For much of the modern era, psychiatry and religion have occupied separate spheres—one clinical and empirical, the other spiritual and symbolic. But Religion and Spirituality in Psychiatry (Cambridge University Press), edited by Philippe Huguelet and Harold G. Koenig, brings these two worlds back into conversation. Drawing on historical, theological, and cross-cultural perspectives, the book argues for a more integrated model of mental health care—one that respects both science and the spiritual lives of patients.
A Forgotten History of Care
Samuel B. Thielman’s chapter, “Spirituality and the Care of Madness,” traces the shifting role of religion in the treatment of mental illness. In ancient cultures, madness was often interpreted as divine punishment or spiritual affliction. Care was largely the responsibility of religious institutions—monasteries, for example, provided refuge and basic support.
The Enlightenment, however, introduced a more secular, medicalized model. Asylums and early psychiatric institutions replaced spiritual frameworks with scientific ones, and the soul was gradually removed from the equation. Thielman highlights how this historical shift narrowed the lens through which clinicians viewed mental suffering—overlooking its existential and spiritual dimensions.
Today, there is renewed interest in revisiting this older integration. Not as a return to superstition, but as recognition that spiritual concerns remain central for many patients and can inform more holistic forms of care.
Theology as Clinical Resource
In “Theological Perspectives on the Care of Patients with Psychiatric Disorders,” Joel James Shuman explores how religious ideas can enhance—not hinder—psychiatric understanding. He focuses particularly on the Christian notion of imago Dei (the idea that all humans are created in the image of God), which affirms the dignity of every person, regardless of mental state.
Shuman also highlights how theological themes—community, compassion, and hope—can support recovery when woven respectfully into clinical care. He does not suggest replacing psychiatry with theology, but rather using theological insights to deepen the understanding of suffering and healing, especially in cases where patients already draw meaning from religious frameworks.
Culture, Belief, and Clinical Practice
Religion is never abstract; it is lived, shaped by culture and experience. The book’s section on Cultural and Religious Diversity stresses the need for psychiatrists to develop cultural competence, particularly in pluralistic societies. Religious beliefs affect how individuals interpret symptoms, choose treatments, and respond to therapy.
Some may see their suffering through a moral or spiritual lens; others may draw strength from prayer, ritual, or religious community. Still others may wrestle with guilt, fear of divine punishment, or religious trauma. A sensitive clinician must be able to recognize this complexity and adapt care accordingly.
The editors advocate for the use of spiritual assessments, collaboration with faith leaders when appropriate, and clinical training that prepares professionals to navigate religious issues with nuance—not as evangelists, but as effective, respectful caregivers.
Religion’s Double Edge
Religion can be both protective and problematic. On one hand, it offers structure, identity, moral clarity, and meaning—all of which can support resilience. On the other, it may foster guilt, rigidity, or delusions, particularly in those with underlying vulnerabilities. The book emphasizes that religion should neither be romanticized nor pathologized. It must be understood in context.
Clinicians need to distinguish between healthy spiritual coping and forms of belief that may reinforce or exacerbate pathology. This requires cultural literacy, empathy, and an openness to dimensions of human experience that cannot be reduced to neurotransmitters or diagnoses.
Toward an Integrated Psychiatry
The overarching message of Religion and Spirituality in Psychiatry is clear: when psychiatry ignores religion, it risks missing the full person. Rather than viewing faith as irrelevant—or worse, as a hindrance—the book invites clinicians to consider how belief can be part of a patient's inner architecture.
This is not about endorsing any one tradition. It’s about acknowledging that for many, healing is not only a medical journey but a spiritual one. The challenge is to create a psychiatric practice that is not only evidence-based, but also existentially aware.
Further Reading
If you're curious to explore more, the following chapters from Religion and Spirituality in Psychiatry, edited by Philippe Huguelet and Harold G. Koenig (Cambridge University Press), offer worthwhile insights:
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“Spirituality and the Care of Madness” by Samuel B. Thielman – A historical look at how religion and psychiatry have evolved side by side.
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“Theological Perspectives on the Care of Patients with Psychiatric Disorders” by Joel James Shuman – Explores how religious ideas like compassion and human dignity can inform clinical care.
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“Cultural and Religious Diversity in Psychiatric Practice” by John Cox – Highlights how spiritual beliefs vary across cultures and why it matters in treatment.
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