Sam Harris

How should doctors deal with patients who are manic from faith?

This is a fascinating article that examines the tension between medical care and the respect of faith.

Should doctors "cure" Mr. Washington?

  The Evangelizing Patient  

"[W]hen a patient believes that God gave him an illness so that he might convert his psychiatrist to fundamentalist Christianity, we certainly ought to raise the issue of whether this patient understands his illness and, additionally, whether he has the ability to give informed consent about receiving treatment.

Where does religious belief begin and mental illness end? That may be difficult to determine, as Mr Washington's case illustrates. Until the mental health professional has become thoroughly familiar with the religious beliefs and culture of the patient, such determinations are often not possible without collateral information. ..And, as noted above, where religious belief ends and mental illness begins is likely determined by how each is defined within a given culture."

Does Mr Washington remind you of someone?

It’s a bit of a frightening thought to imagine that mental illness and religious belief might be two sides of the same psychosis.  What it would mean, for the secularists and atheists/agnostics among us, is that the majority of our population is mentally ill including most of those with political power.  However, if we examine the history of humanity, including the most recent 21st Century history, the idea that the majority of humans are mentally retarded doesn’t seem so bizarre.

On the other hand, I’ve yet to see a mentally ill person cure themselves, yet there is a daily occurance of religious persons losing their religion - curing themselves.  So it can’t all be one and the same thing at that level.

Bob

[quote author=“CanZen”]It’s a bit of a frightening thought to imagine that mental illness and religious belief might be two sides of the same psychosis.

It seems to me the only significant difference between religious worldviews and those of psychotics is popularity. There may be some significant differences in tendencies, but it seems they’re fundamentally the same animal.

Just imagine if there were only one person making the claims of Christianity, for example, or even only a few. If we remove the heading the beliefs fall under and/or change the names and such I think peoples’ take on them would suddenly be quite different.

Byron

As much as I want to agree, it’s just too easy. Mr Washington’s mania also has the benefit of keeping him off the bottle and keeping him from hitting his wife.

The MD from Duke seems to take the moderate approach that Sam vilifies:

“What is considered “acceptable irrationality”? That may depend on what part of the world one is in, and in what period of history. In non-Western cultures, both now and especially in the past, societies have been much more accepting of irrational behavior than we are in the United States today. Many of these cultures normalized aberrant behavior, and the mentally ill in some societies were highly respected and valued (eg, considered to be shamans or spiritual guides) for their ability to “see” into the spiritual world that others could not. This may have enabled such persons to function better because these views preserved their self-esteem and often increased their social support. This approach to the mentally ill likely conferred benefits that such persons in our society do not have. Instead, we label such persons as crazy, often isolate them in institutions, and then treat them with powerful drugs that have disabling side effects that interfere with their functioning and quality of life.”

Or elect him President.

On the other hand, I’ve yet to see a mentally ill person cure themselves…

The implication is that Mr Washington’s religious experience had a real benefit. If not medical, then it was certainly a positive for those around him. The article never resolves the proper amount of “acceptable irrationality” that should be tolerated, but it is obvious that history has slowly lowered that amount. A gradual lowering of this amount is probably prudent. The medical ethicists from Harvard and Duke can’t arrive at a decision because they have a genuine amount of “acceptable irrationality” themselves. They retreat to William James’ tautology of the goodness of any religion as whether or not its effects in the world are beneficial and healthy.

Is it practical to impose rationality onto an irrational patient?

Is it practical to impose rationality onto an irrational planet?

This reminds me of the book, The Three Christs of Ypsilanti. by Milton Rokeach. It’s a psychological study of three patients who were in the Ypsilanti State Hospital at the same time. Each was convinced he was Christ come again. The doctors decided to put them together to see how having to deal with each other would affect their delusional systems, since there couldn’t be three Christs at the same time and they’d have to figure out what was going on. I haven’t read the book for years, but as I recall, it ultimately worked pretty well.