Psychiatric Care From the Inside Out -- A young resident and her husband explore the principled perspective of mental health treatment

Jason Williams
June 2011

For me, my wife's choice to enter the field of psychiatry last year was not a totally welcome one. I had reservations about the practice, stemming from my (perhaps naive) preconception that psychiatrists essentially act only as drug pushers for pharmaceutical companies, treating symptoms from the outside in, labeling everything as a chemical imbalance and ignoring the deep-seated issues. Of course, I ultimately chose to support Myrane in her career a -notion, as long as she could assure me that there was always a way to do things outside the norm. Right away, we began researching together to see in what places the practice showed promise to be more holistically effective and balanced with what we uncerstood through our faith teachings about the spiritual aspect of psychological well-being. In our opinion, addressing the whole person in body, mind, as well as in spirit, falls in line with the Unification Church's teachings of restoring a person to their whole self.

The following is a short interview with my wife, conducted five months into her residency program in the north of France. Here she attempts to explain to me that although the practice may be flawed, there is still some light at the end of the tunnel in terms of working in the field of psychiatry and reconciling best practices with our faith.

It should be made clear that neither myself nor my wife are anything near resembling experts on mental health or the practice of psychiatry. We have just begun to study these topics and wish to share with readers our initial concerns and optimisms.

Question: What have you learned about psychiatry halfway through your first year?

Answer: I've come to realize that I don't like the conventional methods of practice -- which depend on the disease and the treatment. What is quite peculiar is how ironic it is that in psychiatry you basically have imperfect people helping other imperfect people. The doctors have their own concept of normal -- which in most cases does not constitute having a relationship with God or living up to certain moral standards -- and consider themselves to be mentally healthy, even if their notion of "mentally healthy" does not necessarily even constitute being happy.

So, they are trying to restore their patients to this substandard of normality, but it is only a numbed-out version of life. It is not hopeful. Their primary means of restoring patients is through drug therapy, which seems to be a very surface- level treatment.

For psychotic people, I realize that all we have for the time being is medication and that this actually does work fine for some people -- not as a complete cure, but at least to control their symptoms. However, for depressed people and for those who have personality disorders, I feel like they could be taken care of in a more effective way (a way that addresses the whole person both in spirit, mind and body as I have come to understand it). I am also starting to learn more about psychotherapy, which I find much more promising as a treatment. Generally, though, this is not practiced by psychiatrists in France, but more by psychologists and therapists. Still, it is a possibility for me.

Question: Are drugs necessary?

Answer: I'm not adverse to drug therapy as long as it is used in appropriate cases and not as a long-term solution. Right now, I do think that it is over-used for mild cases.

Question: Do you think there is something missing from psychiatry that could be filled by a more holistic and spiritual approach towards mental health?

Answer: Oh yes, of course. Almost every patient I work with has problems that arise from a dysfunctional family life. So I think that a restoration of the family would prevent many psychological issues from occurring. Many patients have simply lacked love and support their entire life, and now they suffer for it. Unfortunately, the doctors whom I work with at the hospital have a fatalistic view towards these patients. Their attitude is that there is little to be done for them. Very generally speaking, in psychiatry, we are separating diseases into two categories: neurosis and psychosis. I think that for those in the neurosis category, if they could just know that there is a God and that they were actually loved, it would help them so much. If we could think outside the norm for just a minute and recognize that we are spiritual as well as physical beings, then we could for certain forms of psychosis -- people who can hear voices, for example -- treat patients with the understanding that the base of their symptoms can be spiritual, rather than just physical. We could say, for example, that people who can hear disembodied voices may have a form of clairaudience (hearing voices psychically), and even if that is not the case, we can at least understand that there is a spiritual as well as a physical base to their condition and we shouldn't just treat them like crazy people. This transformation of perspective towards treatment can also help patients who have difficulty moving on after the loss of a loved one. It could help them with their grief to know that their loved ones are still "alive" and that they're going to see them again. Is it possible as a psychiatrist in France to speak to patients about God, the afterlife, love, etc.? No. In France, spirituality is a taboo subject so you need to be careful. You can't talk about God unless the patients talk about it first, and in that case all you can say is "Who knows?"

Question: What hope is there in the field of psychiatry to recognize the value of faith and a relationship with God in order to improve mental health? Or to at least take a more holistic approach?

Answer: In France, there's definitely a long way to go. In America, it seems to be different. There is one psychiatrist, Dr. James Gordon who wrote the book Unstuck and founded The Center for Mind-Body Medicine in Washington, D.C. He does not believe that depression is a disease, but that it is actually a normal psychological response to one's life being unbalanced. Of course, it is not easy to balance one's life, but in his book he offers a lot of useful advice to get on the right track and conquer depression and anxiety naturally. Also, there's an interesting study that was done by a team of psychiatrists in Switzerland concerning the effects of religion in schizophrenic patients (Spirituality and religiousness as predictive factors of outcome in schizophrenia and schizo-affective disorders. Mohr S, Perroud N, Gillieron C, Brandt PY, Rieben I, Borras L, Huguelet). They determined that there is a distinct difference between helpful and harmful use of religion, and patients who had a positive relationship with religion exhibited fewer negative symptoms as well as a better clinical global impression, social functioning, and quality of life.

Question: And lastly, are you looking forward to your career? Do you believe you will have genuine opportunities to help people through your practice?

Answer: Yes, I am and yes, I do. I'm pretty sure that by the time I finish residency I will have changed my mind on a few things. I hope that by the time I start my career as a psychiatrist I will have studied a lot more of psychotherapy. I do believe at this point that medication and psychotherapy are complementary, and that it can help people to some extent. The bottom line, though, is that as long as psychiatry fails to consider the spiritual aspect of mental health, then it's going to be very limited.