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Spirituality and Psychiatry: Conflicting Values?
- Tony B. Benning, Waqqas A. Khokhar. Senior House Officer.North Trent Rotational Training Scheme in Psychiatry, Sheffield (1 June 2007)
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Tony B. Benning, Specialist Registrar Liaison Psychiatry Department. Sheffield Care Trust., Waqqas A. Khokhar. Senior House Officer.North Trent Rotational Training Scheme in Psychiatry, Sheffield
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tonybbenning{at}hotmail.com Tony B. Benning, et al.
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We read Culliford’s article (2007) with great interest. He stresses the subjective and uniquely personal character of spiritual experience. We agree. Psychiatry’s tendency to privilege the ‘objective’ over the ‘subjective’ has been well documented and its neglect (indeed pathologisation) of spiritual experience is, we feel, related to this. Tension between these ‘two ways of knowing’ in psychiatry has a long history. Despite a trend in recent years towards a ‘flattening’ of this hierarchy, reflected, for example, in increasing interest in qualitative research, psychiatry continues to be underpinned by rationalist values. This is the basis of its continuing tension with ‘spiritual values’. We endorse Culliford’s preference for the term ‘spirituality’ over ‘religion’. The term ‘spirituality’, in emphasising those ‘perennial’ elements common to the religious traditions, avoids focus on dogma that often only obstructs dialogue. This term also helps to identify fundamental points of conflict between spiritual values and those of psychiatry and it is these that we wish to discuss briefly. In contrast to rational or ‘objective’ knowledge which concerns itself with that which is the ‘finite’ and the ‘certain’, spirituality is concerned with ‘transcendence’ and therefore with the ‘infinite’ and the ‘unknown’. In keeping with this, linguistic categorizations should be used tentatively with due regard for the fact that language is itself located ‘at the rational level of consciousness’ as numerous authors have suggested (Watts, 1963 & Danto, 1973). Conventional standards of proof, too, are very much an expression of psychiatry’s rational commitments and spiritual discourse has traditionally acknowledged that prevailing notions of ‘proof’ are of limited relevance. This is illustrated, for example, by the Christian notion of fideism and in the Vedic distinction between higher knowledge vidya and lower knowledge avidya. The late Cambridge logician- mathematician turned theologian, Alfred North Whitehead (1929), in much the same vein, acknowledged the ‘inverse’ relationship between that which is most amenable to measurement or quantification and that which is most meaningful or valuable to humans. Today, spiritual practices such as yoga struggle for validation other than in terms which recognize their ‘measurable utility’. Psychiatry’s commitments to the rational domain are also expressed in its endorsement of the values of ‘mass society’. Maladaptive behaviour by society-at-large is relatively immune from characterization as ‘pathological’ (following Erich Fromm, 1956). In addition, conformity to the values of society-at-large becomes a criterion for ‘sanity’ (however covertly). In contrast, conformity to the values of the ‘material world’ is accorded a subordinate value in the vedic (and other spiritual traditions). Mental illness is, therefore, invariably viewed as ‘falling short’ of an assumed standard.Conventional (rational) approaches leave little room for complementing interpretations of say, depression, anxiety, or psychosis with interpretations that recognize their potential in a uniquely personal way, to facilitate spiritual growth. Declaration of Interest: None References: 1. Culliford, L. (2007) Taking a spiritual history Advances in Psychiatric Treatment 13: 212-219. 2. Watts, A. (1963) Psychotherapy east and west. New York. 3. Danto, A. (1973) Mysticism and Morality: Oriental Thought and Moral Philosophy. New York: Harper & Row, 1973. 4. Whitehead, AN (1929) Process and Reality: An Essay in Cosmology. 1979 corrected edition, edited by David Ray Griffin and Donald W. Sherburne, Free Press. 5. Fromm, E. (1956) The Sane Society. London. Routledge & Kegan Paul |
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