, this was to become the view of the future when it returned.

Until Asclepiades, about 100 B.C., challenged spiritualism, the early Romans viewed mental illness as the work of animistic spirits, s Religion held firm as the answer to unusual behavior.

Following the brief period of enlightenment, the world settled down to the thousand-year escape from reason known as the medieval period. Here superstition demonology, exorcism, sorcery, and witchburning protected man f rom the unknown. During the early period, monasteries were a refuge for the distressed where prayer, incantation, holy water, relic touching, and mild exorcism were used to rid the insane of the "spirits." The priest had returned as healer. As superstition and suspicion of the unknown spread, "madness" was viewed as the work of the devil and was met with cruel punishment and witchburning. 6 It is to be noted that this concept survives today in the less enlightened who view mental illness as frightening and even "catching." In 1484, Pope Innocent VIII decreed that all efforts to eliminate witchcraft be made. Johann Sprenger and Heinrich Kraemer wrote Malleus Maleficarum at that t ime as a definitive work to eliminate witchcraft , that is the insane possessed by Satan. 7 What followed was the execut ion of great numbers of the insane in the name of religion.

Previously, in the four teenth century, Petrarch was an early humanist who tried to reconcile the spirit of the church with the pagan culture of the classical Greeks, especially Aristotle. Desiderius Erasmus in the f if teenth and sixteenth centuries cont inued the attack on the church's position, most notably on the formalism, corrupt ion, and sterile ritualism of the church. Erasmus led the discovery of man's concrete existence or nonsymbolic being during this period. During the same time, Pomponazzi, a philosopher and physician, made efforts to relate mind, body, and immortal i ty of the soul. 8 As evidenced by these contributions, efforts to relate psychiatry and religion into a unified concept came about in this period.

One notes also at this time the revival of the split in ideology that occurred in the classical Greek period. Juan Luis Vives of Spain questioned planetary phenomena, while Paracelsus of Switzerland supported the natural causes of

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mental disorder. Jean Fernel revived the concepts of Hippocrates during this period to foretell the writing of De Praestiguo Daernonurn by Johann Weyer in 1563, in which Weyer insisted that "witches" were ill and should be given medical and humane treatment. 9 The direct influence of religion upon the concepts of mental illness came to a close in this period. Henceforth religion's contributions were to be indirect through men with common interests.

Such contributions were made by Spinoza, a Jew who, during the seventeenth century, was excommunicated from his synagogue for his heretical views. He visualized God as being synonymous with nature, with the attributes of God being no more than the laws of nature that could be deciphered by mathematical reasoning. He saw psychology including religion and physiology as two aspects of the same thing--the living organism. In Ethics, speaking in the religious terms of the then current vocabulary, he described mental processes with remarkable precision. He conceptualized the fundamentals of psychodynamics, such as the urge for self-preservation and the causality of psychic events occurring outside of free will. 10

Religion contributed to psychiatry in another way. Various groups undertook care of the insane as one of their charities. The Quakers, under William Tuke, founded the York Retreat in 1792, following the principles of Pinel, who was advocating the humane t reatment of the ill at that time. Here the mentally ill had a refuge from the prevailing attitudes of the day. 11

During the nineteenth century another individual made substantial contributions to psychiatry, religion, and philosophy. SSren Kierkegaard was struggling with man's life-long questions about his existence. From Kierkegaard's many writings sprang the existential movement that has come to influence religion, philosophy, and psychiatry. In The Concept of Dread, Kierkegaard examined problems of anxiety and guilt. He continued this theme in The Sickness Unto Death, where he elaborated on existential anxiety. Jasper, Heidegger, Binswanger, and Buber over the past century have extended Kierkegaard's influence in psychiatry most notably with the founding of existential analysis. 12 Kierkegaard's influence has recently been extended by modern movements and people such as R. D. Laing, Frankl and logotherapy, and Perls and Gestalt therapy. Yet Kierkegaard's main contribution remained largely philosophical in scope.

With Freud came a new connotat ion for the meaning of religion to psychiatry. Throughout much of the history of psychiatry, religion had played a central theme in the movement. With Freud, religion itself became the subject of study. That influence continues the basic atheistic stance of psychoanalysis today. Freud early likened religion to an obsessional neurosis, later to a collective neurosis. In 1907, he wrote: "One might venture to regard the obsessional neurosis as a pathological counterpart to the function of a religion, to describe this neurosis as a private religious system and religion as a universal obsessional neurosis. ''13 In The Future of an Illusion Freud put forth his most exhaustive comment on religion. He wrote: " . . .

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the true believer is in a high degree protected against the danger of certain neurotic afflictions; by accepting the universal neurosis he is spared the task of forming a personal neurosis. ''14 Further he felt that religion inhibited thinking and a rigorous orientation to reality. He believed that ethics based on religion were not sound. Freud continued his demythologizing studies of religion in his last major work, Moses and Monothe ism. He believed that Moses was an Egyptian who developed a growing theme of monotheism and converted the Jews to it. Freud continued the thesis that finally Moses was murdered by his followers. He regarded this murder as a source of unconscious guilt from which the Jews could not liberate themselves. 1 s From these works grew the psychoanalytic movement 's study of religion and mythology.

Not all analysts agreed with Freud, however. The most notable of the dissenters on religion was Jung, who concerned himself with the psychological study of religion. Jung visualized religious experience as a submission to powers higher than oneself. Further he felt that the unconscious was a religious concept--that is, a power beyond the control of the individual intruding into his mind. This readily led to Jung's concept of the collective unconscious and his studies of myths. ~6 Jung's influence in Western psychology has been minimal, however.

In recent years, new efforts have been made to reconcile religion and psychiatry. Gordon Allport has emphasized this new movement. He wrote in 1963: "May we not hope that the present bilingualism of religion and behavioral sciences--good so far as it goes--may eventually lose its duality and emerge as a universal language suited to a final theory and implementation of both individual health and planetary peace? ''~ 7 In the early 1970s, this nation has witnessed a revival in interest in religion. Mainly the movement is youth-oriented and therefore unlikely to die soon. The significance of this newest change cannot yet be judged.

Discussion

Religion and medicine have influenced each other in interesting ways throughout history. As medical science advanced, however, physical illnesses as religious phenomena were slowly removed from religious doctrine. Behavior, including mental illness, has not undergone such a clear change. This must be at least in part due to psychiatry's own disagreements about the very nature of religion.

A cyclic pattern commonly seen in history can also be seen in the relationship between religion and psychiatry. Early scientific thought in Greece supplanted primeval religion, only to be replaced by early Roman religion. Scientific thought surfaced in Rome, only to become submerged during the medieval period. Spinoza heralded the coming study of religion by science, which Freud began in earnest. However, little consensus was to develop in this effort, as evidenced by Jung's views. To confuse the issue

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fur ther , a segment o f psych ia t ry adap ted a largely religious ph i lo sophy to f ound the existent ial m o v e m e n t in psych ia t ry . Now in the early 1970s, there is seen a revival in interest in religion among y o u t h . In the midst of the confus ion , Al lpor t called fo r a un i f ica t ion of ef for ts toward unders tand ing behavior by psych ia t ry and religion.

Is such a unif ica t ion possible? Perhaps it is not . Science, including psychia t ry , seeks concre te answers to abs t rac t quest ions, while religion supplies abs t rac t answers to undef inab le quest ions. But this m a y in fact be exac t ly the s t rength of each and m a y al low each to con t r i bu t e wha t the o the r canno t to the general welfare o f mankind . Moral i ty is an issue tha t amply demons t ra t e s this. Psych ia t ry can describe, even t reat , men ta l illness tha t gives rise to d is rupt ion o f mora l codes o f a socie ty . But h o w are these codes to be deve loped? Here religion can o f fe r answers tha t science and psych ia t ry cannot . Wi thout bo th enti t ies, soc ie ty would suffer great ly , perhaps even perish. Here, t oo , is an answer for fu tu re cons idera t ion . Even if science were to reduce all behavior , all em o t io n , and all t h o u g h t to def inable chemical react ions , some discipline mus t y e t def ine what is good or bad in life and socie ty . Religion by its very na ture is far be t t e r sui ted to the task than is science.

A con t inua t ion o f the cyclic pa t t e rn so far n o t ed could be e x p e c t e d to occur . The quest ions asked o f religion and psych ia t ry are o f t en inseparable. Suicide, fo r example , involves bo th scientific and mora l quest ions . A scientist obviously canno t r emove himsel f f r o m mora l issues in such a case. In large part , science or religion will p r edomina t e in response to needs o f the hour . However , it would be to everyone ' s disadvantage if e i ther discipl ine were to seek to des t roy the o ther .

R e f e r e n c e s

1. Solecki, R. S., "The Myth of the Neanderthal," Intellectual Digest, 1971, 2, 37. 2. Millan, T., Modern Psychopathology: A Biosocial Approach to Maladaptive Learning

and Functioning. Philadelphia, W. B. Saunders Co., 1969. 3. Ibid. 4. Alexander, F. G., and Selesnick, S. T., The History o f Psychiatry: An Evaluation o f

Psychiatric Thought and Practice from Prehistoric Times to the Present. New York, Harper & Row, 1966.

5. Millan, ot). cit. 6. Ibid. 7. Ibid. 8. Alexander and Selesnick, op. cit. 9. Millan, op. cit.

10. Alexander and Selesnick, op. cit. 11. Ibid. 12. Eaton, M. T., and Peterson, M. H., Psychiatry. Flushing, N. Y., Medical Examination

Publishing Co., Inc., 1967. 13. Freud, S., "Obsessive Acts and Religious Practices." Collected Papers, Vol. 2.

Lnndon, Hogarth Press, 1924. 14. --sele The Future o f an Illusion. Garden City, N. Y., Doubleday & Co., Inc., 1961. 15. - - , Moses and Monotheism. New York, Vintage Books, 1939. 16. Jung, C. G., Psychology and Religion. New Haven, Yale University Press, 1938. 17. Allport, G. W., "Behavioral Science, Religion, and Mental Health," J. Religion and

Health, 1963, 2, 187-197.