Aging and God

Spiritual Pathways to Mental Health in Midlife and Later Years

William M Clements, Harold G Koenig

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317822820
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This important book examines the relationship between religion and mental health throughout the life cycle, with a special emphasis on later life. It asserts that successful aging is possible regardless of physical health or environmental circumstances, and that religious beliefs and behaviors may facilitate successful aging. Aging and God thoroughly examines the effects of religion and mental health on aging and provides a centralized resource of up-to-date references of research in the field. It focuses on recent findings, theoretical issues, and implications for clinical practice and contains ideas for further research. In Aging and God, you'll also find information on project design that can help you develop grant applications and carry out studies.Aging and God is a helpful book for both mental health and religious professionals. It helps mental health specialists better understand the spiritual needs of older adults and the impact that religion can have on facilitating mental health. It also describes how religion can be utilized in clinical practice and integrated into psychotherapeutic approaches to older patients. The book brings religious professionals current knowledge of the major psychological problems that older adults face and how religion can be used to help alleviate these problems.Full of pertinent information, Aging and God

• addresses theoretical aspects of human development, focusing on cognitive, moral, and religious faith development
• examines situations and disorders of particular concern to older persons and looks at how religion can be used as a resource
• applies research findings to the problem of meeting the spiritual and mental health needs of elders with chronic or acute health problems
• provides an in-depth look at end-of-life issues such as physician-assisted suicideHospital and nursing home chaplains will find this book informative and encouraging, as will gerontologists, hospital administrators, and community clergy faced with increasingly older congregations. It gives mental health professionals new strategies to help improve the later years of older adults, and makes an excellent text for courses on religion, mental health, and aging. Middle-aged and older adults, as well as their families, will also find Aging and God enjoyable and inspiring as they attempt to grapple with the myriad adjustment and coping problems associated with aging.

Part I:
Religion and the Mental Sciences

Chapter 1
The History of Psychiatry and Religion

The most important of more recent events-that 'God is dead,' that the belief in the Christian God has become unworthy of belief-already begins to cast its first shadows over Europe.

—Friedrich Nietzsche

In 1828, Webster's Dictionary defined psychology as "A discourse or treatise on the human soul; or the doctrine of the nature and properties of the soul." The separation of medicine and psychiatry from religion has only been a relatively recent phenomenon. Both medicine and the mental health professions have their origins in religion and spiritual practice. The first recorded history of health and illness can be found in the writings of the Mesopotamians and Egyptians almost 5000 years ago. Illness was viewed in religious terms, felt to be connected with sin, and was treated almost exclusively by priests (Kuhn 1988).

Primitive Man

In A History of Medical Psychology, Gregory Zilboorg and G. W. Henry (1941) plot the evolution of psychiatry/psychology from its origins in primitive man (no gender implied) through the time of Freud and beyond. In the early days of humanity, there was no separation of illness into physical, mental, and spiritual categories-all sickness was spiritual. In old age, people with either physical or mental illness were often killed off, since they interfered with the movements of early tribes (Koty 1934; Simmons 1945; Glascock & Feinman 1981). As civilization progressed, persons with mental disorder became distinguished from those with physical illness; rather than being pitied, however, they were regarded with fear and imbued with supernatural power. If benign, such persons were revered; if evil, they were endured and placated-the task of the primitive medicine man.

Because the insane were viewed as sacred, there was no attempt to "treat" them. In large part, their illness was kept a mystery from the general public, and revealed only to the priest. Zilboorg and Henry write, "Things of the spirit, of the supernatural, might not be touched by the hand of the earthy, materialistic, herb-brewing and urine-smelling man" (p. 23). Many different spirits populated the world of early man. By 5000 BC, this was the situation in ancient Egypt where artifacts from that period show images of royalty possessed by demons. The first psychiatric treatment was believed to be hypnotism, practiced by shamans in northern Russia, parts of China, and by priests in Malaysia.

Early Hebraic Times

Zilboorg and Henry then jump to early Hebrew times, when monotheism became a dominant form of religious belief (1500-1000 BC). References are made to persons in the Old Testament with mental disorder, including Hannah (mother of Samuel), Saul (first king of Israel), Ezekiel, and David (feigning as a mad man). The first mention of mental illness in the Bible is in Deuteronomy (28:28): "The Lord shall afflict you with madness, blindness and confusion of mind." Of particular interest is the passage in Leviticus (20:27) that became the primary justification for the merciless killings of the Inquisition during the Dark Ages: "A man or woman who is a medium or spiritist among you must be put to death. You are to stone them; their blood will be on their own heads."

In concluding this section, Zilboorg and Henry note that "... our civilization from the primitive man to early Hebraic culture contributed almost nothing to our understanding of psychological difficulties" (p. 30). In making this statement, they generally ignore the psychological truths and proscriptions contained in the Old Testament. Yet it is to these that Western civilization owes its very shape and form, as well as its notions of morality. Early Hebrew ideas involving interpersonal relations, concern and care for sick or disabled persons, and treatment of older family members, were new concepts in a day when such persons were killed off or left to die unattended. Although many physical and most mental illnesses were viewed as resulting from spiritual influences, this at least provided a framework by which such diseases could be understood and a method by which they could be treated.

The early Hindus also viewed psychopathology from a religious perspective, where it was dealt with by priestly metaphysics. Like others, Indian scriptures (the Yedas, the Code of Manu, Mahabharata, Ramayana) attributed mental illness to demoniacal possession. The Hindu view of man's psychological makeup was a mystic philosophy, involving a union of religion and psychology, where psychological theory was derived from theology and based on spiritual migration. Zilboorg and Henry conclude, "Mental disease, however, whether viewed with the clouded vision of a very primitive man, through the mystic eyes of Mosaic law, or through the pantheistic glasses of the Hindu, remained a mystery, reprehensible or admirable, which did not seem to belong to medicine" (p. 35).

Hippocrates

It was not until around 500 BC that Greek medicine began to take scientific form with the teachings of Hippocrates. Prior to Hippocrates, the Homeric tradition was dominant, which saw mental illness as originating from influences by mythological gods; for instance, Lyssa, the goddess of night and madness, was felt to have caused Hercules to lose his mind. Hippocrates was the first to describe a number of mental disorders, including post-parturn psychosis, phobias, mania, melancholia, paranoia, hysteria, memory disturbances, and delirium, claiming that the brain was the sole cause of mental disease. Despite his genius, Hippocrates' view remained primitive. For instance, he believed that depressive illness was the effect of an excess of black bile, whereas anxiety disorders and nightmares resulted from a sudden influx of bile to the brain. Thus, the Greeks tended to view mental disorder as stemming from physical disorder-physical disorder being a disharmony in the combination of humors.

After Hippocrates, mind and body increasingly came to be seen as distinct entities. Physical illness was viewed as resulting from natural causes, although the forces of nature were felt to have divine origins. In fact, about this time in Greece, a group proclaimed Asclepius as the god of healing, and the Temple of Asclepius became a type of early hospital where the sick came in hopes of being cured. The Aesculapiadae were priests at the temple who had inherited healing secrets. Their job was to stir up the powers of the god of healing through religious ceremonies; the god would then appear to the sick during dreams and produce healing or suggest potions of herbs that may be helpful. About the third century BC, Rome came under the influence of the Greek Asclepian cult, and healing by means of astrology, magic, and herbs became commonplace.

Plato and Aristotle

Plato (427-347 BC) was the next influential personage after Hippocrates. His psychology was a mixture of idealistic and mystical elements. Rational and irrational souls which sought union were thought to exist within each person. When severed from each other, madness was felt to result, of which there were three varieties: melancholia, mania, and dementia. He distinguished one form of mania as a gift coming from the gods; this type of mania was felt to be of a higher nature that carried with it prophetic powers. Zilboorg and Henry write that the "medical point of view was thus considerably weakened by Plato" (p. 53), due to his mixture of scientific and mystic elements.

Plato's student Aristotle, however, is said to have "laid the foundation of the science of psychology" (p. 54), although his knowledge of anatomy and physiology was somewhat limited, and he believed that the heart, not the brain, was responsible for emotional disorder. After Aristotle, interest in man's feelings and behavior became the domain of the philosopher, not the physician. From 350 to 250 BC, the Stoic and Epicurian philosophers debated these issues. This group clearly denied the existence of God or a hereafter. Instead, they invested in social and psychological topics, ethics, contemplation, and introspection, setting the stage for "the true development of the psychology of man" (p. 60). Ideas about the origin and nature of mental illness during this period fluctuated back and forth from those focusing on malign supernatural powers, to those emphasizing the role of intense emotion, to those implicating physical factors. Interestingly, these same notions continue to be the focus of vigorous debate in the field of psychiatry today.

The Psychology of Jesus

Three hundred years after Plato, the teachings of Jesus focused on the meaning of suffering and on healing of the whole person. He made little distinction between the power to heal the body, mind, or spirit. While early science struggled with the diagnosis and classification of illness (linking different disorders with different types of treatment), Jesus was less concerned with this because his method of healing depended little on the type of illness present. Besides claiming miraculous cures, he stressed some very basic psychological concepts that bear a remarkable resemblance to the "nonspecific factors" which mental health professionals claim are common to all forms of effective psychotherapy (see Chapter 3).

Jesus' major emphasis was on relationships. When asked what the two greatest commandments were, he referred to (1) man's relationship to God and (2) man's relationship to man. Positive regard for others and service to one's neighbor were central in his teachings. These principles aimed at preparing man to live a full and happy life in the human community. Long-term satisfactions, rather than short-term thrills, were emphasized. Forgiveness and mercy were stressed: God forgiving man and man forgiving man. Not only did he talk about the need to forgive, but also provided a method by which forgiveness could be obtained. While traditional psychotherapy can point out that bitterness, resentfulness, and unforgiveness are at the root of many psychological ills, it is not always so successful in enabling patients to let go of these negative emotions/attitudes. Jesus provided the basis for a belief system and rituals which help persons to forgive others and obtain forgiveness for themselves.

Other examples of teachings by Jesus which strengthen interpersonal relations included an emphasis on being compassionate (good samaritan-Luke 10:30-37), expressing unconditional love (prodigal son-Luke 15:11-31), treating others as one wishes to be treated (Matthew 7:12), avoiding counter-transference (mote in the eye-Matthew 7:3-5), monitoring cognitions (Mark 7:20-23), valuing every human being as equally important (Matthew 18:12), maintaining a stable family life (Matthew 5:32), avoiding unnecessary anxiety or worry (Matthew 6:34), and being aware of the dangers of narcissism and hypocrisy (Mark 7:6-9). Some of these ideas were truly revolutionary in Jesus' time. Nevertheless, Zilboorg and Henry make little mention of such contributions. For instance, he notes "Soon the early Christian trends began to make themselves felt, and yet the sum total of the scientific equipment [contributions to psychology] which was at the disposal of the world came from polytheistic, pagan sources" (p. 60).

Alter Jesus, came a series of Greeks and Romans who turther advanced knowledge and understanding in the field of psychology: Asclepiades (objected to the dark cells and dungeons where the mentally ill were kept), Cicero (emphasized the role of the emotions in mental disorder), Plutarch (accurately described depressive illness), Celsus and Aretaeus (provided a description and classification of mental disorder), Solanus (treatment of mania), and Galen (summarized all prior knowledge of mental illness). Galen stands out because of his physiological approach to mental illness. In his writings, he described the brain, the meninges, ventricles, cranial nerves, and attributed all psychic functions to the brain. After Galen's death (200 AD), came the Dark Ages. Says medical historian Paul Diepgen in 1914, "Medical wisdom came to an end with the passing of Galen" (p. 9).

The Dark Ages

Although Zilboorg and Henry state "One may not lay the responsibility for this retrogressive change at the portals of the Christian Church" (p, 93), much of what they say both before and after implies the opposite-that the decline in scientific advancement and the abuses and inhumane treatments of the mentally ill during the Dark Ages were largely a result of church activities. Again, an emphasis is placed on the negative, not the positive, contributions of religion to the care of the mentally ill. He does admit, however, that the societal forces which brought on the Dark Ages were not exclusively an outgrowth of Christian theology; a major contribution also came from a fusion of expanding monotheism with pagan spiritistic and polytheistic forces. With gnosticism came the idea of a hierarchy of angels between a Christian and his or her God, as well as the notion of saint worship, reflecting the polytheistic tendencies of pre-Christian Rome. Zilboorg and Henry also note that even before Christianity began having an influence, superstition and intolerance were becoming increasingly common in society. After the third century, when Roman emperor Constantine was converted, Christianity spread rapidly throughout much of the known world. A vigorous effort was made to suppress superstition, magic, and occult practices. The teachings of classical science and philosophy were included among the latter, and the study of Plato and Aristotle became forbidden.

Demonology

In the fourth century, nearly all physical and mental disorders became viewed as demonic possession. According to Zilboorg and Henry, there developed a

formidable structure which became known as demonology and which was to rule medical psychology for sixteen hundred years [my italics] . . . Religious debates and metaphysical contentions took precedence over the empirical traditions in medicine, (pp. 98-99)

Religion finally achieved a complete victory over scientific progress and then nearly obliterated it over the next thousand years. Hence came a widening of the split between the two disciplines, with each pitted against the other as foes.

What Zilboorg and Henry fail to mention, however, is that at no time did the Church imply that "possession" was the only cause of mental illness. There were a number of Christian physicians who accepted the detailed Greek descriptions and teachings on pathology, but rejected its excessively naturalistic explanations. Unlike their Hellenistic colleagues, they believed that even patients with incurable disease should be treated, even if that consisted of nothing more than loving and caring for them in a manner consistent with Christian teachings. Referring to this, Braceland and Stock (1963) note the following:

The early Christians also inaugurated regular medical, nursing, and social assistance through their hospitals, and there came to the fore a religious form of psychotherapy which was both therapeutic and consoling. Had Christianity been able to maintain the equilibrium ...

Table of contents

• Cover Page
• Half Title page
• Title Page
• Copyright Page
• Dedication
• About The Author
• Contents
• Foreword
• Preface
• Part I: Religion and the Mental Sciences
• Chapter 1 The History of Psychiatry and Religion
• Chapter 2 Sigmund Freud
• Chapter 3 Conflicting Approaches to Mental Health
• Chapter 4 Overlap and Complementarity
• Part II: Theoretical Issues
• Chapter 5 Theories of Human Development
• Chapter 6 Fowler's Stages of Faith Development
• Chapter 7 A Theory of Religious Faith Development
• Part III: Advances in Research
• Chapter 8 Depression and Medical Illness
• Chapter 9 Using Religion to Cope
• Chapter 10 Cases of Religious Coping in Action
• Chapter 11 Religious Coping and Depression
• Chapter 12 Religion and Anxiety
• Part IV: Clinical Applications
• Chapter 13 Spiritual Needs of Physically Ill Elders
• Chapter 14 Meeting Psychological and Spiritual Needs
• Chapter 15 Use of Religion in Psychotherapy
• Part V: Special Concerns in Later Life
• Chapter 16 The Nursing Home and Alzheimer's Disease
• Chapter 17 Alcoholism/Sexual Dysfunction
• Chapter 18 Family and Bereavement Issues
• Chapter 19 Religious Conversion
• Part VI: The Final Frontier
• Chapter 20 Hope for the Dying
• Chapter 21 Suicide in Later Life
• Chapter 22 Physician-Assisted Suicide
• Chapter 23 Final Comments
• Subject Index
• Name Index