Religion That Heals, Religion That Harms: a Guide for Clinical

RELIGION THAT HEALS, RELIGION THAt HARMS RELIGION THA T HEALS, RELIGION THA T HA R MS A Guide for Clinical Practice James L. Griffith THE GUILFORD PRESS New York London To Lynne, whose fierce love keeps me forever in the field of play To my late father, Lamont Griffith, who showed me that person-to- person relatedness is neither preceded by a “why?” nor followed by an “in order to” In memory of Tom Andersen, Michael White, and Harry Goolishian, whose lives and work created a radical humanism in which everything about a person in psychotherapy would be pushed back, so the person could be fully brought forward © 2010 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher. Printed in the United States of America This book is printed on acid-free paper. Last digit is print number: 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data is available from the Publisher. ISBN 978-1-60623-889-9 About the Author James L. Griffith, MD, is Professor of Psychiatry and Neurology and Associ- ate Chair of the Department of Psychiatry and Behavioral Sciences at the George Washington University Medical Center in Washington, DC. He also is Director of the Psychiatry Residency Program and Director of the Psychiatric Consultation– Liaison Service in George Washington University Hospital. As an educator, Dr. Griffith has developed a program of psychiatric residency training that balances biological and psychosocial therapies in the treatment of patients within their family, community, and cultural contexts. His first book, The Body Speaks: Therapeutic Dialogues for Mind–Body Problems (1994), introduced family- centered approaches for treating psychosomatic disorders and psychosocial seque- lae of chronic medical illnesses. A second book, Encountering the Sacred in Psy- chotherapy: How to Talk to People about Their Spiritual Lives (2002), presented a clinical approach for incorporating the spiritual and religious resources that patients bring to clinical settings. Currently, Dr. Griffith provides psychiatric treatment for immigrants, refugees, and survivors of political torture at Noth- ern Virginia Family Services in Falls Church, Virginia. From 2000 to 2004, he served as Director of Training for the Kosovar Family Professional Educational Collaborative, a project to develop a family- centered mental health system in Kosovo. Dr. Griffith has received the Human Rights Community Award from the United Nations Association of the National Capital Area and the Marga- ret B. and Cyril A. Schulman Distinguished Service Award from the George Washington University Medical Center, for both the training of mental health professionals and the development of mental health services in the Washington metropolitan area for survivors of political torture; Psychiatrist of the Year from the Washington Psychiatric Society; and the Distinguished Teacher Award from the George Washington University School of Medicine. v Preface I embarked ON writing this BOOK 5 years agO. I sensed the need for a fresh clinical approach to addressing religious and spiritual issues in health care, one that could more even- handedly promote salutary effects of religious life while countering adverse ones. This need was pressing at a distinct juncture in the history of the relationship between religion and medicine. The last decades of the 20th century witnessed a resurgence of interest by clinicians in the role of religion and spirituality in health. As the century closed, regular workshops on spirituality in health care were offered in many clinical disciplines; curricula on spirituality were incorporated into the educational programs of medical schools and postgraduate residencies; and, for mental health clinicians, a plethora of textbooks and clinical trainings on spirituality were available. In 2002 Melissa Elliott and I authored Encoun- tering the Sacred in Psychotherapy as a textbook for psychotherapists seeking to incorporate patients’ spiritual resources in their psychotherapies. Most of these efforts, as did our text, shared common aims of respecting patients’ religious identities and utilizing their spiritual lives as resources for healing and resilience. Done less well, however, was assessment and intervention for problems that have long been common knowledge but seldom discussed: how religion can harm as well as heal, and damage as well as protect. My awareness of destructive uses of religion drew from both personal and professional recollections. Over the 38 years of my medical career, I remember vi Preface vii the cases where no one seemed able to help because a patient had become so sequestered by religious beliefs that he or she could not trust clinicians or accept needed treatments. My psychiatric work with medically ill patients brought me into regular contact with those whose religiousness motivated suicide, violence, or neglect of health needs, or led to unnecessary exacerba- tions of suffering. In my personal life, I knew both acquaintances and kin who abandoned relationships or hurt others needlessly out of some dispute over religious beliefs. Like many, I have been repeatedly puzzled by the strange disconnect between some persons’ religious beliefs that saluted love and com- passion while their actions fueled hatred and violence, all the while feeling no conflict between the two. For clinicians, there was little specific guidance other than to take charge forcibly when someone appeared at risk for serious harm, turning a doctor– patient relationship into a police action. To some extent, advocacy for religion and spirituality has stood in the way of serious efforts to address their dark sides. Religion has long carried the stigma of being antiscience within modern medicine, and antagonism toward religion within psychiatry and psychology has been at times vitriolic. Clinicians seeking a broader incorporation of patients’ religious lives in cop- ing with illnesses have been hesitant to join criticisms of religion’s harmful potential for fear that their words might be twisted by religion’s enemies. This, however, is only a partial explanation. Melissa Elliott and I in fact devoted our longest chapter in Encountering the Sacred in Psychotherapy to “When Spiritu- ality Turns Destructive.” I nevertheless realized at the time of its publication and in a subsequent journal article (Griffith & Griffith, 2002) that our efforts had fallen short of what clinicians needed. In retrospect, this was the only possible outcome. We were utilizing narrative theory and cultural symbol- ogy for our theoretical underpinnings: how one can use idioms, metaphors, stories, beliefs, dialogues, and other symbolic forms when conducting psychotherapy with a religious person. Such an approach can be richly generative when utilizing spirituality within a context of dialogue to promote healing and resilience. It offers little, though, for addressing destructive uses of religion, most of which operate outside contexts of dialogue. Destructive uses of religion in fact originate largely outside language in behavioral systems shared with other mammals. People using religion destructively rarely sit down with a psychotherapist to examine and reflect upon their actions. This book turns to two different scientific domains— neurobiology and sociobiology—for a conceptual framework and clinical methods that can address what goes terribly wrong when religious life produces suffering rather than relieves it. Further into the text, this social neuroscience is joined with observations from existential philosophers whose phenomenological methods viii Preface arrived at similar destinations from different starting points. Above all, this is a clinical textbook that seeks to provide a reader with a clinical map and accompanying methods for assessing and intervening effectively when religious life threatens to harm a patient or others within the patient’s life space. Its aim is to distinguish that which is healing and protective in religious life, while countering that which can be damaging. Although this volume focuses on religion’s destructiveness, it should be read as a complement to Encounter- ing the Sacred in Psychotherapy, a textbook that illustrates manifold ways for psychotherapies to draw from a person’s religious life to support solace, healing, and resilience. It is fair to ask an author to disclose his or her personal beliefs and religious point of view so they can be taken into account in the reading. Passions stirred by religion easily infiltrate a scientist’s reasoning or a writer’s text. Too much on religion and health has been published as “science” that, absent rigorous methodology, simply validated an investigator’s prior religious, or antireligious, sentiments. Too much has been written by clinical teachers too uncritical of the extent to which their observations were shaped by their starting religious, or antireligious, assumptions. In Encountering the Sacred in Psy- chotherapy, I told in some detail my personal story and the development of my religious life (Griffith & Griffith, 2002, pp. 7–10). That account, however, said little about my history of affiliations with different organized religious groups or religious traditions. This text focuses

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