Therapist explores ‘rich inner terrain’ of faith

Second in a series about individuals with mental illness and their religious faith, and mental health professionals.

“Unless they are in grips of psychotic episode, people who suffer with mental illness can think coherently about the spiritual part of their lives,” said Sister Nancy Kehoe, a sister of the Society of the Sacred Heart.

Yet the tendency was to ignore a patient’s references to religion or spirituality, explained Sister Nancy in a recent interview.

In fact, she discovered “a deeply embedded psychiatric fear about the relationship of religion to mental illness.”

“Whether we grew up in a religious tradition or not, we have all been shaped by a consciousness of religion,” Sister Nancy writes in her 2009 book, “Wrestling With Our Inner Angels: Faith, Mental Illness and the Journey to Wholeness.”

As a licensed psychologist and an instructor of psychology in the Department of Psychiatry at the Cambridge Health Alliance, affiliated with Harvard Medical School, Sister Nancy gained a reputation as “an interpreter” who could “translate the foreign language of God” for therapists who were at a loss when clients talked about their beliefs and spiritual experiences.

Her pioneering efforts led to treatment programs that focus on spiritual beliefs and values. Through the frank discussions of group participants, Sister Nancy began to document the “rich inner terrain, one that had been hidden from mental health providers but has been a source of strength and resilience for the clients.”

Damaged, not godless

In “Wrestling with Our Inner Angels,” Sister Nancy quotes one of the men who attended her group treatment programs on Spiritual Beliefs and Values. The man, Buddy, expressed his frustration with the perceptions of others.

“People with mental illness have healthy spirits,” Buddy said. “We may be crazy but we are not stupid.” He said that there were people in every neighborhood who were suffering with mental illness, but who were also “asking for God.”

“Mental illness robbed them of so much of what provides a sense of self-worth,” Sister Nancy writes in her book. “Yet the men and women I know work tirelessly and valiantly to regain a sense of self that is lost with such a damning illness.”

Part of that identity, part of that sense of self is tied into the spirituality of the person. Some therapists have started to inquire about whether a client wishes to talk about religious issues, explained Sister Nancy.

“Before this,” she said, “mental health providers weren’t trained to take a religious history. They weren’t trained to explore people’s beliefs. The tendency was to dismiss religious experiences as symptoms of the person’s illness.”

Perhaps religion and spirituality were ignored because they seemed irrelevant to the treatment. Perhaps a discussion about religious experiences would be too problematic to bring up in a treatment setting.

“Consequently, people still have difficulty finding mental health providers who can talk to them about religion,” said Sister Nancy. “And if they seek out religious professionals for help, they may be turning to someone who doesn’t understand the complexities of mental illness.”

Compassion and casseroles

“We need to have a lot more understanding of and then compassion toward people who suffer with mental illness,” Sister Nancy said.

“Mental illness is not a casserole disease,” said Sister Nancy, explaining that it’s not an ailment or affliction that elicits the kind and sympathetic responses of neighbors and friends who mail cards and drop off casseroles.

Support from family members, friends and communities is important. “However,” she cautioned, “people who suffer with mental health issues need treatment. With appropriate medical and psychological treatment, they may find their way to recovery. Faith can be a part of that, but it is not a substitute.”

“Can a belief in God help you bear your own suffering?” she asks. “Can God — can other people — family members, friends, parish communities, be levied for support in your struggle?”

Mental illness is not a cross that God inflicts on a person, said Sister Nancy.

A sense of God  and a compass

Through her treatment programs, Sister Nancy perceived that it was important to discern when a person saw God as punishing, vindictive or judgmental. Not because it leads to them hurting other people,” she said, “but because it is so painful – and harmful to him or her.”

In her book, Sister Nancy considers the conversations she’s heard in her treatment programs, conversations about internal voices.

“I began to wonder how we discern which voices are constructive and which are destructive? Are some the Voice of God? Are they all symptoms of illness? What do the voices prompt us to do or believe? What difference does it make for treatment to consider the possibility of different kinds of voices? The skeptic might ask whether a more positive voice is simply the individuals’ own healthy voice,” writes Sister Nancy.

Sister Nancy concludes that clients, “besieged by years of illness, having lost a sense of their own strength, can only identify inner voices as those of God, the other.”

But this other, she writes, “is the core of who they are, incredibly resilient individuals who need to have someone else hear the inner voice and work with it, no matter what it’s name.”

“Faith — that is, a commitment to someone or something bigger than yourself — is a compass that keeps you pointing in the right direction when all else seems lost,” believes Sister Nancy.

“Ignoring the potential strength of that faith” can “unwittingly prolong” the distress of the person and frustrate attempts to find a path to recovery.

And attending to a person’s mental illness is treating only half of what the person is.

As she travels across the country to educate people about faith and mental illness, Sister Nancy encourages parish communities to create welcoming, inclusive and supportive environments for people who suffer from mental illness, and for their families.