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Indian Psychiatric Society ‘Spirituality and Mental Health’ Task Force (2008-2009) In association with Indian Psychiatric Society In Association with Medical Wing, Medical Wing, R.E.R.F. Rajyoga Education and Research Foundation, Editor Mount Abu Avdesh Sharma Spirituality & Mental Health Spirituality & Mental Health: Reflections of the Past Applications in the Present Projections for the Future Indian Psychiatric Society ‘Spirituality and Mental Health’ Task Force (2008-2009) : In association with : Medical Wing, Rajyoga Education and Research Foundation, Mount Abu i Spirituality & Mental Health Spirituality & Mental Health: Reflections of the Past, Applications in the Present; Projections for the Future Indian Psychiatric Society 2009 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright holder. The views expressed in this publication are the authors own and do not reflect directly or otherwise the Indian Psychiatric Society or Rajyoga Education and Research Foundation/Brahmakumaris. Printed at Om Shanti Press, Mount Abu Indian Psychiatric Society’s ‘Spirituality and Mental Health’ Task Force (2008-2009) In association with Medical Wing, Rajyoga Education and Research Foundation, Mount Abu ii SpiritualityFOREWORD & Mental Health ‘Spirituality and Mental Health: Reflections of the Past; Applications in the Present; Projections for the Future’ is in your hands. It is through the efforts of Indian Psychiatric Society’s Task Force on ‘Spirituality and Mental Health’ in association with Medical Wing of Rajyoga Education and Research Foundation. Yet, in a way, it is reflective of the inner needs of larger number of mental health professionals in India and indeed globally. The book is a mix of philosophy and spirituality in various shades; essence of religions and meditative practices, as well as the cutting edge scientific knowledge in the field. It focuses on how we could learn to incorporate best of knowledge from all essential dimensions of life, utilize them synergistically through a workable holistic model to cost effectively reach the largest numbers. The book has attracted leading International and National authorities, who have written, worked on, lectured or thought about these dimensions. The ultimate benefit would be when these aspects are experimented upon and utilized on a day to day basis. It is then only that we may be able to create a model of holistic mental health care delivery for India and hopefully rest of the world. I commend the work done by the I.P.S. Task Force on ‘Spirituality and Mental Health’ and the authors for their time and efforts and hope that the book would become both a practitioner’s manual and work of reference. Dr. P.C. Shastri, President (2008-2009) Indian Psychiatric Society iii Spirituality & Mental Health Introduction SPIRITUALITY AND MENTAL HEALTH Spirituality refers to the individual’s personal experience that provides a greater sense of inner peace, harmony, hopefulness, and compassion for others and oneself. The term ‘spiritus’ in Latin means ‘the breath’ that is most vital to life. It involves individual’s experience of and relationship with a fundamental, nonmaterial aspect of the universe that may be referred to in many ways-God, Higher power, Mystery whereby an individual finds meaning and connectedness to something greater than oneself. Religion is an organized belief system promulgated and sustained by a human institution, ethnic group, tribe or culture and involves definite rules of behaviour, practices and rituals. The English word religion comes from the Latin ' religio ' meaning reverence, though a deeper study reveals it to be a combination of two words, ' Re ' meaning return and ' Ligare ' meaning 'to bind'. Religiousness may focus on the personal attitudes, emotions and personality factors. Spirituality may encompass positive emotions- love, hope, joy, forgiveness, compassion, trust, gratitude and awe. Religion refers to the interpersonal and institutional aspects of religio-spirituality based on the doctrines, values and traditions of a formal religious group. In this context, religion draws circles that draw others out, whereas spirituality draws circles that draw others in. Spirituality is based on our biology, whereas religion is based on our culture. Spiritual practices have been documented to improve physical functioning, self esteem, drug compliance, and longevity. Anxiolytic, antidepressant, and anticraving effects of religio- spiritual practices have also been cited in the literature. Positive desirable effects of religio-spiritual practices include decreased functional disability and better perceived health. Religious salience or spiritual practice may be a protective factor in depression. Intrinsic religiosity is significantly associated with a greater iv likelihood of remission. Involvement in religious/ spiritual practices maySpirituality also reduce & Mental suicidal Healthrisk. Similarly spiritually augmented cognitive behaviour therapy (CBT) is superior to CBT in relapse prevention of illnesses, especially substance use disorders.The mechanisms underlying beneficial effects of spiritual practices may include biological factors involved in positive emotions. Also, lifestyle modifications necessitated by methodical religious/ spiritual practices may add to the positive outcome in subjects. Group religious/ spiritual practices may help in developing better coping strategies and a sense of hope born out of compassion and empathetic understanding. Neurobiological explorations may partly explain the changes in the brain related to attentional network and in regions implicated in positive emotions. The relaxation response in spiritual practice may be related to parasympathetic overdrive. However, sympathetic overdrive may be manifest in extreme stages of some of the spiritual practices. Neurochemical alterations may reflect primarily dopaminergic activation. Alterations in serotonergic, cholinergic and glutamatergic system have also been documented. However, the research has not shown that lack of spiritual/ religious inclination results in disease, or that spirituality is the most important health factor. It would be better to conduct research to unearth the need for a spiritual history, spirituality related inputs in culturally relevant psychotherapeutic interventions, and the possible health promoting and neuroplastic attributes of religious/ spiritual practices. The present book focuses on all these aspects and the diverse inputs from authorities in their field makes it a work of reference and starting point for future research and practice. Dr. E. Mohan Das President, Indian Psychiatric Society (2009-2010) v Spirituality & Mental Health SECRETARY’S DESK I am glad to know that a book on Psychiatry & Spirituality has been published. As per WHO, Health is a state of complete wellbeing -- physical, mental, social and let us not forget spiritual. A book linking the two dimensions of health, mental and spiritual is indeed needed. Especially in the Indian tradition, many senior psychiatrists have used spirituality as an integral part of psychotherapy. Heartiest congratulations to Dr. Avdesh Sharma for the successful culmination of his efforts in the form of this book. I am confident that his work as the Chairman of Mental Health and Spirituality, a Sub Specialty of Indian Psychiatry Society will continue in the same vein and help us all enrich ourselves-- both mentally and spiritually. Dr. Govind Bang Hon. Secretary General, Indian Psychiatric Society (2008-2010) vi Spirituality & Mental Health INSPIRATIONS The world today is at crossroads. We have made tremendous progress in the field of science and medicine yet we are not able to eliminate distress. The utopian dream of having health, peace, happiness apart from physical and mental comforts is still that – A Dream. It may not be a possibility unless we bring in Spirituality in Scientific endeavors. Mind is the ‘experiencer’ of the inner and outer worlds and unless the perceived reality is in tune with the original nature of the soul, a sense of incompleteness would exit. It is thus extremely necessary to include spiritual dimension in all aspects of health, especially mental health. We, at the Rajyoga Education and Research Foundation believe that one of the main tasks of human endeavors is to regain our original, perfect condition of the soul. It is heartening to note that leading mental health professionals also are looking at spirituality as one of the important ways to lessen human suffering. I congratulate the Indian Psychiatric Society for this important endeavor. This book 'Spirituality and Mental Health' - Reflections of the past, Applications in the Present and Projections for the future' is a labor of love by professionals on topics that are essential to human experience of spiritual beings. It is my belief that it would serve the purpose of bringing awareness amongst professionals to serve humanity better. Wishing all success to those associated with this ambitious project of bringing out a new publication! B.K. Nirwair Secretary General, Rajyoga Education and Research Foundation Prajapita Brahma Kumaris Ishwariya Vishwa Vidyalaya, Mount Abu (Raj.) vii Spirituality & Mental Health EDITORIAL Mental Health has come a long way in the last century. The scenario in terms of understanding and management of
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