Scientific American: religious or “spiritual” treatment of mental illness produces better outcomes

June 19, 2021 • 11:00 am

Scientific American continues to circle the drain, even after it retracted an anti-Semitic op-ed this week. Several readers have commented that they’ve canceled their subscriptions, and I’ve never had one.  Perhaps the old-fashioned Sci Am that we knew and loved is no longer sustainable in a world where people want their science as short, click-baity pieces.

The latest dire piece is not an op-ed but an article, appearing in the “Mind” section under “mental health”. It’s a justification for including religious and spiritual therapy in mental health treatment, and could be taken as, in part, a defense of the value of religion. Indeed, it may be the case that for believers—though I haven’t checked the references; readers are invited to—some kind of god-infused therapy might ameliorate mental illness. The author gives references supposedly showing this. After all, if you’re already religious, you’ve drunk the Kool-Aid, and so buttressing the comforting bits of what you already believe might make you feel better. After all, that’s what a lot of church is about.

But there are a few problems with Rosmarin’s thesis. First, religious therapy enables religious belief, i.e., faith. Part of what is said to “cure” you involves reinforcing falsehoods rather than facing real or potential truths. I don’t object to that so much, though, as an antitheist, I don’t like it. Second, although “spiritual” therapy is mentioned many times, and is said to help even nonbelievers, the author never tells us what spiritual therapy really is. Given how broad the boundaries of the concept “spiritual” extend, almost any therapy that helps could be said to include a “spiritual” element. For example, one could tell a secular patient  to learn to accept both good and bad as inevitable parts of life. That is the doctrine of many Buddhists, and could be said to be “spiritual”.

Importantly, there’s no mention of religion actually exacerbating or instigating mental illness, and I have no doubt that it does. Martin Luther is a famous example, but think as well of the many children who have been terrified by thoughts of heaven or hell, the people who do horrible stuff because they think God told them to, or the priests who, formally prevented from having sex, become pedophiles. I could go on, but will refrain. But there’s not a word about any of this.

Finally, why on earth is Scientific American publishing stuff like this? I suppose you could include it in the ambit of “popular science”, but barely. They might as well be writing about the value of acupuncture in helping physical ailments. Like acupuncture, religion is a regimen based on false assumptions, and its use encourages a naive reliance on faith: on stuff that is either untested or palpably false.

Rosmarin is a Ph.D. psychologist identified as “director of the Spirituality and Mental Health Program at McLean Hospital and an assistant professor of psychology in the Department of Psychiatry at Harvard Medical School.”

Here’s the evidence adduced by Rosmain:

  • His own SPIRIT program “suggests that spiritual psychotherapy is not only feasible but highly desired by patients”
  • During the last pandemic year, religious people were “the only group to see improvements in mental health”
  • Spirituality, says Rosmarin, is woefully lacking in most forms of therapy, as psychiatrists are the least religious among all medical specialties.
  • As Rosmarin says,

My own research has demonstrated that a belief in God is associated with significantly better treatment outcomes for acute psychiatric patients. And other laboratories have shown a connection between religious belief and the thickness of the brain’s cortex, which may help protect against depression. Of course, belief in God is not a prescription. But these compelling findings warrant further scientific exploration, and patients in distress should certainly have the option to include spirituality in their treatment.

You can check the references for yourself. They may show what he says they do. But I still would be wary of religious treatment, since it uses falsehoods and belief in falsities to help people get better. I don’t necessarily oppose that, but I would have liked to have seen a mention of how religion causes or exacerabates mental illness. It using religion any different from telling patients that acupuncture in their ears could help them, or that everybody really likes them?

Rosmarin winds up giving a few anecdotes as evidence for the efficacy of “spiritual” therapy (I suspect that a lot of the “spirituality” is old-fashioned religion), and asserts that the biggest group of patients who come to his SPIRIT counseling are individuals “with no religious affiliation at all.” These are, of course, the “nones,” but nones may be religious, and simply not affiliated with an established church or sect. Only a minority of “nones” would consider themselves atheists.

When I read this article, the words of Marx kept coming back to me—words from a famous passage usually (and unfairly) truncated to just the last sentence, implying pure religion-dissing. What’s left out is the first sentence in which Marx asserts that religion is often embraced because its the only form of help available to people in bad situations like poverty, illness, lack of social support, and so on.

“Religion is the sigh of the oppressed creature, the heart of a heartless world, and the soul of soulless conditions. It is the opium of the people.”

I doubt that Scientific American will ever get back to the format that attracted many of us to the magazine in the first place. Just have a look at its contents these days, which have become more overtly political with a good dose of fluff.

h/t: Will

26 thoughts on “Scientific American: religious or “spiritual” treatment of mental illness produces better outcomes

  1. Isn’t this all just the placebo effect? Somehow we get a small boost in health if we think we are doing something about our problem. It doesn’t even matter if we truly believe in the offered therapy, spiritual or chemical, just that the patient or the therapist believes it will help. This is very interesting from an evolutionary perspective. Perhaps the placebo effect and the tendency to spirituality and religion arose symbiotically, each supporting the other. Of course, there would also have to be some separate physical mechanism whereby the placebo effect, once triggered, could affect the person’s health.

    The mystery then becomes why the body would need the application of some therapy to trigger it. Why wouldn’t it just do whatever is the placebo triggers by itself? One possibility is that the body doesn’t “know” that there’s a problem until the mind tells it there is. Or, putting it less anthropomorphically, the mind is just one more health monitoring input that helps trigger immune and health processes.

  2. “…spiritual psychotherapy is not only feasible but highly desired by patients…”

    Highly desired by patients? Which patients?

    Telling people what they want to hear is big business. It’s how people like Oprah Winfrey made their millions.

    In some cases it’s harmless, but in many cases it can be useless or even damaging.

    And many times, “pastoral counseling” includes the biases of whatever faith community is the basis for such counseling. Most religions are horribly misogynist, so women who turn to “pastoral counseling” are many times told that whatever the problem is is their own fault, hardly a basis for them improving the situation.

    I had one patient who presented with acute nervous symptoms, tremors, and difficulty focusing on a train of thought. Her husband was physically abusing their children, among other problems. When she turned to her church for help (LDS) she was told that she needed to become a “better” wife (whatever that means). So in addition to the original issues, she was denigrated, big help there.

    When I asked her what SHE wanted to see happen, she jolted in her seat as though hit with an electrical shock. She, predictably, wanted safety for her sons, but she also had dreams for herself, which had gotten lost in all the rancor and judgment.

    After six months, she terminated, having enrolled in college, separated from her abusive husband, gotten her kids into therapy, and left the church. I had several colleagues who commented to me the very visible changes in her physically, which they observed while she was in the waiting area. She was calm, able to sit in one place without endlessly fidgeting, able to carry on a conversation, able to look at others directly, etc. No “spiritual” counseling whatsoever.

    This is a single example, but I have many more that are similar, although not nearly as dramatic. I suspect the author of the above article is religious, and I also suspect that his choice of supporting documentation is one-sided. I’m not inclined to research those suppositions, though. My personal experience is as valid as his, in the opposite direction.

    L

      1. In the case I described above, a big part of the problem was that she was getting mixed messages from her LDS “counselors” about what being a “good” wife entails. Yes, a “good” wife is blindly obedient, which I think she was really trying to do. But a “good” wife also protects her children, which wasn’t happening. Her blind obedience was not stopping her husband from beating the shit out of their kids. She told me that the “counselor” she saw told her husband to stop abusing their sons, which was completely ineffective. So of course, that, too, ended up being her fault, although nobody could tell her how to change her behavior to stop it. The husband bore no responsibility at all for his behavior. How utterly convenient.

        L

        1. Such a sad tale! I’m happy that your patient’s life and the lives of her children have improved, in no small part because of your counseling. I have a feeling that she is very grateful to you.

          1. Thank you for saying that.

            She was a pretty dramatic example, but I had many others, too.

            I don’t see “god” as being very helpful, especially not to women. The women who find their “spirituality” as contributing to their lives don’t usually end up on the doorstep of a secular shrink. The ones whom I saw had been that route, found it unhelpful (to say the least) and cast a wider net for resources, so there was a self-selection process happening.

            Blaming women is a hallmark of xianity. I’m not surprised that the author of this nonsense is a guy.

            L

  3. This article reminds me of my brother’s experience with a psychologist. When in his early 20’s, he was having issues with depression and wanted to see a psychiatrist. My parents were paying, and being the christians that they are, made sure that my brother saw a christian psychologist. The psychologist viewed everything from a christian/spiritual perspective. He concluded my brother was suffering depression because of demon possession. Supposedly, prayer would remove the demon and thus alleviate his depression. He stopped going after two sessions, called the psychologist a crack-pot, and it seems he hasn’t struggled with depression since. That story always pisses me off as did this article.

    1. The horrors perpetrated by my profession stagger the imagination. I left not because of the patients, but because of the people who were my “colleagues” (not all of them, just too many of them).

      I always gave the first appointment free of charge. I figured, and told prospective patients, that people should be able to shop for a shrink with at least as much care as they shopped for a refrigerator. Finding the right shrink is like finding the right pair of shoes – there has to be a good fit.

      L

      1. I asked my last therapist if he believed in God ten minutes into our first session. He was silent for about 30 seconds before saying no. Could I have been the first patient to ask him that? He seemed very surprised by the question.

        I don’t know whether he guessed correctly what I wanted to hear or decided to answer honestly regardless but he had to think pretty long about it.

        Afterwards I was really glad I asked. I was looking for a rational thinker and found one.

        1. I’m not surprised that he thought about it. If you were religious and he would have said no, that would create a big problem and vice versa.
          Note, in my area , which is pretty religious, I’m out of the closet, known to be an atheist. I’m nevertheless seen as an instrument of God, He guides my hands despite my atheism, etc etc. But then my work is not psychotherapy. I guess that would really be a problem in that field.

    2. Does ‘christian psychologist’ mean a psychologist who happens to be a Christian or one who practices something like this:
      Christian psychology? I am asking because I did not know that the field of Christian psychology existed until I saw your comment and looked it up. Is this sort of thing is taught in universities?

      1. It’s most usually taught in seminaries.

        I have a major problem with xianity and mental health. The bedrock principle of xianity, without which the entire rest of it is irrelevant, is that you have to be willing to accept the blame for something you didn’t do. IMO, not the basis for any kind of mental health at all.

        L

      2. I’m pretty sure he was practicing Christian psychology. I don’t know where it’s taught, but Linda says seminaries, and I’d defer to her.

  4. I read the JAMA Psychiatry article supposedly showing that “the thickness of the brain’s cortex…may help protect against depression”.

    JAMA Psychiatry. 2014;71(2):128-135. doi:10.1001/jamapsychiatry.2013.3067

    It’s all correlational nonsense. The claim is that if you’re at high risk of depression, and adopt religious belief, you develop a thicker cerebral cortex that protects you against actually developing depression. The JAMA authors do say that “we cannot determine whether the high importance [self-reported importance of religious belief] altered cortical thickness or whether individuals who had a thicker cortex were disproportionately attracted toward spiritual or religious practice. ” But the only reason this article was published is because readers *want* to ascribe the pattern to the first mechanism (religious belief leads to cortical thickness and protection) and prefer to ignore the second mechanism (thick cortex causes religious belief).

    Also lots and lots of Templeton funding of that JAMA Psychiatry article.

    1. The world would be a better place if people would learn to distinguish between correlation and causality.

      L

  5. Is an LSD trip “spiritual?” I’ve read that psychedelic journeys can alleviate mental illnesses, including PTSD, maybe depression. (Scott Weiner, my rep in Sacramento, sponsors a bill to legitimize.) Would an article discussing the value of such drugs be proper SciAm subject?

  6. I’m wondering if the SciAm managers would bother to run this article in their European/ UK editions. It’s unlikely to recoup the translation costs in terms of additional advertising revenue.
    Actually, though I’ve definitely seen French and Spanish editions of SciAm on airport news stands in various countries, I don’t remember checking if any actually had all the articles translated, some of the articles translated, or none of the articles translated. Generally I’d stocked my briefcase with brain fodder for a month or so before leaving the home airport, and was just throttling time in subsequent changes.
    Well now I have the first actual reason to examine the contents of a SciAm for I-don’t-know-how-long.

    1. The German edition, Spektrum der Wissenschaft (spectrum of science, in the sense of covering a large range, not in the sense of ghostly*) has some articles translated as well as some original articles.

      * There is a German word “Geisteswissenschaften”, literally “ghostly sciences”, but here “Geist” is used in the sense of “mind” as opposed to the physical world; it is the term for the humanities.

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