As far as I can tell, spirituality has no boundaries. Science ad spirituality go together. Years ago, a psychiatry trainee in South Australia, I was sent to work in one of the ‘back wards’ for women in a large state mental hospital. On arrival, the nurses asked me to see an elderly Irish Catholic woman; as a favour, it seemed, because her mental health was stable. While we sat together in a small, darkened interview room for twenty minutes or so, I found the experience peaceful. All I had to do really was listen, and occasionally to encourage flow in the ensuing, essentially one-sided, conversation. The stream of words – of which, regrettably, I now remember none – eventually slowed to a trickle and then dried altogether, at which point we rose simultaneously and left the room. The final softly-spoken remark I heard as we parted was, ‘Thank you, Father’. This child of God had very likely used me to make her final confession, for she died several days later.
The nurses indulged the Irishwoman’s religiosity as harmless, but I could see how a routine of prayer and worship, however low key, might offer an effective antidote to the encroaching melancholy of old age after a barren, restricted and potentially meaningless life. This poignant episode was one of a number of encounters with patients – both medical and psychiatric (for I had earlier been a GP for two years) – persuading me of the importance of taking full account of the spiritual dimension of people’s lives. Thinking and later writing about this, discussing it with colleagues (doctors, psychologists, nurses, social workers, hospital chaplains and other clergy of my acquaintance), also with a Buddhist monk I encountered at the time, served only to convince me further.
A recent book, ‘Sadness, Depression, and the Dark Night of the Soul: transcending the medicalisation of sadness’ by Glòria Durà-Vilà, a Spanish psychiatrist working in London, reports a study designed to explore ‘deep sadness and consequent help-seeking behaviour’, through analysis of interviews with 57 practising Catholics on different religious pathways and in different parts of Spain. They included contemplative monks, contemplative nuns, lay theological students, and Roman Catholic priests.
‘Carrying out this research was a wonderful and exciting experience for me’, the author writes. Her enthusiasm for the task, and for even-handedly discussing her findings, shines through on every page. She distinguishes two types of ‘deep sadness’ – one pathological, one salutary – that sometimes overlap. One is a mental illness, not a reaction to identifiable challenges or loss. It is characterised by hopelessness and risk of self-harm, even suicide, and requires psychiatric intervention and physical treatment. The other reflects the notion of a spiritual aspect to human suffering, and the understanding that times of intense sadness often represent a normal and valuable aspect of spiritual growth, a condition (usually temporary) sometimes referred to as ‘The Dark Night of the Soul’, during which the subject remains ‘hopeful in the middle of hopelessness’ and is not at risk of self-harm.
A result of this dichotomy is a divergence of views and allegiances. On one side, there is an essentially worldly and commercial, science-based, pharmaco-medical community, apparently ignorant and intolerant of the ways and wisdom of religious people. On the other is a more spiritually orientated, faith-based congregation, wary of secular formulations and the pharmaceutical remedies prescribed for what is for them ‘meaningful sorrow’, the leaders of which in turn admit lack of training on matters pertaining to psychiatry and mental illness. Those in each camp, the author concludes, would do well to examine their own weaknesses, with the aim of improving the service they offer people in distress, rather than entrench themselves in fixed positions and cast blame on opponents, on real or imaginary enemies.
The fixed position of psychiatry, Durà-Vilà tells us, depends on a diagnostic classification system, ‘deeply embedded in all aspects of psychiatric research and practice’, that fails to tease out normal from pathological forms of sadness’. This system is unlikely to change, she regretfully predicts, but adds more hopefully that conscientious doctors and other healthcare professionals who patiently give sufficient consideration to the personal, social, cultural and spiritual dimension of patients’ lives, rather than applying an expedient and inflexible, ‘tick-box’ medical model for diagnosis and treatment (overcoming constraints of time and resources where necessary), will contribute to progress and general enlightenment by setting examples of ‘good practice’ for others to follow.
The discussion here is about science and spirituality as complementary aspects of human thought and experience. Right-wrong, either-or thinking is often destructive, in other words. Both approaches, scientific and spiritual, are clearly required to provide the best possible patient care.
Sometimes it can be as easy as sitting and listening patiently to an elderly lady in a quiet room while she makes her final confession. In the absence of a priest, there is no reason I can see why a sympathetic mental health worker or psychiatrist cannot do that. Marvellously, for one thing, as I can attest, both parties may gain from the encounter.
Copyright Larry Culliford
'Science and Spirituality 1' was published on February 11, 2014.
Durà-Vilà, G. (2017). Sadness, Depression, and the Dark Night of the Soul: transcending the medicalisation of sadness. London and Philadelphia: Jessica Kingsley Publishers.