[HN Gopher] A pilot program to include spirituality in mental he...
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       A pilot program to include spirituality in mental health care
        
       Author : xriddle
       Score  : 39 points
       Date   : 2021-06-15 19:00 UTC (4 hours ago)
        
 (HTM) web link (www.scientificamerican.com)
 (TXT) w3m dump (www.scientificamerican.com)
        
       | throwaythiesit wrote:
       | This is wacky.
       | 
       | It's like you are about to have surgery and the surgeon insists
       | on performing an animal sacrifice to ensure the success of the
       | surgery.
       | 
       | I would not see such a surgeon and I will not see a psychologist
       | who wants to involve imperceptible deities in my treatment.
       | 
       | Whatever his beliefs are he should not involve his patients in
       | it.
        
       | hprotagonist wrote:
       | from "the other side", this has been known for rather a while:
       | seminarians usually have a few obligatory courses in psychology
       | and counseling best practices lumped in under "pastoral care".
       | There's usually a hospital chaplaincy rotation that can give you
       | exposure to psychiatric care as well (or other areas, depending
       | on what you're interested in).
       | 
       | It's no real surprise that, for example, confession and talk
       | therapy are extremely close cousins. People seem to fundamentally
       | _need_ to put words to ideas and fears and sadness and stress and
       | angst, and in putting words around those things we can hope to
       | control our reactions to them better.
       | 
       | Doing this with a guide who is there to tell you that no matter
       | what, _you matter_ , and probably give you some rituals to do
       | that'll settle your mind a bit, has proven to be durably useful
       | for approximately ever. Whether you call that person "your
       | therapist" or "your priest" or "your imam" or "this monk i talk
       | to sometimes" seems more or less secondary.
        
         | thehackerjew wrote:
         | In judaism, we have in our morning/afternoon prayers
         | (shacharit/mincha) a section that roughly translate as
         | confessions (tachanun). In this section, there is a subsection
         | called vidui, in which we confess our mistakes, to Gd (blessed
         | be), to the empty room and mostly to ourselves.
         | 
         | When I started doing this part, it was quite weird to say my
         | mistakes both out loud or quietly, but as time kept going, I
         | found that it is such a good form of dealing with our errors.
         | When we try to say it in form of phrases, we have to first
         | understand it minimally, then, we can say it and see that it is
         | not as bad as we thought (or it is even worse...), we feel
         | shame, we try to justify it, we try to explain it, but in the
         | end the one listening is just the person, the walls and Gd the
         | almighty.
         | 
         | I've done years of therapy, but never before I have felt more
         | listened to. There is something special, a special kind of
         | circuit, when we say things that we don't want to say to
         | ourselves. We break it, externalize, hear it, internalize and
         | every day and every day. It is funny how the problems dissolve,
         | how some become actions, how some persist.
         | 
         | Of course, I still talk to my parents, my SO, my friends, my
         | rabbi and even my therapist from time to time. But I hope that
         | someone on this forum can use this comment to try and succeed
         | in talking to yourself.
        
           | brightball wrote:
           | Praying out loud, by yourself, is very therapeutic.
           | Especially when there's something you're really struggling
           | with there's an incredible feeling of release that comes with
           | it.
           | 
           | When those prayers get answered, usually not in the way that
           | you'd expect, you learn to do it more often.
           | 
           | Anecdotal, I know, but I've noticed a pattern that the most
           | likely prayers to be answered are the ones where I'm praying
           | for something that God would want for me; help forgiving
           | someone when I can't let it go, breaking a bad habit, being a
           | better husband or father, connecting with someone who needs
           | help and guidance.
        
             | Jotra7 wrote:
             | Confirmation bias perhaps?
        
         | kar5pt wrote:
         | This is likely because the modern psychiatric industry evolved
         | partly out of religious institutions. I wouldn't look at it and
         | assume it's a sign of some universal human need.
        
       | grawprog wrote:
       | A few years ago now I was reading a lot about Buddhism and its
       | tenets about mindfulness and other ways of dealing with the
       | things life throws at you or when you get into a negative state
       | of mind.
       | 
       | A couple years after that I had a friend that was going through
       | Cognitive Behavioural Therapy with a psychiatrist, a really good
       | one from what I could tell I might add, my friend let me read
       | through the CBT book. Turns out, it's nearly identical to what
       | the ideas Buddhism tries to teach, with all the religious aspect
       | stripped away.
       | 
       | It's essentially the same concept though. Being mindful of
       | patterns of behaviour or thoughts that lead to negative actions
       | or mind states and the tools you can use to conciously avoid and
       | correct them.
       | 
       | It really seemed to help my friend and honestly, it seems like
       | something that would be good for everybody to learn.
        
         | nescioquid wrote:
         | The rather similar philosophical schools (stoicism,
         | epicurianism, cynicism) arising in Greece at a time not
         | terribly long after the death of Siddhartha Guatama always made
         | me wonder if there was a connection. Ex oriente lux, ex
         | occidente lex (from the east light, from the west law).
         | 
         | I've read that the roots of CBT were founded on stoic
         | philosophy, so perhaps there is a connection.
        
           | grawprog wrote:
           | I have to admit I don't know much about the history of stoic
           | philosophy. I never realized such a thing existed. I also was
           | never sure about exactly what CBT was based on or anything
           | about the history of it.
           | 
           | Thank you, I'll have to do some reading it seems. The way
           | different philosophies, myths and religions travelled around
           | the world and evolved over time has always fascinated me. So
           | much still is based on things from hundreds or even thousands
           | of years ago.
        
           | webnrrd2k wrote:
           | I haven't gotten into the details, but there was a connection
           | via Alexander the Great.
           | 
           | https://en.m.wikipedia.org/wiki/Greco-Buddhism
           | 
           | Edit: less on topic, but I've always thought that Jehosephat
           | was an interesting confection, too:
           | https://en.m.wikipedia.org/wiki/Barlaam_and_Josaphat
        
           | Retric wrote:
           | Stoicism actually has roots in Cynicism. It's unclear where
           | individual ideas come from, but it's actually possible
           | Buddhism has some roots in western philosophy.
           | 
           |  _As reasoning creatures, people can gain happiness by
           | rigorous training and by living in a way which is natural for
           | themselves, rejecting all conventional desires for wealth,
           | power, and fame. Instead, they were to lead a simple life
           | free from all possessions._
           | 
           | https://en.wikipedia.org/wiki/Cynicism_(philosophy)
        
             | bumby wrote:
             | > _it's actually possible Buddhism has some roots in
             | western philosophy._
             | 
             | I think the OP was implying it was the other way around.
             | I.e., Cynicism (and thus Stoicism) draw from Buddhism. It
             | seems like Siddhartha Gautama predates Antisthenes by
             | nearly 150 years. (Granted, that doesn't mean that ideas
             | between them weren't shared later, it just indicates which
             | was started first)
        
               | Retric wrote:
               | I agree that's what OP was saying, my point is it's not
               | the only way things could have happened.
               | 
               | First the dates aren't that clear. Gautama Buddha was
               | born between 563 BCE or 480 BCE. Antisthenes was born in
               | 446 BC. So he's between 38 and 117 years more recent,
               | though they both lived to ~80, so it's possible they
               | where alive at the same time.
               | 
               | Anyway, it's obvious similar ideas in different places
               | where very contemporary to each other. What's unclear is
               | what these philosophers where culturally exposed to.
               | Basically, we can't trace which ideas they came up with
               | and which ones they copied unless we find an older
               | source, as such it's impossible to say the origins of
               | such things.
        
               | nemo wrote:
               | There definitely was interchange between various Greeks
               | and Buddhists since Mahayana Buddhism's early development
               | was in much contact with the Greeks from Hellenistic
               | kingdoms in Bactria and India and some of those Greeks
               | converted to Buddhism:
               | 
               | https://en.wikipedia.org/wiki/Greco-Buddhist_monasticism
               | 
               | Gandharan Buddhist art is steeped in Greek stylization
               | and the first images of the Buddha followed Greek
               | stylizations - early Buddhists didn't depict the Buddha
               | at all, just symbols like empty footprints, it wasn't
               | until Greek contact that this began.
               | 
               | Thomas McEvilley's _The Shape of Ancient Thought:
               | Comparative Studies in Greek and Indian Philosophies_ has
               | an interesting discussion of similarities between earlier
               | Stoic texts by Sextus Empiricus and some works of
               | Nagarjuna (one of the most important Mayahana
               | philosophers) that use the same arguments, metaphors, and
               | structuring. He goes over a number of other ancient
               | sources, Greek and Indian, describing various sorts of
               | cultural contact and interchange.
               | 
               | Pre-Hellenistic contact between the Greeks and India
               | occurred but we can only speculate about it since there's
               | no reliable evidence. After Alexander there was a lot of
               | interchange and it had a big impact on Indian art,
               | architecture, theater, and culture (as well as bringing
               | significant influence of Indian stylization, philosophy,
               | etc. on Greek Hellenistic kingdoms in Bactria and India).
        
       | ggggtez wrote:
       | Just because people _think_ prayer will help them doesn 't mean
       | it actually will. Psychologists have a duty not to lie to their
       | patients. Having a psychologist offer a lie that may make people
       | feel better in the short term does nothing to actually fix their
       | long term problems. Psychological or otherwise.
       | 
       | And further more, many psychologists _do this already_. There are
       | many psychologists that specialize in patients of a particular
       | religion. The LDS church comes to mind. They have no better
       | success record than any other treatment.
       | 
       | "Scientific" American, my ass.
        
         | dang wrote:
         | Please do not take HN threads into religious flamewar. That's a
         | circle of hell we badly need to avoid here, and which also is
         | particularly easy to avoid.
         | 
         | https://news.ycombinator.com/newsguidelines.html
        
           | ggggtez wrote:
           | I disagree, this comment is on topic. The author presents an
           | opinion that conflicts with the reality of the world.
           | Psychologists are not merely trying to make people feel
           | better with temporary solutions, but to help that person
           | solve what is actually bothering them.
           | 
           | Furthermore, _psychologists already do this_. They already
           | recommend taking to family, friends, pastors, etc.
        
             | dang wrote:
             | The issue isn't the topic, it's comment quality.
        
       | btheshoe wrote:
       | Camus is rolling over in his grave
        
         | dang wrote:
         | If you wouldn't mind reviewing
         | https://news.ycombinator.com/newsguidelines.html and taking the
         | intended spirit of the site more to heart, we'd be grateful.
         | Note this one: " _Please don 't post shallow dismissals,
         | especially of other people's work. A good critical comment
         | teaches us something._"
         | 
         | Your thoughtful comments are welcome.
         | 
         | p.s. Camus was more nuanced than that.
        
           | Jotra7 wrote:
           | A shallow assertion deserves a shallow dismissal.
        
       | ganzuul wrote:
       | Should not confuse spirituality with religion. They rarely meet.
        
         | TheTester wrote:
         | That is a cynical way to actually try to talk about something
         | you seem to have no idea about, yeha religion has its quirks
         | but it is strongly linked to spirituality lets not lie to
         | ourselves
        
       | hellbannedguy wrote:
       | If there is anything I would like to see changed in Psychiatry is
       | mandatory visits, especially when the paitient, and the doctor
       | find the right drug, and both admit talk therapy is not helping.
       | 
       | In the USA, this is how the dealeo usually works:
       | 
       | 1. If you don't have good insurance, or not wealthy, you don't
       | have Talk Theraphy sessions with the Psychiatrist.
       | 
       | 2. You usually have to find a MFCC, and yak away until the
       | Psychologist gives you a recommendation to a Psychiatrist. (They
       | all that their favorites,)
       | 
       | 3. You finally see the Psychiatrist. He quickly determines if you
       | need meds. The honest ones will tell you about current studies,
       | like long term Schizophrenia patients seem to due better long
       | term without medications. (This is a tough call.), or the
       | evidence of efficacy of depression drugs is murky at best. (This
       | will never come out of most doctors mouths. Placebo is their
       | bread and butter.)
       | 
       | 4. Ok you find a medication that works.
       | 
       | 5. Many medications that actually work are habit forming. This is
       | a problem.
       | 
       | 6. A medication that works costs money, and it's not just the
       | price of the drug.
       | 
       | 7. It's those mandatory pricey office visits.
       | 
       | 8. A psychiatrist can drag you in every week, or day, in order to
       | ok those scripts. (most keep them at 6 weeks, or much longer if
       | the patient does not want to come in.)
       | 
       | 9. It get's irritating, and expensive.
       | 
       | 10. I would like to see a federal law stating you only need to
       | see a doctor once a year if you are on a drug long term. You
       | obviously can't be a danger to society.
       | 
       | In fact, I would like to limit mandatory office visits for most
       | medicines. Say you have been on a high blood pressure drug for
       | years, you should be able to get refills in most cases without
       | seeing a doctor.
       | 
       | 11. You will never see a hard cap on mandatory office visits.
       | That is how the Psychiatrists/MD's affords that very comfortable
       | lifestyle.
       | 
       | Plus---the AMA knows the rap, and protects their members money.
       | (Yes--it's more nuanced than I am writing write now, but the
       | mandatory office visits for well functioning patients is
       | expensive. And what is well functioning? You got me. By the time
       | you end up in the Psychiatry office, and on meds, you life is
       | never quite the same, and most doctors know that.
       | 
       | The one's that exploit their patients for money should be looked
       | at, or delicenced.
        
         | tosser-a99f993 wrote:
         | Lots of truth here. Below certain economic lines, mental health
         | is often a pipeline to lifetime dependency on big pharma. It's
         | really heartbreaking trying to explain to someone recovering
         | from addiction that they've traded street drugs for new, state-
         | approved meds.
        
       | jfengel wrote:
       | I'm all for applying whatever tool works. If somebody is
       | suffering, and religion/spirituality can help them without too
       | many side effects, let's apply it.
       | 
       | However... it's not like people haven't been self-treating with
       | religion since time immemorial. Certainly longer than psychiatry.
       | And it's usually cheaper than a therapist. So people tend to try
       | that first, and go for a medical route only after religion has
       | failed them.
       | 
       | The article cites a study with some positive results, but
       | psychiatry is an area rife with unreproducible studies. This
       | seems to warrant more study, but it wouldn't surprise me if there
       | are a lot of contradictory results.
       | 
       | I'd really like to see it work. It does seem reasonable that some
       | patients find spirituality to be a tool for coping, and
       | psychiatry can benefit from that. At the least it sounds as if it
       | shouldn't be, "Well, religion failed you, now let's chuck it and
       | try something different."
        
         | corobo wrote:
         | I think the actual results here are "have a solid support
         | network" rather than spirituality.
         | 
         | If you can get that in spirituality, awesome, but I don't think
         | spirituality itself is the actual fix - it's the people you
         | share your beliefs with that help. Community and that, it's a
         | thing humans do (and haven't been able to do in a while)
        
         | groby_b wrote:
         | Note that "organized religion" and "spirituality" are often
         | very different. Helping people find out that they can be
         | spiritual without having to buy into a prescribed belief system
         | is an extremely helpful step that many _don 't_ undertake on
         | their own.
         | 
         | The fact that the author ignores that entirely makes me fairly
         | convinced that he's advocating to proselytize, not to introduce
         | people to spirituality. (Part of me wants to book a session
         | with them and talk to them about wood fairies, just to see what
         | happens :)
        
           | aarpmcgee wrote:
           | I didn't have a feel for what the word 'spirituality' meant
           | until I left organized religion and began the working-it-out
           | for myself. Its relatable and understandable when I see how
           | often people mistake the two, since we're nearly all raised
           | into confusion by confused people.
        
             | pstuart wrote:
             | I think organized religion is more about organized religion
             | rather than spirituality.
        
               | squarefoot wrote:
               | Organized religion is what happens when few greedy people
               | realize they can make money out of many spiritual people.
        
         | ggggtez wrote:
         | It's amazing the cognitive biases that are present in every
         | example.
         | 
         | A person who writes about how he doesn't believe in atheism,
         | stating his "secular" client believes in god and such... In a
         | country that is 80%+ Christian... Even if he had an atheist
         | client, they would leave his practice as soon as he continued
         | to insist that they pray and talk to priests as a solution to
         | their problems... It's a self fulfilling prophecy
        
       | mensetmanusman wrote:
       | Many lateral studies over generations show that religion helps
       | one generate a mental model of perceived reality that is more
       | robust against hardship. It helps explain why religion survives
       | since forever.
        
       | xgulfie wrote:
       | Funny, every therapist I've ever seen (4/4, none were
       | Psychiatrists) has started discussions with me on spirituality.
       | some even talked about christianity and/or god on their webpages
       | etc.
       | 
       | As a very non-spiritual person it didn't do anything for me
        
       | vincent-toups wrote:
       | I'd rather experience more stress than believe dumb shit. Editing
       | lest I seem glib: I have tried spirituality. The amount of work I
       | feel I must do to maintain anything but a relaxed materialist
       | worldview is not worth the promise that believing in some silly
       | cosmology will reduce my anxiety about death or whatever.
        
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