Tuesday, September 04, 2007

Guest Blogger Ron Pies-- Religion & Psychotherapy: Two Armed Camps or Allies of the Soul?

Hey, I made a friend on Shrink Rap!

Dr. Ron Pies is a Professor of Psychiatry at both Tufts and S.U.N.Y. Upstate Medical University and I met him when he surfed over to read
Don't Shrink Me. Ron is the author of The Ethics of the Sages (Rowman & Littlefield) and the upcoming book, Everything Has Two Handles: The Stoic’s Guide to Happiness (to be published in Spring, 2008 by University Press of America). Ron is a prolific writer and his work includes some fiction (we like that here). Finally, he's Editor-in-Chief of Psychiatric Times. I invited Dr. Pies to be a guest blogger, and here's what he sent:

Religion and Psychotherapy: Two Armed Camps Or Allies of the Soul?

Religion did not sit well with the early psychoanalysts. Although Freud’s views evolved over the many years he spent analyzing religion, he generally explained religion as a kind of neurotic “compromise”: focused as it is on an all-powerful “Father-God”, religion allows us to admit our vulnerability in the world, while also giving us a feeling of superiority and control. We become “God’s children”, develop all kinds of rituals and prayers designed to gain God’s good will, and thereby secure our place in the scheme of things. [I am oversimplifying greatly—for those interested in Freud’s views on religion, I recommend the web site of Prof. Jurgen Braungardt, a philosopher and psychotherapist]. For Freud and most of the early psychoanalysts, religion was a sort of childish problem to be, well, outgrown—often through the aid of psychoanalysis. Modern-day critiques of religion—witness the spate of books by Daniel Dennett (Breaking the Spell), Sam Harris (The End of Faith ) and many others—also focus on the supposed “irrational” or extremist elements of religious faith.

There is some truth to these critiques of religion, but in many ways, they obscure as much as they illuminate. For no matter how many theories we devise as to how religion arose, or what “neurotic” needs it may serve, we will never succeed in refuting the basic claims of most conventional religions; i.e., that there is a “Superior Being” of some sort; that this Being created and guides the universe; and that we are all governed by universal and “God-given” moral principles. There are simply no scientific experiments that could conceivably refute these claims—for no matter how many failed attempts to “detect” such a Superior Being, it is always possible that the very next experiment would succeed. And even if religion first arose out of some neurotic need to keep “Big Daddy” happy and on our side, this does not disprove the existence of a Father or Mother (or any other) God. (Imagine a primitive tribe that had a “neurotic need” to believe in tiny, sub-microscopic particles—this would hardly serve as evidence against the existence of atoms!).

But there is a deeper and—from my perspective as a psychiatrist—more important sense in which the critics of religion have missed the proverbial boat. This involves their failure to distinguish what I would call pathological religiosity from the religious impulse. Think about it this way. Mr. A. is convinced not only that his religion is valid, but that it is the only “true faith”, and that everybody else is a “heretic”. Mr. A. is completely impervious to any attempts to challenge his beliefs, rituals, or religious practices. Any attempt to do so sends Mr. A. into fits of frothing rage, and violent fantasies of “avenging the slur against the One True Faith.” Furthermore, when Mr. A. violates his own religious commandments, he is thrown into deep bouts of self-hatred and depression.

Sound familiar? Mr. A’s relationship to his religion encapsulates, in my view, a certain type of fanaticism that has become all too familiar in our age. (Fanaticism, by the way, can exist in folks of any faith, or no faith at all—it is a psychological type, not a religious label). Mr. A’s religiosity is clearly at odds with most traditional goals of psychotherapy; namely, reducing excessive guilt and anger, broadening the individual’s perspective on life, and increasing the patient’s “cognitive flexibility”. Mr. A. would be one tough customer in psychotherapy!

Now consider Ms. B. She describes herself as “not a religiously observant” individual, but one who does attend religious services “when I’m feeling a little lost or alone.” Ms. B. is not sure she believes in an all-knowing, all-powerful God; however, she says that, “I feel like there is something out there greater than us—some kind of order or intelligence in the universe that I feel drawn to very strongly.” Ms. B. has undertaken psychotherapy in order to “help me figure out who I am, and where I’m headed—like, is there a purpose to life beyond just working and getting by?”

Ms. B.’s relationship to faith is clearly very different in tone and content from that of Mr. A. Indeed, Ms. B would find little difficulty relating to many traditional psychotherapists, all other things being equal. In fact, one type of psychotherapy, called Existential Therapy, would be nicely suited to the kind of exploration Ms. B. is seeking. She represents what I call the religious impulse—a yearning for something larger than ourselves, often manifest as a sense of awe, mystery, or ineffable bliss. (The word “religion” is probably derived from the Latin, ligare, meaning to “bind” or “connect”—as in feeling “connected” to some larger community, set of laws, or spiritual purpose). I believe Freud would be quite wrong in regarding Ms. B’s religious impulse as “neurotic” in any way. Her sense of wonder and awe is certainly not a feeling I would ever want to “outgrow.” On the contrary, Ms. B’s powerful attraction to some transcendent “order or intelligence” in the universe is quite like the feeling expressed by Albert Einstein—arguably the greatest scientist since Isaac Newton. Einstein said
"Try and penetrate with our limited means the secrets of nature, and you will find that, behind all the discernible concatenations, there remains something subtle, intangible and inexplicable. Veneration for this force beyond anything that we can comprehend is my religion. To that extent I am, in point of fact, religious.”1

Not only should psychotherapy be tolerant of this mature kind of religious impulse, its goals should be compatible with those of such a seeker. This is not to say that psychotherapy should be intolerant of more conventional or orthodox forms of faith; it is just to say that, in so far as the religious impulse veers over into pathological religiosity, its difficulties with traditional psychotherapy will multiply.

In my book, The Ethics of the Sages, I try to show how several different religious faiths hold views compatible with those of cognitive-behavioral therapy (CBT). For example, in the Jewish tradition, we are instructed, “…do not consider yourself wicked.”

[Pirke Avot 2:18]. The rabbis believed that, while we could certainly judge our individual acts as “wicked”, we should not entirely condemn our very being. (Hence, the modern-day expression, “Hate the sin, not the sinner.”). All this is quite compatible with a type of CBT developed by Dr. Albert Ellis, known as Rational Emotive Behavioral Therapy (REBT). Ellis (who died just recently) argued that, “If human beings have any intrinsic worth or value, they have it by virtue of their mere existence, their being, rather than because of anything they do to “earn” it...You are “good” or “deserving” just because you are…” 2

Similarly, in another portion of the Talmud [Pirkei Avot 2:21], we are told, “...it is not up to you to complete the task, but you are not free to desist from it...” This teaching is part of a powerful "anti-perfectionism" in Judaism. It tells us, in effect, “Don’t condemn yourself if you don’t finish everything successfully—but don’t just give up on it, either.” This is quite consonant with the position taken by Ellis and Harper: “People who lead a lazy, passive existence...are almost always (consciously or unconsciously) defending themselves against some irrational fear, especially the great fear of failure. Viewing failure with horror, they avoid certain activities that they would really like to engage in...” (A Guide to Rational Living, p. 174).

There are many such fruitful intersections between psychotherapy and various religious traditions. The values of psychotherapy—and let us be clear, there are such values—may never coincide completely with those of traditional religion; but neither do psychotherapists and the religiously faithful need to be adversaries. Though they proceed from different premises and may seek different goals, psychotherapy and religion may yet be “allies of the soul.”

Albert Einstein, Response to atheist, Alfred Kerr (1927), quoted in The Diary of a Cosmopolitan (1971)

Ellis A, Harper RA: A Guide to Rational Living; No. Hollywood, Wilshire Book Co., 1971, p. 89